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HomeMy WebLinkAboutTR-7067A 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 Permit No.: 7067A Date of Receipt of Application: March 27, 2009 Applicant: Diana Delucia SCTM#: 107-4-5 Project Location: 4573 Wickham Ave., Mattituck Date of Resolution/Issuance: April 22, 2009 Date of Expiration: April 22, 2011 Reviewed by: Board of Trustees Project Description: The as-built replacement of the windows and door with sliding glass doom on the existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plan prepared by North Fork Drafting & Design dated March 5, 2009. Inspections: None If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jame .~King, P~~ Board of Trustees James F. King, Pt'esidcnt Jill M. Dohelly, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. PO Box 1179 Southold. NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: DIANA DELUCIA requests an Administrative Permit for the as-built replacement of the windows and door with sliding glass doors. Located: 4573 Wickham Ave., Mattituck. SCTM#107-4-5 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: __&King __J.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- James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob ~nosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, NewYork 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 fAdminislxative Permit Amendment/Trans f~r/Ex~nsion ece~vved Application.' 3]~ 7/~ eceived Fee:$~/ff v/Completed Application ~ Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordinafion:(date sent) ~,kWRP Consistency Assessment Form _~CAC Referral Sent: _~l~te of Inspection:~'t __Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~blic Hearing Held: __Resolution: Name of Applicant Address Phone Number:~ Suffolk County Tax Map Number: 1000 - Property Location: (provide LILC0 Pole #, distance to cross streets, and location) AGENT: A6V O T y Tqt D (If applicable) Address: Phone: trd of Trustees Applicati( Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Intended use of property:_ Covenants and Restrictions: ,,~ Yes If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency No Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~ No Yes If yes, provide explanation: Project Description (use attactunents if necessary): l :5-AO tt',400-'c, Lq ard of Trustees Applicat~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~ I l'q O0v~l $ ~t~/~'F-X~ Area of wetlands on lot: ~ 0 C) .square feet Percent coverage of lot: [ O ~/o % Closest distance between nearest existing structure and upland edge of wetlands: ~t~ ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~2. c( ~ feet Does the project involve excavation or filling? ~ No Yes If yes, how much material will be excavated? '~ cubic yards How much material will be filled? 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_ o~t_he ~-ec_t~ if any? 9_n fl!e wetlands an.d_l.tid_al' waters o£~ [pwn that _ma7 result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 6'17.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: 2. PROJECT NAME. C o u nt y ~ ~";"~ C/~--~ PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mad IS PROPOSED ACTION: ~ New ~ Expansion ~ Modification / 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? I~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) [~Residential ~]]ndustdal I--'~Commercial r-~Agriculture E~Park/Fores, lOpenSpace I'~Olher (describe) 10.' DOES ACTION INVOLVE 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. uut=~5 ANY A~SFECI OF tHE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? F]Yes r~No If yes. list agency name and permit / approval: 12. AS A RESULT OF PROPOSEO ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? E~Yes ~')No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: Signature ~'~~ '~, ~-~ I - (~---~ 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 Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. r~Yes r~No WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwdflen, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levets, exisUng traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic. agricultural, amhaeologicat, historic, or other natural or cultural resoumes; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shelh%h or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing ptans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activiUes likely to be induced by the proposed acUon? Explain briefly: C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: CT. Other impacts (including changes in use of either quantity or type of ener?/? ~ ? ? ~ri~fl~/: Will THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTALAREA CEA'~ if es ex lain bdefl ' E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS~; If ~/es ex?lain': I iYes r--lNo [ PART fll - 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) irreveraibility; (e) geographic scope; and (f) magnitude. If necessan/, add attachments or reference supporting materials. Ensure that exptanations contain sufficient detail to show that all relevant adverse impacts h~ve been identified and adequately addressed. If question d of part ii was checked ve-., the determ!naUen ofe!gn!fic~nce must eva!uctc thc pcte~f~m pact c.f thc pro~3c~ .2. c, fic. 7, On fha ~ nv~ronmantal charact~rlatlcs of bh~ C ~...t. Check this box if you have identified one or mom potendaUy large or significant adverse impacts which MAY occur. Then proceed dimcOy to the FULL EAF and/or prepare a positive declaration. ~-hecl~ ~i~ bo~you I~ave determined, b~sed on the information and analysis above an(~ ann ~uppo~ting" docam~t~tionl t h-~t'~'~roposed actio-i~ WILL NOT resu[t in any significant adverse environmental impacts AND provide, on attachments as necessary, the masons supporting thi~ determination. Name of Lead Agency Date Title of Responsible Officer Pdnt or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) OBoard of Trustees pp 1ca=ion County of Suffolk State of New York DIAP,~, ~'?~-'L..k~l/'~ BEINGDULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD 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 CONJUNCTION WITH REVIEW OF THIS APPLICATION Signature SWORN TO BEFORE ME THIS ~ DAY OF JL/~'~ .,20 ~ ClNDI ZAKREWSKI NOI~7 Public, State of New York No. 01ZA617g 106 Qualified in Suffolk County OOMMI8810N EXPIRES 12/2¢/2011 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the om of town Officers and emolovees. The our0ose of this form is to nrovidc information which can alert the town of~ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, galddie 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 Of"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parenL 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 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 applicanlJagenffrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or ~hild is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applic0m (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 1 Submitted t~l~C~,, ~da~y' of ~'~ Signature ~ Print Namo ~D~a t~ (4 ~q.b-O ca~ 200 at 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 arc subject to thc Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information nscd 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- supoortin~ 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# IO00- PROJECT NAME The Application has been submitted to (check appropriate response): TownBoard [] Planning Board [] Building Dept. [~ Board ofTrustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: Present land use: Present zoning classification: ~:~ ~,~t~ L~ If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: QI/~'?,.3~- D~-LAZC~, ~ (b) Mallingaddress: \-~90D~'-14~2'~y ~L~ ~'~O~---T- ?x~y I(C4t4 I (c) Telephone number: Area Code ~J'~{ 5 2 g ~ I O (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 Ill - 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 ~7~ 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 Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. .Yes No Not Ap~able Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~-~ Yes ['~ No ~ Not Applicable / Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria Yes NoR Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Yes~ Nof~ Not Applicable Attach additional sheets if necessary (c) Telephone number: Area Code ( ) F~l ~ g~tO (d) Application number, finny:_ Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~] Noir] Ifyes, 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, make? 5enellcial use of a coastal location, and minimizes adverse effects of development. See LWRP Section IH - 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 HI - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No N 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 IH - Policies Pages 8 through 16 for evaluation criteria ~ Yes ~] No ~-] Not Applicable At~ach add/t/onal sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. Sec LWRP Section HI - Policies Pages 16 through 21 for evaluation criteria '~ [-~ Yes [] No ~-]Not Applicable At~ach 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. Sec LWRP Section IH - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not App~l~ble Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. Sec LWRP Section HI - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~ No~ Not Applicable ~'o I ~v~f~Ac'r~ At~ach additional sheets if necessary Policy 8. MJDimiT~ environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section HI - Policies; Pages 34 through 38 for evaluation criteria. --I ] 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 LvtrRP Section HI - Policies; Pages 38 through 46 for evaluation criteria. [] Ye~ No [] Not Applicable Attach additional shcc~s if necessary WORKING COAST POLICIEO Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent ases 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 ~X~.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 PREPARED BY ~)t.ZxNA2k E~'t~'~,(JC~ ~- TITLEOL0~,)C~-~ DATE APPROVED BY £OARD OF TRUSTEES TOW'N OF SOUTHOLD SOUTHOLD BUILDING DEPARTMENT CRITr'I~IA IFICATION N 310 BUILDING CODE N.Y.S, DWELLING UNIT* SECTION 310 - 310.2 HEIGHT NIAI FIRE AREA (st) N/A! : CONSTRUCTION DESIGN CRITERIA FRAME CONSTRUCTION PRESCRIp~VE DESIGN - 1995 HIGH WIND EDITION WFCM FRAMING ELEMENTS DESIGN LOAD CALCULA~ONS ' AND DOOR SCHEDULE PATH FLOOR pLANS AND SECTIONS SPEC SHEET SHEET4 SEE SHEET3 t SEE SHEET4 PLUMBING RISER DIAGRAM FlEE PRO~CTION )RAWINGS NFITE' THESE ARE AS BUILT DRAWINGS, ALL WAS PERFORMED BY OWNER BEFORE VALIr OF NORTH FORK DRAFTING &: DESIGN THEREFORE N.F.D. & DESIGN AND OR PE WILL BE HELD LIABLE FOR ANY MISINFORMATION NOT <F4- n,× Oo Lt."" DRAI,~: JOHN R. 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