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HomeMy WebLinkAboutTR-7056 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0483C Date October 14, 2009 THIS CERTIFIES that the demolition and reconstruction of the sunroom At 2170 The Strand, East Marion Suffolk County Tax Map #30-2-53 Conforms to the application for a Trustees Permit heretofore filed in this office dated 3/31/09 pursuant to which Trustees Wetland Permit #7056 dated 4/22/09 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 demolition and reconstruction of the sunroom. The certificate is issued to SUSAN TSAVARIS owner of the aforesaid property. Authorized Signature James F. King, President Jill M. Dohe~ty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box II 79 $outhold, NY 11971 Telephone (63 l) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction ¼ constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction ¼ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7056 DATE: APRIL 22~ 2009 ISSUED TO: SUSAN TSAVARIS PROPERTY ADDRESS: 2170 THE STRAND~ EAST MARION SCTM# 30-2-53 AUTHORIZATION Pursuant to lhe provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of S outhold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 22, 2009, and in consideration of application fee in the sum of $250.00 paid by Susan Tsavaris 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 demolish the existing sunroom fa~:ade and replace with a new sunroom, and as depicted on the site plan prepared by CNC Design Consultants, last dated October 2008, and received on March 31, 2009. 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 Susan Tsavaris, residing at 2170 The Strand, East Marion, 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 Pcrmittee 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 Pennittee 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 Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 April 22, 2009 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Ms. Susan Tsavaris 2170 The Strand East Marion, NY 11939 RE: 2"170 THE STRAND, EAST MARION SCTM# 30-2-53 Dear Ms. Tsavaris: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 22, 2009 regarding the above matter: WHEREAS, SUSAN TSAVARIS 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 31, 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 Hearing was held by the Town Trustees with respect to said application on April 22, 2009, 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, 2 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 approve the application of SUSAN TSAVARIS to demolish the existing sunroom fa(;ade and replace with a new sunroom, and as depicted on the site plan prepared by CNC Design Consultants, last dated October 2008, and received on March 31, 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, 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 (6311 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ~l,~O,J('X Please be advised that your application dated f)'~w~ ,~] ,, ~:~c:ZT~ has been reviewed by this Board at the regular meeting of and your application has been approved pending the completion o{~ the following items checked off below. Revised Plans for proposed proj~ect __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ¼ 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: TOTAL FEES DUE: BY: 'James F. King, President Board of Trustees 30.-2-53 1/08 ' kxterfsion [ Porch Total i 4 oo Foundation ~C.~ Bath Dinette Ext. Walls ~',,~,,~. ~//~.~ nrenor Finisn ~ LF Fire PJace ~. Heat , Type Roof _ ~ ~ ~ Rooms 1st Floor ~ ~R Recreation Roc ~ ~ooms 2no FIo~ FIN Dormer TOWN O~: SOUTHOLD PROPERTY RE~RD CARD %WNER ---- I STREET _~ / -'~ O VILLAGE DIST, SUB. LOT ~ /// ~ [ S W TYPE OF BUILDING ~ RES. VL. :' FARM COMM. CB. MICS. Mkt. Value ~ '~,~"~,--- lb SEAS LAND IMP. TOTAL 42o~ / '~ ~400 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadowland House Plat Totcl DEPTH BULKHEAD Donald Wilder, Chairman L~uren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 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: SUSAN TSAVARIS to demolish the existing sunroom fa§ade and replace with a new sunroom. Located: 2170 The Strand, East Marion. SCTM#30-2-53 Inspected by: Don Wilder, Peter Young A vicious dog prevented the CAC members from entering the property, therefore no recommendation was made. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dicketson Dave Bergen Bob Ghosio, Ji 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: SUSAN TSAVARIS requests a Wetland Permit to demolish the existing sunroom fa~:ade and replace with a new sunroom. Located: 2170 The Strand, East Marion, SCTM#30-2-53 ~rea to be impacted: er Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part/of Town Code proposed work fails under: ~c/6hapt.275 Chapt. 111 other Type of Application: L.--'C~'etland __Coastal Erosion ~Amendment __Administrative__Emergency Pre-Submission Violation Info needed: (~ (k~- Modifications: Conditions: Present Were: __&King %_Xf. Doherty __P.Dickerson __ __ D. Dzenkowski Mark Terry__other Form filled out in the field by D. Bergen__ B.Ghosio, Mailed/Faxed to: Date: Environmental Technician Review- 29"E 22.655 % F OR 0 52 ACRES -~9.64' !IE LINE 130.09' S28°26' 17"E EOT 217.54' ,¢ M/Bldg. ir.~tension ' terfsion xte n 30.-2-53 Porch Breezeway Garage Patio~ Total 1/08 Foundation /cC., Bath ~/_ Dinette Basement I/~/~z~ .~ cell Floors ~t. Wc s i~_~/~ Interior Finis~ ,~ LR Type Roof ~ ~ ~ ,~ Rooms ls~ Floor Recreat on Room d Floor Dormer ~A~ TOWN O1: SOUTHOLD PROPERTY RE~"GI~ D CARD OWNER STREET ,,FORMER OWNER_.-*- . N h S SEAS. VL, ' ~es. ¢/~ ~ ~ND IMP. TOTAL VI LLAGE E W FARM ! COMM. CB. MICS. DATE REMARKS DIST. i SUB. LOT TYPE OF BUILDING Mkt. /abe ~r-t::o¢"--~ TiHoble Woodland FRONTAGE ON WATER FRONTAGE ON ROAD Meodowiand House Plot Total DEPTH BULKHEAD ~ t3 ;',:N OF SOt. BUILDING DEPARTMENT ]O\\N ItAL[ SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 705-9502 SoutholdTown. Nor thFork.net BLDG DEPT. PERMIT NO. BUILDING 1~ T APPLICATION CI[ECKL[Si 4 sets of Building Plans_ Planning Board approval Check Septic Form NYSD EC Flood Perm t __ .. Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a Fhis application MUS] be completely filled m by typewriter or 111 ink and submitted to file Buildmg Inspcetoi with 4 sc~s o[ plans, accurate plot plan to scale Fee according to schedule b P[ol p/an showmg location of lot and of buildings on premises relationship ~o adjoining premises or public streets m c The work covered by this application may not be commenced befbre issuance of Building Permit. d Upon approval of this application, the Building Nspector will issue a Building Pem~it to the applicant. Such a penmt shall be kept on the premises available ibc inspection tkoughout the work. e No bui!dmg shall bc occupied or used in whole or in pa~ for any puq~ose wbal so ever m~til thc Buikling lnspcctoi - ~i~r~e o~ apphcant n: name, i~,~mloor,mu:i} State v ~c ~.er app c it is owr, er lessee, agent, arch tec, engmeer, general contractor electrician, plumber or builder (As op- the tax roll ol latest deed) 1~ applicant ~s a corporation, s~gnaturc ot duly authorized officer (Name and title of comorate officer Plumbers License No N I Localmn ui ]ap.d en v, hicl/pioposcd v, otk x~ill be done }louse kumb~i7 Stred .......... Ha~nlet County Tax Map No. 1000 Section ~ 0 j~ jJi~k~l YF~}~AH ~ tO~{a =llduq ~u~ Lot Subdivksion Filed~;~ .o~ . Lot State existing use and occupancy of premises and intended use and occupancy of(proposed construction: a Exstnguseandoccupancy / /5'-/~l/.qlZ.~/ b. Intended use and occupancy ~/,fy -,,/ey/4-Tz~9 ff-c/,a2,~oo /~ _ / ~,/¢A/. .~'~:_2 . Nature of work (check which applicable): New Building P. epair Remo;al Esfimatcd Cost . 5. If dwelling, nmnber of dwelling units If garage, number of cars Addition Alteration Demolitien Other Work ~:57.b< ~-/A)/-/~,~2Q ..-X'~c'~'zf (Description) Fee (To be paid on filing this applicatien) Nmnber of dwelling umts on each floor 6 If business, co'nmerc a o' mixed occupano:, specify' nature and extent of each ty'?e of usc 8. Dimensions of entire new construction: Front Height Number of Stories ~). Size of lot: Front r53OC ffff ' Rear Dimens,ons ofexistiug structures, if any: Front 6/9 ff_' Rear ~'-~. Z ' Depth Dimensions of same structure with alterat ons or additions: Front Depth // ~ Height ~ ~'/~ Number of Stori{~k~ '~ Depth wf~,' Date of Purchase i I. Zone or use district m which premises are situated 12. Does proposed construction violate auy zoning law, ordinance or regulation? YES NO 13. \Vill lot be re-graded? YES NO ~"~\Vill excess fill be removed fi'om premises? YES NO_~~' [4. Names of Owner of premises ~S~ T~e/~ ,Address &:~/~, ~//~Phone No.~/ U77- Name of Architect ~7 ~~ Address ~=~5f~ Phone No Name c fCon fac o~~ Address-/gg~sa~ B)~a:'Phone No.k¢/- 15 a Is this prope~y within 100 feet of a tidal wetland or a ~eshwater wetland? *YES / NO * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is ~is property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PE~ITS MAY BE REQUIRED 16. Provide su~,ev to scale, with accurate foundation plan ,-md distances to property lines i g Are there any covenants and restrictions with respect to this propezty? * TES _ NO · IF YES, PROVIDE A COPY· STATE OF NEW YORK) SS: COUNTY OF ) (Contractor, A. gent, Corporate Officer, etc ) FORM NO. 3 NOTICE OF DISAPPROVAl. DATE: March 4, 2009 Susan T. Tsavaris 2170 Thc Strand East Marion. NY 11939 Please take notice that yom' application dated February 4, 2009: For per,nit for additions and alterations at: Location or' property: 2170 The Strand East Marion~ NY County Tax Map No. 1000- Section 30 Block 2 Lot 5~3 Is returned herewith and disapproved on the tbllowing grounds: Thc rtLL~gsed additions and altcrations~on this non-conforming 22,635 waterfront lot in the R40 District~i~ not permitted pursuant to Article XXI1, Section 280- 116(A~l ), which states "All buildings or structures located on lots adiacent to sounds and upgn ~hich there c×ists a bluffor bank landward of the shore or bcach shall be set back not ~kwcr than from thc top_ ol such blutt or ba · Thc proposed construction is shown at 70 feet +/- from existing top of bank. Vicki Toth CC: file. ZBA Note 1o applicant any changes to the above noted application may require further review by the Southold Town Building Dept. O3O OFFICE LOCATION: Town Hall Annex 54375 State Route 25 Main Rd. & Yonngs 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 To: From: Date: Re: Jim King, President Town of Southold Board of Trustees Mark Terry, LWRP Coordinator Scott A. Hilary, LWRP Coordinator April 14, 2009 Chapter 268, WATERFRONT CONSISTENCY REVIEW Wetland Permit for SUSAN TSAVARIS SCTM#30-2-53 SUSAN TSAVARIS requests a Wetland Permit to demolish the existing sunroom faqade and replace with a new sunroom. Located: 2170 The Strand, East Marion. SCTM#30-2-53 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. § 268-3. Definitions. MINOR ACTIONS -- Include the following actions, which are not subject to review under this chapter: Replacement, rehabilitation or reconstruction of a structure or facility, in kind on the same site, including upgrading buiMings to meet buiMing or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures mci)? not be replaced rehabilitated or reconstructed without a permit. The following Best Management Practice (BMP) is recommended: 1) Install gutters, leaders and drywells to manage/control storm-water on site. 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 ~Vetland Permit Application __ Administrative Permit Amendment/Transfer/Extension ~'Received Applicafion:~J~ ~Received Fee:$ __C, on~leted Appl'~at/on~' .:~! ~ !O4 Incomplete __SEQKA Classification: Type I Type II Unlisted Coordmation:(date sent) ~-EWRP Consistency Assessment Form AC .¢fe al Sent: ~.~)ate of Inspection: Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~/ffl~c Hearing Held: qT~-/~ Resolution: Name of Applicant Address ~T~ ~ --[ 0 '-~ Suffolk County Tax Map Number: Property Location: ~t (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: of Trustees Applicatio Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: GENERAL DATA a / Covenants and Restrictions: x/Yes No If "Yes", please provide copy. 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? v/ No Yes If yes, provide explanation: Project Description (use attachments if necessary):. of Trustees Applicati, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 1 Area of wetlands on lot: .square feet Percent coverage of lot: % 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? J No Yes If yes, how much material will be excavated? How much mater/al will be filled? 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: cubic yards cubic yards 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): of Trustees Applicatio0 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? x/ No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? _(cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed, fUse attachments if necessary) 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 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: 4, PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: ~ Now ~ Expansion ~Mooiflcaaon/alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER .RESTRICTIONS? [~ Yes [~J No If no, describe briefly: ResT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) idential r~lndustdal [~Commercial ~]Agriculture ~'~Park/Forest/OpenSpace [~]Other (describe) 10. DOES ACTON NVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~]Yes [-~No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~]Yes [~No E yes, list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~Yos [~No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponso~r .Name · D te: 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~enc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL EAF. [~] Yes r--~ No WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declarafion may be superseded by another involved agency, [~] Yes F~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, exis§ng traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: C2. Assthafio, agricultural, archaeological, histodo, or other natural or cultural resources; or community or neighborhood charaPtar? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or throataned or sndangemd species? Explain briefly: C4. A community's e×isting plans or goals as officially adopted, or a change in use or inton$iht of uso of land or other n,rural resources? ~plaln briefly: I C5. Growth, suhssqusnt deYslopment, or related acfi~ties likely to be induced by the proposad action? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified id Pt-¢5? Explain bhefly: C?. Other impacts (includin[I chan~es in use of either quantity or tyDe of energy? Ex¢idin briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ~]Yes E. IS THERE, OR IS.~HERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If },es explain: PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidentlfiedab~ve~determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potantJal impact of the proposed action on the environ mental 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 action WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necassap/, the reasons supporting this 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) PROOF OF MAILING OF NOTICE ?IFIED MAIL RECEIPTS Ceflifled Fee (EndorSement Requ red) 133 ~ Total Postage & Fees -~6766U]~ytT-61-~I ............... ~ .................. Address: Return Rcpt (Green $2.20 Card) Certified $2.70 Label #: 70081830000420900578 Customer Postage -$0.42 Subtotal $4.90 Issue PVI $4,90 GREENPORT NY 11944 $0,42 Zone-O First-Class Letter 0.90 cz, Return Rcpt (Green $2.20 Card) Certified $2,70 Label #: 70081830000420900561 Customer Postage -$0,42 Subtota]: $4,90 Issue PVI: $4.90 MELVILLE NY 11747 $0,42 Z0ne-1 First-Class Letter 0,90 cz. residing at 2- [ -7 0 "~ %T-$~ ~t AJ ~ being duly sworn, deposes and says that on the 200c~, deponent mailed a true copy o£the Notice pplication, directed to each of the above named e there respective names; that the addresses set are the address of said persons as shown on the current thold; that said Notices were mailed at the United States Post _, that said Notices were mailed to each of said persons by LAUREN M. STANDISH Notary Public, State of New York No. 01ST6164008 Qualified in Suffo k County Commission Expires April 9, 20~1 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTItOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3. That the project which is subject to Environmental Review under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: . You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. Enc: Copy of sketch or plan showing proposal for your convenience. NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES~ TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3. That the project which is subject to Environmental Revie~w under Chapters 32, 37, and/or 97 of the Town Code is open to public comment on: ~{9/~ [/_ ~.D_COe~ . You may contact the Trustees Office at 765-1892 or in writing. ' ~ The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. MAILING ADDRESS: ~.~ 1-/ 0 "Tq-Je:~ Enc: Copy of sketch orplan showing proposal for your convenience. James F. King, President Jill M. Dohcrty, Vice-President Peggy A. Dickerson Dave Bcrgcn Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of SUSAN TSAVARIS COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and say: That on the [. [ day of ']~Fi [ , 200~, I personally posted the property known as by placing the Board of Trustees official poster where it ~:a~ ~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: k(~ignature)~ Sworn to before me this day oflqpri1200c~ Notary Public CONNIE D BUNCH Notary Public. State of New York No. 01BU6185050 Qualified in Suffolk COunly Commission Expires Apd114, ~oard of Trustees Applicatioh County of Suffolk State of New York ~ ~)~'~bD -~c. ~ 0q ¢ t_q BE*G DU~Y SWO~N DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE 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), IF GRANTED. IN COMPLETING THIS APPLICATION, ! 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. / v Sighat~re SWORN TO BEFORE ME THIS MANUEL VILLAFAN~ ~--~IMMI$SION~'-R OF DEEDS ...... ,a,,~ Ynrk - No. 1-2420 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethias nrohibits conflicts of interest on the oart of town officers and emnlovces. The nuroose of this form is to orovide information which can alert the town of oossible conflicts ofintero~t and allow it lo take whatever action is necessasv to avoid same. (Last name, lust name,~iddie 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 thc 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 ownemhip of(or employment by) a corporation in which thc town officer or employee owns more than 5% of the shares. YES NO If you answered "YES", complete the balance of this fom~ 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/agenttrepre~e ntative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space progidod. The town officer or employee or his or her spouse, sibling, parent, c;r ~hild is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicont (when the applicant is a corporation); __.B) the legal or beneficial owner of any interest in a non~orporate entity (when the applicant is not a corporation); ___C) an officer, director, parlner, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I 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 ail of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action wilt 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- suooorfin~ 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 Tpwg~ 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 SCTM# /40 PROJECT NAME ~tlZcx.q T~o~3ot6 ~ The Application has been submitted to (check appropriate response): TownBoard ~ Planning Board [] Building Dept. ~-~ BoardofTrustees [] Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital conslruction, planning activity, agency regulation, land t~ansaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: Present land use: ¢i t4,0} I( 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: ¢ (_~\ }~) '-~ ~'/~ XJ ~ lQ- ~ ~ (b) Mailing address: t ¥'r (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 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 - Polio:les Pages 3 through 6 for evaluation criteria [] Yes [-~ No[-71/~ 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 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 Pa~es 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[~t23Not 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 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. [] Ye? No [~Not Applicable Attach additional sheets if necessary woRKING COAST POLICIE~ -J~ Policy 10, Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations~LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. ~ Yes [] No I -I 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. F-I Yes [] No ~/Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energ~ and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ['~ Yes [] No [~-~/Not Applicable tl[ 2512:3 r~IO~-IIOOS ~0 N,',AOI NVq,~ ~tOOq~ .OIg ~Z ,rr NVq~t ~OOq4 PI NNI~IVq OG gNLL~IY ~ ~ NOI.LO~G r f ON~IOOPON~D~ ~ __ ONIIOOy'O'O ~ ~lO07yO'yl~Iyly'O"l ~? ~O~Y ~VONIL'£~,-I3 ~"~':'"~ NVd~ NOI.LVGN~OJ ............................................ : .............................................................................................. F~4 EX,, HOUSE EXISTIN~ FOUNDATIOH LRPT ~IDI: VIL~ G~4~E ~L45HINg~S P~Q~ ROOF EX. HOUSE EX/STING FOUNDA T/ON F_LEVA'FION ©[] EX.. HOUSE ®~ND~AL NOTE¢ ENE~®¥ NOT~ IN~TI~UGTION¢ f=OR Tlli~ IN~I'ALLEI~ LIGHT, VENTILATION AND HEATING IN ACCORDANCE W/SECTION R303.1 WFCM T=bfe 3.1 MA TERIAL /VOTES: I~OOP CONST~tJC'FION ,3, f/2' 1~3X ~ I'WOC¢ ~E4 rH/,~ WALL CONSTEUCTION INSUbATION NOTES FOUNDATION ANCHOR 80L T CONNECTION REQ~JlREMENTS NAILING SGHEDULE A gOOP ~ GELLING P~NIING WALL I~g/fIING P LO0~' F~ING ~OOF ~HfN~E¢ ~OOF CHE~HIN8 CEIMN6 ~HEA~HIN8 W~L ~0~ F~AHIN% WFCM 3.2A ~OUND^TION NOTE~ NOTE: NO HEATING ELEMENT AND NO A/C, CENTRAL AIR CONTEMPLATED AT THIS TIME NOTE: ALL INTERIOR HEADERS TO BE (2) 2 X 12 UNLESS NOTED OTHERWISE THESE PLANS WERE PREPARED IN DIRECT ACCORDANCE WITH THE METHODS SPECIFIED IN THE 2001 EDITION - WFCM WOOD FRAME CONSTRUCTION MANUAL GLIM ^TIC ~; ®EO®g^FHIG DE©I®N Gl~rFl~giA WINDOW OPENING UPLIFT STRAP CONNECT/ON REQUIREMENTS WFCM 3.3B SHEA fl./lNG A TTACHMENT REQUIREMENTS NAIL SPACING 8d COMMON NAILS LOCATION EDGES F/ELD 4' PER/METER ZONE 6 6 INTER/OR ZONES 6 12 GABLE ENDWALL RAKE WITHLOOKOUTBLOCKS 4 4 WFCM 3.2,l. l RIDGE TENS/ON STRAP CONNECT/ON REQUIREMENTS FASFESTMILE ~EEO (~) ~o I t~ I,o I ~,~ WFCM TABLE 3,4 T/,CLE i~Ol,O MINIMUM UNIFOEM DIST~IPUFED DESIGN LOADS I~E UVELO/~ BE4DLOAO i~) POSTC^P MOUNT HANGEI~ (~ H~ADDR TO JACK STUD (~ OLrFSIDE COI~NEI~ DCFAIL m:,rro~¢,~ (~) INSIDE COENEE DETAIL , r J O O n, Z :D - O LU © QJ