HomeMy WebLinkAboutTR-6899A James F. King, President
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hail Annex
54375 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0471C
Date: September 29, 2009
THIS CERTIFIES that the extension of the existing dwelling landward
At 710 Truman's Path, East Marion, New York
Suffolk County Tax Map # 31-12-3
Conforms to the applications for a Trustees Permit heretofore filed in this office
Dated 6/2/08 pursuant to which Trustees Administrative Permit # 6899A
Dated 6/18/08 was issued and conforms to all of the requirements
and conditions of the applicable provisions of law. The project for which this certificate
is being issued is for the extension of the existing dwelling landward.
The certificate is issued to EDWARD AND CATHERINE FORTE owner of the
aforesaid property.
Authorized Signature
James F. King, President
Jill M. Dohen'y, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall, 53095 Main Rd.
P.O. Box I 179
Southold, NY 11971
Telephone (631 ] 765-1892
Fax (631~ 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOIJTHOLD
DATE.,~ INSPECTION:
V' Ch. 275
Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1 ~ day of construction
~ constructed
Project complete, compliance inspection.
INSPECTED BY:
COMMENTS:
CERTIFICATE OF COMPLIANCE: ~--~ ~
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
1st day of construction
¼ constructed
Project complete, compliance inspection.
T ~
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.: 6899A
Date of Receipt of Application: June 2, 2008
Applicant: Edward & Catherine Forte
SCTM#: 31-12-3
Project Location: 710 Truman's Path, East Marion
Date of Resolution/Issuance: June 18, 2008
Date of Expiration: June 18, 2010
Reviewed by: Board of Trustees
Project Description: Extend the existing structure landward.
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
site plan prepared by Frank Uellendahl, Architect, last dated June 18, 2008, and
received on June 19, 2008.
Special Conditions: The installation of gutters, leaders and drywells to contain
roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water
Runoff.
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.
This is not a determination from any other agency.
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
Please be advised that your application dated ~o~, ~ ~ h~s
been reviewed by this Board at the regular meeting of ~e ~ ~
and your application has been approved pending the completion of 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)
__ ~ Constructed ($50.00)
~inal Inspection 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 foKh in Chapter 275 of the Southold Town Code.
The following fee must be paid within 90 days or re-application fees will be
necessaw. You will receive your permit upon completion of the above.
COMPUTATION OF PERMIT FEES:
TOTAL FEES DUE: $ .~(..,) ~'~
BY: James F. King, President
Board of Trustees
................. ,~,,~,:~: ~.~ ........... J ~ COUNTY OF SUFFOLK (~) I ~"~1~w"~ SOVTHOLg
OFFICE LOCATION:
Town Hall Annex
54375 State Route 25
(cor. Main Rd. & Youngs Ave.)
Southald, NY
M~II.ING ADDRESS:
P.O. Box 1179
Southald, NY 11971
Telephone: 631 765-1938
Fax: 631 765-3136
LOCAL WATERFRONT REVITALIZATION PROGRAM COORDINATOR
TOWN OF SOUTHOLD
To;
From:
Date:
Jim King, President
Town of Southold Board of Trustees
Scott Hilary/Mark Terry, LWRP Coordinators
June 16, 2008
JUN 17 2008
Re:
Chapter 268: Waterfront Consistency Review
Wetland Permit for EDWARD & CATHERINE FORTE
SCTM#31 - 12-3
Frank Uellendahl, Architect on behalf of EDWARD & CATHERINE FORTE requests an
Administrative Permit to extend the existing structure landward. Located: 710 Tmman's Path,
East Marion. SCTM#31-12-3
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 (LWRP) Policy
Standards. Based upon the information provided on the LWRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation that
the proposed action is EXEMPT from review pursuant to § 268-3, Exempt Minor Actions;
provided that all operations associated with the proposed action remain outside of the
Board of Trustees minimum setback pursuant to § 275-3 as referenced below.
§ 2 75-3 Findings; purpose; jurisdiction; setbacks
D. Setbacks.
(1) The following minimum setbacks apply to any and all operations proposed on residential
property within the jurisdiction of the Board of Trustees:
(a) Weflandboundary.
[lJ Residence: l OO feet.
[3] Sanitary leaching pool (cesspool): l OO feet.
[4] Septic tank: 75feet.
[6] Landscaping or gardening: 50feet.
[7] Placement of C & D material: l OO feet.
James F. Ifdng, 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
Office UseOnly
Coastal Erosion Permit Application/
Wetland Permit Application ~' Administrative Permit
Amendment/Transfer/Extension
ece~vved Application:
eceived Fee:$ ~'"~ ' _
__Completed Appiication
__Incomplete
SEQRA Classification:
Type I Type II Unlisted
Coordination: (date sent)
~WRP Consistency Assessment Form
CAC Referral Sent:
-~ate of Inspection:
Receipt of CAC Repo'-rt~
Lead Agency Determination:
Technical Review:
..P.~01ic Hearing Held: ~
Resolution:
Name of Applicant
Address /t:~2-7-- VA~AJO~_~ ~t 6~- ~ ~~T
~ ~g~ PhoneNumber:()[~) ~~
Suffolk County Tax Map Number: 1000 - ~g- [~- O~
Property Location: ~g~ ~~ ~
(provide LILCO Pole ~, dist~ce to cross streets, ~d location)
(If applicable)
~rd of Trustees Applicati~
Land Area (in square feet):
Area Zoning:.
Previous use of property:
Intended use of property:
GENERAL DATA
Covenants and Restrictions:
If "Yes", please provide copy.
Yes / No
Prior permits/approvals for site improvements:
Agency Date
I~No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
~ No__ Yes
If yes, provide explanation:
Project Description (use attachments if necessary): ~gtt]6]~'~'~ /~t'lffng 7Z7
of Trustees Applicati~
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
square feet
Does the project involve excavation or filling?
No /Yes
If yes, how much material will be excavated? [/8
How much material will be filled? /tv',,&:)
cubic yards
cubic yards
Depth of which material will be removed or deposited: ~ ~'. feet. ~
Proposed slope throughout the area of operations: ,'~67
Manner in which material will be removed or deposited:
Statement of the effect, if any, on the wetlands and tidaJ waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
Area of wetlands on lot: ,v
Percent coverage of lot: /~.0~ %
Closest distance between nearest existing structure and upland
edge of wetlands: ~,.~' feet
Closest distance between nearest proposed structure and upland
edge ofwetlands: //~ .~_. feet ~,~_-.~7~
of Trustees Applicati~
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity:
Are wetlands present within 1 O0 feet of the proposed activity?
No Yes
Does the project involve excavation or filling?
No ? Yes
If Yes, how much material will be excavated? //~ (cubic yards)
How much material will be filled? ,..~a~ (cubic yards)
Manner in which material will be removed or deposited: ,~),~'~O ~'
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
617,20 SEQR
PROJECT ID NUMBER APPENDIX C
STATE ENVIRONMENTAL QUALITY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Only
PART I - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor)
1. APPLICANT / SPONSOR 2. PROJECT NAME
3.PROJECT LOCATION:
4. PRECISE LOCATION: S~eet Addess and Road Intersections, Prominent landmarks etc - or provide map
5. IS PROPOSED ACTION: ~ New ~Expansion ~ Modification / alteration
6. DESCRIBE PROJECT BRIEFLY:
7. AMOUNT OF ~ND AFFECTED:
Initially acres ugimate&y acres
8. WILL. PROPOSED ACTION COMPLY ~TH EXISTING ZONING OR OTHER RESTRICTIONS?
~Yes ~ No If no, describe briefly:
AT IS PRESENT ~ND USE IN VICINI~ OF PROJECT? (Choose as many as apply.)
esidential ~ Indu,trial ~ Commorcial ~dculture~a~lFor*~tlOponSpace ~ Othor <doscribo)
10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL
AGENCY (Federal, S~te or Lo~l)
~es ~ No If list name and permit / approval:
yes,
agency
11. DOES A~PECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
~Yes ~No If yes, list agency name and permit / approval:
RES LT OF
12. AS A ~ESU PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION?
~es~N~ ,
I CE IE THAT THE INFORBATION PROVIDED ABOVE IS TRUE TO THE BEST OF ~Y KNOWLEDGE
If th~ action I~ a Co~tal ~roa, and you am a ~tat~
complete the Coastal Assessment Form before proceeding with this assessment
PART II - IMPACT ASSESSMENT (To be completed by Lead Agency/I
A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF.
B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a negative
declaration may be superseded by another involved agency,
E~] Yes ~1No
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible)
C1. Existing air quality, sun'ace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal,
potential for erosion, drainage or flooding problems? Explain bdefly:
C2. Aesthetic, agricultural, archaeological, historic, 'or' 0~i~r natural o'~' C~'l{~;~i'resources; Or ~0m~nu~ity or neighborhood characieh Explain briefly:
/
C3. !eg~t~t'i~"~ iadnal fish, stieiifi~ ~Niidiiie s~ecies,'~i~'nific~nt habita~;, or threatened or endangered species? Explain briefly:
CM. A community's oxistin~ p~ans or goals as officially ~dopted, or a chan~ in uso or intensity o~ uso ~f I~nd or other n~tural resources? ~xplain briefly:
C5. Growth, subsequent development, or related activities likely to tie induced by the proposed action? Bxplain briefly:
C6. Long term short term cumulative or other effects not ~denhfied p
C7, Other impacts {including chan es in use ofeither uanflt¥or eofener[l¥? Ex?lainb~efl '
~ ~1 t~p ¥.~
D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTALAREA CEA ? If es, ex lain brieti :
[---~Yosj---INoJI I IY P ~' - i t
E, IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL I PACTS?
r--lYes r--t No
If yes explain: J
PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency)
INSTRUCTIONS: F~reachadVersee~ectidenti~edab~ve~determinewhetheritissubstantia~~~arge~important~r~therwisesIgnificant~ Each
effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e)
geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain
sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed, ff question d of part ii was checked
yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA.
Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL
EAF and/or prepare a positive declaration.
Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior
WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessap/, the reasons supporting thti
determination.
Name of Lead Agency
Date
Title of Responsible Officer
Signature of Preparer (If different from responsible officer)
Print or Type Name of Responsible Officer in Lead Agency
Signature of Responsible Officer in Lead Agency
of Trustees Ap~
AUTHORIZATION
(where the applicant is not the owner)
(print owner of property) (mailing address)
do hereby authorize~K
(Agent)
to apply for permit(s) from the
Southold Board of Town Trustees on my behalf.
(Owner' s ~gnature)
8
Board of Trustees Application
County of Suffolk
State of New York
~-e~ ~./'~Z~),~ ~/'~ BEING DULY 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 A_ND 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 l~ ;.~I]E.Wu Ofl~ ~HIS APPLICATION.
Signature
SWORN TO BEFORE ME THIS 3 0'[~1- DAY OF ~A ~
,20.
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold 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.
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).
If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus~ each answer must be explained in detail, listing both supporting and non-
suooortiw, facts. If an action cannot be certified as consistent with the LWRP 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 Southold ' 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
PROJECT NAME
The Application has been submitted to (check appropriate response):
TownBoard [] Planning Board [] Building Dept. ~ BoardofTrustees
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)
(b) Financial assistance (e.g. grant, loan, subsidy)
(c) Permit, approval, license, certification:
Nature and extent of action:
Location of action:
Site acreage:
Present land use:
Present zoning classification:
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:
(b) Mailing address:
(c) Telephone number: Area Code ( ) d~:~/_) '~:~ ~2'~5
(d) Application number, if any:.
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes [] No.~ If yes, which state or federal agency?
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 LWRP Section III - Policies; Page 2 for evaluation
criteria.
[] Yes [] No ~ Not Applicable
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III - Policies Pages 3 through 6 for evaluation criteria
[] Yes ['~ No [] Not Applicable
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See
LWRP Section III - Policies Pages 6 through 7 for evaluation criteria
~-~ Yes [~ No ~ Not Applicable
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Section III - Policies Pages 8 through 16 for evaluation criteria
[] Yes [] No ~ Not Applicable
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
Yes ~ No I I Not Applicable
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.
Yes
No Not App~able
Attach additional sheets 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.
~ Yes ~ No [---~Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
~ Yes [] No ~-~Not Applicable
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 LWRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
~ Yes~ No~Notnpplicable
Attach additional sheets if necessary
WORKING COAST POLICIESO
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria.
~ Yes [] No ~Not Applicable
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 LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
[] Yes ~ No ~Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages
62 through 65 for evaluation criteria.
[] Yes ~ No ~Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Polic~ges 65 through 68 for evaluation criteria.
~ Yes [] No~ Not Applicable
PREPARED BY ~- -~)~L/~~~-- TITLE ~_.C~[/7~ DATE~~
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts of interest on the hart of town officers and emolovces. The ouruose of
this form is to t~mvide information which can alert the town of ~ossible conflicts of h,i,i,~t and allow it to take whatever action is
ne to avoid same.
(Last name, fa'st name, middle initial, unless you ar~ applying in thc name of
someone else or other entity, such as a company. If so, indicate the other
person's or company's
NAME OF APPLICATION: (Check ail that apply.)
Tax grievance Building 4-
Variance Trustee
Change of Zoce Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(lf"other", name the activity.)
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 blood, marriage, or business interest. "Business interest" means a business,
including a partnership, in which the town officer or employee h~ 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 ~'~
If you answered "YES", complete the balance of this form and date and sign where indicated.
Name ofporson 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, parent, or child is (check all that apply):
__.A) thc 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 RELATION SHIP
Form TS 1
Submitted this "~O~t~ :y~/~t ,/l/,/.~. t.~ 200 ~
EXI~dNG SOUTH ELEVATION
LANDWARD LIMIT OF FRESHWATER WET~NDS
AS FLAGGED BY EN-CONSULTANT% INC ON 11/23/05
PROPOSED SOUTH ELEVATION
269.44'
r
! PROPOSED 4'DIA. X 6' DEEP DRYWEL. L
I WITN GUTTER LEADERS FOR ROOF RUN-OFF
112.2' distance [o flagged weUands line
EL,13.8'
84' dis'Lance (o re,a~nmc
EXISTING
WOOD DECk
EXISTING FOOTPRINT
EL22.I'
EL22.1'
FLOOR ADDITION
PROPOSED 4'DIA. X 6' DEEP DRYWELL (TYP/)
WITH GUTTER LEADERS FOR ROOF RUN-OFF
APPROVED BY
BOARD OF TRUSTEES
TOWN OF SOUTHOLD
DATE '_ - f~ '
PROPOSED 1ST FLOOR ADDIIlON
SURVEY BY JOSEPH A, INGEGNO ]
DATED: NOVEMBER 28, ~005
l~'~ LEADER CONNECED TO DR'~VELL
~ GUTTER
'7
SCALE: 1/16" =1'-0"
SITE PLAN]
SCTM# = 1000-51-12-0,5
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
WETLAND PERMIT
APPLICATION
ADDITION
TO THE
FORTE
RESIDENCE
EAST MARION, NY
710 TRUMANS PATH
ARCHITECT
FRANK UELLENDAHL
P.O,BOX 516
GREENPORT, NY li944
TEL: 651-477 8624
FAX; 651-,!77 8624
OWNER
EDWARD FORTE
DATE: 06/18/2008
SCALE: 1/16" = 1'-0~
SITE PLAN
DWG. NAME
DWO. NO
\/
1\0
X~
NOTES:
1. ELEVAIIONS ARE REFERENCED TO N.G.V.D. l~2D DAIU~
EXISTING ELEVATIONS A~E SHOWN IHUS:~
EXISTIFIG CONTOUR LINES ARE SHOWN THUS:
5
SURVEY OF PROPERTY
SITUATED AT
EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-~1-12-05
SCALE 1"=20'
NOVEMBER 28, 2005
AREA 20,157.63 sq. ft.
(TO TIE LINE) 0.463 ac,
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
Ingegno
Surveyor
PHONE (631)727-2090 Fax (631)727 1727
25-40"/