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Home My WebLink AboutTR-7255 Jill M. Doherty,President r3f soorjto Town Hall Annex Bob Ghosio,Jr.,Vice-President h0 l� 54375 Main Road P.O. Box 1179 James F.King Southold,New York 11971-0959 Dave Bergen G Q %k deme er • �� Telephone(631) 765-1892 John Bre Y ?ycouno,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0643C Date: May 17, 2011 THIS CERTIFIES that the construction of a one-story addition and deck addition with steps,• gutters to leaders to drywells installed• a 10' wide non-turf buffer to be maintained along the bulkhead At 1025 Albacore Drive, Southold,New York Suffolk County Tax Map# 57-1-14 Conforms to the applications for a Trustees Permit heretofore filed in this office Dated February 12, 2010 pursuant to which Trustees Wetland Permit#7255 Dated March 17, 2010 and Amended on August 18, 2010 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 construction of a one-story addition and deck addition with steps; gutters to leaders to drvwells installed,• a 10' wide non-turf buffer to be maintained along the bulkhead The certificate is issued to MICHAEL & CAROLEE LEVISON owner of the aforesaid property. thorized Signator John Bertani Builder Inc. 1380 Oakwood Drive Southold, N.Y. 11971 (516)765-1594 FAX(516)765-3916 tl - 6 2011 May 6,2011 Michael and Carolee Levison-Pero no.7255 Ms. Jill Doherty, President Southold Town Trustees P.O. Box 1179 Southold, NY 11971 Dear Ms. Doherty: We are requesting a project complete, compliance inspection for the Michael and Carolee Levison Residence, 1025 Albacore Drive, Southold, permit#7255. Thank you. Sincerely, Linda D. Bertani Vice President Jill M. Doherty,President �O�gpFFO(,fCO Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President .\ P.O. Box 1 179 James F. King - Southold,NY 11971 Dave Bergen T Telephone(631)765-1892 John Bredemeyer ��. '� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /'� Ltt Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction % constructed JProject complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: MARTIN D. FINNEGAN SCOTT A.RUSSELL TOWN ATTORNEYO�``0 f SOurO! Supervisor s martin.finnegan@townouthold.ny.us `` /y JENNIFER ANDALORO ~ Town Hall Annex, 54375 Route 25 ASSISTANT TOWN ATTORNEY P.O. Box 1179 jennifer.andaloro@town.southold.ny.usG Southold, New York 11971-0959 • i� LORI M. HULSE Ory .�1 Telephone (631) 765.1939 ASSISTANT TOWN ATTORNEY CO� ,� Facsimile(631) 765-6639 lori.hulse@town.southold.ny.us OFFICE OF THE TOWN ATTORNEY TOWN OF SOUTHOLD Robert E. Herrmann September 8, 2010 Coastal Management Specialist 1319 North Sea Road Southampton, NY 11968 RE: Michael and Carolee Levison, Wetlands Permit No. 7255 Dear Mr. Herrmann, I have reviewed the Declaration of Covenants draft you submitted to this office with respect to the above referenced applicant concerning the ten foot wide non-turf buffer. The covenants and restrictions document must be executed and filed with the County pursuant to §275-10(K) of the Southold Town Code. Please note that a copy of this document or, in the alternative, a sworn statement attesting to the filing is to be presented to the Office of the Board of Trustees within 90 days of issuance of the permit. Regards, F ' i„- Lori M. Hu Assistant Town Attorney Cc: Board of Trustees 1319 North Sea Road Southampton, New York 11968 ^^ 631-283-6360 36 EN-CONSULTANTS, INC. www.enconsultants.com ENVIRONMENTAL CONSULTING pp September 16, 2010 ��—� U ,. ! SEP 17 2010 I Lauren Standish Board of Trustees BSf lT Town oardrd oof Trustees Town of Southold P.O. Box 1179 Southold,NY 11971 Re: Michael & Carolee Levison.Wetlands Permit No. 7255 Dear Ms. Standish: In satisfaction of Term and Condition #8 of the captioned permit, the required Declaration of Covenant was recorded in the Office of the Suffolk County Clerk on September lb, 2010. A copy of the recorded document is enclosed for your files. Xselyyours,ens � '" Enclosure cc: Michael & Carolee Levison CC# : C10-33778 COUNTY CLERK'S OFFICE j STATE OF NEW YORK ( ', $EP 7 20Jo I COUNTY OF SUFFOLK Southhold Town'—�'' e 6o2rd of husters I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 09/16/2010 under Liber D00012637 and Page 528 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 09/16/2010 SUFFOLK COUNTY CLERK n JUDITH A.PASCALE SEAL SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 09/16/2010 Number of Pages: 4 At: 09: 49:25 AM Receipt Number : 10-0108268 LIBER: D00012637 PAGE : 528 District: Section: Block: Lot: 1000 057 . 00 01 . 00 014 . 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15. 00 NO TP-584 $0. 00 NO Notation $0 . 00 NO Cert.Copies $5.20 NO RPT $30 . 00 NO Fees Paid $95 .20 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County ❑I Z❑ Number of pages L his document will be public cord. Please remove all .tial Security Numbers irx Io recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee (✓ Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation ` ` SpecJAssit. 7 U or EA-5217(County) Sub Total Spec./Add. EA-5217(State) TOT.MTG.TAX R.P.T.S.A. Dual Town Dual County — Affidavit Held for Appointment Comm.of Ed. 5. 00 Trans ferTax Mansion Tax Certified Copy The property covered by this mortgage is C )G or will be improved by a one or two NYS Surcharge 15. 00 Sub Total J family dwelling only. Other 2U YES or NO — G Grand Total If NO, see appropriate tax clause on page# of this instrument. 4 1 Dist. 1 C 1000 05700 0100 014000 0 5 Community Preservation Fund Real PropertyPTS Consideration Amount $ Tax Service F2 VIT A Agency 15SEP-10 CPF Tax Due $ Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: Vacant Land TO En-Consultants, Inc. 1319 North Sea Road TD Southampton,NY 11968 TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffo[kcountyny.gov/clerk Title# s Suffolk County Recording & Endorsement Page This page forms part of the attached Declaration of Covenants made by: (SPECIFY TYPE OF INSTRUMENT) Michael Levison The premises herein is situated in Carolee Levison SUFFOLK COUNTY,NEW YORK. TO In the TOWN of Southold Town of Southold In the VILLAGE Board of Trustees or HAMLET of Southold BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over DEC1",AR,,Tivl>'. i)F COVENANTS THIS DECLARATION made tli_i.� t day of -AW-461 2010, by Michael and Carolee Levison, residing at_ 1015 Albacore Drive, Southold, NY 11971, hereinafter referred to as "DECI:7'.RANT5 " : W I 'I' N (E S S E T H WHEREAS, DECLARANTS are the owners of certain real property located qn Albacore Drive, Southold, Town. of Southold, County of Suffolk, State of Now York, described in the Suffo'.k :ounty Tax Map as District 1000, Section Block Oil, Lot 14, whicl, i.i more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property s on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANTS therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake :.E9r rain regulated activities; and. WHEREAS, as a condition ;,f the granting of a Wetlands Permit to on.derr_ake such regulated activities , the Trustees required that a ten-foot aide "nonturf buffer" be estatilshed adjacent to and landward of the oul.khead on the Property, NOW, THEREFORE, the DECLARANTS do hereby covenant and agree as :allows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained adjacent to and landward of the bulkhead on the Property a ten- foot wide "nonturf bi,fier" as defined by Chapter 275 of the Town Code; and 2) This requirement may cn i be modified by the DECLARANTS, their heirs, assigns, purchase r[+, or successors in interest upon resolution of the Trustees . LN WITNESS WHEREOF, the owners have duly executed this instrument this day of 2010 . Michael Levison r Grin Carolee Levison Jeanne Sweet Banos STATE OF �� NOTARY PUBLIC,State of New York No.O1BA6210083 s Qualgied in Suffolk County --OL7NTY OF � "�- Commission Expires August 10,2Q115 On the 1 day of Av,,o-,Lj-&T , in the year 2010, before me th.e undersigned, a Notary Public in and for said State, personally appeared Michael and Carolee Levison, personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacity, and that by their signatures on the instrument, the individual or the persons on behalf of which the individuals acted, executed the instrument. r�^Q� "v` �- otary Public 2 SCHEDULE A ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 33 as shown on a certain map entitled, "Map of Southold Shores as Arshomomaque, Town of Southold, Suffolk County, New York" made by Otto W. Van Tuyl and Son, Licensed Land Surveyors, Greenport, New York, dated July 1, 1963, and filed in the office of the County of Suffolk, New York, on August 29, 1963 as Map No. 3853. 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 August18,2010 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Mr. Robert E. Herrmann EN-Consultants, Inc. 1319 North Sea Road Southampton, NY 11968 RE: MICHAEL& CAROLEE LEVISON 1025 ALBACORE DRIVE, SOUTHOLD SCTM# 57-1-14 Dear Mr. Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 18, 2010: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Wetland Permit #7255 to modify the proposed one-story addition from a 10'x17.7' square foot addition to a 12'x17.7', 212 square foot addition; and to modify the configuration and reduce the size of the proposed deck from 186 square foot to 168 square foot, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated July 27, 2010, and stamped approved on August 18, 2010. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Jill k~D~hert~y' ~'~~ President, Board of Trustees JMD:eac Jill M. Dohe~ly, President James F. King~ Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer P.O Boxl179 Southold, NY 11971 Telephone ( 631 ) 765 - 1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: En-Consultants, Inc. on behalf of MICHAEL & CAROLEE LEVISON requests an Amendment to Wetland Permit #7255 to modify the proposed one-story addition from a 10'X 17.7' sf. addition to a 12'X 17.7', 212 sf. addition; and to modify the configuration and reduce the size of the proposed deck from 186 sf. to 168 sf.. Located: 1025 Albacore Dr., Southold. SCTM#57-1-14 reato be impacted: ter Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland own Code proposed work falls under: 275 Chapt. 111 other Type of Application: LL--~tland __Coastal Erosion __Administrative__Emergency Pre-Submission __ ~Amendment Violation Info needed:/~., Modifications: Conditions: Present Were: ~J.King __~J.J.Doherty __J.t'~Bredemeyer /-'~D. Bergen__ B.Ghosio, __ D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: James F. King, Jill M. Dougherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631 ) 765-1892 FAx (631) 765-1366 LETTER OF REQUEST FOR AN AMENDMENT DATE August 1, 2010 OWNER Michael & Carolee Levison PHONE 239-642-6731 ADDRESS P.O. Box 1235, Southold, NY 11971 AGENT En-Consultants, Inc. PHONE 631-283-6360 ADDRESS 1319 North Sea Road, Southampton, NY 11968 PROPERTY LOCATION 1025 Albacore Drive, Southold TAX MAP NO. 1000-57-1-14 l/We EN-CONSULTANTS, INC. request an Amendment to Permit # 7255 To modify the proposed one-story addition from a 10' x 17.7', 177 s.f. addition to a 12' x 17.7', 212 s.f. addition; and to modify the configuration and reduce the size of the proposed deck from 186 s.f. to 168 s.f., all with no effective change in wetlands setback (setback will increase from 58' to 58.5') and as proposed on the site plan prepared by Nathan Taft Co,win III, last dated July 27, 2010. Signed By: ROBERT E'~ERRMANN, ~OASTAL MGMT. SPECIALIST Board of Trustees Applica~ AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the S~~Town Trustees on my behalf. (Owner's signature) of Trustees Applicat~ County of Suffolk State of New York (~4',4oc~f_ I{ /--~0'[5o/w BEINGDULYSWORN 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 1N 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), 1F 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. RE/yI~W O]~ THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF~27~,20 0 ~ -]Noiary P~olic t LtNDA J COOPER NOTARY PUBLIC, Stale of New York NO, 01CO4822563, Suffolk County Term Expires December 31, 30~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of $outhold'~ Code of Ethio~ prohibits ¢o0flic~:~ of interest on the vart of town officers and emolovees, The nurvose o£ this form is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action is necessary to avoid same. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) X 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 partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO & If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the 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, or child is (check all that apply): __A) the owner of greater than 5% of the shares of the 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 actual applicea~t. DESCRIPTION OF RELATIONSHIP Form TS ] EN-CONSULTANTS, INC. ENVIRONMENTAL CONSULTING 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants.com August2,2010 REOIIEST FOR AN AI)MINISTRATIVE~ AMENDMENT Town of Southold Board of Trustees Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Michael & Carolee Levison 1025 Albacore Drive, Southold SCTM #1000-57-1-14 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including a) authorization & disclosure forms, and b) surveys. Copy of Permit #7255. Application fee of $50.00. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Sincerely, Enc. Jill M. Doherty, President .lames F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederneyer 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 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 ~ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7255 DATE: MARCH 17~ 2010 ISSUED TO: MICHAEL & CAROLEE LEVISON PROPERTY ADDRESS: 1025 ALBACORE DRIVE~ SOUTHOLD SCTM# 57-1-14 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 Resolution of the Board of Trustees adopted at the meeting held on Marchl7, 2010. and in consideration o£application fee in the sum of $250.00 paid by Michael & Carolee I~vison and subject to the Term~ hud Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits th6 follOWing: Wetland Permit to cons,truct a one,story addition and. deck addition with steps onto an existing one-story, on//'21Iamily dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide non-turf buffer, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated January 28, 2010, and received on February 12, 2010. IN WITNESS WHEREOF, th~ 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 Michael & Carolee Levison, residing at 1025 Albacore Drive, Southold, 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 th~ said Permittee assumes full liability with respect thereto, to the complete exclnsion 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. 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. 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 March 17, 2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Robert E. Herrmann En-Consultants, Inc. 1319 North Sea Road Southampton, NY 11968 RE: MICHAEL & CAROLEE LEVISON 1025 ALBACORE DRIVE, SOUTHOLD SCTM# 57-1-14 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, Mamh 17, 2010 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of MICHAEL & CAROLEE LEVlSON 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 February 12, 2010, 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 March 17, 2010, 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, 2 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 MICHAEL & CAROLEE LEVlSON to construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide non-turf buffer, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated January 28, 2010, and received on February 12, 2010. 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, Ji M~.Dohedy~ President, Board of Trustees JMD/eac Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 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., March 10, 2010, the following recommendation was made: Moved by Peter Young, seconded by Anne Tdmble, it was RESOLVED to SUPPORT the Wetland Permit application of MICHAEL & CAROLEE LEVISON to construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide non-turf buffer. Located: 1025 Albacore Dr., Southold. SCTM#57-1-14 Inspected by: Peter Young Vote of Council: Ayes: All Motion Carried Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer P.O. Box 1179 Southol& NY 11971 Telephone(631)765-1892 Fax (631)765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: MICHAEL & CAROLEE LEVISON request a Wetland Permit to construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide non-turf buffer. Located: 1025 Albacore Dr., Southold. SCTM#57-1-14 area to be impacted: ater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland ~,of Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application:/'//"Wetland __Coastal Erosion ~Administrative__Emergency Pre-Submission __ __Amendment Violation Info needed: Modifications: Conditions: Present Were: ~r~J.~King ~J.Doherty ~. Bredemeyer B.Ghosio, D. Dzenkowski other Form filted out in the field by L~D ~'Bergen~V''''~ Mailed/Faxed to: Date: MICHAEL AND CAROLEE LEVISON~ 1025 ALBACORE DRIVE, SOUTHOLD Figure 1. Looking south from canal at existing dwelling and location of proposed addition and deck. Figure 2. Looking north from location of proposed addition Wward canal to Southold Bay. OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) $outhold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southeld, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jill Doherty, President ~ Town of Southold Board of Trustee~/ From: Mark Terry, Principal Planner \'~J ~ LWRP Coordinator ~ Date: March 15, 2010 Re: Proposed Wetland Permit for MICHAEL & CAROLEE LEVlSON SCTM#1000-57-1-14 En-Consultants, Inc. on behalf of MICHAEL & CAROLEE LEVlSON requests a Wetland Permit to construct a one-story addition and deck addition with steps onto an existing one-story, one- family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide non-turf buffer. Located: 1025 Albacore Dr., Southold. SCTM#57-1-14 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 below Policy Standards and therefore is CONSISTENT with the LWRP. 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 Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Brederncyer 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 Office Use Only Coastal Erosion Permit Application --~Vetland Permit Application Amendment/Transfer/Extension ..~eceiv~d Application:~ ~Received Feel r'~~ ~Ompleted Application ~ ~ ITO Incomplete SEQRA Classification: Type I Type 11 Unlisted Coordination: (date sent) ~_ ~[TWRP Consistency Ass~rm o~[~0 1 ]'~ ~-AC Referral Sent: ~l,~tnllD ..J~gte of Inspection: 3!1/~ !]~ Receipt of CAC Report: Lead Agency Determination: Technical Review: S/l~blic Hearing Held: ~'~! I"~ ]! 0 Resolution: Administrative Permit Name of ApplicantMICHAEL & CAROLEE LEVISON Address P.O. BOX 1235, SOUTHOLD, NY 11971 Phone Number: (![531 ) 765-3638 Suffolk County Tax Map Number: 1000 - 57-1-14 Property Location: 1025 ALBACORE DRIVE, SOUTHOLD (provide LILCO Pole #, distance to cross streets, and location) AGENT: EN-CONSULTANTS, 1NC. (If applicable) Address: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 Phone: 631-283-6360 Board of Trustees Appli GENERAL DATA Land Area (in square feet): 22,450 SQ. FT. Area Zoning: R-40 ion Previous use of property: DEVELOPED-RESIDENTIAL, ONE-STORY, ONE-FAMILY DWELLING Intended use of property: NO CHANGE Covenants and Restrictions: X No Yes If "Yes", please provide copy. Prior permits/approvals for site improvements: Agency Date ~e No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Proiect Description (use attachments if necessary): Construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide nonturf buffer, all as depicted on the site plan prepared by Nathan Taft Corwin Ill, last dated January 28, 2010. Board of Trustees Applic~on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Addition to existing dwelling to accommodate master bathroom and deck addition. Area of wetlands on lot: +/-453 _square feet Percent coverage of lot: +/-2 % Closest distance between nearest existing structure and upland edge of wetlands: 64 feet Closest distance between nearest proposed structure and upland edge of wetlands: 56 feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated?N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: feet N/A 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): The project consists of a 177 s.f. addition to an existing one-story dwelling and a 186 s.f. addition, which will increase lot coverage by 363 s.f. or 1.65 percent. The proposed footprint addition will achieve a 60' wetlands setback compared to the existing 64' wetlands setback to the dwelling, and the deck steps will be located a minimmn 56' from wetlands. As mitigation for the marginal increase in coverage and decrease in wetlands setbacks, the project incorporates the establishment of a 10' wide nonturf buffer landward of the existing bulkhead, whose area will total more than 1,000 s.f. or three times the area of the proposed increase in coverage. The addition will also be equipped with leaders, gutters and a drywell, which together with the nonturf buffer will result in an increase in the runoff absorption capacity of the properly. Therefore, the project will have no significqant adverse impact on the adjacent tidal wetlands or waters of the Town and should in fact result in an improvement to the overall environmental condition of the property. ~ROJECT ID NUMBER PART 1 - PROJECT INFORMATION EN-CONSULTANTS, 1NC. 3. PROJECT LOCATION: Municipality SOUTHOLD 617.20 ~ APPENDIX C W STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME LEVISON ADDITIONS County SUFFOLK 4. PRECISE LOCATION: Street Address and Road Intersections. Prominent landmarks etc - or provide map 1025 ALBACORE DRIVE, TOWN OF SOUTHOLD, SCTM #1000-57-l-14 5.1SPROPOSEOACTION: [] New C-~E~oansio~ [~Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: SEQR Construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide nonturf buffer, all as depicted on the site plan prepared by Nathan Taft Corwin II1, last dated January 28, 2010. 7. AMOUNT OF LAND AFFECTED: Initially 0.515 acres Ultimately 0.515 ac~es 8. WILL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? ~]Yes [] No Ifno. describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~ResidenlJa, Olndustdal OCommerdal ~gdculture O Park / Forest / Open Space OOther(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: NYS DEC LETTER OF NON-JURISDICTION, SOUTHOLD ZONING BOARD OF APPEALS 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? []Yes [~No If yes, list agency name and permit / approval: NYS DEC LETTER OF NON-JURISDICTION # 1-4738-03946/0000 l 1~,S A P~ULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? L.JTM ~ No I CERTIFY TI'-~T THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Na~_ROBERT E. HERRMANN, COASTAL MANAGEMENT SPECIALIST [~t~: FEB. 5, 20 ] 0 Signature If the action is a Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. [] Yes [] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative dectaratirm may be superseded by another involved agency. r-i Y~, []No c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwntten, if legible) C1. E~sffeg air quality, surface or groundwater quality or quantity, Noise levels, existing traffic pattern, sotid waste preduction or disposal, potential for erosion, drainage or flooding problems? Explain bdefly: I"° I C2. Aesttmfic, agrleufiurel, archaeological, historic, or other natural or cultural resources; or community or neighborbcod character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain bdefiyi C4. A community's existing plans or goals as off~ially adopled, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent devstopment, or related activit!es likely to be Induced by the proposed action? Explain bdefiy: L",.°. ..... C6. Long term short term cumulative, or other effects not identified in Cl-C57 Explain briefly: C7. O~r Impacts Iincludin~l chan~e$ in usa of etih~r quanti~ ar ~/~ of er~r~l~? E~ain brlefi~: I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? (If [(esr explain bdefl¥: E. IS THERE, OR IS THERE LIKELY TO BE1 CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If~es explain: PART Ill - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse etfect identified above, detarrnine whether it is substantial, large, important or otherwise signirmant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) in'evemibilit¥; (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 CEA. Check this box if you have identified one or mom potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULl EAF and/or prepare a positive declarelion, Check this box f you have determined, based on the information and analysis above and any supporting documentation that the proposed actior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Board of Trustees Name of Lead Agency Jill U'J p~DntOchreTy~Ype Name of Resppnsible Officer in Le~d Agency ~// 'g ~.v,,~,7 v,,,~ ' Agency President Date T~tle of Responsible Officer Signature of Preparer (If different from responsible officer) EN-CONSULTANTS, INC. ENVIRONMENTAL CONSULTING 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www.enconsultants.com March 11, 2010 Re~ Michael & Carolee Levison 1025 Albacore Drive, Southold SCTM #1000-57-1-14 Dear Sir or Madam: Recently you received a "Notice to Adjacent Property Owner" for the above referenced meeting scheduled for March 17, 2010 at 6:00 p.m. Review of the notice indicates that the correct names, addresses, meeting time and survey was provided, however, the project description was incorrect. The corrected project description is as follows: Construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a lO' wide nonturf buffer, all as depicted on the site plan prepared by Nathan Taft Corwin II], last dated~lanuary 28, 2010. A revised Notice is also included for your review. Should you have any questions, please do not hesitate to contact our office. Thank you for your attention to this matter. Sincerely, KimStephens Adminis~ative Asst. Unc. cc: Town of Southold Board of Trustees OFFICI Po~g, ~ [s~t ro Claus Rademacher ~ ~,~:~ 156 Sheridan Terrace r,-~%~.~x..~ Ridgewood, NJ 07450 1 2010 ~ rn OFFICI E Southold Shores Group, Inc. "-I P.O. Box 870 570 Tarpon Drive Southold, NY 11971 .- OFFICIA E j.~ D°nald Hymans Evergreen Drive er S · PP addle R~ver, NJ 07458 OFFICIA Return Receipt Fee (Endorsement R~:lulred) Here Restricted Delivery Fee (Endomement Required) m m s,,tro Virginia D. Bayles Revocable Trust ~[~ ~'t-' P.O. Box 396 ..%...~o....soL~ Southold, NY 11971 OFFICI E s~tro R.H. Chilton Credit Shelter Trust '1 / [~£.~.~, ~1305 Blue Marline Drive I~'~- ~outhold NV : m,-,, NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: MICHAEL & CAROLEE LEVISON S C TM#1000-57-1-14 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide nonntrf buffer, all as depicted on the site plan prepared by Nathan Taft Corwin Ill, last dated January 28, 2010. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1025 ALBACORE DRIVE, SOUTHOLD 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: MARCH 17, 2010 ~ 6:00 P.M. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: MAILING ADDRESS: PHONE#: MICHAEL & CAROLEE LEVISON P.O. BOX 1235, SOUTHOLD, NY 11971 631-765-3638 AGENT: EN-CONSULTANTS, INC. MAILING ADDRESS: 1319NORTH SEA ROAD, SOUTHAMPTON, NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of MICHAEL & CAROLEE LEVISON COUNTY OF SUFFOLK) STATE OF NEW YORK) being duly sworn, depose and say: That on the ~[~day of AFFIDAVIT OF POSTING 4'/' ,2010, I personally posted the property known as by placing the Board of Trustees official poster where 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.~ March 17~ 2010 on or about 6:00 PM. Dated: ~: (signature) -- S~_wom to before me this ]7''B' day of fi{a'd20~/o NO'(ar~ Public ~ - NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: MICHAEL & CAROLEE LEVIS ON S C T M # 1000-57-1-14 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a 25' vinyl groin extension to the landward side of an existing timber groin and remove +/-14 linear feet of adjacent deteriorating steel groin, as depicted on the project plan prepared by En-Consoltants, lnc. dated 2, 2010. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1025 ALBACORE DRiVE, SOUTHOLD 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: MARCH 17, 2010 ~ 6:00 P.M. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: MICHAEL & CAROLEE LEVISON MAI LING ADDRESS: P.O. BOX 1235, SOUTHOLD, NY 11971 PHONE#: 631-765-3638 AGENT: EN-CONSULTANTS, INC. MAILING ADDRESS: 1319 NORTH SEA ROAD, SOUTHAMPTON, NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. I PROOF OF MAILING OF NOT~E~p '~ATTACH CERTIFIED MAIL TS Name: VIRGINIA D. BAYLES REVOCABLE TRUST Address: P.O. BOX396 SOUTHOLD, NY 11971 R.H. CHILTON CREDIT SHELTER TRUST 1305 BLUE MARLIN DRIVE SOUTHOLD, NY 11971 SOUTHOLD SHORES GROUP, INC. P.O. BOX 870, 590 TARPON DRIVE SOUTHOLD, NY 11971 CLAUS RADEMACHER 156 SHERIDAN TERRACE RIDGEWOOD, NJ 07450 DONALD HYMANS 10 EVERGREEN DRIVE UPPER SADDLE RIVER, NJ 07458 STATE OF NEW YORK COUNTY OF SUFFOLK ROBERTE. HERRMANN doing business atEN-CONSULTANTS, INC. 1319 NORTH SEA ROAD SOUTHAMPTON, NY 11968 , being duly sworn, deposes and says that on the 5 th day o f t4arch ,20 10 , deponent mailed a true 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 their respective names; that the addresses set opposite the names of said persons 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 SOUTHAMPTON , that said Notices were Mailed to each of said persons by (certified) (registered) mail. ROBERT E. HERRMANN COASTAL MANAGEMENT SPECIALIST Sworn to before me this 5th day of Morcb ,20 10 ~ ~/ ~ Notary P~iblic OFFICIAL O liAR - 5 USE Virginia D. Bayles Revocable Trust P.O. Box 396 Southold, NY 11971 OFFIC Donald Hymans 10 Evergreen Drive Upper Saddle River, NJ 07458 Southold Shores Group, Inc. P.O. Box 870 570 Tarpon Drive Southold, NY 11971 J OFFI USE Postage Cellifled Fee m D Return Rsce[pt Fee (Endorsement Required) Restricted DerNe~ Fee [::3 (Endomement Required) m ru Total Postage ~ F 133 [:::'..:: ........ Claus Rademacher 156 Sheridan Terrace Ridgewood, NJ 07450 ~- OFFICI u3 ~ m SE R.H. Chilton Credit Shelter Trust 1305 Blue Marlin Drive Southold, NY 11971 AUTHORIZATION (where the applicant is not the owner) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the S~~v~{oTown Trustees on my behalf. (Owner's signature) of Trustees Applicatio~ County of Suffolk State of New York C~o 6~. p( l.- ~Vi$Ox~ 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 O~' THIS AP.PLICATION. Signature SWORN TO BEFORE ME THIS DAY OF~ _,20 O ~' -JNo:tary P~olic [INDA $ COOPER NOTARY PUBLIC, State of New York NO. 01 C04822563, Suffolk Coun~ Term Expires December 31, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tbe Town of Southold's Code of Ethics r~mhibits conflicts of interest on the vart of town officers and employees. The Durt>ose of this form is to orovide information which can alert the town ofvossible conflicts of interest and allow it to take whatever action necessary to avoid same. (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ~ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (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 partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the 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, or child is (check all that apply): __.A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); B) the legal or beneficial owner &any interest in a non-corporate entity (when the applicant is not a corporation); __C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Town of Southold A. INSTRUCTIONS I, LWRP CONSISTENCY ASSESSMENT FORM A ll applicants f0r perm its* inctudingT0wn 0fS0uth01dagencies,shallc0mpletethisCCAF for proposed actions that are subject to the Town 0f S0uth01d W aterfr0nt Consistency Review Law. This assessmentisintendedt0supplement0therinf0rmati0n used byaT0wn 0fS0uth01d agency in m a k in g a d ete r m in a ti 0 n 0 f c 0 n s is t e n c y. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- suvvortin~, 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 all libraries and the Town Clerk's office. SCTM# 57 I 14 PROJECT NAME MICHAEL & CAROLEE LEVISON DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): TownBoard ~] Planning Board [--] Building Dept. ~] BoardofTrustees[~] Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Construct a one-story addition and deck addition with steps onto an existing one-story, one-family dwelling; install a drainage system of leaders, gutters and drywell; and establish a 10' wide nonturf buffer, all as depicted on the site plan prepared by Nathan Taft Corwin ill, last dated January 28, 2010. Location of action: 1025 ALBACORE DRIVE, SOUTHOLD Site acreage: 0.515 ACRE Present land use: DEVELOPED-RESIDENTIAL, ONE-STORY, ONE-FAMILY DWELLING. Present zoning classification: R-40 If an application for the proposed action has been flied with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: MICHAEL & CAROLEE LEVISON (b) Mailing address: P.O. BOX 1235 SOUTHOLD, NY 11971 (c) Telephone number: Area Code 631-765-3638 (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. NYes V'~ 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 I11 - 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 The minor one-story & deck additions proposed to the existing dwelling will not alter the existing visual impact of the property; and the establishment of the nonturf buffer behind the bulkhead will create an improved natural appearance along the shoreline. 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 [5~ Yes ~'] No [---] Not Applicable The project will protect and improve water quality and thus be consistent with Policy 5 through the establishment ora 10' wide and more than 1,000 square-foot nonturf buffer in place of existing maintained lawn area landward of the existing bulkhead. The surface water runoff absorption capacity of the site will be increased not only by the establishment of the buffer but also via installation of a drainage system of leaders, gutters, and a drywell to capture and recharge roof runoff from the proposed addition. 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 The project is consistent with Policy 6 the incorporated nonturf buffer and drainag gation outlined above (see Policy 5) and because a project-limiting fence and staked haybales will be installed to contain site disturbance during construction. With respect to compliance with Trustees and NYS DEC laws and regulations, the work has been exempted from the DEC's Tidal Wetlands Land Use Regulations due to its location landward ora functional, pre-1977 bulkhead. Due to the location of the preexisting house and the proposal to install a master bathroom to the existing master bedroom, which is on the watemide of the house, the additions cannot be located more than 100 feet from wetlands, but the scope of the project has been limited and potential impacts will be mitigated as described above. 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 [--] Noir] 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 R 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 lSo. iicy 10. Pro. tect Southold's ~4~r-dependent uses and promote sit'of new water-dependent uses in statable Iocataons. See LWRP Sec-~ion II1 - Policies; Pages 47 through 5'6'for evaluation criteria. [--] Yes [--] No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peeonie 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 [--] No [~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [---] Yes ~'] No [5~ Not Applicable PREPARED BY RTE'. ROBE ERRMANN TITLEcoASTALMGMTSPECIALIST DATE 2/5/10 Amended on 8/1/05 EN-CONSULTANTS, INC. ENVIRONMENTAL CONSULTING 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www. enconsultants,com February5,2010 Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold, New York 11971 Attn.: Lauren Standish Re: Michael & Carolee Levison 1025 Albacore Drive, Southold SCTM #1000-57-1-14 Dear Ms. Standish: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: Three (3) Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization & Disclosure Forms; c) project plan; and d) survey. One (1) set of site photographs. Application fee of $250.00 wetlands. Three (3) LWRP Consistency Assessment Forms including: a) project plan. I trust this information shall allow you to process our permit request. Should any additional information be required, please do not hesitate to contact our office. Robert E. Herrmann Coastal Management Specialist /kbs Enc. · lS, N 84°3o'°,°'' E 33.85 STORy FRAME .00' $ NOTES. 1. 2. 3. FEB 12 2010 SURVEY OF LOT 33 MAP OF SOUTHOLD SHORES FILE No. 3853 FILED AUGUST 29, 1963 SITUA TED A T ARSHAMOMAQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-57-01-14 SCALE 1"--20' OCTOBER 14, 2008 DECEMBER 1, 2009 ADDED PROPOSED ADDITION JANUARY 2B, 2010 ADDED ADDITIONAL NOTES AREA = 22,450 sq. fi, 0.515 ac. CERTIFIED TO. MICHAEL LEVISON CAROLEE LEVISON ELEVATIONS SHOWN ARE REFERENCED TO N.A.V.D. 1988 DATUM LOT AREA LANDWARD OF BULKHEAD = 21,997 sq. ft. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 36103C0159 H ZONE AE. BASE FLOOD ELEVATIONS DETERMINED. ZONE X: AREAS D~ERMINED TO BE OUTSIDE THE 0,2% ANNUAL CHANCE FLOODPLAIN. AREA DATA (OVER LOT AREA LANDWARD OF BULKHEAD (21,997 sq ft.)) DESCRIPTION AREA % LOT COVERAGE EXISTING HOUSE 2,000 sq. ff. 9.09% PROPOSED 1 STORY ADDITION 177 sq. ft. 0,80% PROPOSED DECK 186 sq. ft. 0.85% TOTAL 2,363 sq. ft. 10.74% DZAINAOE SYSTEM CALCULATIONS. 1 STORY ADDITION AREA: 177 sq. ff. 177 sq. ff. X 0.17 = 31 cu. ff. 81 cu. ff. / 8.73 = 4 vertical ft. of 4' dTa. leaching pool required PROVIDE (1)4' dia. X 4' high STORM BRAIN POOL PROPOSED 4' DIA. X 4' BEEP BRYWELL WITH GUTTER LEADER FOR ROOF RUN-OFF: APPROVED bq [',OARD OF TRUSTEES TOWN OF,$OUTHOLD___~ THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, N.Y.S, Lic, No 50467 Nathan Taft Corwln III Land Surveyor PHONE (631)727-2090 Fax (651)727 1727 k °U RogD 84'30'0,0" E 33.85 / ./ / / PROPOSED 4' DIA. NOTES' 1. 2. 5. SURVEY OF LOT 33 ' MAP OF SOUTHOLD SHORES FILE No. 3853 FILED AUGUST 29, 1963 SITUATED AT ARSHAMOMAQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK s.c. TAX No. 1000-57-01-14 SCALE 1':20' OCTOBER 14, 2008 DECEMBER 1, 2009 ADDED PROPOSED ADDITION JANUARY 28, 2010 ADDED ADDITIONAL NOTES AREA = 22,450 sq, ff. 0.515 ac. CERTIFIED TO: MICHAEL LEVISON CAROLEE LEVISON ELEVATIONS SHOWN ARE REFERENCED TO N,A,V,D. 1988 DATUM LOT AREA LANDWARD OF BULKHEAD = 21,997 sq. ft. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No, 56105C0159 H ZONE AE BASE FLOOD ELEVATIONS DETERMINED ZONE X' AREAS DETERMINED TO BE OUTSIDE THE 0,2% ANNUAL CHANCE FLOODPLAIN, AREA DA TA (OVER LOT AREA LANDWARD OF BULKHEAD (21,997 sq ft.)) DESCRIPTION AREA % LOT COVERAGE EXISTING HOUSE 2,000 sq. ft. 9.09% PROPOSED 1 STORY ADDITION 177 sq. ft 0.80% PROPOSED DECK 186 sq. ff. 0.85% TOTAL 2,565 sq, fl, 10.74% DRAINAGE SYSTEM CALCULATIONS, STORY ADDITION AREA: 177 sq. ff. 177 sq. ft. X 0.17 31 cu. ff. 31 cu. ff. / 8,73 4 vertical fl, of 4' dia. leaching pool required PROVIDE (1)4' dia. X 4' high STORM DRAIN POOL X 4' DEEP DRYWELL WITH GUTTER LEADER FOR ROOF RUN-OFF: THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. NYS. Lic No 50467 Nathan Taft Corwln III Land Surveyor PHONE (651)727-2090 Fax (551)727 1727 234, LOT / / / ~0.00 20% SURVEY OF LOT 33 MAP OF SOUTHOLD SHORES FILE No. 3853 FILED AUGUST 29, 1963 SITUA TED A T ARSHAMOMAQUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S,C, TAX No. 1000-57-01-14 SCALE 1"=20' ~ AUG -5 £0~0 OCTOBER 14, 2008 L'~ ~ DECEMBER 1, 2009 ADDED PROPOSED ADDITION , ' JANUARY 26, 2010 ADDED ADDITIONAL NOTES '~ ,, " J MARCH 8, 2010 SET LATH FOR SITE INSPECTION ,u / ,% ~blARCH 51, 2010 ADDED SETBACK FROM BULKHEAD TO PROP DECK JULY 27, 2010 REVISE PROPOSED ADDITION AREA = 22,450 sq. ff. 0.515 ac. CERTIFIED TO: MICHAEL LEVISON CAROLEE LEVISON NO TES' 1. ELEVATIONS SHOWN ARE REFERENCED TO N.A.V.D. 1988 DATUM 2. LOT AREA LANDWARD OF BULKHEAD = 21,997 sq. ff. 3.FLOOD ZONE iNFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 36103C0159 H ZONE AE' BASE FLOOD ELEVATIONS DETERMINED ZONE X. AREAS DETERMINED TO BE OUTSIDE THE 02% ANNUAL CHANCE FLOODPLAIN AREA DATA (OVER LOT AREA LANDWARD OF BULKHEAD 21,997 sq ft.)) DESCRIPTION AREA % LOT COVERAGE EXISTING HOUSE 2.525 sq. fi. 11.48% PROPOSED 1 STORY ABDITION 212 sq. fi. 0.96% PROPOSED DECK 168 sq. ff. 0.76% TOTAL 2,905 sq. fi, 15.20% DRAINAGE SYSTEM CALCULATIONS' I STORY ADDITION AREA: 212 sq. fi, 212 sq. ff. X 0.17 = 36 cu. fL 36 cu. ff. / 8.73 = 4 vertical ff. of 4' did. Jeaching PROVIDE (1)4' dWJ. X 4' high STORM DRAIN POOL pool required PROPOSED 4' DIA. X 4' DEEP DRYWELL WITH GUTTER LEADER FOR ROOF RUN-OFF: APPROVED BY gOARD OF TRUSTEES TOWN OF SOUTHOLD _? - THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, PREPARED iN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS I NYS, L,c, No. 50467 Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 Fox (631)727-1727 28-320(