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HomeMy WebLinkAboutTR-7231AJill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederneyer Town Hail 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 # 0565C Date: August 16, 2010 THIS CERTIFIES that the removal of the two existing dormers and replaced with two larger framed dormers At 474 Wilderness Point~ Fishers Island, New York Suffolk County Tax Map # 12-2-6.15 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated 12/22/09 pursuant to which Trustees Administrative Permit # 723 lA Dated 1/20/10 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 removal of the two existing dormers and replaced with two larger framed dormers The certificate is issued to JAMES BAILEY owner of the aforesaid property. Jill 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 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE Of INSPECTION: iCh. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain st 1 day of construction constructed /...~roject complete, compliance inspection. INSPECTED BY: ~ COMMENTS: H.P. BROOM - HOUSEWRIGHT, INC. P.O. BOX 70 - 162 FERRY RD. HADLYME, CT 06439 (860) 526 - 9836 FAX (860) 526 - 2647 LETTER OF TRANSMITTAL Date: 8/09/10 BOARD OF TOWN TRUSTEES ?. O. BOX 11'79 SOUTHOLD, NY 11971 ATT: LAUREN WE ARE SENDING YOU X Attached __ Under seperate cover via BAILEY RESIDENCE 474 WILDERNESS POINT FISHERS ISLAND, NY the following items: __ Shop Drawings -- Prints __ Plans __ Samples __Specifications -- Copy of Letter __ Change Order __ Other Copies Date N__o Description 1 Photos THESE ARE SUBMITTED as checked below: __ For approval __ Approved as submitted -- Resubmit__ copies for Approval X For your use -- Approved as noted __ Submit __ copies for Distrib. AS requested __ Returned for corrections __ Return__ corrected prints X For review and cogent PRINTS P~TU~ED A.~"x'mR LOAN TO US Enclosed you will find the above referenced material which, I hope, are all the documents needed for the completion a Trustees Permit. Please feel free to give a call should you have any questions or should additional material be required. Thank you, Reed Newton - Permits H.P. Broom - Housewright, Inc. SmarLZone Communications Center Page I of I SmartZone Communications Center Bailey job From: Gary Nistick <gmistick@sbcglobaLnet> Subject: Bailey job TO: hbroomL~comcast.ne[ Thu 3ul 8 2010 12:54:51 PM I a~tachmen~ 112 KB http://szO071 .wc.mail.comcast.net/zimbra/h/printmessage?id=40980&xim= 1 8/9/2010 Jill M. Doher~y, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 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 Ist day of construction ½ constructed v/' Project complete, compliance inspection.- Jill 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 Permit No.: 7231A Date of Receipt of Application: December 22, 2009 Applicant: James Bailey SCTM#: 12-2-6.15 Project Location: 474 Wilderness Point, Fishers Island Date of Resolution/Issuance: January 20, 2010 Date of Expiration: January 20, 2012 Reviewed by: Board of Trustees Project Description: Remove two (2) existing dormers and replace with larger framed dormers. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Jacob D. Albert, Architect, last dated December 4, 2009, and received on December 22, 2009. Special Conditions: None. Inspections: Final !'nspection and/or photographs of completed project. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. of Trustees v JMD:eac Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 TO: Please be advised that your application dated'-'J~,,,,[c~z-~. ~,~3oc~ has been reviewed by this Board at the regular meeting of~,~o,,-~ ,-20; o1~/(~ ~nd your application has been approved pending the completior~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) 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: Jill M. Doherty, President Board of Trustees Jill M Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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: H.P. Broom-Housewright, Inc. on behalf of JAMES BAILEY requests an Administrative Permit to remove two (2) existing dormers and replace with larger framed dormers. Located: 474 Wilderness Point, Fishers Island. SCTM#12-2-6.15 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment ~Ad ministrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: __&King __J.Doherty __J. Bredemeyer B.Ghosio, __ D. Dzenkowski other Form filled out in the field by D. Bergen__ Mailed/Faxed to: Date: ~:{ File View Toolbar Help Double click to open a window H.P. BROOM - HOUSEWRIGHT, INC. P.O. BOX 70 - 162 FERRY RD. HADLYME, CT 06439 (860) 526 - 9836 FAX (860) 526 - 2647 LETTER OF TRANSMITTAL Date: 1/27/10 To: TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES P. O. BOX 1179 SOUTHOLD, NY 11971 ATT: LAUREN Re: BAILEY RESIDENCE 474 WILDERNESS POINT FISHERS ISI2%ND, NY WE ARE SENDING YOU X Attached -- Under seperate cover via -- the following items: __ Shop Drawings -- Prints __ Plans __ Samples __Specifications __ Copy of Letter -- Change Order __ Other Copies Date No. 1 Description H.P. Broom-Housewright check # ;~q~ in the amount of $50.00 for Final Inspection THESE D~RE SUBMITTED as checked below: __ For approval -- Approved as submitted __ Resubmit__ copies for Approval X__ For your use __ Approved as noted __ Submit -- copies for Distrib. __ AS requested __ Returned for corrections __ Return__ corrected prints _X_ For review and comment PP.INTS P~Tu~NI~D AFxmR LOAN TO US Enclosed you will find the check for Town Trustees Final inspection. Please feel free to give a call should you have any questions. Thank you, Reed Newton - Permits H.P. Broom - Housewright, Inc. FZLE NOTES (For Office Usc Only) bATE & INITIALS OFFICE 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: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Jim King, President Town of Southold Board of Trustees From: MarkTerry, Principal Planner N~~ LWRP Coordinator Date: January 15, Re: Proposed Wetland Permit for JAMES BAILEY SCTM# 1000-12-2-6.15 H.P. Broom-Housewright, Inc. on behalf of JAMES BAILEY requests an Administrative Permit to remove two (2) existing dormers and replace with larger framed dormers. Located: 474 Wilderness Point, Fishers Island. SCTM#12-2-6.15 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 EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "B" which states: A. Maintenance or repair involving no substantial changes in an existing structure or facility. Cc: Lori Hulse, Assistant Town Attorney James F. King, President Jill M. Dohe~y, Vice-Preeident Peggy A. Dickerson Dave Bergen Bob ~nosio, Jr. Town Hall 53095Route 25 P.O. Box 1179 Southold, New York11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application }~ Adminis~ative Permit ~ __Amendment/Tram fer/Extension Received Applicatio~ I ~ ~4~eceived Fee:$ ~.~ , _ .~ompleted Application I ] [6!1 ~_ Incomplete SEQRdk Classification: Type I Type II Unlisted Coordination:(date sent) ~LWRP Consistency Assessment Form t !"/! ! 0 CAC Referral Sent: 7Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: ,~Public Hearing Held:~ Resolution: Name of Applicant Address ~dro~K' Phone Number:(~/) ) #grT~ ~ Suffolk County Tax Map Number: 1000- ~CPCr/,~ /.2 6'~f-~ 2. l_~-' d~'~ PropertyLoeation:q?~/ I. Otto~4l~ ,~o,,vv- /c-/sa~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: ~,/q. ~,qoc,~ -/¥a~.Cc/T~/G/~7--, .~'d. (If applicable) J Address: t~.~, ~?a~ ~'o /o/-~ ~-,~I/ /~O /~//,OO~./r,'/~/ ~ Phone: )ard of Trustees Applicat Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: Yes X/' No If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? )d No Yes If yes, provide explanation: Project Description (use attachments if necessary):. R~u~ .Tz~o ~er~alq ~o~. Beard of Trustees Applicat~em WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ~' ~ .square feet Percent coverage of lot: ./,3"fi- % Closest distance'between nearest existing structure and upland edge of wetlands: /.R.,f'" ~./- feet Closest distance between nearest proposed structure and upland edge of wetlands: Aff. g'"'b~- 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: - 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 b~y~ i'eas0n 0f ~uch pf~cl- b ' ail nS"(hs at~ii~hmen~ ii' app~:-0p/-i-at ~i 8;,052;,2 RART'I - PROJECT INFORMATION 1. APPLICANT ! SPON8OR 3.PROJECT LOCATION: lip ]~ROON HOUSEI~GHT et?,,~O ' APPEND~ C STATE ENVIRONMENTAL QUAUTY REVIEW SHORT ENVIRONMENTAL A88ESBMENT FORM for uNUm~D Acnofl80nty ( To be complet~ by A :~ant ar Proj~t Spot.·or] 2. PROJECT NAME SEQR 02 B. DE~,RIBE PROJECT I~RIEFLY: ?. AMOUNT OF LA,'NO AFFECTED: ~ ~. WILL PROP(~ED ACTION COMPLy ~ E~5"TING ZONING OR OTHER IM~"rRICTIONS? LAND USE IN VICINITY OR PROJECT? ";O,'DOES ACTION ,INVO~.VE A F'~MIT AFPROVH.., OR FUNDING, NOW OR ULTIUAI~LY FROM AJCY' OTHER GOVERNM~NT, M. AGENCY (Federal, I~Yee ["--~Ye~ L~No agency llama permll I Ap~¢~t I PROP.~O ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I (~RTIFY THAT THE INFORMATION PROVIDED ABOVE iS 'I~UE TO 11-1E BE;~T OF MY KNOWLEDGE If tile a,:tlon b · Co~tal Area, and you are a state agency, complete the Coa·tM Aa·e~ment Fomt be~re proceeding with this a~,sessment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF. ["-'lYes r~--i NO B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declarafion may be superseded by another involved agency. r--lYes r~lNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quan~y, noise ievela, existing traffic pattem, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeoio~i-cal, historic, or other natural or cultural resources; or community or neighbe~hced character? Explain briefly: ! I.. C3. !~g~iati0~n-~i~a~J~a, fish, shellfish or Wil~liife species, signiflca~lt habitats, or threatened 0'i~'endangered sp~i~ Explain I~fly~ "'J C4. A community's existing plans or goals as officially adopted, or a change in use or ntens ty of use of and or other nalura resources? Exp a'n bnefly C5. Growth, subsequent development, or related activit es key to be nduced by the proposed action? Expla;n b y C~. kontt term, short term, cumulafive, or other effects not idantiffed in C1~§? Explain bbefly: INo ....... C7. Other im¢e~ linc ud n~ chanties in use of either ({uanti[~ or t'i/pe of ene~l}~? Exp aln beetle': D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CFAI? Iii )'es, explain bbefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: [] es 171"o I PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantiai~~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 determination 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 kJentified one or more potentially large or significant adveme impacts which MAY occur. Then proceed directly to the FULl. EAF and/or prepare a positive declaration, Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NOT result in any significant adveme environmental impacts AND provide, on attachments as necessary, the roasons supporting thti determination. Board of Trustees Name of Lead Agency Jill M. Doherty Printjor Type Name of Responsible Officer in Lead Agency _~ Signature of RespOnsible Offide~ Lead Agency Date President Title of Responsible Officer Signature of Preparer (If different Eom responsible officer) H.P. BROOM - HOUSEWRIGHT, INC. P,O. BOX 70 - 162 FERRY RD. HADLYME, CT 06439 PHONE (860) 526 ~ 9836 FAX (860) 526 - 2647 12/10/09 To Whom It May Concern: H. P. Brooro- Housewri~.ht. Inc:., P.O. Box 70, Hadlyme, CT - 06439, is authorized to act as my agent to conduct and apply for all necessary permits pertaining to the alteration of a residence located at 474 Wilderness Point, within the Town of Southold, Fishers Island, New York. Owuer(s) of record: Jmes ~ Address: Cambridfe Ass~iates 100 Summer Street Boston, MA 02110 Board of Trustees Applic~on County of Suffolk State of New York 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 1N 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. 1N 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 Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Etifies omhibits conflicts of interest on the omi of town officers and emnlovees. The vurcose of ~0. 'rs form is to orovide information which can aler~ thc town of uossible conflicts of intem~t and allow it to take whatever action is necessary 1o avoid same. (Last name, lb'at name,~niddle initial, unless you are applyiag in the name of someene else or other entity, such as a ~ompany. 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 Coostal 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 blo6d, marriage, or hush,ss interest "Business interest" means a business, including a pa~nership, in which the town officer or employee has even a partial ownership of(or employment by) a coh~oration in which the town officer or employee owns more than 5% of the shares. YES NO )<5 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 Descrihe the relationship between yomself (the applicant/agant/represe nt ative) and the town officer or employee. Either check the appropriate line A) through D) and/or deserihe in tl~ space pro~ided. The town officer or employee or his or her spouse, sibling, parent, or ~hild is (cheek 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); __.(2) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Signature Print Name H.P. BROOM - HOUSEWRIGHT, INC. P.O. BOX 70 - 162 FERRY RD. HADLYME, CT 06439 (860) 526 - 9836 FAX (860) 526 - 2647 LETTER OF TRANSMITTAL Date: 1/04/10 To: TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES P. O. BOX 1179 SOUTHOLD, NY 11971 ATT: LAUREN WE ARE SENDING YOU __~Attached Under seperate cover via Re: BAILEY RESIDENCE 474 WILDERNESS POINT FISHERS ISLAND, NY the following items: __ Shop Drawings __ Prints -- Plans __ Samples __Specifications __ Copy of Letter __ Change Order __ Other Copies Date 1 12/22/09 1 12/30/09 1 No. Description Transactional Disclosure Form LWRP Consistency Assessment Form H.P. Broom-Housewright check % in the amount of $50.00 THESE ARE SUBMITTED as checked below: __ For approval -- Approved as submitted -- Resubmit__ copies for Approval ~_ For your use __ Approved as noted -- Submit __ copies for Distrib. -- As requested __ Returned for corrections -- Return__ corrected prints X For review and comment -- PP--~NTS RETURNED ~a~rma--LOAN TO US Enclosed you will find the above referenced material which, I hope, are all the documents needed for the issuance of a Trustees Permit, Please feel free to give a call should you have any questions or should additional material be required. Thank you, Reed Newton - Permits H.P. Broom - Housewright, Inc. H.P. BROOM - HOUSEWRIGHT, INC. P.O. BOX 70 - 162 FERRY RD. HADLYME, CT 06439 ($60) 526 - 9536 FAX (860) 526 - 2647 LETTER OF TRANSMITTAL Date: 12/17/09 To: ATT: TOWN OF SOUTHOLD BOARD OF TOWN TRUSTEES P. O. BOX 1179 SOUTHOLD, NY 11971 WE ARE SENDING YOU X Attached -- Under seperate cover via Re: BAILEY RESIDENCE 474 WILDERNESS POINT FISHERS ISLAND, NY the following items: Shop Drawings Prints Plans __ Samples __Specifications -- Copy of Letter __ Change Order __ Other Copies Date No. 3 12/14/09 3 12/04/09 A-1 /A-5 3 2/12/04 1 12/14/09 1 Description Application For Trustees Permit (3 copies) Architectural Plans (1 STAMPED -2 copies) Site Plan Act As Agent Letter H.P. Broom-Housewright check % in the amount of $500.00 THESE ~=RE SUBMITTED as checked below: __ For approval __ Approved as submitted -- Resubmit__ copies for Approval X__ For your use -- Approved as noted __ Submit -- copies for Distrib. AS requested -- Returned for corrections -- Return__ corrected prints _X_ For review and cogent PRINTS RET~ A~-rmR LOAN TO US Enclosed you will find the above referenced material which, I hope, are all the documents needed for the issuance of a Trustees Permit. Please feel free to give a call should you have any questions or should additional material be required. Thank you, Reed Newton - Permits H.P. Broom - Housewright, Inc. Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Tow~ of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Water~ont 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 detail~ listing both suooortin~ and non- sun~ortin~ 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 SCTM# PROJECT NAME The Application has been submitted to (check appropriate response): TownBoara PinaningBoaraV] .ui aingDept. oa ofT usteesl Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital constmetion, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Location of action: Site acreage: ~'.~. Present land use: Present zoning classification: 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: X'f, fl ~',e~m~ ,44va,c~rco~e~-~) .,z~. (b) Mailing address: /o/o~ ~'O?/g~' /'/o~ W. & ~o~ 3~0 (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 Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section IIl- 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 ~7~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 Applicable 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 POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations% Se~,LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. ~ Yes [] No~12~l Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. [] Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. Yes NoJ NotApplicablc 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 J/~.~ d/~/e7~07~ TITLE/o~,~ -/df, g'~o~ DATE ~F ~c,, 9_ 2 2ggg APPROVED BY BOARD OF TRUSTEE.~ TOWN OF $OUTHfOLD DATE / ~o ~o o 20 (~RAPHIC SCALE IN FEET REVISIONS DATE DESCRIPTION DATE: dANUARY 1,7, 1990.,.J SCALE: 1" = 20' SHEET I OF 1 TOPOGRAPHICAL PLAN MADE FOR JAMES N. FISHERS BAILEY ISLAND, NEW YORK CHANDLER, PALMER & KING ARCHITECTS, ENGINEERS & SURVEYORS 110 BROADWAy, NOR~ICH, CONNECTICUT 06360 (203) 889-3397 (203) 883-780! TOP OF 2ND Fl_R, FIN. FLR, ~ B SOUTH ELEVATION SCALE: t/4" = t'-0" BAILEY DORMERS FISHERS ISLAND, NY TABLE OF CONTENTS Al.0 COVER SHEET I0/20/09 I2/04/09 A2.0 2ND FLOOR PLAN O O A3.0 EXTERIOR ELEVATIONS O O A4.0 DETAILS O O A5.0 INTERIOR ELEVATIONS O O A WEST ELEVATION SCALE: 1/4": 1'-0" TOP OF 2ND Ifil! BB lIE ,F1E] I lie lib LIB BE] r BBBiB_m ~BlEI II I- 511 BB[3Zl["]~ ]3 I[ i'll I I II I Il Ills 111313Z iB TOP OF 2ND FUt. FIN, FLR. ~ ,St,,N,,B, BBB O -- I 2o5 ~ BEDROOM~ ~ BEDROOM IBEDROOM ~ ~ BEDROOM ~~ BEDROOM, J I 20~1 BATH ~06 ] ~H ~ ' l 208] ~ DORMER BORMER = 2ND FLR P~N TOP OF 2ND R.R, FIN. FLR, EXIST'G DORMER "A" B SOUTH ELEVATION SCALE: 1/4": I'-D" A WEST ELEVATION SCALE: I/4" = 1'-0" NEW ~MER "B" NEW DOI~MER "C" A B MNFIN. CUSTOM CUSTOM IYHk R-24 MIN. OPEN-CELL FOAM INSULATION 2x8 RAFTERS, @ 16" O.C. -- ~" CDX PLYWD. SHEATHING ICE & WATER SHIELD, ENTIRE ROOF -- COPPER STANDING SEAM ROOFING 12 10 HURRICANE TIE ~" GYP, BD, ON STRAPPING BLOCKING COPPER DRIP CEDAR COVE, 2" RAD. WINDOW CASINO TO MATCH EXISTING lx CEDAR FASCIA lx CEDAR SOFFIT CEDAR BED MOLDING, TO MATCH EXIST'G DORMER "A" ~x CEDAR FRIEZE BD., BLOCK OUT AS REQ'D TO OVERLAP CASING COPPER FLASHING -- Ix CEOAR CASINO A WINDOW ELEVATIONS SCALE: 1/2" = 1'-0" DETAI SCALE: WINDOW R.O. Ix CEDAR CASINO -- COPPER FLASHING R-19 MIN. OPEN-CELL FOAM INSULATION DBL HUNG FIXED PAIrLHN 8/8 VARIES WINDOW SASH SIZI- WxH SCHEDULE HOUGH UPLNING 4:-0 1/2" x 5'-0 1/2" 2'-5' x VARIES WxH 4'-3' x 5'-3" 2'-7 1/2' x VARIES C CUSTOM FIXED 3W x VARIES 2'-5" x VARIES 2'-7 1/2' x VARIES HLMAHKS HORIZ. MUNT1NS TO ALIGN W/ A HORIZ. MUNTINS TO AUGN W/A WINDOW NOTES: SASH FRAMES, JAM¢IS, SILLS TO BE MAHOGANY. ALL WOOD EDGES TO BE SHOP-PRIMED. GI.,e,Z1NG TO BE 1/8' CLEAR, SINGLE GLASS. B/%ANCES FOR DBL HUNGS TO BE CONCEALED SPRIN~-IYPE "PUI.I.MAN" BALANCES. MuNT1N PROF1LE TO BE SHAPED TO MATCH EXIST'G. DORMER 'A' WINDOWS, ~ DETAIL W/ARCH'T. EXiLKiOR CASINGS TO BE CLEAR, VERT1CAL GRAIN C~, FLAT STOCK. SASH UFTS TO BE BALDWIN, DE-LAQUERED BRASS, MODEL ~'I'BD, 2 PER DBL HUNG SASH. ALL NEW WINDOWS TO HAVE: STORM WINDOWS, WHIR BAKED ENAMEL RNISH. DOUBLE HUNG WINDOW TO HAVE TRIPLE-TRACK STORM/SCREEN. WINDOWS TO BE MADE BY ONE OF THE FOLLOWING COMPANIES: ARCHITECTURAL COMPONENTS, INC 26 NORTH LEVERul ROAD MONTAGU~ MA 01351 PHONE: 413-367-9441 SOUTHSHORE MILLWORK 7 MAPLE ST. NORTON, MA 02766 PHONE: 508-226-5500 CONTACT PERSON: DOUG EDWARDS NOTE: 1. MAX. U-FACTOR FOR NEW SINGLE GLAZED WINDOWS & STORM WINDOWS TO BE 0.56 2. PROVIDE PRE-CUT STRUCTURAL PANELS FOR WINDBORNE DEBRIS PROTECTION. PANELS SHALL BE MADE O~ 1/2" THICK CDX PLYWOOD. INSTALL WITH 2 1/2" ~8 WOOD SCREWS ~ 16" ON CENTER. <CD © ~-,~ r,~ z'~ I ~ I BEDROOM 202 C BEDROOM 202 SCALE: 1/2" = 1'_0" SCALE: 1/2" = 1'_0" ~DROOM 20S 3 B~D~oo~ 2os X