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Home My WebLink AboutTR-6812A . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction _ Y, constructed L Project complete, compliance inspection. . . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6812A Date of Receipt of Application: January 25, 2008 Applicant: Scott & Jennifer Schulman SCTM#: 122-4-3 Project Location: 1570 Ole Jule Lane, Mattituck Date of Resolution/lssuance: February 27, 2008 Date of Expiration: February 27,2010 Reviewed by: Trustee James King & Trustee Jill Doherty Project Description: Construct a second-floor addition to the existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by John Schnurr, last dated January 13, 2008, and received on January 25, 2008. Special Conditions: None. Inspections: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. Th;::.-a';7J;" from aoy othec age",>,. James F. King, President Board of Trustees JFK:eac . . James F, King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: 5:::.oi+ 4 .]e{)(\I' Q:r .3:.h LA II'V\Q,f) Please be advised that your application dated d ~oo8' been reviewed by this Board at the regular meeting of r<Jcv a and your application has been approved pending the completion f the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) Yz Constructed ($50.00) ~nallnspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 'J-cJ99 BY: James F. King, President Board of Trustees . . James F. King, President Jill M. Doherty, Vice-President Peggy A Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Southold Town Board of Trustees Field Inspection/Work session Report Date/Time: 1-15 -?Jf' J "5 P . Applicant: Agent: Location and SCTM#: I ?-) --Lf /' 3 Description of Activity: Type oJ area to be impacted: v' Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of above: Part o(Town Code proposed work falls under: -V-Chapt.275 Chapt. 111 other Type of Application: _ Wetland _Coastal Erosion _Amendment _Administrative _Emergency _Pre-Submission _Violation Info needed: Modifications: Conditions: ($0 ~ € l~'L fD 0 un.?r 1101 11 D..., --/u f.(' cZ5 i J f() tr ,..'1. t3C.:Lt.. / Present Were: j! J.King /J.Doherty _P.Dickerson _D. Bergen _B. Ghosio, Jr _H. Cusack _D. Dzenkowski _Mark Terry _other Form filled out in the field by: MailedIFaxed to: Date: Environmental Technician Review: . . ~ ~ nI t: ~ ~ Q( t ~ ~ 1 ~ ~ ~ ~! l~H ~ J ~ ~i 11.:. t(J~ I-\- ~ u-~ D:-~~ Cl :5 ~~~ 11~~ . . . ~LY\hN ~e'SIl::JeNc..E -t:::><.\ s n I\J ~ Co-..l D\T10 t-....l '::> ~.Q. CoQN~ ( l.--.:?O\<.\NG, S?> \A11\-W~$ ~~ [.:?r4NeR. (~,?t1Klt-J~ jJt7R1ltW~T) \510 ~ ;j"u\..f.. \J.:N'G. ~l'T\J~ ~y I I t::>~-e,.EY<... 2.=0 l . . ~ft:!;. , ,~~ ..- I ,,''1''-", A .....r\.' , ~LY\hN ~eS\beNc.E !5><.\Snl\J~ u::,....H:::::>\T10t.J":> -N,W. GoR.lJ~ _(W't7\GI~ . --~~-f) _~ S.W. U;>R.N~ (lP'.::>l<.ltJ4 - I-JO(l..-m~1) .\15"1::> 0U2.. j\A\..f.. Ws HP?IT\1\u.-K t-ly I I b~~ER..... 2001 . . l V\e.w ~ \:5<1~T1t-lCSl \.\o\'\;,~ 1.?\lJAAD IIDP<L- WE--TLpq..Jt),? (.TA:V'I\'e:S CR~ ') I I .sG\1 ULt'\bM RE S\DeNCb \Sl~ t7\X. jul..S L41~ 11-'\A1i11\JGI<.Jl~( S~be<... Q.,o"'1 . . I. (UJ IY GREA' ., +-- ~~C/'&-11t7N~f' -\6'0 a..& ..::JU\..E. Uq.JQ _' . t ~ULKI<N . 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N:W YORK 11976 41 EAST MAPLE ROAD, GREEN:..AWN. ~ YORK. 11740 Ta 631.754-5555 FAX 631.261-1064 ~IiIClMlllmC'ii' March 3, 2008 Southold Town Trustees Town of South old Annex PO Box 1179 Southold, New York 11971 RE: SCOTT & JENNIFER SCHULMAN- 2nd FLOOR ADDITION 1570 Ole Jule Lane, MATTITUCK, TOWN of SOUTHOLD, NY SCTM# 1000-122-04-03 Southold Town Trustees: Attached please find a check in the amount of $50 for the fee required for the Final Inspection. Please process this for a Trustees Permit. Please contact me if you need any additional information for this application and send all correspondence to my Greenlawn address. Thank you very much. !!~{WEBEVA MAR - 4 2JCS . . OFFICE WCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY MAIliNG ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR TOWN OF SOUTHOLD MEMORANDUM To: James King, President Town of South old Board of Trustees ~fE~fE~W~ o .'.. FEB 2 1 2008 !i.W. From: Mark Terry, Principal Planner L WRP Coordinator Southhold Town Board of Trustees Date: February 21,2008 Re: Proposed Wetland Permit for SCOTT & JENNIFER SCHULMAN SCTM#122-4-3 Frederick Weber, Architect on behalf of SCOTT & JENNIFER SCHULMAN requests an Administrative Permit to construct a second-floor addition to the existing dwelling. Located: 1570 Ole Jule Lane, Mattituck. SCTM#122-4-3 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (L WRP) Policy Standards. Based upon the information provided on the L WRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is generally CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. .. . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Han 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicati9W" _Wetland Permit Application L Administrative Permit / Amendment/Tran erIE tension ~ceived Application: I~), oJ" Received Fee:$ 5?J '7 _Completed Application 11f1~J()], _Incomplete . _SEQRA Classification: Type I_Type II_UnIisted~ _ Coordination:( date sent) ~WRP Consistency Assessment Form J)~ FJrr& .--eJ\C Referral sent,=& --Pate ofInspection: I 0& _Receipt of CAC Report: _Lead Agency Determination:_ Technical Review: ~cHearingHe~ Resolution: fi5) fE ~ fE ~ W fE fR) If1l JAN 2 5 2008 tW Southhold Town Board of Trustees Name of Applicant ~ .::r~t-l,F"fR- ~"\..\.-\A.N Address 'li>o ~ER.L'1 ~I SGN<.SOA\...E.) NY \OS8? Phone Number:(9~+) 1111.:> - 441J Suffolk County Tax Map Number: 1000 - 11..'l.. - "'4 - 02:> Property Location: 1510 0 uz. :J14l...e. ~e. ( th~\W~ l-I~ ~"\"M..\c. ~. \ k.kn1TU.vt..) \--.1.'(. \.......0 ~ ~<>kC> ~ ....",eR...BIIo.,Il<l.......) (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~eo~\~ W~ , kc..H \-re.q- (If applicable) Address: 4\ \2.. ~~L.6 RoPeD, ~~L;.WN I N.Y., 1111-0 Phone: (~':;l\) 154-,5555 (r.&.o<) (j,'? \) '1..10\ - \og<(- "'rd of Trustees APPlicati~ GENERAL DATA Land Area (in squarefeet): ~\I~?7 >r. (.1'2.. .Ac.Re.?) Area Zoning: L4.0 Previous use of property: SlN~ F~YV\\L,-,\ t>WE1..UtVCsl .s\N~1 ". FAM\L'-'\ DAIt=\ 1 ItJC. . Intended use of property: (.6.001"'''' +"'" tz.,..,p ~ '\ Covenants and Restrictions:_ Yes No If "Yes", please provide copy. (UIJ~"w"",,) Prior permits/approvals for site improvements: Agency Date J~"4\I.O\\')Cc t'e.fit~\i (~\O%I)" ~1vGou;; ~\I.J.I\ t>\rl~ S~~ \b.I.\I.JpI~ ~rrt~ l.%il)~ f'Ra..u",,-/p.aPL. > 5/1'>"/01;. ~.l>.O.~.<? - S~I'IO.~ ~vr (I<.\!lf:-' e,-s.o-I~) ---) 1/~1/8.0 trz~~j\2>~ l'Ef2.'M\i' C* 5'=>'10"> N.'\.l;,. D.e-.v. ( \- 41'!.@, -o'l.~e, J _ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a govermnental agency? ~No_ Yes If yes, provide explanation: Project Description (use attachments ifnecessary): A'DDli"lo<>N T <::> GNO~ \::.x...\~T\~ IJ..NQ IN "fb'c?'ff~\to.JT" ') ~ ~rd of Trustees APPlicati~ WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ADOlT\O,.j 1'.0 E.~H..T\~ Il-NC rt.a.:>R........ (t-.lb ~N~ \1-1 ~V.\l..0I""'4" fb.=.TPt<.INT') ('1\ ,oc.. , c;..~. ' UpL.6.tol1;:>S) Area of wetlands on lot: 1O,4%~f. ...~tlt~are feet Percent coverage oflot: I c..,. % (ot' uf'V<'tJU'S.) Closest distance between nearest existing structure and upland edge ofwetlands:~feet . Closest distance between nearest proposed structure and upland edge of wetlands: 2:>11 ("!:.) feet Does the project involve excavation or filling? X' No . Yes Jfyes, how much material will be excavated? N"N~ cubic yards How much material will be filled? Nc:ItJ~ cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: ..... Manner in which material will be removed or deposited: ...... Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): ~~... i"D ~ ~mo...J o\l~ ~\"'TI~(, ~"'(;.. "f"'dff~INi" . "'rd of Trustees APPlicati~ COASTAL EROSION APPLICATION DATA (NO ~. ~~"t\9N 10 't:><~~ 'l..NO n-,:<. I ~N (bl.\\Lt:>lrJc..." \'!:>~INf" ') Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No X Yes Does the project involve excavation or filling? X No Yes If Yes, how much material will be excavated? -- (cubic yards) How much material will be filled? -- (cubic yards) Manner in which material will be removed or deposited: -- Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) ~~I.\,~ON Of i\1"e. fRo po.z.eo I)...c, ~ ~rnoN U\~ ~~ v~ UW\\\'elO l:N\I\(WNW\~ \'Mf~' 1. W\\.A-- & E.\.\\\.:::r ov~ 1ltE ~I.S~ ~~ . Lv.'M'fb'eR. ~\J~ ~4::..S::> AND ~AAOtwN ~ CAv.J ~s --nn:. Ptool..\.~~ Ot-J ~ ~()lAW\'1D SlOE ~ Th\::. ~I s..,."v~ 'DR W6.N,6.1.. . . Board of Trustees Application County of Suffolk State of New York 0c.orr ~\..~....s BEING DOL Y SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REj OF HIS APPLICATION. Signature >..:-:."..;, SWORN TO BEFORE ME THIS s- DAY OF JCll/\ ,200l? ~GUGuERI Noftay Public, State otNew Y orfl No. 0IGt/6137229 Qua/Ifted In Putnam . COIl'IIIIi8Iion c........ CQUnly -....... Nowmber 21, 2llO9 .rd of Trustees APplicati. AUTHORIZATION (where the applicant is not the owner) .'t. I, S>Go1T Sat\4L-~N (print owner of property) residing at 1.~ ~V~'1 RoAo (mailing address) , ~\:;>.I6o.U;, NY. loSb'? do hereby authorize , (Agent) ~\V\C:.. 'Ne~,~T to apply for permit(s) from the of Town Trustees on my behalf. (Owner's signature) .lClHN GUGlIERI Nollay PIilIlc, SlaIe of New York No.01GlJ8137229 QUIIIlled In PulnIm County Conrrlll'm ExpnI No.eI,. 21, 2009 8 . . APPLICANT/AGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Tc;;;;" of Southold's Code of Ethics orohibits conflicts of interest on the Dart oflown officers and emoJovees. The Duroose of this fo_ is to nrovide information which can alert the town ofoossible conflicts of interest and allow it to take whatever action is necessarY to avoid same. . YOUR NAME: SGop:: ~L.MhN (fi 'ddl . . 'al I I" th f Last name. Irst name, -!pI e IDltI ,un ess you are app ymg me name 0 someone else or other entity, such as a company. Ifso, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other", name the activity.) Building Trustee Coastal Erosion Mooring Planning X .x.. Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by bloo~ marriage, or buSiness interest "Business interest'~ means a business., including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO x If you answered "YES'" complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, paren~ o(child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); _C) an officer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELA TIONSHJP Itl.-. J '" S~bmitted this -rJ-;~ay, 'Jf ~ -;} 200 ~ SIgnature ~L Print Name v^H $Ch-l............... Form TS J . 617.20 . Appendix C . Slate Environmental Quality Review . SHORT ENVIRONMENTAL ASSESSMENT FORM For UNUSTED ACTIONS Only PARTI-PROJECTINFO~nON 1. APPUCANTISPONSOR SG4\'f S~~~ 3. PROJECT LOCATION: Municipality ~L1'I.\."'" 1lPW'" () unty ~\t 4. PRECISE LOCATION (Street add""", and road in_cIIons, prominenllanclmarks, etc., or provide map) l?l.o O\..\S. J\4l-lZ ~ ~~1'\...\.Vt=:-.... ~~~ 1V'\.kp~r-Jc..Ll4.teer.::> (;ruiJr ~ (12.'\ I}~ lVIR~'.7 l ~ 1<R.6M~ Rc::>-'<c"') "- ~laJc.G. 5. PROPOSED ACTION IS: o New 0 Expansion Mocfdicalionlalleralion 6. DESCRIBE PROJECT BRIEFlY: .&.co\'TtoN "1"0 I<.N ~-n,.r<<. fLNo ~ L -n~ \.'nu... fl:,~ 1-10? Q,\-.-..lI4~ \1-> 1lt\::. le5I-\.STl"'~ "~fe'IiV1" Ol;" 1l-HG ~1.~.'tW" 1.-~"tOIt-'1 ~~ S\tJ(jp~ f'~V\ V>W~ 7. AMOUNT OF LAND AFFECTED: No ~ DN 1\te. ~ c.-9'ol~~"'on."N ",nu_ ~ Initially - acres U_ly - acres eu~ -...sn... 8. WILL PROPOSED ACTION COMPL YWITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? :g( Yes 0 No If No, describe briefly . _ 9. WHAT IS PRESENT lAND USE IN VICINITY OF PROJECT? & ResfdenUsI 0 Indusbial 0 Commercial 0 -Agriculture 0 ParklForestJOpen Space 0 Other Desaibe: ShJ~ ~\'-'t twet..t..ttXe':> ~" f~A...uo1. '^'~ S~\ 10. DOES ACTION INVOlVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAl, STATE OR LOCAL)? o Yes K No If Yes, list agency(s) name and pennillapprovals: 11. DOES ANY ASPECT OF THE ACTION HAVEA CURRENTLY VAUD PERMIT OR APPROVAL? o Yes l8r. No If Yes, list agency(s) name and pennil/approvaIs: (~ 'eJt\!on"c. 1W_~e W& A ~~\'\"""'" OF E>~t.J.&" ~o ~\6111UCc Stre 1)')tu.\c>'..rC. ~uf>t 4 v-.... "~ ~ f'laMolo\l~V\ ~~v\?C U>-\Ilre ~I~'t:a:.:'\ , ,~ ~No . .'"'\'fZ."I&: ./ 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? o Yes No Signature: :r THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE !R'~ '" ~f<o.\- l) ...,~) Dale: <:tl.N. '1. ~ ,~ Applicanllspo If the action is in the Coastal- Area, and you are a state aeency, complete the Coastal Assessment Form before proceeding with IS assessment OVER 1 PART 11- IMPACT ASSESSMENT CTo Lead . . - om A. DOES ACTION EXCEEDIWY 1YPE I THRESHOLD IN 6 NVCRR, PART'617.4? If yes. coonIinaie lha I8View PfDCIBIS and .-lha FUI.L EAF. Dyes DNo . .. B. WlLLACTION RECEIVE COORDINATEDREVlEWAS PROVIDED FOR UNIJSl'EDACTlONS 1N6 NYCRR. PART 617.6? If No. a negatiw db.;b"..... may be superaede.l by anolher InvolVed agenc:y. . D Yes D No C. COULD ACTION RESULT 1NAK'f ADVERSE EFFEC'I'S ASSOCIATED WITH THE F'Oi.J.l:J\!VJNG: ~ may be .....1lIwriIIet..IfIeglJle) C1. Em&Ig eirquaJ/ly. SUIfac:e or groundwalerqU8lly orquanlllv. noise ......1IlCI8Ung lIlItlIc paIblm, solid waste produdlon or disposeI, poI8Iltia1 for erosion, dr8inage or lIoodIng Jl")bIb...6? ExpIajn brielIy: . C2. Aeslhelic, agricullural, "'''''-'''1ClII. hiIlIxIc, or other _ or c:ulbn11eSOUn:e&; or c:ommunllr or neighborhood ctwacler? Explain brielIy: . C3. VegeLdio.' or fauna. fish. shellfish or _ species. 8IgntIIcanl habitaIs, orlhrealened or.endangered species? ExpIa;;, brlelly: C4. A communiIy's 8lIlsting plans or goals as oIIiciaIy adopled. or a ch8nge in use or inIIlnsiIr of use of _ or _ __? Explain brieIly: C5. Growth. subsequent cIeveIopn*1I, or reIatsd activiIIes likely to be induced by lha pnlpllS8CI aclIon? Explain brIeIIy:. C6. Long lIlnn, short lIlnn, CUIIIlI/aINe. or olherellecls not idellllled in C1-c5? ExpIajn brielIy: - r:T. Other inpacts (mc:iudIng changes In use of ellher quan\Ily or type of energy? ExpIajn brIelIy: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERIS11CSTHAT CAUSED THE ESTABLi~ OF A CRITICAL ENVIRONMENTAL AREA (CEA)? Dyes DNo if yes, expIaln brielIy: E. IS THERE. OR IS THERE UKELYTO BE. CONTROVERSY RElATED TO P01ENTIALADVERSE ENVIRONMENTAL IMPACTS? DYes DNo If yes, explain bIIeIly: , PART 81- DETERlllNATION OF SIGNIFICANCE (To be compIllled by Agency) INSTRUCTIONS: For each advenle effllctldenllfied above. dBlerminewhelherltissubslanlial, large. importantorolherwlse sIgniIicant. Each effect should be assessed in connection with lis (a) selling (Le. lIIban or ruraJ); (b) proballIIily of 0CI:UI1:ing; (e) duration; (d) In8Verslbiifty; (e) geographic scope; and (ll magnllude. If r>et I 'Yo add lIIIactlmenla or I8ference IlllppOI1Ing malierIaIs. EnsuIll1hat expIanaIIons conIaIn suIIiclent delaillo shllw1hat all relevant ~ imp8ctI '-..... ........11 and adecp-.Wy addreesed. Ifquesllon d of pert R_c:hecked yes, the detieo...",...1ion ofsignlficancemustevalualethe pcQIdIaIlmPllClofthe PIl!POI8d acIIonontheenvironmenlalchanlcterisllcsoftheCEA. o CI1ecklhis box If you have idelllllled oneormont......_ I8Ige or """.......ltedwel8einpacts which MAYoccur. Then proceed directly to the . EAF and/or pNpII/ll a poeiIive dedaraIion. o Check lhis box If you have deIelnlliled. beeed on the itu......u..n and anelysis abcwe and any supparIing iiocumanratIon, lhat the pRlpOHd WILL NOT resulln any signlIIcanl..s- _iOl"'....... impac:ls AND pnMde. on .dtac:h.._1s .. """ 'Y. lha .- _u... _. Name ofLe8d~ Dale Print or Type Name of Respo4_ 0IIialr in L88d AgenI;y TIle of R l;onaIbI8 omcer Signabmo of ~I 'P"_ otIIc8rln Le8dAgency stgnal1n orA..._ (lfdlf8rent from ~ oIIiCer) Town of South old . . L WRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of South old Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. * Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the L WRP policy standards and conditions contained in the consistency review law. Thus. each answer must be explained in detail. listine both supportine and non- supportine facts. If an action cannot be certified as consistent with the L WRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of South old 's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# \000 - 11.fl. - 04 - O,?::> PROJECT NAME ~L.I-'\.6.N 'F\SQp4eN~" 1..Mo ~ hoCmo....1 The Application has been submitted to (check appropriate response): Town Board D Planning Board D Building Dept. D Board of Trustees ~ I. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) D D (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: 181 Nature and extent of action: tl.l.Jc, fl.a,p.., ..koDmli9N i.c::> aLbl1tJG... , 5\NG.\L-e. ~\t.."( bw El-t... \..J <:. 2..-~-W~,,\ . . Location of action: \ Sl ~ VU:. :J\.\U? \,~~ I ~~1'\4C..'\(... I \--\~. Site acreage: ..1'1.. ~~ l'?\,f')tlt? ~.f. ') Present land use: 51~1A~ r/ow)\\-'i" Dv-'el' *~ Present zoning classification: R-'\-o 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: 5~ J~l'(\~ ScMv.UV\.kN (b) Mailing address: 1.~~ e,~~\...'1 ~f<P 5vMs.pA~, ~~loE~~ (c) Telephonenwnber:AreaCode(l)~I!>-4i.O ~.. (~I') 8<\:?r118\ -(;oav (d) Application nwnber, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes~ NoD If yes, which state or federal agency? ~,\.". D.E-v. ~A4... '> C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See L WRP Section III - Policies; Page 2 for evaluation criteria. ~Yes D No D Not Applicable ~ ~Ec::> fR.c{)t:::oC\" \? )... SYV\Ku- ~ n..a::.~ ,..r.;oOt\lDN -ro ~ ~\~'T\N~ 2.-S~,,\ SbJr.U<.. f~\~ \?W~ I l"j~. 1'l\1<:. M>D\'T\cN Will _ /XJ'JJR ~'Jf:.. '1l1t. ~\bTl~ \40~_ MfR.ttJT A.IO If, bE:S"....a:::. 1b ~c..f. 'ntE.. AfF.?"Vhl(t;:", nf' ~ \-\.o~~ Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See L WRP Section III - Policies Pages 3 through 6 for evaluation criteria DYes D No ~ Not Applicable ~\~rJ~ ~C> I--Jo ~~\'"v NeT 6lr A-N~ ""~,A,,, Sl'-NI ~ ~~ WllAr &>r4llR... 40"-1 ~ S\'TB. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L WRP Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes 0 No 0 Not Applicable ~~~~~Ho~~~\~_V~Y~~~:N:~\pr ~ ~(~ l.~.n- ~ _,~~..o "t'\fe.~ ~ n;:;- ~ "==,l.\~. \-..10 .<..r&-JlC_ \I\!;::.~ WlAlo- -~ e~~. ~ ~ ~\ l-~ .$\()wrq L~ l24:=I.....liO UTIl.\'"7 ~D Attach additional sheets if necessary J NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See L WRP Section III - Policies Pages 8 through 16 for evaluation criteria DYes 0 No~ Not Applicable ~ fRu.J'eZ'I WI\.L.- ~<:lT ~e- ~ ~~\ ~~ ~~~~~~~.~~a:~~~ ~L-lf r::;:lN 1"\re. fl..wo FI.n?R. - k7~ Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria DYes 0 No ~otApplicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. o 0 ~ . Yes No ~ot AP!able . . ~~~l~~~:~~~~~~'. Attacb additional sbeets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. DYes D No ~ Not Applicable Ex.\bnN{O C)IL- fVR.::=v--. ~\L.~ W\U- 'R:ew\AI~. \Janc.u~ ~ \'-. \"wy\'"t'W"> ~ 'M'e: l...h-JOW~ $,lDE; Of- \l1b \\O\At-.o, Attacb additional sbeets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See L WRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~Yes D No D Not Applicable Au-- ~~\.\o'\\a-..1 ~\'::..AND lO!:'&IO~1AL. ~~-. W\\.L.. ~ ~~ ~ "'ntE- ~\-n=... PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See L WRP Section III - Policies; Pages 38 through 46 for evaluation criteria. D YeD No~Not Applicable ~ ~l~-ntl(g \10~~ \~ NO\~\/7'~ A1 A 5~ ~'NXT 1l'JG;. ;Ier' A 5"",~] I.....e:. ;'<Nc ~e.u.L. ~ -", T...... twe W~~ ~1-\ot2.e'-\l'-E WOwI.\-D N..oT fbe ~~~ Attacb additional sbeets if necessary WORKING COAST POLlCIE' . . Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See L WRP Section 111- Policies; Pages 47 through 56 for evaluation criteria. DYes 0 NojglNot Applicable ~l~t-llA 5> tte. ~N? .;lcN -F)sM\1..J..o\ R~\~. ~ ~ NO\ C9r-.1TQI\~. EX' S:\'l'.Jr-Cl &l~ ~ u.:.~ ~ ~ S~ Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See L WRP Section 111- Policies; Pages 57 through 62 for evaluation criteria. DYes 0 No~NotAPPlicable No \+p<l<.\J~"1'Thlu. o~~ ~ oR.... A<:R\.\AGuCJ'A.J> r- I':::> ~fO-';I=r-,.. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See L WRP Section III - Policies; Pages 62 through 65 for evaluation criteria. DYes 0 No~NotApplicable S\~ \5 f~\\J<u...J-\ "t'42~/\}..h::"O~) w/ ~l..<::=>fl~ ~at~~ ~\A~~~3-u~' Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. DYes 0 No,g[ Not Applicable PREPAREDBy--.fR~Ivt:- \A)~_ TITLE ~~DATE~'~I~ - 1FIlIIlEIDllEImICIl( IlIIOlalElillT WEBER . . 52 NOYACK PAlH, !PO BOX 13741. WATER Ml.L, feN YORK 11976 41 EAST MAPLE ROAD. GREENLAWN. IIEW YORK. 11740 1R. 631.754-5555 FAX 631. 261-1084 .\IlIICIlOO'II"IEC"Il' January 23, 2008 f[i5) ~ (G ~ 0 Wi ~ lrm lilJi JAN 25 200B ~, Southold Town Trustees Town of South old Annex PO Box 1179 Southold, New York 11971 Southhold Town Board ot Trustees RE: SCOTT & JENNIFER SCHULMAN- 2nd FLOOR ADDITION 1570 Ole Jule Lane, MATTITUCK, TOWN of SOUTH OLD, NY SCTM# 1000-122-04-03 Southold Town Trustees: Attached please find the following documents submitted in an application for an Administrative Permit to construct a 2nd floor dormer/roof addition to an existing 2-story single family dwelling. It should be noted that the 2nd floor addition will occur over the existing 1 st floor and there will be no change to the existing house "footprint". . 1- Fee $50 (Check #477, FRW) 2- Three (3) copies of Application including Hold Harmless, Authorization, Disclosure, Short Environmental and L WRP 3- Three (3) copies of the current survey with the proposed 2nd floor addition indicated. (John Schnurr, Land Surveyor, January 13, 2008) 4- Three (3) copies of previous survey/previous owner w/ contours (John Schnurr, Land Surveyor, May 28, 2002, last updated February 5, 2003) 5- Three (3) copies of sketch of proposed roof/2nd floor addition shown on existing photo 6- Three (3) copies of pictures of existing house and wetlands 7- Three (3) copies oflocation map Please contact me if you need any additional information for this application and send all correspondence to my Greenlawn address. Thank you very much. ~er;nty ~~' F~~~CK~.A.