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HomeMy WebLinkAboutTR-7149 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. 7149 DATE: JULY 22~ 2009 ISSUED TO: RICHARD BOSWORTH PROPERTY ADDRESS: 4553 WlCKHAM AVENUE~ MATTITUCK sCTM# 107-4-13 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code oft_he Town of Southold and in accordance with the P, esolution of the Board of Trustees adopted at the meeting held on July 22~ 2009, and in consideration of application fee in the sum of $250.00 paid by Richard Bos?orth 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 install a new spa, in-ground swimming pool and patio, 4' high fence and gates, clear existing trees and shrubbery to 50' of freshwater wetlands and re-vegetate, and install an impervious driveway, with the conditions that a 50' Non- Disturbance Buffer will be maintained from the pool fence seaward to the freshwater wetlands, there be no clearing from the proposed limits of clearing line seaward to the tidal wetlands without further review from the Board of Trustees, the pool patio is made Pervious, and as depicted on the survey prepared by Metes and Bounds Surveying, last dated July 8, 2009, and received on August 4, 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 Richard Bosworth, residing at 4553 Wickham Avenue, 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 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 Permittec will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Petmittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. 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 July 22, 2009 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Richard Bosworth 5035 Peconic Bay Blvd. Laurel, NY 11948 RE: 4553 WICKHAM AVENUE, MATTITUCK SCTM# 107-4-13 Dear Ms. Bosworth: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, July 22, 2009 regarding the above matter: WHEREAS, RICHARD BOSWORTH 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 15, 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: no cleadng between the pool fence and the tidal wetlands, a 50' Non-Disturbance Buffer is to remain from the pool fence to the freshwater wetlands, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on July 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, 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 requirement 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 RICHARD BOSWORTH to install a new spa, in-ground swimming pool and patio, 4' high fence and gates, clear existing trees and shrubbery to 50' of freshwater wetlands and re-vegetate, and install an impervious driveway, with the conditions that a 50' Non-Disturbance Buffer will be maintained from the pool fence seaward to the freshwater wetlands, there be no cleadng from the proposed limits of clearing line seaward to the tidal wetlands without further review from the Board of Trustees, the pool patio is made pervious, and as depicted on the survey prepared by Metes and Bounds Surveying, last dated July 8, 2009, and received on August 4, 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, 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 (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ---~ fl e__- I~, c:~O ~ has been reviewed by this Board at the regular meeting of and your application has been approved pending the compld~on of {he ' following items checked off below. __ Revised Plans for proposed project __ Pro-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) ~_ 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 to-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: 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 (63 I) 765-1892 Fax (63 I) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 15, 2009, the following recommendation was made: Moved by James Eckert, seconded by Peter Young it was RESOLVED to SUPPORT the Wetland Permit application of RICHARD BOSWORTH to install a new spa, in-ground swimming pool and patio, 4' high fence and gates, clear existing trees and shrubbery to 50' of freshwater wetlands and to-vegetate, and install an impervious driveway. Located: 4553 Wickham Ave., Mattituck. SCTM#107-4-13 Inspected by: James Eckert, Peter Young The CAC Supports the application with the Condition the patio is pervious and there is a 50' non-disturbance buffer from the freshwater wetlands. Vote of Council: Ayes: All Motion Carried James F. King, President Jill M. Doherty, Vice-President Peggy A Dickerson Dave Bergen Bob Ghosio, J: PO. Box ll79 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: RICHARD BOSWORTH requests a Wetland Permit to install a new spa, in- ground swimming pool and patio, 4' high fence and gates, clear existing trees and shrubbery to 50' of freshwater wetlands and re-vegetate, and install an impervious driveway. Located: 4553 Wickham Ave., Mattituck. SCTM#107-4-13 .TY~alOtwf area to be impacted: ater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland ¢~hapTOWn Code proposed work falls under: t.275 Chapt. 111 other Type of Application: c-'~Wetland __Coastal Erosion ~Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: PresentWere:'~/J.King __~J.Doherty__P.Dickerson ~D. Bergen__. hos,o. D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: From: Mark Terry, Date: July 16, 2009 Jim King, President Town of Southold Board of Trustees Principal Planner LWRP Coordinator Re: Proposed Wetland Permit for RICHARD BOSWORTH SCTM#107-4-13 RICHARD BOSWORTH requests a Wetland Permit to install a new spa, in-ground swimming pool and patio, 4' high fence and gates, clear existing trees and shrubbery to 50' of freshwater wetlands and re- vegetate, and install an impervious driveway. Located: 4553 Wickham Ave., Mattituck. SCTM#107-4-13 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 below 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. Provide adequate buffers between wetlands and adjacent or nearby uses and activities in order to ensure protection of the wetland's character, quality, values, and functions. The adequacy of the buffer depends on the following factors: Potential for adverse effects associated with the use. Uses such as those involving hazardous materials, on-site sewage disposal, or mineral extraction have high potential for adverse effects and may require substantial buffer. The nature and importance of the wetland and its benefits. Substantial buffers may be necessary to avoid adverse effects from adjacent or nearby uses based on the nature of the land use and the characteristics of the affected wetland. Direction and flow of surface water between a use and adjacent or nearby wetland. Buffer widths may be reduced in areas where drainage patterns normally do not lead directly to the wetland and where adverse affects on the wetland, other than those due to runoff, are not likely. Buffer width necessary to achieve a high particulate filtration efficiency of surface runoff as determined by vegetative cover type, soil characteristics, and slope of land. Other management measures or design alternatives to protect wetlands from adverse effects where site constraints do not allow sufficient buffer width. E. Maintain buffers to ensure that adverse effects of adjacent or nearby development are avoided: Maintain buffers to achieve a high filtration efficiency of surface runoff. Avoid permanent or unnecessary disturbance within buffer areas. Maintain existing indigenous vegetation within buffer areas. Staff has researched the best available science on wetland buffers and the effectiveness of such buffers relative to width, spe(~ies composition and percent cover. Wetland buffer widths from 50 -100 feet are typically recommended to protect water quality and buffers widths of 100 to 350 feet or more are recommended to provide important wildlife functions. Wetland buffer widths assume that a buffer is vegetated with a native plant community necessary to provide adequate buffer functions. If a buffer (existing or otherwise) is sparsely vegetated, grass, or dominated by invasive species, the buffer should be enhanced with appropriate native species or widened. It is important to note that improving buffer vegetation (species composition and percent cover) is more effective in maintaining and/or enhancing buffer values and functions than merely widening the buffer. Although it is difficult to determine the proposed landscape area in relation to the freshwater wetland boundary, it is recommended that a 50' perpetual, natural vegetated buffer be required from the freshwater wetland and 100' perpetual natural vegetated buffer from the marine wetland boundary. 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, trimmin.q 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. 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: Lori Hulse, Assistant Town Attorney 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 ~:,~Cwoastal Erosion Permit Application etland Permit Application Adrtdnis~'ative Permit Amendment/Trans fer/E~tension Rece~vW~d Application: ~h ~'~]O ~t Received Fee:$ c.~%--'~) Completed Application ~ [l~O q __Incomplete __SEQRA Classification: Type I Type II Unlisted Coordination:(date sent). ~VRP Consistency Assessment Form ri! ~.,C..AC Re ferr al Sent: ql ~_~ate of Inspection: q l __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~olic Searing Held: q I a &[0 ~ Resolution: Name of Applicant /~eA/~.e~O ~3'~1/~r~7?-/ Phone Nmber:~~) ~ff 7- ~ Suffolk Co~ty T~ Map Nmber: 1000 - /~ ~-- ~ ~-/~ ~rovide LILCO P01e ~, ff~st~ce to cross s~eets, ~d location) AGENT: (If applicable) Address: Phone: of Trustees Applicatio GENERAL DATA Land Area (in square feet): ~'O! Area Zoning: Previous use of property: Intended use of property: /'~ Covenants and Restrictions: If "Yes", please provide copy. Yes ~( No Prior permits/approvals for site improvements: Agency, 77'.0. t / __ 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: of Trustees Applicatic WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Po~&/Ptf'~O/l.~$t. wgtg~/f~"A]~(1'' I Area of wetlands on lot: ! 4-01 square feet Percent coverage of lot: 7' / % Closest distance between nearest existing structure and upland edge of wetlands: ! Z~ feet Closest distance between nearest proposed structure and upland edge of wetlands: 5"c3 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? ED cubic yards Depth of which material will be removed or deposited: /~. ~' feet A¥ffg.~l~' Proposed slope throughout the area of operations: Manner in which material will be removed or deposited:/e/4,T~-J,~/.~ T'~ Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): PROJECT ID NUMBER SEQR PART 1 - PROJECT INFORMATION 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 county 3.PROJECT LOCATION: Municipality 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent Jandmarl~s etc -or provide mad 5, IS PROPOSED ACTION: ~ New ~ ~pansion ~Modifi~,on/alteration 7. AMOUNT OF LAND AFFECTED: Initially . ~ ~.J acres Ultimately , ;~ ~'~ acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? r'-~Yes [] No If no, describe bdefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ,~Residenti~l [~lndustdal [~Commercial [~]Agriculture [~Park/Forest/OpenSpace r~other (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.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes [~No If yes, list agency name and permit / approval: 12. AS A Rr.~ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~Yes ~__.JNo I CERTIFY THAT THE INFORMATION PROV~DEO ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ~ / Sponsor Name ~t~''~'lt~ Signature ~,/~.,,/'~Date: 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~lenc¥) A. DOES ACTIOt~ EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. E~]TM ~1No WiLL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration ma be superseded [] Yes []a~° NO by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pat[em, solid waste production or disposal, potential for erosion, drainage or floeding problems? Explain briefly: C2. Aesthetic, agricultural, amhaeologicol, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: Ca. Vegetation or fauna, fish, shalifish or wildlife species, significant habitat*, or thraatened or enden§srod sp~ies? Explain briefly: C4. A community's existing plans 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 activities likely to tie induced tiy the proposed action? Explain briefly: C6. Long term, short term, cumulative, or other effect* not identified in C7. Other impacts {inoludin~ ctian~es in use et oitharquantit,/or t~'pe of ener[l¥? ~xplain D, WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ~IRyeOsNME~°AiEi ii~17 llf )'es' explain bdefl}~: E. iS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If)'es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude, if necessary, add attachments or reference supporting materials. Ensure that explanatior~ 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 FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentabon, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons suppot[ing 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) James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of RICHARD BOSWORTH COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, [~lffdY~-~ /t~S/ot,~ff~, residing at/dba being duly sworn, depose and say: That on the Z~' d~ay qf,J~v~t~ , 200~, I personally posted~tt? property known as by placing the Board of Trustees official poster x~,here it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed., July 22, 2009 on or about 6:00 PM. Dated: Sworn to befo, ~ me this '200 ~ DEBBIE J MARITATO NOTARY PUBLIC-STATE OF NEW YORK No. 01MA6101833 gualltl®cl In Suffolk Courtly My Commal~ IK~M~II ~ i1~, PROOF OF MAILING OF NOTICE ATTACH CERTIHED MAIL RECEIPTS Name: :1)Y"F Fq° CIAL USE I Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $1 $2.80 $2,~0 Address: ~i~i~;2r~"'--";'"--'~ ............ -7 ........ ~"~'~ .................. 1 duly swom, d~oses ~d says ~at on ~e . '. ~,,. ~ I~.¢~. ... !,deponentmadeda~ecopyof~eNoUce' ~~ ~e Bo~f T~tees Apphcation, directed to each of ~e above n~ed persons at ~e ad&esses set opposite ~ere respective nines; ~at ~e ad&esses set opposite ~e nines ofs~d pemons ~e ~e address ofs~d p~sons ~ sho~ on the cu~ent ~sessment roll of ~e Tom of Sou~old; ~at s~d Notices were mailed at the U~ted States Post Office at~ ~o~o~ , that s~d Notices were mailed to each of said persons by (ce~ified) (re~stered) ~ail. DEBBIE J MARITATO NOTARY PUBLIC-STATE OF NEW YORK NO. 01MA6101833 Qualified In Suffolk County My Commission Expires November 17, 2011 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in deta'fl~ listing both supporting 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 Soufiaold ' 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# /07 04 I ~ PROJECT NAME /~5WC.,~-7'~ /~3"~4~ ~'~ The Application has been submitted to icheck appropriate response): TownBoar~ VI Planning Boar~ [--] ~uilaingOcpt. [] ~oar~ofTr.stees 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) Pen'nit, approval, license, certification: Nature and extent of action: Location of action: 45"'5'.,~ }%/tOdJ4~Pf/qP'~A/'~'~"'/ I17( . Site acreage: 1, ~' 3'-3'- Present land use: ~"3't 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: ;F_tC.~,%/E43 Co) Mailingad&ess: f-035- //ffl ' (c) Telephone number: Area Code ~3)t 7d'7-'3"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 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 Seetinn III - Policies Pages 16 through 21 for evaluation criteria [-~ Yes ~ No ~Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not App~ble At~ach 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. ~ 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 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 ~-~ Nog~E-] 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 Applleahle 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 TITLE DATE ~oard of Trustees ApplicatiOn County of Suffolk State of New York /~/4,~ ~/d..~,~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF 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. SWORN TO BEFORE ME THIS /ZQ~''A DAYOF /~ ,200~ DESS~E J NOTARY PUSL;C-$TAi'E OF NEW YORK NO. O~&&~01833 Quolltl®a In Suffolk County APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nmhibits conflicts of interest on the oart of town 6fficers and emnlovees. The purpose of this form is to nmvide information which can alert the town of oossible conflicts of intereSt and allow it to hake whatever action is necessary to avoid same. YOUR NAME: (Last name, first name,~iddle 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 Mooting 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? ' ' ' ' - · ' Relat onsh p ncludes by blood, mamage, or bus ness nterest. Business interest" means a business, including a partnership, in which the town officer or employee has even a paffial ownership of (or employment by) a corporation n wh ch the town officer or employee owns more than 5% of the shares YES NO ~ Ify0u ans ~ered YES , complete the balance of th s form and date and sign where indicated. Name of person employed by thc Town of Southold Title Or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in thc 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 thc corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, partner, or employee of the applicant; or __.D) the 9ctual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this .~day of ,~e. an/~- 200 9 Signature I~ ~ PrintName /~/e~t~4 ~rV'~£~ff~q SURVEY OF PROPERTY SITUATE MATTITUCK TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-107-04-13 " 40' SCALE 1 = FEBRUARY 25, 2009 MAY 12, 2009 ADDED PROPOSED POOL dUNE 9, 2009 FOUNDATION LOCATION JUNE 15, 2009 REVISED SITE PLAN JULY 8, 2009 REVISE SITE pLAN AREA = 80,818 sq. fi'. 1.855 cc. CEBTIFIED TO: RICHARD BOSWORTH CHICAGO TITLE INSURANCE COMPANY 5 NOTES: 1. ELEVATIONS ARE REFERENCEO TO N,G.V.D. 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS: ~1~ EXISTIHG CONTOUR LINES ARE SHOWN THUG: ...... 5 ..... 2, ANY WETLAND BOUNDARIES SHOWN ARE SUBJECT TO VERIFICATION BY NEW YORK STATE AND/OR OTHER REGULATORY AGENCIES. PROPOSED ELEVATIONS ARE SHOWN THUS: I I[J I S. MINIMUM SEPTIC TANK CAPACITIES FOR 0 4 BEDROOM HOUSE IS 1.200 GALLONS. 1 TANK; 6' DIA. 5' HIGH 4. MINIMUM LEACH[ND SYSTEM FOR 4 BEDROOM HOUSE IS SOO sq ff SIDEWALL AREA. 6 POOLS; 2' DEEP, 8' die. ~ PROPOSED EXPANSION P~)OL O PROPOSED LEACHING POOL ~ PROPOSED SEPTIC TANK 5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS, 6. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 11) FLOOD INSURANCE RATE MAP No. S6105C0146 D ZONE AR: BASE FLOOD ELEVATIONS DETERMINED 7. ADJACENT AREA (LOT AREA NOT INCLUDINO WETLANDS) = 74,121 sq. ff. PROPOSED HOUSE = 5,296 sci. fi. OR 7.1% OF THE ADJACENT AREA. APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD 8, FOR THE SEPTIC SYSTEM 200 cu. yds. OF SANDY LOAM AND SILTY SAND SHALL BE REMOVED AND 650 cu. ¥d$, OF CLEAN SAND TRUCKED IN FROM AN UPLAND SOURCE SHALL BE USED TO BACK FILL THE SYSTEM. TOTAL LOT COVERAGE OVER ADJACENT LOT AREA (74,121 sq, ~t,) DESCRIPTION AREA ~ LOT COVERAGE EXIST. HOUSE WITH PORCHES & ROOFED 5,296 sq, ft. 7.1% LANDINGS PROP. HOUSE PATIO 496 sq. ff. 0.7% =ROP. POOL & HOT TUB 705 sq. ft. 1.0% PROP. POOL PATIO 755 sq. ff. 1.0% PROP. DRIVEWAY 5,452 sq. ff. 4.6% TOTAL EXIST. & PROP. 10,704 sq. ft. 14.4% \ METES AND BOUNDS SURVEYING 22 AMERICAN AVENUE CORAM, NY. 11727 PHONE (631) 736-B~50 FAX (651) 766-9550 LOT: 13 BLOCK: 04 SECTION: 107 DISTRICT: 1000 MAP OF: SITUATED AT: MATTITdCK TOWN OF SOUTHOLD, SUFFOLK CO., N.Y, CERTIFIED TO: I~ICHARD BOSWORTH CHICAGO TITLE INSURANCE COMPANY JOB NO.: __09-~102D / DATE' JULY 7, 2009 / t DRAINAGE SYSTEM CALCULATIONS. DRIVEWAY AREA: 5,452 sq. ff. 597 cu. ff. / 42.2 = 14 verNcel fL of 6' dim le~chlng pool required PROV[D£ (7) 8' die. X 2' hIBh STORM DRAIN POOLS ROOF AREA: 5.272 sq. ff. 5,272 sq* ff. X 0.17 -- 896 cu. ff. PROVIDE (11) 8' dia. X 2' high STORM DRAIN POOLS PROPOSED 6' OIA. X 2' DEEP DRYWELL$ FOE ROOF RUN-OFF ARE SHOWN THUS: ~_~' PROPOSED 6' DIA. X 2' DEEP DRYWELLS FOR DRIVEWAY RUN-OFF ARE SHOWN THUS: POSWOR H j'4A-t'f ITUC/C ~ ~.Y. %CA b'~: ~A~ICIA oc~o ~J / L:~C4 h"T'l kJC TO CONFOff~ TO STATE AND LOCAL CODES. CC)NTRA~UK L (~e.,c~u~ ,/ ~ FOR ~SHIP AND WARIIANTIES.~e~./'" --, ~,~ f POOL ., '