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HomeMy WebLinkAboutTR-6931 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghos±o, Jr. Town Hall 53095Route 25 P.O. Box 1179 Southold, New York11971-0959 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 ¼ constructed J Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6931 & 6931C DATE: July 23,2008 ISSUED TO: KEVIN FAGA PROPERTY ADDRESS: 12580 MAIN RD., EAST MARION SCTM#31-14-8.2 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 11 ! 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 Julv 23. 2008 in consideration nf application fee in the sum of $500.00 paid by Kevin Fana and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and following: Wetland Permit and Coastal Erosion Management Permit to renovate and construct additions to the existing single-family dwelling and upgrade with the condition of a 10' non-turf buffer, the addition of gutters and drywells to roof run-off in accordance with Chapter 236-Stormwater Management of the Town and the installation of a line of staked hay bales and silt fence prior to construction activities, and as depicted on the site plan prepared by Jeffrey T. Butler, P.E. last dated October 29, 2008. IN 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, Kevin Faga, residing at 12580 Main Rd, East Marion, NY, 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 fi.om 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 ail such suits initiated by third parties, and the said Permittee 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 cimumstances 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Office of the Clerk of the County of Suffolk as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 23, 2008 Jeffrey T. Butler, P.E. 206 Lincoln St. Riverhead, NY 11901 RE: KEVIN FAGA 12580 MAIN RD., EAST MARION SCTM#3t-14-8.2 Dear Mr. Butler: The Board of Town Trustees took the following action during its regular meeting held on Wed., July 23, 2008 regarding the above matter: WHEREAS, Jeffrey T. Butler, P.E. on behalf of KEVIN FAGA applied to the Southold Town Board of Trustees for permits under the provisions of Chapter 275 of the Southold Town Code the Wetland Ordinance, and Chapter 111 Coastal Erosion Management, applications dated June 25, 2008, and, WHEREAS, said applications were 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 recommended that the proposed applications be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent practical through the imposition of the following Best Management Practice requirements: the Board of Trustees did not find it practical to relocate the existing dwelling 100' from the wetland boundary, however, requires the installation of a 10' non-turf buffer, the addition of gutters and drywells to contain roof run-off in accordance with Chapter 236-Stormwater Management of the Town Code, and the installation of a line of staked hay bales and silt fence prior to construction activities, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said applications on July 23, 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 these applications, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 and Chapter 111 of the Southold Town Code, and, 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 for the mitigating factors and based upon the Best Management Practice requirements imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approves the applications of KEVIN FAGA to renovate and construct additions to the existing single-family dwelling and upgrade the sanitary system, with the condition of a 10' non-turf buffer, the addition of gutters and drywells to contain roof run- off in accordance with Chapter 236-Stormwater Management of the Town Code, and the installation of a line of staked hay bales and silt fence prior to construction activities, and as depicted on the site plan prepared by Jeffrey T. Butler, P.E. last dated October 29, 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: $100.00 Very truly yours, JamE :. King, Board of Trustees JFK:lms 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 COASTAL EROSION MANAGEMENT PERMIT Permit #6931C Date: July 23, 2008 SCTM#31-14-8.2 Name of Applicant/Agent: Jeffrey T. Butler, P.E. Name of Permittee: Kevin Faga Address of Permittee: 12580 Main Rd., East Marion Property Located: 12580 Main Rd., East Marion DESCRIPTION OF ACTIVITY: To renovate and construct additions to the existing single-family dwelling and upgrade the sanitary system. SPECIAL CONDITIONS: The installation of a 10' non-turf buffer, addition of gutters and drywells to contain roof run-off in accordance with Chapter 236-Stormwater Management of the Town Code, and the installation of a line of staked hay bales and silt fence prior to construction activities. The Coastal Erosion Management Permit allows for the activities as indicated on the site plan prepared by Jeffrey T. Butler, P.E. last dated October 29, 2008. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) James . K~ing, Preside~ Board of Trustees JFK:lms James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hal! 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: ~(~Ji?/ 'Fo, c~o~ Please be advised that your application dated f~ ! 2 ~-I0 ~ been reviewed by this Board at the regular meeting of q ! ¢33~0 ~ and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project has Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) ½ 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 ~et 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: $ lot), O0 BY: James F. King, President Board of Trustees JUL-22-2008 18:~0 Sofia Antoniadis 12500 Main Road PO Box413 East Marion, New York 11939 1646-201-3560 P.O02 July 22, 2008 $outhold Board of Town Trustees Town Hell Annex Building 54375 Route 25 P.O. Box t179 Southold, New York 11971 Re: '/2,580 Main Road East Mar/on, New York 11939 SCTM~ 1000-031.14-008.2 Kevin Fage JUL 2 3 2008 Sor. thold Town Bear~ of Trustees Gree§ngs: I am in receipt of the Notice To Adjacent Property Owner and as the owner of 12500 Main Road I have concerns with the renovation and upgrade to the sanitary system. I respectfully request that in my absence of the scheduled hearing on July 23, 2008 at 6:00pm that my concerns be documented and made public. Although I did not have adequate time to review the site plan provided with knowledgeable authorities. I am concemed that the proposed three pools shown close to the proper~y line are too close to my existing ddnking water well. Thank you and should you have any questions please do not hesitate to contact me. TOTAL P.O02 JUL-22-2008 18:40 P.O01 1990 Coney Island Avenue Brooklyn, New York 11223 (718) 998-8437 (718) 627-3585 fax 1~ Town Tmslees From: Sofia Antoniadis Fax: 631-765-6641 ~ 2 elmae~ 631-765-1892 Oaf~e: 7/22/2008 Re: Kevin Faga 1000-031-14-008.2 CC: ~ Usgen~ i-I For Re,view rl Please Comment C] Ple~e ReSdy I-1 Please Rec,~le Kindly include the attached letter in regards to the headng scheduled for July 23, 2008 at 6:00pm: Kevin Faga 12580 Main Road East Ua~n, New York 11939 1000A)31-14-008.2 Thanking you inadvance for your assistance. ~O0/ZO0~ ~N¥8 3~¥~$ [SS[J ~ZSg ~8 ~08 XWJ 8~:80 800~/~/LO I:IR II'I; IMNK Kay Largo Bt. erich 97670 Overseas Highway Key Largo, Florida 33037 Phone: 305-$52-2070 Fax: ~05-852-~922 www.kcysba~zk, com Company Fgom $OUTHOLD TOWN HALL AMELIA HuKTr A~d. om Date BOARD OF TKUSTEF, S 07/22/2008 631-765-6641 2 __ Urgent __ For Review KEF: KEV1N FAGA SCTM 1000-031-14-008.2 ..-- please Comment __ Please Reply dUL 2 ~~ gOO/LO0~ ~N¥8 31¥1~ ISSIJ ~8~ g~8 §0~ XYJ 8g:60 800~/gg/ZO 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., July 16, 2008, the following recommendation was made: Moved by Don Wilder, seconded by James Eckert, it was RESOLVED to SUPPORT the Wetland Permit application of KEVlN FAGA to renovate and construct additions to the existing single-family dwelling, and upgrade the sanitary system. Located: 12580 Main Rd., East Marion. SCTM#31-14-8.2 Inspected by: Don Wilder The CAC Supports the application with the Condition the proposed addition is relocated away from the water as far as possible, and drywells and gutters are installed to contain roof run-off. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: '"7~ I~-D ~ K£¥1N FAGA requests a Wetland Per'nit to renovate and construct additions to the existing single-family dwelling, and upgrade the sanitary system. Located: 12580 Main Rd., East Marion. SCTM#31-14-8.2 Type 9f area to be impacted: ~fl'twaterWetland Freshwater Wetland Sound ~ Distance of proposed work to edge of wetland .~cOf Town Cc~Je/l~'oposed work falls under: hapt.275 ~/Chapt. 111 other Type of Application: _~Wetland b~Coastal Erosion __Amendment ~Administrative__Eddergency Pre-Submission Violation Info needed: Modifications: Conditions: Present.,Were:/~/.'.~ing ~oherty L/~..Dickerson ~/O. Dzen~z"~wski Mark Terr~ ~<rt~er.~¢~. - Form filled out in the field by J..~. Berge n~&~B.G hosio, Mailed/Faxed to: Date: Environmental Technician Review- OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Jim King, President Town of Southold Board of Trustees From: Scott Hilary, LWRP Coordinator Date: July 16, 2008 Re: Proposed Permit to Wetland Permit for KEVIN FAGA SCTM#31 - 14-8.2 Jeffrey T. Butler, P.E. on behalf of KEVIN FAGA requests a Wetland Permit and Coastal Erosion Permit to renovate and construct additions to the existing single-family dwelling, and upgrade the sanitary system. Located: 12580 Main Rd., East Marion. SCTM#31 - 14-8.2 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 INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southoid ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the SouthoM Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction I. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The distance from the bulkhead to the proposed action is approximately 24 feet; a minimum setback distance of 100 feet from the wetland boundary {bulkhead) is required pursuant to Chapter 275-3. Findings; purpose; iurisdiction; setbacks. Please require that the applicant amend the application to meet the above policy to the ~,reatest extent oracticable. Further the proposed action may require a variance from the Zoning Board of Appeals pursuant to § 280-116. § 280-116. Building setback requirements adjacent to water bodies and wetlands. B. All buildings or structures located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than 75feet from the bulkhead. § 268-5. Review of actions. F. Upon recommendation of L WRP Coordinator, the designated agency shall consider whether the proposed action is consistent with the L WRP policy standards summarized in 3~ 268-1 herein. Prior to making its determination of consistency, the designated agency shall consider the consistency recommendation of the £ WRP Coordinator. The agency shall render a written determination of consistency based on the CAF, the L WRP Coordinator recommendation and such other information as is deemed necessary to its determination. No approval or decision shall be rendered for an action in the coastal area without a determination of consistency. The designated agency will make the final determination of consistency. The Zoning Board of Appeals is the designated ageno, for the determination of consistencF for variance applications subiect to this chapter. The Zoning Board of Appeais shall consider the written consistencF recommendation of the L WRP Coordinator in the event and at the time it mahes a decision to grant such a variance and shall impose appropriate conditions on the variance to make the aetivitF consistent with the objectives of this chapter. If the action is approved the following best management practice (BMP) is recommended: 1. Require a minimum 10' non-turf, permeable buffer landward of the bulkhead. The BMP will further Policy 5, Protect and improve water quality in the Town of Southold and 6.3 Protect and restores tidal and freshwater wetlands 6.3 Protect and restore tidal and freshwater wetlands. D. Provide adequale buffers between wetlands and adjacent or nearby uses and activities in order to ensure protection of the wetland's ~, values, Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Office Use Only ~Coastal Erosion Permit Application ~..,4(/elland Permit Application Administrative Permit A mcndment/Trans f~r/F.,xtension ~'- -~Recci'~dApplication: ~0~ ~. ~ecelvcd Fcc:$ ~ ' ~,npleted Application ¢~O~ ~ Incomplete SEQRA Classification: Type I Type I1 Unlisted Coordination:(date senl)__ ~AC Refc,-ral Sent: Receipt of CAC Report: Lead Agency Determination: Technical Review: Resolution: Namc ot'Applicant 2008 Address "(~'<,,A. ..... Sufl'olk County Tax Map Number: Property Location: (provide IJI.CO Pole #, distance to cross streets, and location) (1 f applicable) Board of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: ¢ -t-tO Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspende~y a governmental agency? I,/No Yes If yes, provide explanation: Project Description (use attachments ir necessary): Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 7'0 Area of wetlands on lot: O square feet Percent coverage of lot: O % Closest distance between nearest existing structure and upland edge of wetlands: ~ '~. feet Closest distance between nearest proposed structure and upland edge of wetlands:. /~ ~ feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated?,20~:~ubic yards How much material will be filled? O cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: feet 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): Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes ofproposedactivity: ~ ,~')."~{ J/~O0)~ Are wetlands present within 100 feet of the proposed activity? No ~ Yes Does the project involve excavation or filling? No If Yes, how much material will be excavated?~/,~(:~, bic yards) I How much material will be filled? O (cubic yards) Manner in which material will be removed or deposited:~a~_~ Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Ir. 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 In the Matter of the Application of ...... ............................... COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFiDAVIT OF POSTING I, ]~,~-.///~/4( ~dY'-~-f~_,residing at ~)~ being duly sworn, depose Md s~y: Tha?n the 2~d-~day of :J'cd ¥ ,200~, I personally posted the property known as by piecing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held [l~r2d...-~Ll.l_J r,).~, oO00~" . Dated: (signature) Sworn to before me this day of ,.Tv~, 2008 Notary Public GINA A. LOCKE No. 01 LO6057960 Notary Public, State of New York Qaalified in Suffolk County My Commission Expires 04/30/201'/ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name/Address/SCTM: William Hukill 1770 Stars Road East Marion, NY 11939 SCTM# 1000-031-14-8.1 Maria Xefos P.O. Box 413 East Marion, NY 11939 SCTM# 1000-031-14-7 William Clayton 12832 Route 25 Ea~Marion, NY l1939 SCTM# 1000-031-14-15 STATE OF NEW YORK COUNTY OF SUFFOLK Melissa C. Butler, residing at 206 Lincoln Street, Riverhead, NY 11901, being duly sworn, deposes and says that on the 30t~ day of June, 2008, deponent mailed a tree copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons; that the addresses 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 Shoreham, NY, that said Notices were mailed to each of said persons by certified return receipt mail. Sworn to before me this Day of ~, y ,2008 Notary Public GINA A. LOOKE No 01 LO6057960 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) (pfini owner o~'prt(Perty) residing at /~/29 0_)q/3£$ iS/. (mailing address) do hereby authorize (Agent) to apply for permit(s) from the SouSes on my ~ signature) behalf. Board of Trustees Application County of Suffolk State of New York DEPOSES AND AFFII~MS 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. 1N 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 REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS ~ ~, _ DAY OF _ ,20oF' APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics vrohibits conflicts of interest on the Dart of town officers and emvlovecs. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessaw to avoid same. (Last name, ~ir.qt name, middle 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 ,Crom plat or official map Planning Other (If"Other", name tim 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 has even a partial ownership of (or employ~nent by) a corporation in which the town officer or employee owns more than 5% of~.~hares. YES NO 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 thc relationship between yourself (the applicantJagentIrepresentative) and the town officer or employee. Either check thc 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 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 RELATIONSHIP Form TS I Submitted n~u{. ~'~ day of' ~ 200 Signature Print~ame ,~'g~--~-~--~-~ f'_ ~.~ "~ ~ Butler Engineering Architectural and Engineering Services 206 Lincoln Street Riverhead, NY 11901 Tel: (631) 208-8850 Fax: (631) 727-8033 LETTER OF TRANSMITTAL DATE: 6/23/08 PROJECT NO.: TO: Lauren Standish Town of Southold Trustees FROM: JeffreyT. Butler RE: FagaApplication WE ARE SENDING YOU: [] Attached [] Under Separate Cover Via The following items: [] Prints [] Sample [] Specifications [] Plans [] Document [] Shop Drawings [] Letter [] Change Order COPIES DATE NO, DESCRIPTION 3 Copies of site plan 3 Applications 1 Check for $250.00 ~,.,,, 5 2308 [~ THESE ARE TRANSMI'I-FED AS CHECKED BELOW: ~. ~0~r.¢ of ~rus e~,s [] For your use [] Resubmit__ copies [] Subn'~ osp~ ,u~ ui~i. flbutlon [] As requested [] For signature [] Return __ corrected prints [] For review and comment [] For bids due__ [] Returned for corrections [] Prints returned after loan to us REMARKS: Lauren, Please review application packet and call with any questions. Thank you, Jeff Butler COPY TO SIGNED ~ ,r cnc,osurcs arc not as noted, kind,y noti~as aet ~cy T. Butler LWRI CONSIS FENCY ASSESSMEN I FORM , INSTt,ll I(!TIONS All apl>lie:mis lbr permits* including Town of Southold agencies, shall complete Ihis Imqmscd ~ctions that arc sulk]eot to the Town ol'Soulhold Waterfi'ont Consislency il~qst;sslnclll is inlcndcd to supplement other infommtion asecl by a Tovw~ miflqing a determination o[' consistency. *~k'Cel)l minor exempt I lcfi~rc ;mswcring thc questions in Section C, the preparer of this lbrm should minCer m.:lion list, policies and explanations ofcach policy contained in the Town Witlc~lionl I.}cvilaliTalion Progranl. A~proposed action will bo ewllualcd as bcnclk:ial filial adverse efl'ects upon the coastal area (which ~.l_q(!os I1' mty question in Section C co this l'orm is answered "yes" or "no", then thc ;tl'llzcl thc achievement of the LWR? policy standards and conditions contained review law. Thus~ each answer nmst be explained in detail~ listinI2, both SUplmrtinl4 fi~cts. I1' an action cannot be certified as consistent with the LWI,~P policy c{mditions, il shall not be undertaken. A ~_:~q)y o1' thc I.WRI' is availahlc io the following places: online at Ihe Town ul' ~;oulh~fld wchsilc (stmlho/dlown.norlhl'(n'k.net), the Board of Trustees Office, the Planning I)cp;H Inh'nl Il>cai libraries and the Town Clerk's off'ice. PlqS( :I~IlI'TII)N ()Ii' SITE AND PROI+'OSED ACTION J i~,_, Applicalion has I'mcn submitted to (check appropriate response): i,~,~, ~;,,:,,',l [ii~] I'lan,,ingBoa,-d~ Buildingl)ept. [] Board ol' Trustees ( ';}lcgory el'Town ol:Southold agency action (check appropriate response): Action undertaken directly by Town agency (e.g. capital conslruction, plmming activity, agency regulation, land transaction) I"inmlcial assistance (e.g. grant, loan, subsidy) Pcrmil, appl'owfl, license, certification: 9 II un Ul~plicaliun Ibc the proposed actbn has been flied with the Town of S¢t thc Id agency,, thc ]nlb~nlution shall be provided: lb) Maili~lgaddrcss: ~ ~_~ '~'~ id) Al)lflicalbn number, il:any: Wilt thc adion be directly undertaken, require lh~ding, or approval by a stale or l~dcral agone} ? N,,ITI If yes, which state or lkderal agency? ~' iq'ahmic ihe project to thc following policies by analyzing how tl~c project will further support md snppol'| lhe policies. I'rovide all proposed Best Management Practices that will ftn'lhc4' each h,tuinpkle answers will require that the form be returned for completion. Pi, :v'FL¢ilq,',l) (~OAST POLICY Ih}slot a pattern of development in the Towu of Southohl thai cnhauees cnllllllnuity dlflF;~d~'? , open si)acc, makes cflicieut use of iufrastructure, makes beneficial usc of a coaslal I.calioa, ;:,k ud,imizes adverse effects of development. See LWRP Section III - I'olieies; Page 2 for cv:duati~at Iii N. :] Not Applicable caicy 2. Protect and preserve historic and archaeological resources of the Town of i ',V R p Ncc tion I I I - Policies Pages 3 through 6 for evaluation criteria Enhance visual quail .ty and protect sccoic resources throughout ~l~c Town of Somh~ hi. :.;c~, ,qcclion III Policies Pages 6 through 7 for evaluation criteria ~':~'cs Iii No [~ NotApl)licablc i i, Ii :lddi/i{m:d :dlccls ii ncccssm'y COAST I'OLICIES ¥ 4. Mimmizc loss of life, structures, aud natural resources from flooding and erosion. ;:,cc ~.,~ :~.ibm Ill - Policies Pages 8 through 16 for evaluation criteria ,' Vcs No Not Applicable J ;ii[I ;Mdilmnal shouts il IIcccs~qal'y ~'~licy 5. Protect and iml)rove water quality and supply in the Town of Southold. See i,WRP Scdhm ;[,~ i'~>]hScs Pages 16 Ihrongh 2 [ fin' evaluatioo criteria .[;d[ addilio[ml ~;ht ds if ncccssmy ~'~ik'y 6. I'rolcct and restore thc quality and function of the Town of Southohl ccosyslcms c [i~i~ qig~J~'icanl ¢ 'oastal Fish and Wihllife itabitats and wethmds. See LWRP Section II I - Politics; Pages ~'~,gh 32 for c¥;Ihmlion criteria. ;'c'; No dicable and iml)rnve air quality in the Town ol S{ nth >hi. Ncc [.Will' Set'lion 34 fro' cvalnation criteria. [~] Not Apl, hcablc !g,iic~' ~. Nlilmnizc environmental degradation in Town of Southold from solid waste ami ha:~ac,%as s~,:~:mccs and waslcs. Sec LWRP Section 111 - Policies; Pages 34 through 38 for evalualim~ crime %. I R:s E I N,,[~,tAl,l, licablc ]qqil,]{'(;()ANT ) " ~ ~ I ()Li(/IcS . ,.%y I'rovidc for i)nblic access to, and recreational rise of, coastal waters, phi)lie lands, i'c,;~t~r.ci:s of ~l~e Town of Soulhold. See LWRP Section I11 - Policies; Pages 38 thrnugh 46 for i Yc~ ]l No[~otApl, licable / ,~,. h i,,Iditit>lli~} shccis it ncccssaly l'rntccl Suulhohl's water-dependent uses and I)romotc siting of new watcr-dcpcmlcnt ~s~':': h~cathms. S{~c I,WRP Section I!i- Policies; Pages 47 through 56 for ewtluatiolt crilcria. h'omolc sustainable use of living ]narine resources in Long isJaml Souml, Ibc Town w~tlers. Sec LWRI Section Ill - Policies; Pages 57 through 62 I~}r cvalu:tli~m ~:~'~:[: ~. J~i,Ji~)i¥ i.~. J)I'UUIUtC apprul)riate use and development of energy and mineral resources. ~';~,iim~ ~ti - Politics; Pages 65 through ~8 for evaluation criteria. J JY,s I~:}] N,, ~t Applicable h'olccl agricultural lamls in the Town of Southohl. See LWRP Section III for cvalualion crileria. Nu [~0t Apl, licaJ, Je LAUNDRI~ ROOH DATHROOh'i KITCHEN DINING ROOh4 6L~ LIVING ROOM DEDROONi (2)2650 g~9'10 (2)2650 LAV 0 C, LOSRT AP. EA DEHINP KNEE HALL A~EA BRHIN~ KNEE HALL ~ A~EA ~EHtN~ KNEE HALL LINE SITE ~ .......... ~ ~o~ ~,. ~o ~,~ *~,.=) '~ ~'~' I~~ ~ ~X X, X "~*~f~ . ' ' ' ~ ~EP *25.00 ~.PT. *25.00 ~.PT. UT[LIT~ POLE ~ ' "' , '" TOTAL [IVIN¢ ARE~, ~,OO SO.FT. I¢5S.82 ~.PT. 2~¢.00 ~.FT. 5~.12 ~.FT./NOT TO "XISTI~ ~ILOI~ COVB~eE, ADDREVIATION5~AN l~4~2 ~.FT (~XI~TI~) + ~0,~2 ~.~T, ~P~D) = 2~,~ ~,PT, (TOTAU ~DE AC --- ~OVE CROUND NTD --- NOT TO ~ALE TOHN O~ ~ ,~ ~LINE OF P~PO~P t 126~2 HAIN ROAP ~_ ~ ~ JN ~ BALD5 AND GILT ~ ,~, ....... EADT MARION, NY ~'~ ~ /V=" ~ /~u~ , ~ 15' RI~T ¢ ~ 5~P5 W ~ILI~ ~ ~ ~ CALL US TOLL FREE 1~06~2-7962 ,. % ~; ~ ~ ' ~ /~ / ~ ~LOT 8I) , , )~ ~ less$~kvo'wo~ngdaysnotlm butnot q J , .. ~ I ~ ~ ~ ~ *~,. ~ .... .L.. % *Xa~ ""'"'" =~ '~~:~% V//~%~ X ' ¢ , RESIDENTIAL DISTRICT '~;~ ' ~ ~1 HOLE '":.~ ~'~ "".'"'. ~ ~ ~';~ y / / ~ ~ ~ _ ', MNMUM ~LOWED: 40,000 SQ.~. I '~ ~ ~ '~.. ~ "'...'".. %~ ~'~ ~/ / / ~ ~ ~'~ m '~ PROVIDED: ~17532.5S SO.~. , bX ~ ' /'..~. ~ISTI~PH~T ..... ~~~,S~/~O~g~ . ~.~ ~ ' MNIMUM ~LOWED 1~0' I/ ~ ~ ~ ~ / 'J ~~%n~,~ / ~ PO~H ~ ~ ~ ~ M N MUM mo~ S~K: , // ~ .... ~%~ % ~, TO ~E ~MO~m N N~ · ~ ~ ~ ~ os~v ~ r PROVIDED. 9 3 / ~ X ~ A~PlTION XC ~ ~ 5 . ,N ,,.. t, N = , , I- ~ e2~' % %~ ~ ~' ~'"" ~/ J ~ ~ / / /A~/ ,¢ ~ ~ PROVIDED. 65-6 8 _ , %, =., (/ ~% ; ~'~~ ~~ ~ ~ MINIMUM REQUIRED: 850 ~ ~5.0' %%X%%/,%%%~q~ r' '. % : ~ ~~ / / ~ ~ ~ / EXI~ING: 1ST:. 1 088.62 * XX ~Xt ~ X .' ~/ ~ ~~/ / / A/ ~ / ~ PROPOSED' ~ST: 288 SQ. zI kx N' ~ ~ %...: ~ ~ ~'~t ~V / / /N~ ~ ~ ' 2ND: 55g.~1 r ~ / d ~: ~ ~ ~x I ~ ' ........ ~L, II.~') ~~ V / / ~ ~ ~ ' EXI~ING: 7.26~ ~' ~ ~ . ~ACO ~ ~ ......... N~2"55,o~,..- ~ ~ '¢~" i ' ~ ~ ~ . ' .I ¢~ ~ ~ / / / ~ ' t PROPOSED: 28-0 EXISTI~ 5TOO ~ ~ ' -- __ t -- ~ EXISTINe'~ ~DE FENCE ~ ~ ~ CONC~ NUMBER OF ~ORIES.' _ J M~. ALLOWED. 2.5 J~ ~ ~ EXI~ING 2.0 '" ' ' '