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HomeMy WebLinkAboutTR-7196 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0734C Date: April 3, 2012 THIS CERTIFIES that the demolition of existing dwelling and garage; construction of new dwelling with a stoop approximately 140 square feet in size on the seaward side, new garage, and new sanitary system At 5600 Indian Neck Lane, Peconic, New York Suffolk County Tax Map # 98-5-13 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated September 30, 2009 pursuant to which Trustees Wetland Permit #7196 Dated October 21, 2009 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the demolition of existing dwelling and garage; construction of new dwelling with a stoop approximately 140 square feet in size on the seaward side, new garage, and new sanitary system The certificate is issued to SYLVIA SAFER owner of the aforesaid property. Authorized Signature 25235 Main Road, Cutchogue NY 11935 (631) 734 6405 Fax {631} 734 6407 SAHUELS&STEELHAN PAGE 01/~2 Pages: Phone: Date: .-; ~4Pe~ cc= Urgent ~For Review [] Please Comment [] Please Reply Comments: 0~/0~/2012 11:06 6317~6~07 S~MUELS&STEELM~N PA~E 02/02 S A M U E ~ S S T E E L M A April 3, 2012 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 FAX 765 1366 & N APR - 3 2012 RE: DEMOLITION & RECONSTRUCTION OF THE SAFER RESIDENCE 5600 INDIAN NECK LANE PECONIC, NY 11957 TAX MAP # 1000-98-05-13 TRUSTEE'S PERMIT #7196 Dear Sir/Madam: The above referenced project is complete. During construction it was decided by the Owner not to build the waterside terrace as drawn and approved by the Trustees. Instead, the terrace was reduced to a more simple enlarged "stoop", totaling approximately 140 square feet, It is not intended to build the terrace. Please proceed with your final assessment of the project, culminating in a Certificate of Compliance. Please call us with any questions or concerns. Sincerely, SAMUELS & STEELMAN ARCHITECTS James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O, Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ~' Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction ½ constructed Project complete, compliance inspection. INSPECTED BY: ~'~~)~ ~ COMMENTS: ~ - CERTIFICATE OF COMPLIANCE: James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE I~Pre-construction, hay bale line st day of construction constructed fProject complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES ~UTHOLD; NEW YORK PERMIT. NO. 7196 ISSUED TO: SYLVIA SAFEI~ PROPERTY ADDRESS: 5600, INDIAN NECK LANE, PECONIC DATE: OCTOBER .21, 2009 SCTM# 98-5-13 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the_ResoP4tion of the Board of TrusWes adoPted at the meeting held on October 21, 2009? and in consideiaffi~ii.of aPl~!ication fee in the sum of $250.00 paid by Sylvia Safer and sub~ex:t to the Terms and ConditiOns as stated in the Re~lution, the Southold Town Board of Trastees authorizes and permits the following: Wetland Permit to demOli~h the existing dwelling and garage; construct a new dwelling and garage; new terrace on grade; and install a new sanitary system, and as depicted on the site plan prega~'ed by Samuels & Steelman Architects, last dated October 12, 2009, and received on October 14, 2009. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and thes~ presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permlttee Sylvia Safer, residing at 5600 Indian Neck Lane, Peconic, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project 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 p~t, 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 October 21, 2009 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Tom Samuels Samuels & Steelman Amhitects 25235 Main Road Cutchogue, NY 11935 RE: SYLVIA SAFER 5600 INDIAN NECK LANE, PECONIC SCTM# 98-5-13 Dear Mr. Samuels: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 21, 2009 regarding the above matter: WHEREAS, Samuels & Steelman Architects on behalf of SYLVIA SAFER 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 September 30, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 21, 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 the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of SYLVIA SAFER to demolish the existing dwelling and garage; construct a new dwelling and garage; new terrace on grade; and install a new sanitary system, and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated October 12, 2009, and received on October 14, 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:$100.O0 Very truly yours, Os es~F. KingC~'~' 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 TO: ~ Please be advised that your application dated ~has been reviewed by this Board at the regular meeting 'of ~ 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) ~ Constructed ($50.00) Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town COde. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: BY: James F. King, President Board of Trustees James Eckert, Chain~an 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., October 14, 2009, the following recommendation was made: Moved by Jack McGreevy, seconded by Doug Hardy, it was RESOLVED to SUPPORT the Wetland Permit application of SYLVIA SAFER to demolish the existing dwelling and garage; construct a new dwelling and garage; stone terrace on grade; and install a new sanitary system. Located: 5600 Indian Neck Lane, Peconic. SCTM#98-5-13 Inspected by: Jack McGreevy, Doug Hardy The CAC Supports the application with the Condition hay bales are installed prior to any construction activities, there are plans to secure the bluff, the run-off from the southeast corner of the new patio is contained and an effort is made to save trees above an 8" DBH. Vote of Council: Ayes: All Motion Carried James F. King. President Jill M. Dohcrty. Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. P,O, Box 1179 Southold, NY 11971 Telephone(631) 765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: SYLVIA SAFER requests a Wetland Permit to demolish the existing dwelling and garage; construct a new dwelling and garage; and install a new sanitary system, located: $600 Indian Neck lane, Pe¢oni¢. SCTM#98- 5-13 ~ I~LL~ 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: ~hapt.275 Chapt. 111 other Type of Application: ~etland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: V~King ~[d~oherty .~--F~ckerson ~rgen__ B.Ghosio, D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: +- OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAI[LING 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: Date: Re: MEMORANDUM Jim King, President Town of Southold Board of Trustees Mark Terry, Principal Planner ~-~% LWRP Coordinator October 15, 2009 Proposed Wetland Permit for SYLVIA SAFER SCTM#1000-98-5-13 Samuels & Steelman Architects on behalf of SYLVIA SAFER requests a Wetland Permit to demolish the existing dwelling and garage; construct a new dwelling and garage; new terrace on grade; and install a new sanitary system. Located: 5600 Indian Neck Lane, Peconic. SCTM#98-5-13 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 CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the following recommendations to further the below listed policies are implemented. Figure 1. Subject site. To further Policy 6. "Protect and restore the quality and function of the Town of Southolrl ecosystem" it is recommended that a natural ve.qetated buffer on the property landward of the "top of bank line" be established. A sample definition of a natural vegetated buffer follows: NATURAL VEGETATED BUFFER -- a land area of a certain length and width where existing (non-turf) 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 and replanting of vegetation. Additionally, to further Policy 5, "Protect and improve water quality and supply in the Town of Southold" and protect and improve the water quality and supply in the area; the following best management practices are recommended: 1. Require that all driveways be constructed of pervious material. 2. Prohibit the use of synthetic herbicides and fertilizers capable of entering surface waters or groundwater supplies. Pursuant to Chapter 266, 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 October 14, 2009 S A M U E L S & S T E E L M A N Southold Town Trustees P.O. Box 1179 Southold, NY 11971 Re: Safer Residence Dear Town Trustees: Enclosed please find the update surveys for the Safer residence on 5600 Indian Neck Road in Peconic. This project is scheduled to be reviewed at the October 21, 2009 meeting of the Southold Town Trustees. Please note that the new surveys and the revised site plans both have the land contours on them. Please substitute these in the packets for the 10/21/09 meeting. ~els Samuels and Steelman Architects ARCIqITECTS 25235 MAIN ROAD CU[CH©GUE, NEWYORK 11935 ~631) 734 6405 FAX (631 ) 734-6407 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosin, 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 .~wOaStat Erosion Permit Application efland Permit Application Adminisl~'ative Permit  __Amendment/Transfer/Extension eceived Application: eceivcd Fee:$ o~.~"~~r:( ~ _ ompleted Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) -~JvVRP Consistency Assessment Form [ C)~ .~GAC Referral Sent: .~l~tc of Inspection: I ~[ Receipt of CAC Report: Lead Agency Determination: Technical Review: J;~tb'lic Hearing Held: iO[ Resolution: Name of Applicant Ad&ess PhoneNumber:(C~3 4~;>2-~0 FXT- 2o~50 Suffolk County Tax Map Number: 1000- 7~7- I~) 5 '*/5 Property Location: ~j~ ~00 ],l~[]~l~ 3[ ~'t~' L~,~[~ ?l~¢x)d [~ (provide LILCO P01e #, distance to cross streets, and location) (If applicable) 25235 Phone: rd of Trustees Applicati¢ Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property:. GENERAL DATA /4(~t4q5 ~. = $.~ fid Covenants and Restrictions: Yes V 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 suspen, ded by a governmental agency? ~/ No Yes If yes, provide explanation: Project Description (use attachments if necessary): rd of Trustees Applicatic WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ¢~/~0{-I'/[c5/~/ 0~ .square feet Area of wetlands on lot: Percent coverage of lot: (~) % Closest distance between nearest existing structure and upland edge of wetlands: 0~[ £7tt fv~t Closest distance between nearest proposed structure and upland edge of wetlands: [ ~ ~ feet Does the project involve excavation or filling? No F Yes If yes, how much material will be excavated? [ C~ cubic yards How much material will be filled? [ C)O cubic yards Depth of which material will be removed or deposited: ~9 feet Proposed slope throughout the area of operations: '~ 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): ^to PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality FEC O~I//I ~i 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 Coun SEQR PRECISE LOCATION: Street Addess and Road InterseclJons. Prominent landmarks etc -or provide mad li DIFtN NECk' LMg£, ,b?f'£oK. r..'r. °F IS PROPOSED ACTION: [] New []Expansion [~Modification/alteration DESCRIBE PROJECT BRIEFLY: 7. AMOUNT F~/~/¢AND AFFECTED: Initially acres Ultimately ' ~/~ acres 8.1~ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? Yes [] No If no, describe briefly: lS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many asapply.) denfial []Industrial [~Commercial [~Agriculture []Park/Forest/OpenSpace E~]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGE y (Federal, State or Local) ~yG~$ •No If yes. list agency nam~ anri permit / approYa,: tJlO U r['"~ ~0 '-/-~ s ~1:7~ 11, DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? E~]Yes r"-~No If yes. list agency name and permit / approval: 12. AS A RESULT Of PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Spons~/~/~.~Signature Date: ~/~ 0/ 0 7 ' If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~enc¥1 A. DOES ACTION EXCEED ANY TYPE [ THRESHOLD tN 6 NYCRR, PART 617.47 If yes, coordinate the review process and use the FULL FAF. [--]Yes [~No B. WILLACTION RECEIVECOORDINATEDREVIEWASPROVIDEDFORUNLISTEDACTiONSIN6 NYCRR, PART617.67 IfNo, anogative declaration may be superseded by another involved agency. COULD ACTION RESULT ~N 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 bdefly: 1 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 use or intensity of use of land or other natural resources? Explain briefly: C5, Growth, subsequent development, or related activities likely to be induced h~ the proposed action? Explain briefly: C§. Long term, short term, cumulatiYe, or other effects not identified in C'i-~57 Explain bri*fly: C7. Other impacts lincluding changes in use of either quanfi~ or [Tpe of ene~l;/? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEAI? Ill yes, explain briefl~': PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve'determinewhetheritissubstantia~'[arge~imp~rtant~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the d etermination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the C EA. Check this box if you have identified one or more potenfially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF and/or prepare a pesifive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio WILL NOT result 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 Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (If different from responsible officer) 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 (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of SYLVIA SAFER COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, {J. F/0 Q '~-~01 ~ , residing at/dba c//'~ (152 ~ ~' being duly sw~m, d~o~e ~d~a~: That on the ]~dqy of ~, 200 {. I p~sonally posted the prop~y known ~ by placing the Bo~d of Trustees official poster where it c~ easily be seen, ~d that I have checked to be s~e the poster h~ remained in place for ei~t days prior to the date of the public hearing. Date ofhe~ng not~ thereon to be held Wed.~ October 21~ 2009 on or about 6:00 PM. Dated: (sig~) ~ ~/ Sworn to before me this day of 6~ 200f Notary Public ?¢ 5~:i2L~ RICHARDS Not?y Peb',ic, State of New York [!o. Ol RI6042467 Qualified in Suffolk County Commission Expires May 30,,2%~ Warren & Edit Meihado 165 Wood Lane Peconic, NY 11958 maTue: PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Robert & Eileen Wax Postage Eleanor Lang 102 Bradford Point Rd. Friendship, ME 04547 ~s & D. Schule I iA 01907 ~ m~.~ r~ ........... ,.,,,,,=,,, ................................................. ranK, n Dr. ~ ' * *~.~' ~* ~35 7068 ~2.30 Hem $~.32 5455 Indian Neck Rd. Peconic, NY 11958 Address: Sandra Engelke 83 Chelsea Rd. Garden City, NY 11530 William & Nettle Vantreuren 408 Arbor View Pompton Plains, NJ 07444 [ '801 Vito & Carla Santarsieri 22 Old Homestead Rd Albertson, NY 11507-1535 Sen ' ........................... [~.e.!.sea Rd. - ...........ling at c//--/0 ~'~_C~. ~-,-~.  duly sworn, dc'poses a~d says that on the ~0_~ deponent mailed a tree copy of the Notice set forth, in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said porsons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at C.M¢~/~ A~..K_0 , that said Notices were mailed to each of said persons by (certified) (re~iste{e~l) mail7. Sworn to before me this Day of ~5~/-~b/ , 20 Notary Public BABETTE CORNINE Notary Public, State Of New York No. 01 CO5792800 OLa tied in Suffolk County Commission ExpireS ~ July 8, 2008 Albert Safer 1875 McCarter Highway Newark, NJ 07104 I hereby authorize Thomas C. Samuels of Samuels and Steelman Architects, at 25235 Main Road, Cutchogue, NY, to apply for all required permits from the Town of Southold, Suffolk County and State of New York, for my project at 1295 Robinson Lane in Peconic, NY 11957. Sincerely, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the oart of town officers and emolovces. The p~se of this form is to provide i.i'vimation which can alert the town of oossible conflicts of interest and allow it to lake whatever action is necessary to avoid same. (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 cempany'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? "Relationship" includes by blood, marriage, or business interest "Business interest'? means a business, including a parmership, in which the town officer or employ~x.has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 57 ~the shares. V YES NO lfyou 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 pemon 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 the space provided. The town officer or employee or his or her spouse, sibling, parent, o~ ~hild is (check all that apply): A) the owner of grester than 5% of ibc shares of the corporate stock of the applicant (when the applicant is a corporation); __B) the legal or beneficial own~ 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 this dayof 200 ..~ Signature x'~E d/M~a~ 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", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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~ website (southoldtown.northfork.~,e.t), the Board of Trustees Office, th~ ~g ~eP~ u~-~--~---~t local libraries and the Town Clerk s office. B DESCR[PTIONOF SITE AND PROPOSED ACTION ~'~ The Applieation has been submitted to (check appropriate response): TownBoard [-~ Planning Dept. [] BuildingOept. [-~ BoardofTrnstees [] Category of Town of Southold agency action (check appropriate response): (a) (b) (c) Action undertaken directly by Town agency (e.g. capital [] construction, planning activity, agency regulation, land transaction) [] Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: Nature and extent of action: Demolition of existinq residence and abandonment of existing sanitary system, construction of new two story residence with new sanitary system & new attached qaraqe Locationofaction: 5600 Indian Neck Lane, Peconic, NY Site acreage:_ 3.363 AC Present land use: Single Family Residence Present zoning classification: R- 8 0 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: (b) Mailing address: Newark, Sylvia Safer 1875 McCarter Hwy NJ 07104 (c) Telephone number: Area Code ( ) 973-482-6400 (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? NYS DEC 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 ora coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. Yes [] No [] Not Applicable Demolishln9 an existin9, non-conformin9 structure and replacin9 it with a new structure, and sanitary system will improve the environmental situation on this beach and site. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of $outhold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria [] Yes [] No [] Not Applicable There are no historic or archeological structures on property. 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 The new structure is in keeping with the style of all neiqhborinq structures. Aaach 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 Ail rainwater runoff is and will be retained on site with the use of underground drywells. Durinq construction hay bales will be placed between the construction and the shore, to keeD runoff spoils on the site. 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 All rainwater runoff is and will be retained within the upland, by use of underground drywells. The sanitary system for the residence meets current SCHD standards for sanitary waste water. 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 Applicable No development will take place in the "protected" or "natural indi~inous environment" . 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 The development will not add pollutants into the air. All construction vehicles meet the Federal standards for air pollution discharge. The mechanical systems of the residence meet the federal standards for air pollution discharge. 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 The construction and use of the residence will make use of the town's disposal and recyclin~ center. Ail waste water "sanitary" will be discharged into an approved SCDMS sanitary system. 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 No public land involved. Littoral access unimpeded. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [] Yes [] No [] Not Applicable There are no public or commercial activities or uses on site. Historically this property and neiqhborinq properties are residential in use and will 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 - Palieies; Pages 57 through 62 for evaluation criteria. [] Yes [] No [] Not Applicable This project will protect and preserve the living marine resources by maintaining all rainwater discharge and sanitary flow from the residence on site by approved SCDHS sanitary system and drywells for rainwater runoff. 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 74 Not Applicable There are no agricultural lands on site. 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 The construction will be using equipment approved by the Federal government for energy usage. The residence will meet Federal standards for conserving enerq¥ "enerq¥ Star Proqram" and will use "NY State Enerqy Conservation and PREPARED BY ~~ Created on 5/25/05 11.'20 AM DATE S A M U E I_ S S T E E L M A September 30, 2009 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 RE: DEMOLITION & RECONSTRUCTION OF THE SAFER RESIDENCE 5600 INDIAN NECK LANE PECONIC, NY 11957 TAX MAP # 1000-98-05-13 Dear Sir/Madam: We are requesting a WETLANDS PERMIT for the above reference project, which the demolition of an existing residence and detached garage and abandonment of sanitary system, and the construction of a new residence with attached garage and new sanitary system, with associated improvements. For your review we are submitting the following documents: 2. 3. 4. 5. 6. 7. 8. Application Short Environmental Assessment Form Application Affidavit LWRP Consistency Assessment Form (3) SITE, FLOOR PLANS and ELEVATIONS prepared by Samuels & Steelman Architects Site Survey Letter of authorization from Owner Check for $250.00 Please ca. II us with any questions or concerns. Sincerely, SAMUELS & STEELMAN ARCHITECTS ~mu~els, Architect enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 (631) 734-6405 FAX (631) 734 6407 INDIAN NECK LANE 4.40 ~.od,~ ~ ~ ~o.e2 ~. ~1 [~ I? ~Oo~ ol I1~ ~'~ 1 II~ ~OE~ · l: ~// ~ ~ ~1 I1~ I ~ RESIDENCE o OVERALL ~ SITE PLAN ] REVISIONS: [ ~ 1~13 ~~NE SITE:, t46,4955F = 3.363ACRES ~ /// ~~~=::=~ ~_+~ /~~~'~~, ~ ~,,'/~..~/~// ~,, ~1' ,'/ ~ ~,~..~ ~ ~ I[ I I' =' I ~ / ~51OENOE ~ } PUBLIOMATE~ ~ ', J &OARD OF TEUoT'E~S ISHEET NO:' ' ' 0 ~.. TOWN OF SOUTHOL~_ 1 ~E PLAN ENLARGEMENT ~EGULATORY APPROVAL8 / Z Z m 0 0 oo m m m NOTES: SURVEY OF PROPERTY SITUATE INDIAN NECK - PECONIC TOWN OF $OUTHoLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-98-05-15 SCALE 1"=50' MAY 12, 2000 JUNE 17, 200g UPDATE SURVEY AUGUST 25, 200g STAKE 100' LINE FROM HWM OCTOBER 4, 2009 ADDED TOPOGRAPHICAL SURVEY AREA = 146,495 sq. ff. (TO TIE LINE) 3.563 ac. ELEVATIONS ARE REFERENCED TO N,G,V.D, 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:~ EXISTING CONTOUR LINES ARE SHOWN THUS: CERTIFIED TO' SYLVIA SAFER STEP 45 ~oo (?,~0~ic :NCE Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 F~x (651)727 1727 UNAUTHORIZED ALTERATrON OR ADDITION TO THIS SURVEY IS A VIoLATIoN OF THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED,