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Home My WebLink AboutTR-6817 Glenn Goldsmith, President OF S0/r�, Town Hall Annex Michael J.Domino,Vice-President ,`O� ®lam 54375 Route 25 P.O.Box 1179 _ John M.Bredemeyer III [ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams '�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 20, 2020 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: PETROS:& PENNY TSEKOURAS 1852 NORTH BAYVIEW ROAD, SOUTHOLD SCTM# 1.000-70-12-39.4 Dear Mrs. Moore: The following action was taken-at th&Southold Town-Board-of Trustees regular meeting held on Wednesday, August 19, 2020: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#6817 from Joanna Lane to"Petros & Penny Tsekouras, as issued on February 27, 2008. Any'other activity within 100' of the wetland boundary requires a permit,from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, e'lennGo dsmith, President Board of Trustees GG/dd J James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town H~lAnnex 54375MainRoad 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 # 0427C Date: June 4, 2009 THIS CERTIFIES that the installation of privacy fencing along the northern property line with a 10' post & rail fence at the most seaward end At 1852 North Bagview Road, Southold, New York Suffolk County Tax Map # 70-12-39.4 Conforms to the applications for a Trustees Permit heretofore f'ded in this office Dated 1/17/08 pursuant to which Trustees Permit # 6817 Dated 2/27/08 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 installation of privacy fencing along the noahern property line with a 10' post & rail fence at the most seaward end The certificate is issued to JOANNA LANE owner of the aforesaid property. Authorized S~gnature James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES · TOWN OF SOUTHOLD DATE OF INSPECTION: V/ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 ~ day of construction constructed JProject complete, compliance inspection. CERTIFICATE OF COMPLIANCE: ~z m0 ~0 0 0 · LAND NOW OR LUCy B. E~OGOV/c ,~ FOI~MEI~Ly OF PETEI~, A. BOGovic ~2 00o0 APPROXIMATELY 200 PT. OF g'-O"' HEIGHT WOODEN PRIVACY PENCE I0. 75.,8' I 0 FEET OF FENCE TO BE SPLIT RAIL FOR WILDLIFE CORRIDOR A5 PER TRUSTEES REQUEST AT 2-27-08 MEETING x c o.,,ox 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 ½ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6817 DATE: .FEBRUARY 27~ ISSUED TO: JOANNA LANE PROPERTY ADDRESS: 1852 NORTH BAYVIEW ROAD~ SOUTHOLD SCTM# 70-12-39.4 AUTHORIZATION Pursuam to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 27, 2008, and in consideration of application fee in the sum of $250.00 paid by Joanna Lane and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to install privacy fencing along the northern property line, with the condition that the last 10' on the seaward end is to be a post & rail fence to allow for a wildlife corridor, and as depicted on the site plan prepared by Peconic Permit Expediting, last dated October 7, 2008, and received on October 8, 2008. 1N WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Joanna Lane, residing at 140 Wagon Wheel Lane, Cutchogue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages; of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Pennittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 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 February 27,2008 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Mr. Robe~ Lehne~ Peconic Permit Expediting 32645 Main Road Cutchogue, NY 11935 RE: JOANNA LANE 1852 NORTH BAYVIEW ROAD, SOUTHOLD SCTM# 70-12-39.4 Dear Mr. Lehnert: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 27, 2008 regarding the above matter: WHEREAS, Peconic Permit Expediting on behalf of JOANNA LANE applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated January 17, 2008, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 27, 2008, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of JOANNA LANE to install privacy fencing along the northern property line, with the condition that the last 10' on the seaward end is to be a post & rail fence to allow for a wildlife corridor, and as depicted on the site plan prepared by Peconic Permit Expediting, last dated October 7, 2008, and received on October 8, 2008. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, 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 TO: BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated .~o.~o~% 17 ~?09o~ has been reviewed by this Board at the regular meeting of and your application has been approved pending the completion-~f thC following items checked off below. )/'""*Revised Plans for proposed project/.-o-~L iO"o~E~-o~e~ __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ~,4 Constructed ($50.00) ~'/'-Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: CO TOTAL FEES DUE:$ BY: James F. King, President Board of Trustees Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 13, 2008, the following recommendation was made: Moved by James Eckert, seconded by Jack McGreevy, it was RESOLVED to NOT SUPPORT the Wetland Permit application of JOANNA LANE to install privacy fencing along the northern property line. Located: 1852 North Bayview Rd., Southold. SCTM#70-12-39.4 Inspected by: James Eckert The CAC does Not Support the application and recommends natural fencing such as Arborvitaes or Leyland Cypress, in order to keep the wildlife corridors open. Vote of Council: Ayes: All Motion Carried James F. King, President JiI] M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-095,~j 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: q. [ l ff /(..3 -~ JOANNA LANE requests a Wetland Permit to install privacy fencing along the northern property line. Located: 1852 North Bayview Rd., Southold. SCTM#70-12-39.4 T~SSe of area to be impacted: altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of above: P~C of Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application: V/Wetland __Coastal Erosion __Amendment __Administrative __Emergency Pre-Submission Violation Planning Info needed: Modifications: Conditions: Present Were:__J.King __J.Doherty P.Dickerson H. Cusack D. Dzenkowski Form filled out in the field by /(0. Bergen__ B. Ghosio, Jr Mark Terry~other Mailed/Faxed to: Date: Environmental Technician Review COUNTY OF SUFFOLK OFFICE LOCATION: 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 To: James King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: Re: February 27, 2008 Proposed Wetland Permit for JOANNA LANE SCTM#1000-70-12-39.4 JOANNA LANE requests a Wetland Permit to install privacy fencing along the northern property line. Located: 1852 North Bayview Rd., Southold. SCTM#70-12-39.4 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 CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. It is recommended that the following be applied to further the below listed policies to minimize hazardous chemicals into the surface and ground ~vaters. Policy 5. Protect and improve water quality and supply in the Town of Southold. 1. Minimize the use of chromated copper arsenate (CCA) treated wood in the construction of the structure pursuant to § 275-11. B,1 (f) Construction and operation standards below. In order to prevent the release of metals and other contaminants into the wetlands and waters of Southold, the use of lumber treated with chromated copper arsenate (also known as "CCA "), creosote, l)enta l)roducts or homemade wood preservatives is prohibited for use in sheathing and decking. Preservatives of any type, including but not limited to those listed above cannot be apl)lied to any bulkheads, retaining walls or revetments after installation. Encapsulated pilings or native nonchemically treated (untreated) lumber only should be used in sensitive areas. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. MT/hkc James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel Town Hal! 53095Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Office Use Only w OaStal Erosion Permit Application etland Permit Application Administrative Permit f AmendmentfFrans fer/Extensio~ ~(ece~ved Application:~ ~Received Fee:$ ,~'Completed Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordinafion:(date sent). -~'EWRP Consistency Assessment Form ~ACReferral Sent: l ..~l~te of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: __Resolution: Suffolk County Tax Map Number: 1000- 7t57 - Jif- - 3q/~ Property Location: /[/at'J'r4 ~p'.~/ ']-., ,0',~,,.~, ~gtt, t.-.- (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Address: ~,,~f ~" Pho.e: of Trustees Ap~ Lm~d Area (in square feet): Area Zoning: ]~ 4t~ Previous use of property:_ ~SIdFr~ ~'-~ Intended use of property: /~'~51d~'"; ~' '~ GENERAL DATA 74., q33 Covenants and Restrictions: Yes ,~ No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date X 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): · / ~ard of Trustees Applicat: WETLAND/TRUSTEE LANDS APPLICATION DATA Propose of the proposed operations: //7,9/n,/1 ]~grlt~t:,),/ Area ofwetlands on lot: 3 4,,/f~*' square feet Percent coverage of lot: 4~'~, 0~' % Closest distance between nearest existing structure and upland edge of wetlands: 7.5'. aO feet Closest distance between nearest proposed structure and upland edge of wetlands: ~. 3-' feet Does the project involve excavation or filling? ~ No Yes If yes, how much material will be excavated?/Id'//l~ cubic yards How much material will be filled? /~t/~ cubic yards Depth of which material will be removed or deposited: /[//~ feet Proposed slope throughout the area of operations: 0 Manner in which material will be removed or deposited: /Gt/~J[ 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): ,ard of Trustees Applicati COASTAL EROSION APPLICATION DATA Purposes of proposed activity: ! Are wetlands present within 100 feet of the proposed activity? No /~ Yes Does the project involve excavation or filling? /~ No Yes If Yes, how much material will be excavated? /V/~ (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) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1, APPLICANT / SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) county SEQR 3.PROJECT LOCATION: Municipality 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc - or provide mae DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: thi,a,y 1,72. acres Ultimately I~, 7:~-- acres 8. WiLL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? ~Ye, [~ "0 If "0, describe briefly: X / 9. WHAT iS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) r'---~Residential ~'] Industrial [~ Corn mercial ~--'~Agriculture [~ Park / Forest / Open Space J-]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, AGENCY (Federal, State or Local) ~JYes ]'~No If yes, list agency name and permit / approval: NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes r~No If yes, list name and permit / approval: agency 12. AS ARERE~SUULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE iS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: Signature If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD iN 6 NYCRR, PART 617.47 if yes, coordinate the review process and use {he FULL EAF. r-]Yes ~'~No 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. [~Yes [~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flcoding problems? Explain briefly: C2.Aesthetc a d t', ' ~ , '"' "'i .... ' "~ ........ ' " ' ' : g cu urel, archaeological h~stonc or other natural or cultural resources, or commundy or neighborhood character? Explain briefly C3. Vegetation or fauna, fish, shelltish or wildlife species, significant habitats, or threatened or endangered species? Explain bdefly: C4. A community's existing plans or go;Is ;S ~fficiaily adoptsd, or a change in use or inteasity of use of lan~ (~r 0thor natural resources? Explai'n briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain bdefiy: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain bdefiy: '~''~ '""' ....... C7. Other impacts I nc ud n~ chan~es n use of either quanti~ or t~pe of ene r~¥? Ex plain briefly.' D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA CEA ? IIfyes, explain briefly: r~Yes ~--~ No I E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If)'es ex lain' r~Yes [~]N° I ~ ; I PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstant~a~~~arge~imp~rtant~r~therwisesigni~cant~ 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 exp[anafions contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If 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 actiol WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Reeponsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD (Endowment Required) Sent To [~i~);~.?~'"~-'--'~--~ ........ ;---yy-y--~...~ .............. ~ ~RetumR~lptforMemh~dl~ ~ ~0~ S I°rPO~xN°' ~*~- ~ J~ I I ~COD Y a [~i&;~;~;7~Z'""~;'--=--~-~---r-S-~...J ...................... _- .__., -,, -~- ~ '~ . , .... ~secn, ~d that I have Dated: Sworn to before me this ~.lS/rorday ofJ7-~ 200o'~ ary Public ~-- NOTAIV PUJLIC-ITAT! OF NJW YORK NO. 0'JMC6t 3t 614 Guallr~cl In Suffolk County .My Commlfl~o~, Ixl)ife~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Nartle~ Address: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at '~tf~..4" Mt*Itt R~.~ , being duly sworn, deposes and says that on the · ~ -, 20ttg, deponent mailed a tree copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at (certified) (registered) mail. Sworn to before me this /~7~' Day of/~-~ ,20 O~' , that said Notices were mailed to each of s~...ql persons by PETER R. MC:GI~E'~ NOLAllY pUbLIC.STATE O1~ NEW YORK N~. 02~61~1814 Board of Trustees Application County of Suffolk State of New York 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 I-tIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE 1N 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), 1F GRANTED. IN COMPLETING TI-IlS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS / .~ DAY OF Notary Public No, II11C4,1~11~! 4 an 1,4 08 01:46p PROPERTY i~ELS i663569203 PECONIC PERMIT EXPEDITING , ,,~ ~;~%, Building / DEC / Variance / Marine - ~'~ ~t;~" E-Mail pcconicpc~its(~;,oplonlinmnet Ph 631.734.8361 - Fx 631.734.2276 p.1 January 14, 2008 Board of Town Trustees Town of Southold P.O. Box l 179 Southold, NY 11971-0959 RE: Trustees Authorization Letter To Whom It May Concern, This letter is to authorize employees of"Peconic Permit Expediting Inc." to act as my agent in obtaining a permit from the Board of Town Trustees of the Town of Southold. If you have any questions, please feel free to call me at any time. Respectfully yo~fi, Joanna Lan~ _~Ho~/~ /~'~' APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the anrt of town officem and emolovees. The t~umose of this form is to provide information which can alert the town of tmssible conflicts of interest and allow it to take whatever action is necessar~ to avoid same. (Last name, flint name,~niddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee oftbe Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest'~ roeans 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 lfyou 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 applicanffagent/reprosentative) 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) the owner of greater than 5% of the shams of the corporate stock of the applic0nt (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, parmer, or employee oftbe applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted Signature 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- suooortino 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.norttffork.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# 79_ .- 12. 3q, 4 The Application has been submi~ed to (check appropriate respome): Town Board ~ Piann~g Board ~ Bufld~g Dept. ~ Board of T~stees ~ 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) Nature and extent of action: /,, Permit, approval, license, certification: 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) Nameofapplicant: P~rlnl-9 :~ ~"p~'~/~n (b) Mailingaddress: ]git9 ~'/~fl~n [4/~¢.~] (c) Telephone number: Area Code (). (d) Applicafionnumber if any:. Will the action be directly undertaken, require fimding, 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 []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 Ap~p icable 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. [-~ Ves~ Ne ~. Not Applicable Attach additional sheets if necessary WORKING COAST POLICI~ Policy 10. Protect Southoid'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 Peconie Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes ~-~ No ~J 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 - Policies; Pages 65 through 68 for evaluation criteria. Yes [~ No ~ Not Applicable SURVEY OF PROPERTY 51TUATE: EX~UTHOLO ~ TO}MN .. ~3OUTHOLO ~.,IFFOLI< COUN'r~, N'Y 54JFFOLK C,OUNT'T' TAX # 1000--~0-12-~q.4 (~IRi'IFII~ TO: Jcmm~ l.m~. NOTE'~: MONUMENT FOOND AREA = '-t4,q~,,~ OF OR I.-~2 AC, RE.~ DEED REFERENOE L. 12Oq-/' FEMA FLOOD ZONE LINE A5 ANNOTATED FROM FIRM MAP # DATED MAT' 4, Iqq~ ELEVATION~ t;~EF. OAD JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\\Compaqserver~pms\02~02-120a.pm N69°OO'OO*W. LANE) NOW ON FORHERLy OF DOROTHy FZRGUS ~: EDhIARE) FER®US ®RAPHIC 5GALE I"= .gaO' dAN 1 7 ~53' $ot4hhold Town 8oa~ of Trustees j 7~ O " - ~ ~" LUcy D, BOGOVIc ,¢ ~_ ~ ,' 04 '~,,L, LAND NOw 0~ FO~,ME~,LY OF' g8 ' ~'" 582 O0 ' ' APPROXIMATELY 200 ~ I O FEET OF FENCE TO BE Df=LIT PAIL FOP-. WILDLIFE CORRIDOR AD PEP-, T~UST[E5 ~.EQUEST AT \ \ .--. ~- \LgO^,o SCALE: I =30' ~ NOTE: rNFORMATION FOR SITE PLAN TAKEN FROM SUP-,,VEY BY JOHN EHLERS LAND SURVEYOR DATED: I 2-27-07 LEGEND TG - TOP OF GRATE ELEV. (CATCH BASIN) CL - CENTER LINE OF STREET TC - TOP OF CURB ELEV. 72.5 - EXISTING SPOT ELEV. NST - NEW SEPTIC TANK NLP - NEW LEACHING POOL NDW - NEW DRYW'ELL 72.5-- EXISTING CONTOUR5 W EXISTING WATER BERVICE --G G NEW GAS SERVICE --E E NEW' U.G. ELECTRIC SERVICE NEUJ 8'-0" DIA. 5TOND1 DP-.AIN PROPOSED NEW FENCES ATTHE LANE RESIDENCE SOUTHOLD, NY I SCTM. # 1000 - 70 - 12 - 39.4 REVISIONS DATE; PER TRUSTEED I O-7-O8 OCT - 8 2008 APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE PECONIC PEP. MIT * EXPEDITING 32G45 MAIN ROAD CUTCHOGUE, N.Y. I 1935 PHONE: G3 I .734.&3G I DATE: 1-15-08 DR. BY: R W L SCALE: AS NOTED CHKD: PROJECT NUMBER I I SHEET NUMBER SP- 1 I 0709