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HomeMy WebLinkAboutTR-7121Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 # 0536C Date May 5, 2010 THIS CERTIFIES that the detached three-car garage and 40' non-disturbance buffer from the rear of the garage seaward At 100 West Mill Rd., Mattituck Suffolk County Tax Map #113-4-2 Conforms to the application for a Trustees Permit heretofore flied in this office dated 7/1/09 pursuant to which Trustees Wetland Permit #7121 dated 6/24/09 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 detached three-car garage and 40' non-disturbance buffer from the rear of the garage seaward. The certificate is issued to PAUL KATZ owner of the aforesaid property. A t~orlzed Si )gll~tu~F~ Jill M. Doherty, President James F. King, Vice-President Dave Bccgen Bob Ghosio, Jr. John Bred~rneyer 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 DATE OF INSPECTION: ,44/'/7' z/ / o .///Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain __ 1st 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 GhosJ. o, 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 St 1 day of construction ~ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERM, IT NO. 7121 ISSUED TO: PAUL KATZ. DATE: JUNE 24~ 2009 PROPERTY ADDRESS: 100 WEST MILL ROAD~ MATTITUCK sCUM# 113--4~2 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of South01d and in accordance with th~ Resolution of the Board of Trustees adopted at the meeting held on June 24. 2009. and in consideration of app!ication fee in the sum of $250.00 paid by Paul ,~,tz t/nd subject to the T~mS and Conditions as stated in the ReSolution~ ihe Southold ToWn BOard of Trustees authorizes and permits the following: Wetland Permit to construct a detached three-car garage, with the condition of maintaining a 40' Non-Disturbance Buffer from the rear of the g/irage seaWard, and as depicted on the site plan prepared by Nancy Dwyer, last dated July 14, 2009, and received on August 3, 2009. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seltl to be affixed, and these presents to he':subscribed by a majority of the said Board as o,f this da~e. TERMS AND CONDITIONS The Permittee Paul Katz, residing at 100 West Mill Road, Mattituck, 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 uny 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 9f 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 6btain 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 June 24,2009 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Ms. Nancy Dwyer P.O. Box 632 Southold, NY 11971 RE: PAUL KATZ 100 WEST MILL ROAD, MATTITUCK SCTM# 113-4-2 Dear Ms. Dwyer: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 24, 2009 regarding the above matter: WHEREAS, Nancy Dwyer on behalf of PAUL KATZ 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 June 1,2009, 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, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: maintaining a 40' Non-Disturbance Buffer from the rear of the garage seaward, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 24, 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, 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 for the mitigating factors and based upon the Best Management Practice raquirament imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of PAUL KATZ to construct a detached three-car garage, with the condition of maintaining a 40' Non- Disturbance Buffer from the rear of the garage seaward, and as depicted on the site plan prepared by Nancy Dwyer, last dated July 14, 2009, and received on August 3, 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/eac James F: King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application' dated ,..'~(.h~ e-Il oO-OO~' has been reviewed by this Board at the regular meeting of .3'-(.~'~e- c~c// c~2o? and your application has been approved pending the completion Of the following items checked off below. Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) ¼ Constructed ($50.00) V/ 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 Donald Wilder, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 17, 2009, the following recommendation was made: Moved by James Eckert, seconded by Peter Young, it was RESOLVED to SUPPORT the Wetland Permit application of PAUL KATZ to construct a detached three-car garage. Located: 100 West Mill Rd., Mattituck. SCTM#113-4-2 Inspected by: James Eckert, Peter Young The CAC Supports the application with the Condition gutters, leaders and drywells are installed to contain roof run-off. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M. Dohelty. Vice-Presiden! Peggy A. Dickerson Dave Bergcm Bob Ghosio, Jr, P.O~ Box I 179 Southold. NY 11971 Telephone (63 I) 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: Nancy Dwyer on behalf of PAUL KATZ requests a Wetland Permit to construct a detached three-car garage. Located: 100 West Mill Rd., Mattituck. SCTM#113-4-2 Type/~rea to be impacted: [~-,~altwaterWetland Freshwater Wetland Sound --B~y Distance of proposed work to edge of wetland Part of T.T..e~vn Code proposed work falls under: C_L~pt.275 Chapt. 111 other Type of Application: [.~etland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Present Were: __&King - J.Doherty__P.Dickerson __ D. Dzenkowski Scott Hilaw__other Form filled out in the field by D~. Bergen~io, Mailed/Faxed to: Date: (.--fA" * O~'IcE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-31~6 LOCAL WATERFRONT REVIT~I,17,ATION PROGRAM MEMORANDUM To: Gerard Goehdnger, Chair Town of Southold Zoning Board of Appeals From: Mark Terry, Principal Planner ~ LWRP Coordinator TOWN OF SOUTHOLD Date: March 18, 2009 Re: ZBA file Ref. No. 6258 (PAUL KATZ ) Location: 100 West Mill Road, Mattituck SCTM 1000-113-4-02 This proposal is a request for a vadance pursuant to the Building Inspector's June 23, 2008 Notice of Disapproval concerning a proposed accessory garage at a setback of less than the code-required minimum of 50 feet from the front yard lot line. The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Water[ront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this depa, l.~ent, as well as the records available to me, it is my determination that the proposed action is EXEMPT from waterfront consistency review pursuant to: § 268-3. Definitions. MinorActions, i~m F: F. Granting of individual setback, lot line and lot area variances, except in relation to a regulated natural feature or a bulkhead or other shoreline defense structure or any activity within the CEHA; [Amended 6-6-2006 by L.L. No. 7-2006] Cc: Jenifer Andaloro, Assistant Town Attomey Office Location: Town Annex/First Floor, Capital One Bank 54375 Main Road (at Yo~gs Avenue) Southold, NY 11971 Mailin~Address: 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 http://southoldtown.notthfork.net BOARD OF APPEALS TOWN OF SOUTHO!,D Tel. (631) 765-1809 Fax (631) 765-9064 FINDINGS, DELIBERATIONS, AND DETERMINATION MEETING HELD APRIL 14, 2009 ZBA FILE # 6258 - Paul Katz, Applicant PROPERTY LOCATION: 100 West Mill Road (at Matfituck Creek), Mattituck CTM 113-4-2 SEQRA DETERIVflNATION: The Zoning Board of Appeals has visited the property under consideration in this application and determihes that this review falls under the Type II category of the State's List of Actions, without further st~s under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Adminislrafive Code Sections A 14-14 to 23, and the Suffolk County Department of Plauning issued its reply stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. PROPERTY FACTS/DESCRIFIION: The subject property is located on Mattituck Creek and is 41,392 square feet in the R40 District. It is a comer lot with 297 ft. fronting on Mill Road, 108.27 ft. fi.onting on a 25 ft. right-of- way to the west and 187.4 ft. along the easterly property line. It is hhp~oved with a two-story, single-family dwelling. BASIS OF ApPLICATION: Request for Variances under Sections 280-15(F), based on the Building Inspector's June 23, 2008 Notice 6f. Disapproval conceaming a proposed acccssory garage at a setback of less than the code- required minimum of 50. feet fi.om the fi.ont yard lot line. RELIEF REOUESTED: The applicant's original plan was submitted for a 30 ft. x 23.4 ft accessory garage with a front yard setback from Mill Road of 37 feet, were the code requires a minimum setback of 50 feet. AMENDED APPLICATION: On March 20, 2009,'the applicant's agent, Nancy Dwyer, submitted to the Board of Appeals an mended plot plan requesting an additional two feet in size on the proposed garage, now measuring 32 fL x 23.4 feet and located two feet closer to the house at 32 feet 10.5 inches rather than the 34 feet 10.5 inches applied for. The front and side yard setbacks remain the same as applied for and the size, height and location of the proposed accessory garage remain conforming as proposed with this amendment. Page 2 -April 14, 2009 ZBA File # 6258 - Paul K:alz CTM 113.4-2 FINDINGS OF FACT LWRP DETERMINATION: This application is exempt under Chapter 268, also confirmed on March 18, 2009 by the Town LWRP Coordinator in a letter received by the Board of Appeals, for the reason that no natural resources concerns were observed relative to construction of the proposed accessory garage. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted 'and personal mspeetions, the Board makes the following findings: 1. Town Law §267-b(3)fo)(3)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The proposed accessory garage is in keeping with the architectural style~ in the neighborhood. The subject property and the adjacent properties are naturally wooded, and the garage will have limited visual impacts. 2. Town Law §267-b(3WoX2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The location of the accessory garage is heavily ~onstrained by the presence of wetlends and slopes on the subject property. 3...Town Law ~267-b(3'~(b)(3). The variance granted herein is not substantial given burden of two street fro~?ages and a waterfxont location with wetlands on the propertyth,e odd shape of the parcel, the 4. Town Law §267-b(~WoX5). The difficulty has not been sel£-ereated but is the result of constraints on the site. 5. Town Law §267-b(8)(b)(4). No evidence has been submitted to suggest that a variance in this residential community Will have an adverse UnPaet on the physical or environmental conditions in the neighborhood. The proposed garage is loeated on fiat terrain and a dryweil is proposed to contain rain water runoff. 6. Town Law §267-b. :Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy .the benefit of an accessory garage, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD:'hi eonsid&4ng all of the above faeto~ and applying the balancing test under New York Town Law 267-B, motion was offered by Member Weisman, seconded by Chahman/Merfiber Goehringer, and duly carried, to GRANT the ~ce as applied fur and shdw'a on the AMENDED copy of the John C. Ehlers partial plot plan/survey dat~ 08-18-05, as modified March 20, 2009 by Nancy Dwyer, Designer with cover letter of explanation, su',b)ect to the following Condition electricity. . ~ That thc accessory garage shall only contain the utility uf That the above condition be Wr/tten into the Build/ny Inspector's Certificate of Occapan6y, when issued. Any deviation from the vafi~nen given such as extensions, or demolitions.wh/ch are not shown on the a~licant'$ dia/p~u~ or survey site maps, are not authorized under this ~gplieation when involving nonco~onnities under the zoning code. Thin a~titm dcos not amhoriz~ or condone any current or futore use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, ~ethacks and other fealures as are expressly addressed in this action. The Board reserves the fight to substitute a similar design that is de minimis in nature for an alteration that doe~ not increase the degree of nonconfOnmty. Vote of the Board: Ayes: Members ~~ ~ Goehrin i~an), zva , and Schneider. This Resolution was duly adOPted (5-0). ~/2009 Approved for Filmy New York State Departme~l)of Environmental Conservafl~ Division of Environmental Permits, Region One SUNY ~ Sto~y Brook, 50 Circle Road, Stony Brook, NY 11790 - 3409 Phone: (631) ~.~.~.O365 · FAX: (631) 4440360 Website: www. dec. state, ny. us LETTER OF NON-JURISDICTION - Article 25 Au~st 28, 2008 100 East Mill Rond Mattituck, NY 11952 Application #1-4738-03180/00002 100 East Mill Road, Mattituck SCTM#I000-113-4-2 Based on thc information you have submitted, the Department of Environmental Conservation (DEC) ha3 dete~:iifined that: The property landward of the 10 foot elevation contour as shown on the survey p~-pared by John C. Ehlcrs dated 8/18/05, is beyond Tidal Wetlands Act (Article 25) jm'isdicfion. Therefore, in accordance with thc current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required. Be advised, no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdieti0nal boundary, as indicated above, without a permit. It is your responsibility to ensure that all precautions are taken to prevent any sedimentation or disturbance within Article 25 jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or e~ting a temporary fence, barrier, or hale bay This letter shah remain valid ,lnl~$ site conditions change. Please note that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies or local municipalities. Sincerely, Permit Admini.~i~utor CC: Nancy Dwyer file ~ 6EASTM ------------ 369--8288 c~ee~ JOH5 PLANNING BOARD MEMBERS MARTIN H. SIDOR Chair WILLIAM J. CREMERS KENNETH L. EDWARDS GEORGE D. SOLOMON JOSEPH L. TOWNSEND MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southotd, NY Telephone: 631 765-1938 Fax: 631 765-3136 PLANNING BOARD OFFICE TOWN OF SOUTHOLD To: Jim King, President Town of Southold Board of Truste/~' From: Mark Terry, Principal Planner LWRP Coordinato? Date: June 23, 2009 Re: Proposed Wetland Permit for PAUL KATZ SCTM#1000-113-4-2 7 PAUL KATZ requests a Wetland Permit to construct a detached three-car garage. Located: 100 West Mill Rd., Mattituck. SCTM#113-4-2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The proposed setback from the "garage" to the top of bank is 53.4 feet; a minimum separation distance of 100' is required Chapter § 275-3. Findings; purpose; jurisdiction; setbacks. Please require that the applicant amend the application to meet the above policy to the greatest extent practicable. Additionally, if the action is approved and to further Policy 5: Protect and Improve Water Quality in the Town of Southold and Policy 6; it is recommended that a minimum 25 foot natural vegetated buffer (see below) be required. NATURAL VEGETATED BUFFER -- a land area of a certain length and width where existing vegetation occurs prior to the commencement of any grading or clearing activity. Vegetation shall be maintained to achieve a minimum percent ground cover of ninety-five (95) percent. To achieve the percent ground cover indigenous, drought tolerant vegetation shall be planted. Survival of planted vegetation shall be (ninety) 90 percent for a period of three (3) years. Maintenance activities within the buffer are limited to removing vegetation which are hazardous to life and property, trimming tree limbs up to a height of fifteen feet (15') to maintain viewsheds, replanting of vegetation and establishing a four foot (4') wide access path constructed of pervious material for access to the water-body Figure ii Ka~ residence. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Jennifer Andaloro, Assistant Town Attorney James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 Office Use Only Coastal Erosion Permit Application T~Wetland Permit Application Administrative Permit Amendment/Transfer/Extension ./R~c eived Application: ~91l ~P~reeived Fee:$ ,~ ~- ~pleted Application {9 [~ ~ O~ Incomplete __SEQRA Classification: Type I Type II Unlisted · Coordination:(date sent) t..~c%VRP Consistency Assessment ~ Referral Sent: ~.D'ate of Inspection: (,o!} Receipt of CAC Report: ' __Lead Agency Determination: Technical Review: Resolution: Name of Applicant Address Phone Number:l 'j Suffolk County Tax Map Number: 1000- /t/3.~ / PropertyLocation:/~70 [~6165]' /~7,/l ~ (p~ovide LILCO Pole #, distance to cross streets, and location) AGENT: ]~}&/q (..~ (If applicable) Address: Phone: of Trustees App Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Intended use of property: ~'~!'/'1~.~ 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 suspci~ded by a governmental agency? ~x. No Yes If yes, provide explanation: Project Description (use attachments if necessary): ! Bud of Trustees Applicatio~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose o f the proposed operations: -~te~-- ~'~(~-- Area of wetlands on lot: ~q~5/0 square feet Percent coverage of lot: ~ ~ % Closest distance between nearest existing structure and upland edge of wetlands: yr./ feet Closest distance between nearest proposed structure and upland edge of wetlands: ~'~ feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? 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: /. ¢ ~/"/o,O Manner in which material will be removed or deposited: 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): PROJECT ID NUMBER PART I - PROJECT INFORMATION I APPLICANT / SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 4. PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc ~ or provide map t / I , 5. IS PROPOSED ACTION: SEQR  -New []Expansion [] Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT ~;;~D~r ~ F~.C T E D: Initially Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? E~Yes ~rNo If no, descdbebriefly: 99~ W~AT tS PRESENT LAND USE IN VICINI~ OF PROJECT? (Choose as many as apply.) esidential ~lndustrial ~Commercia, ~Agric, lt, re ~ParklForestlOpenSpace E] Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) F-lYes rt~,~o if yes, list agency name and permit / approval: 11 DO S ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ~es LINc If yes, list agency name and permit / approval: 12. AS A EI~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? /I ~'ERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / on,ser me ~ Date: Signature S~~ 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. B 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. F-~ Yes r~No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1 Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3 Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in uso or intensity of uso o[ land or other natural rosoumos? Explaia briefly: C5 Orowlh, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6 Long term, short term, cumulative, or other effects not identified in C1-C57 Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL E IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENt!AL ADVERSE ENV!RONMENTAL !MPACTS? !f ~/e~ e?~la!n! 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 (0 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 potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any suppoding documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi.. determination. Name of Lead Agency Date Title of Responsible Officer Signature of Preparer (if different from responsible officer) Print or Type Name of Responsible Officer in Lead Agency Signature of Responsibte Officer in Lead Agency James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD PAUL ~TZ COUNTY OF SUFFOLK) STATE OF NEW YORK) , residing at/dba ~'--~ 1D bfq being duly sworn, depose and say: AFFIDAVIT OF POSTING That on the [(a day of~,)Gq ~ ,200~, I personally posted fhe prgperty known as by placing the Board (~f ~'ms~e~_J official poster where {t can'ea~ily 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. June 24~ 2009 on or about 6:00 PM. Dated: Sworn to before me this day of~.J.200 o~ Notary Public (signa!ureIW'~ ~ CONNIE D. BUNCH Notarj Public. Slate of New York No. 01BU6185050 .. qual~_ in,Suffolk Counly. ~omm~ssion ~'xpires April ~4, 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 That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: /oO /b/// 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. of Trustees Applicat County of Suffolk State of New York ~J~FlOl. q T~t/~.ff BEINGDULY SWORN DEPOSES ANE{ AFFIRM~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 PREMISES IN CONJUNCTION ~H_ RE~/}EW OF THIS APPLICATION SWORN TO BEFORE ME THIS DAYOF ~'-..~ ~ _o~ 20 ~9 Notary Public VICKI TOTH Nota~y..Publio, State of New York ~o. 01'[06190696 Qualified in Suffolk County Commission Expires July 28, 20 ( Z~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southotd's Code of Ethics nrohibits conflicts of interest on the aart of town officers and emnlovees. The numose of this form is to nrovide information which can alert the town of t~ossible conflicts of interest and allow it to take whatever action is nec ss to avoid same. YOUR NAME: ~'~t~.F_~ ,.~a/JqCc0 e name of (Last name, first name, ~niddl(m{tial, unless you are applying in th someone else or other entity, such as a company. If so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply~) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" memos 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 ,t~ 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 applicantYagentYrepresentative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __A) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a corporation); --B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted t~is ~day o~tr~~- 7 200 ~ Signature '-7 /eT/4.~A-- ~ . PrintName ' / ~) t{.,/~.~t /')~/-¢f 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. Thns~ each answer must be explained in detail~ listing both supportin~ and non- suooortin~ 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 SCT. /oOa -//6 - 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 transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: tl{)O Site acreage: , ~'-g9 ~ r'~. Present land use: f~'~,'cJa_~k ~ 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) Name of applicant: ~c// (b) Mailing address: ilo0 tl'~i/[ (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 - 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. 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 v ~cz/~ b~ r~,~,'-42 b~, ~,, ~ ~,'~,s. 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. ~-~ Yes~ No'Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE~ 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 $6 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 ~ N 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 TITLE ~O~d,4~ DATE Zone X Zo[3o PROPERTY AP~EAD; LOT. 4 I UNOFF CALCULATIONS: ~3'-o 112 © Co N87°32'15"W 42.56' ~/'e top of I(,ATZ I ESI DENCE edge of pavement 297,00 9~02'20 W 41.20' Iq ew POSE 52'-0 MAINTAIN 40'-0" DUffffEP~ Off UN DIDTP-,UBED VEGETATION BETWEEN CONSTRUCTION 4- TOP Off DANR 0 __ Orywell · 32'- 1/2" 11' 19' od curb c u rb balcor y g 20' el = 14' 2 Story Frame House Nood steps 12' ¥10SO/flr-~ sloop stone -7, driveway ?¢ _ 13 119' 07 f/aa t 079 o~ ~APPROVED BY ~ARD OF TRUSTEES OF SOUTHOLD DATE ~- z/ ~2'~ PAGE'