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HomeMy WebLinkAboutTR-7062 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. T~wn Hall 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 May20,2009 Mr. Robed Lehnea Peconic Permit Expediting 32645 Main Rd. Cutchogue, NY 11935 RE: MADELINE DROEGE 885 PETTY'S DR., ORIENT SCTM#14-2'24 Dear Mr. Lehnert: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., May 20, 2009: RESOLVED, that the Southold Town Board of Trustees APPROVES the Amendment to Permit #7062 to include the existing 5'X 7' frame sauna, as depicted on the site plan prepared by Peconic Permit Expediting dated March 12, 2009. This is not a determination from any other agency. .Since~.,~ (:~~' Jame~' F. King, Presid~'t 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 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 ~ constructed ~" Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOuTHOLD, NEW YORK PERMIT NO. 7062 DATE: April 22~ 2009 ISSUED TO: MADELINE DROEGE PROPERTY ADDRESS: 885 PETTY'S DR.~ ORIENT scTM#14-2-24 AUTHORIZATION Pursuant 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 April 22, 2009 in consideration of application fee in the sum of $250.00 paid by Madeline Droeee and subject to thc Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and the following: Wetland Permit to cgnstruct exterior stairs from the second floor deck to grade, and as depicted on the plan Prepared by Robert Lehnert dated March 12, 2009. 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, Madeline Droege, residing at 885 Pctty's Dr., Orient, NY, as part of the consideration for the issuance of the Permit does understaiid find 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 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 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 here. in 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 Pennittee 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 Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 Apd122,2009 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. RobeR Lehne~ Peconic Permit Expediting 32645 Main Rd. Cutchogue, NY 11935 RE: MADELINE DROEGE 885 PETTY'S DR., ORIENT SCTM#14-2-24 Dear Mr. Lehnert: The Board of Town Trustees took the following action during its regular meeting held on Wed., April 22, 2009 regarding the above matter: WHEREAS, Peconic Permit Expediting on behalf of MADELINE DROEGE 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 March 13, 2009, 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, in accordance with Chapter 268, said application was found to be Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on April 22, 2009, at which time ail 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 .w I not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of MADELINE DROEGE to construct exterior stairs from the second floor deck to grade, and as depicted on the plan prepared by Robert Lehnert dated March 12, 2009. 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, President, Board of Trustees JFK/Ims APR-21-2~9 09:01 FROM:GREG~ADOURIAN 16317656641 P.1/2 To: Board of Trustees Of the Town of Southold Re: Meeting on Wed. April 22nd for: Madeline Droege 885 Petty's Drive and proposal to construct stairs from second floor deck to grade SCTM# 1000-14-2-24 From: Kamen Dadourian Fax: 516.627.0072 APR-21-20Bg ~:01 FROM: GREG~OADOURIAN ~:16~1765~641 P.2x2 Kannen Dadourian 5 Ridge Circle Manhasset, NY 11030 516.627.0450 April 21, 2009 Board of Trustees Of the Town of Southold Madeline Droege at 885 Petty's Drive and proposal to consl~ct stal~s from second floor deck to grade SCTM# 1000-14-2-24 Dear Board Members: I am the owner of the property directly adjacent (west) to Mrs. Droege's at695 Petty's Drive. I unfortunately can not attend your review meeting but would like to comment regarding Mrs. Droege's proposal to construct exterior stairs from her second floor deck to grade. Firstly, I would like to understand why Mrs. Droege intends to build these stairs. If they are for her personal use, then I am not opposed to it. However, Mrs. Droege has also applied for a varience to establish an Accessory Bed and Breakfast in her residence. The Bed and Breakfast will be used by for up to 10 casual and transient roomers. If thc stairs are being constructed to access this Bcd and Breakfast, then I am strongly opposcd to it. I am currently in the process of building a single family house on my property. My husband and I have three very young children and are looking forward to enjoying this new house with our children. Thc thought of having transient roomers next door to us while our children freely play in our backyard is unsettling. I purchased this property because it is in a well established, peaceful community with single family homes. Having a bed and breakfast with transient visitors directly next door to us violates our sense of security and peacefulness. Thank you in advance for your attention to this matter. I hope you will take my concerns into consideration while voting on this proposal. Since~ly, This map wos prepared by the New York State Department of ~*n.~rnnm..t.I ~nns.rvation It wos financed. In oart. throuah a arant LEGEND Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (63 I) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 15, 2009, the following recommendation was made: Moved by Peter Young, seconded by Don Wilder, it was RESOVLED to SUPPORT the Wetland Permit application of MADELINE DROEGE to construct exterior stairs from the second floor deck to grade. Located: 885 Petty's Dr., Orient. SCTM#14-2-24 Inspected by: Peter Young, Don Wilder The CAC Supports the application with the Condition the existing gravel non-turf buffer is continued across the top of the bluff, set back from the grass line, non-treated lumber is used, and drywells are installed to contain the pool backwash and the 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: MADELINE DROEGE requests a Wetland Permit to construct exterior stairs from the second floor deck to grade. Located: 885 Petty's Dr., Orient. SCTM#14-2-24 Ce of area to be impacted: altwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland _c rt of Town Code proposed work falls under: hapt.275 Chapt. 11.1/, other Type of Application: ~etland __Coastal Erosion __Administrative__Emergency Pre-Submission __ __Amendment Violation Info needed: Modifications: Conditions: Present Were: __&King __J.Doherty __P.Dickerson __ __ D. Dzenkowski MarkTerry other Form filled out in the field by ~fC,_~z~' Mailed/Faxed to: Date: D. Bergen~B.Ghosio, Environmental Technician Review- 013 - l',! - James F. K/ng, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 PVO. Box 1179 Southnld, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coa~Permit Applicatio~ __/W~f~d-'~P~ .rr~ifft)Application ~ Administrative Permit / AmendmentfVxfans fer/Extension ..-42ompleted Application Incomplete SEQILA Classification: Type I Type H Unlisted__ Coordination:(date sent) __LWRP Consistency Assessment Form CAC Referral Sent: ~.-'Date o f Inspection: .q-] .Receipt of CAC Repor[: ' __Lead Agency Determination: Technical Review: ~---~lfublic Hearing Held:~ Resolution: APR 2 S 2009 NameofApplicant /~e~rl C 0£0~'~-~ Address o°g%9 25- pc/~rz,¢ ~£,v¢/ Phone Number:( Suffolk County Tax Map Number: 1000- /~ Property Location: ~ff~ (provide LILCO Pole #. distance to cross streets, and location) (If applicable) ~ard of Trustees ApplicatJ GENERAL DATA Land Area (in square feet): Area Zoning: /~- ~t~ Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes ~ No Prior permits/approvals for site improvements: Agency Date ,,~ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): ~- eg4a !1 ~' ~, 1 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Youngs Ave. Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 Jim King, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Scott A. Hilary, LWRP Coordinator Date: April 14, 2009 Chapter 268, WATERFRONT CONSISTENCY REVIEW Wetland Permit for MADELINE DROEGE SCTM# 14-2-24 Peconic Permit Expediting on behalf of MADELINE DROEGE requests a Wetland Permit to construct exterior stairs from the second floor deck to grade. Located: 885 Petty's Dr., Orient. SCTM#14-2-24 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 us, it is our recommendation that the proposed action is EXEMPT pursuant to § 268-3. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen 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 Use Only Coastal Erosion Permit Application Wetland Permit Application __ Adminisa-ative Permit Amendment/Transfer/Extension ece~ved Application: ~//~ eceived Fe¢:$C-~5'0~ -- ~mpleted Application __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordmation:(date sent)_ ~'L"WRP Consistency Assessment Form ~AC Referral Sent: q [ ~E)ate of Inspection: ql Receipt of CAC Report! Lead Agency Determination: Technical Review: ..l}ablic Hearing Held: Resolution: Name of Applicant Address Phone Number:( ) Suffolk County Tax Map Number: 1000- ]4 - 2 ' 24 PropertyLocation: ~c~.fi-- f~/3_6 Pfl~r~' / ~fle~>.., ~Z (provide L1LCO Pole #, distance to cross streets, and location) (If applicable) Address: .,~.~ p" ~ ~" of Trustees Applicat! Land Area (in square feet): Area Zoning: /'~- {It~ Previous use of property: Intended use of property: GENERAL DATA Covenants and Restrictions: Yes /~ No If "Yes", please provide copy. Prior permits/approvals for site improvements: ~A, gency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): -f/aa," of Trustees Applicatl WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: R(~$/~ er~ ~:~ Area of wetlands on lot: /V//~' square feet Percent coverage of lot: / o/, 7 % Closest distance between nearest existing structure and upland edge of wetlands: ~[2; ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ,9'-gJ 5'" feet Does the project involve excavation or filling? /~ No Yes If yes, how much mater/al will be excavated? A//_~r. cubic yards How much material will be filled? /[//~ cubic yards Depth of which material will be removed or deposited: /~///~ feet Proposed slope throughout the area of operations: /I//~ Manner in which material will be removed or deposited: /[//t~' 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): of Trustees Applicat] COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 1 O0 feet of the proposed activity? (cubic yards) (cubic yards) No /~' Yes Does the project involve excavation or filling? ~ No Yes If Yes, how much material will be excavated? ~/,~t How much material will be filled? ~/t~ Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting fi.om 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, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of MADELINE DROEGE COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I,/~Ol'er''vL ~Atr'//~,residingat ~.~ff'~:b~ ~/~ta/rt being duly sworn, depose and say: That on the/~ day of~t'// ,200~, I personally posted the property known as by placing the Board of Trustees official poster ~here 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 Wed.~ April 22~ 2009 on or about 6:00 PM. Dated: q,/¢ O~t~ Sworn to before me this day off2)/,.~ 200 ? Nota~yPublic -- _.~ atu~) ~J NO~IY P~I~K~4TA~ OF NEW YORK ~llf~ ~ ~ County .~ Com~ ~m ~t ~, ~ Board of Trustees Application County of Suffolk State of New York II~ l'~," J''' Z.~ ~ rl cr ~ BE1NG 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 IIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN TI-IlS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONIUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS / / 77/ DAY OF /~;=;,~e-4t' ,20 D ~' NO. Og~M~61 $$614 PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME SEQR PART 1 - PROJECT INFORMATION ri. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality t~f l¢,'3 7~ 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [] New J~ExpansJon [] Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT F LAND AFFECTED: nitia,,y acres Ultimata y acr* 8. WiLL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes [] No If no, describe briefly; 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~[Residential E~lndustrial E~commercial ~'~Agriculture E~ Park / Forest / Open Space [~]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) ~Yes E~No If yes. list agency name and permit/approval: .~'~,..~]X~'~ .~/././/d/.q~ ~ti~'~' 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes ]~rNo If yes. list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED Applicant/ Spons~or~31;ne fJ~¢"~-~/'~ ~ If th* action i~ a ¢o~tal ~ma, and you ar~ a ~tat~ a~oney, complete tho Coastal ~*~8~m*nt Form boforo ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Date: 3"/2 PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥/ A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF. r~l Yes [~]No B. WILLACTIONRECEIVECOORDINATEDREVIEWAS PROVIDEDFORUNLISTEDACTIONSIN6 NYCRR, PART617.67 IfNo, anegative declaration may be superseded by another involved agency. 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, potenfial for erosion, drainage or flooding problems? Explain briefly: / C2. ~,esthefic, agricufi'uml,'~:llaeologica~l~ ~istedc, or o~h~; natural or cultural resourcas; oi c0nl~lunlty or nel'~h~)rhood chamctsr? Explain bflefly: C3. Vegetation or fauna, fish, shellfish or wiJdffie species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's e×isting plan* or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? ~xplain briefly: C5. Growth, subsequent development, or mlatsd activities ~ikely to be induced by the proposed action? Explain briefly: C6. Long term, sho~ tee'n, cumulative, or other offect~ not identified in Ct-CS? Explain briefly: Other~m acts moludm chart osmuseofeitherquanti or peofener 9 Ex Isinbriefl · D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? Ill }'es, explain briefl}': I--lYes r--INoi E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if ~'es explain: r-t yes r-q.o I PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. 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. If question d of part ii was checked yes, the d etarmination of significan ce 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 potenfially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any suppo[ting documentation, that the proposed actio~ WILL NOT result in any significant adverse env[ronmentsl impacts AND provide, on attachments as necessary, the masons supporting determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 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- suooortim, 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 scm# 14 . PROJECT NAME The Application has been submitted to (check appropriate response): Town Board [] Planning Board [] Building Dept. [~ Board of Trustees [] 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 Iransaction) Co) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent ofacfion: ~ a _ f Location of action: Site acreage: Present land use: Present zoning classification: /v~_ ~t 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: /~t~ ~v/~ fit rt (b) Mailing address: J?~, ,~)(. (c) Telephone number: Area Code (). (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 ali 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 IH - 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 A p~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. 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 HI - Policies; Pages 38 through 46 for evaluation criteria. ~-~ Yes~ No [] Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES 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 - Policies; Pages 65 through 68 for evaluation criteria. Yes [] No [] Not Applicable APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the hart of town 6fficere and emnlovees. The nuroose of this form is to nrovidc information which can alert thc town of oossible conflicts of interest and allow it to take whatever action is necossarv to avoid s~'ne. (Lost name. first name, ~niddle initial, unless you are 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.) 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 (lf"Othef', 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 parmership, 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 ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/ngent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. Thc 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% oftha shares of the corporate stock of the applicant (when the applicant is a corporation); __.B) the legal or beneficial ownqr of any interest in a non-corporete entity (whet~ the applicant is not a corporation); C) an officer, director, par~er, or employee oftbe applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submltted this J~_.,~.day of Signature ~'~'~ Print Name ~[~.~'f]'~ FI=CONIC ?E MIT EXFEDITING ~ulldm~j / DFC / V~lrl~ll¢~ / N~rIFl~ 32645 Main Road · Cutchogue, NY 11935 E-Mail peconicpermits~,optonline.net Ph 631.734.8361 · Fx 631.734.2276 February 9, 2009 Board of Town Trustees Town of Southold P.O. Box 1179 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 permits 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 yours, Respectfully yours, Madeline Droage - Homeowner · ' ' NOTICE Police Dept. - Bay Constable Town of Southold Peconic, New York 11958 NOTICE' OF VIOLATION Date: July 31, 2001 Madeline Droege Address: (Owner or authorized agent of owner) 279 Church St., New York, N.Y. 10013 (Address of owner or authorized agent of owner) Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article II, Section 97-20 a premises hereinafter described in that you have erected a sauna and jacuzzi within 100 Feet of a wetland without first obtaining a Trustee Permit. You are therefore directed and ordered to comply with the following: Cease al 1 further activityuwithin 100 feet of wetlands. Apply for a Southold Town Trustee Permit. If permit is denied sauna and jacuzzi are to be removed. on or before the 17 dayof August ,20 01 . The premises to which this Notice of Violation refers are situated at: 885 Pettys Drive, Orient, N.Y. 11957 Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000 Section: 14 Block: 2 Lot: 24 ) Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both: NOTICE: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. Ba~ Constable, Tor~ o NOTICE Police Dept. - Bay Constable Town of Southold Peconic, New York 11958 NOTICE' OF VIOLATIQN Madeline Droege Date: August 28, 2001 Address: Owner or authorized agent of owner) P0B 695 Cana] Street Station, New York, N.Y. 10013 (Address of owner or authorized agent of owner) Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article II, Section 97-20 a premises hereinafter described in that you have erected a sauna and jacuzzi within 100 feet of wetland without first obtaining a Trustee Permit. You are therefore directed and ordered to comp~ with the following: Cease all further activity within t~00 feet of wetlands. Apply for a Southold Town Trustee Permit. If permit is denied sauna and jacuzzi are to be removed. on or before the 21 .day of September, 20 0! The premisesto which this Notice of Violation refers are situated at: 885 Pettys Drive, Orient, N.Y. 11957 Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000 Section: I4 Block: 2 Lot: 2~ .) Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both: NOTICE: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. Ba~ Constable, Jbwn of Sout~old, NY ~~ · ~o~ ~O INCIDENT R~PORT 7. Red, Day 6Oate g Red, Time O~ro~J . lO:~O ~'1 13. Day 14. Date 1S. Ti~e 2 2a. NO. Of Su~ 0 ~ S6 Scar~ M ar ks ~a~oos (De~ri~) 57. Mist ~ ~ 65 Veh. Yr. 66. Make 67 Model 68 Style DCJS-3205 (2/971 *FALSE STATEMENTS ARE PUNISHABLE AS A CRIME, PURSUANT TO THE NEW YORK STATE PENAL LAW. 7/31/01 7/31/01 7/31/01 7/31/0 l 7/31/01 *** BUILDING PERMIT APPLICATION *** 7/27/01 15:18:09 ~473889 14.-2-24 ' CIPITELLI BROS REALTY CORP . PERMI VERIF ~ZE: SIDES: CIPITELLI~_.~__~_~._~___.?~._ 175-16 ,R: 175-16 LIBERTY AVE .AMAICA, NY 11433 %¥0/00X00 ZONING DISTRICT: YARDS SETBACK FRONT: PERMIT OWNER/AGENT: ADDRESS: CITY: ESCRIPTION: DECK 19102 APPLY#: 'LOT: PETTY'S DRIVE DENY DATE: 0/00_/_00 EXPIRATION:~s-18~ __ BUILDING#:~'N~765'ls°2~ AREA: REAR: JAMAICA STATE: ~y. ZIP: 11433 __ & FENCE ENCLOSURE AS APPLIED F BP #19102-Z ISSUED 6/7/90 FOR NE FAMILY DWELLING WITH ATTACHED GARAGE, DECKS, SWIMMING POOL WITH DECK & FENCF WETLANDS Y/N: TRUSTEES APPROVAL DATE: DEC APPROVAL DATE: FLOOR AREA: VALUE OF WORK: ADD/CHG/DEL: CHANGE COASTAL EROSION Y/N: -0/00/00 PLANNING BOARD APPROVAL DATE: -0/00/00 0/00/00 ZBA APPROVAL DATE: 0/00/00 0 · 00 FEE CODE: FEE: .00 F2=Summary F3=Exit F7=Reprint F8=CO F9=Denial F12=Clear Fl=Next Permit ~j ' .~,~ ~J~ · ** BUILDING PERMIT APPLICATION *** 7/27/01 15:18:24 14.-2-24 ~ APPLY#: ~ ~E DROEGE LOT: ~ ~CH ST ~v~85 PETTYS DR ]013 HA ~z~./0~00 PERMI~t~_~~ DENY DATE: O/~OZOQ ~! VERIFy: 0 EXP IR A TION: ~gy~?~.~ s~~ ~ USE: SINGLE 4CE BUILDINGS: ZONING DISTRICT: ~ZE: AREA: YARDS SETBACK FRONT: SIDES: REAR: PERMIT OWNER/AGENT: MADELINE ADDRESS: 279 CHURC~~ ~_~.~ ~.CITY: NEW YORK STATE: N~ ZIP: 10013 DESCRIPTION: WETLANDS Y/N: TRUSTEES APPROVAL DATE: DEC APPROVAL DATE: FLOOR AREA: VALUE OF WORK: ADD/CHG/DEL: ADD 0/00/00 0/00/00 0 .00 PERMIT Fl=Next Permit COASTAL EROSION Y/N: PLANNING BOARD APPROVAL DATE: -0/00/00 ZBA APPROVAL DATE: 0/00/00 F2=Summary FEE CODE: FEE: .00 NOT FOUND, ADD NEW PERMIT OR F12 CLEAR F3=Exit F7=Reprint F8=CO F9=Denial F12=Clear ~ COUNTY DEPARTMENT Ot~ HEALTH SERVICES Au LV Dwmmc DATEE~ 0 5 1992H.S. REF. NO. ~ The ~ewage disposal and water supply facilities for this location have been inspected by th s Department and/or other aeencie~and foLmd to.be~at~sf~'v. ~-~ CL. L~'T% tr.: Chief o~ Bureau of Wastewater Management PJAY 80 ,~z STATE~NT OF I~T-E~T THE WATER SU~Y AND SEWAGE DI~AL 5YST[~ FOR THIS RES}OENCE WILL CONFORM TO THE STANDAR~ OF THE S~FO~ CO. DE~. OF HEALTH ~ERVICE$. A~LICANY ' ' SERVICES -- FOR APPROVAL OF CONSTRUCT ~N ONLY SURVET OF LOT 6 LOT NUPfE~F~..~ F~,Et=E~ TO "HAP OF F~'I-I~'~ E~I~HT" FILED IN THE~ .,~UFFOLK C, OUNT'¢ C, LEt~KS OFFIGE~ AS I"fAP NO. 5~..5q 51TUATE.. ORIENT TOP, IN.. 50UTHO/P 5L, IFFOLK 6,0UNT'r', N'f' \ \ \ \ 5~URV'E~ED: NOV. I~, 200~ .~UFFOLK C-.,OIJNI~f' TA~ ~ I000- 14- 2- 24 CE~'I'~'~,D TO: ~ELII~ D~.@~GE \ \ \ \ o PIPE FOUNP ~_ ~ r'oo ~ ",' ~ · ~TAKE FOUND ~"'"""~-~ '"'"'~ ~ ~'~ TOPO REFE~JENGE5 N~',/~ '2q DATUH ~. ' 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\pros\08\08-198.pm ®t~.APHI E. SC. ALE N [] [] FIRST FLOOR PLAN 3705ED EXT~RIOR)~ o 0 mon. © INFORMATION FOR 51TI~ FLAN TAKEN fiR`OM 5UR`VEY BY JOHN EHLER`5 LAND 5UR`VEYOR`, DATED NOVEMBER. 1~5, 2008 SECOND FLOOR PLAN APPROVED BY BOARD OF TRUSTEES T3¥,'lq OF SOUTHOLD BEDROOM5 TO DE UDED FOR. BED ¢ DI~EAK?A~T UDE SUBJECT PROPERTY KEY MAP PROPOSED DECK STAIRS AT THE DROEGE :SIDENCE PETTY S DRIVE ORIENT, NY S.C.T.M. # 1000-14-2-24 REVISIONS DATE; F'HONE PECONIC PERMIT EXPEDITING : G3 I .734.O3G I TIIESE PLANS AND SPECIFCATIONS ARE INSTRUMENTS OF SERVICE AND ARE THE PROPERTY OF PECONIC PERMITCEXPEDiTiNG [NC INFRINGEMENTS WILL BE PROSECUTED. DATE: 3-12-09 DR. BY: R W L SCALE: AS NOTED PROJECT NUMBER SHEET NUMBER 0836 A-1 \ / FIRST FLOOR PLAN ~CAI-U' I/4" = ILO" INFOI¢.MATION FOP-. E~ITE PLAN TAKEN FIe. OM 5UP--.VEY DY JOHN EHLEP-.5 LAND 5UP-.VEYOP-., DATED NOVEMBEP-. 16, 2006 c~ O 0 © (~ 0 ii SECOND FLOOR PLAN SCALE' I/4" = I' 0Ii SUBJECT PROPERTY KEY MAP PROPOSED DECK STAIRS ATTHE DROEGERESIDENCE PETTY'S DRIVE ORIENT, NY S.C.T.M. # 1000-14-2-24 REVISIONS A5 ?EI~ ~OUTHOLD T~.USTEE5 DATE; 7-09 PECONIC PEP. MIT EXPEDITING PHONE: G3 I .734.63(; I ITHESE PLANS AND SPEC[FCATIONS ARE INSTRUMENTS OF SERVICE AND AI~E TIlE PROPERTY OF PECOHIC PERMIT EXI~EDITING INC. INFRINGEMENTS W1LL BE PROSECUTED. DATE: 3-12-09 DR. BY: RWL SCALE: AS NOTED CHKD: IPROJECT NUMBER 0836 SHEET NUMBER A-1