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Home My WebLink AboutTR-7242Jill 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) 76545641 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 ½ constructed __ Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7242 DATE: FEBRUARY 24, ~q~0 ISSUED TO: AMY ORR PROPERTY ADDRESS: 625 TERRY LANE~ SOUTHOLD SCTM# 65-1-23 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 February 24, 2010, and in consideration of application fee in the sum of $250.00 paid by Amy Orr and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit for the existing dwelling; abandon existing septic system and install new system not less than 50' landward from the top of the bluff; enlarge existing deck on eastern side of house by 8'x13'; permit existing deck structures, wood walk, steps, and outside shower, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated February 26, 2010, and received on March 1, 2010. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be atTtxed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Amy Orr, residing at 625 Terry Lane, 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 Pennittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authOrization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain ail 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 February 24,2010 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Ms. Cindy Schmidt P.O. Box 252 East Madon, NY 11939 RE: AMY ORR 625 TERRY LANE, SOUTHOLD SCTM# 65-1-23 Dear Ms. Schmidt: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 24, 2010 regarding the above matter: WHEREAS, Cindy Schmidt on behalf of AMY ORR applied to the Southold Town Trustees for a permit under the previsions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated January 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, in accordance with Chapter 268, said application was found to be Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on February 24, 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 approve the application of AMY ORR for the existing dwelling; abandon existing septic system and install new system not less than 50' landward from the top of the bluff; enlarge existing deck on eastern side of house by 8'x13'; permit existing deck structures, wood walk, steps, and outside shower, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated February 26, 2010, and received on March 1,2010. 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, ' /~. i~M.' Dohe~ ~resident, Board oFTrustees 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 I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631 ) 765 -6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD off below. __ Revised Plans for proposed project __ Pro-Construction Hay Bale Line Inspection Fee ($50.00) __ '1st Day of Construction ($50.00) __ ~A Constructed ($50.00) I// Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE:$J~O°-~ BY: Jill M. Doherty, President Board of Trustees Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631 ) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Thurs., February 18, 2010, the following recommendation was made: AMY ORR for the existing dwelling; abandon existing septic system and install new system; enlarge existing deck on eastern side of house by 8'X 13'; permit existing deck structures, wood walk, steps, and outside shower. Located: 625. Terry Lane, $outhold. SCTM#65-1-23 The CAC did not make an inspection, therefore no recommendation was made. Jill M. Dohel~y, President James F. King, Vice-President 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: 2'/¢'//¢ AMY ORR requests a Wetland Permit for the existing dwelling; abandon existing septic system and install new system; enlarge existing deck on eastern side of house by 8'X 13'; permit existing deck structures, wood walk, steps, and outside shower. Located: 625 Terry Lane, Southold. SCTM#65-1-23 Type of area to be impacted: j- __Saltwater Wetland Freshwater Wetland Sound'/Bay Distance of proposed work to edge of wetland ~)~t~ of Town Code proposed work falls under: __Chapt.275 Chapt. 111 other Type of Application: JWetland __Coastal Erosion __Amendment ~Administrative__Emergency Pre-Submission __Violation Info needed: Conditions: Present Were: '~King ~J.Doherty c-'~i Bredemeyer B.Ghosio, --~). Dzen~wski ~ther Form filled out in the field by j, ](./*~? Mailed/Faxed to: Date: ~D. Bergen__ 62S Terry Lane ~ September S, 200g 625 Terry Lane - September S, 2009 625 Terry Lane - September 5, 2009 62S Terry Lane - September S, 2009 Jill Doher'q', President Southold Eoard of Trustees 54375 Main Road Southold, Hew York 11971 Re: Amy Cfr permit SCTM #65~1-23 March 1, 2010 Dear Ms. E oherty, As per your request at the Februa~, 24th Trustees meeting: Please find attached a revised survey showing that the proposed new septic system for the aforementioned property has been moved 10 feet closer to the street. Many thanks to you and the Board for your prompt approval to our permit request. Respectful y submitted, Cinc~e Rabbit Rut Home, Ltd. POB 252 East Marion, NY 11939 631-949-9~77 Agent of A~y Orr C: File Amy Or r 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 MEMORANDUM To: Jim King, President Town of Southold Board of Trustees/ From: Mark Terry, Principal Planner LWRP Coordinator - Date: February 17, 2010 Re: Proposed Wetland Permit for AMY ORR SCTM#1000-65.-1-23 Cindy Schmidt on behalf of AMY ORR requests a Wetland Permit for the existing dwelling; abandon existing septic system and install new system; enlarge existing deck on eastern side of house by 8'X 13'; permit existing deck structures, wood walk, steps, and outside shower. Located: 625 Terry Lane, Southold. SCTM#65-1-23 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 "CC" which states: CC. Structures less than 250 square feet in size that are accessory to existing permitted primary structures, and which accessory structures are greater than 50 feet from a tidal wetland; Cc: Lori Hulse, Assistant Town Attorney James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Administrative Per/mt / --_, ompleted Application ~mcomplete -~ o [ . ..... ] [ SEQ~ Class~fica~on. ~ Co~istency Assessment Fo~ ~AC Refe~al Sent: ~ate of ~pecfion:~ ~Receipt of CAC R~om ' ~Lead Agency Dete~a~ ~Tec~c~ Renew: ~blic He~g Hero ~Resolution: Name of Applicant ,~~:~~ _ Address~ ~~ .... Suffolk coUnty Tax Man Numb ' - ~ '"' ' - er: lo00- Property Location .~_ff '~//}. L'.,/ ... '-' ,..f. (P 'de LILCO Pol~ #, distanc~to cross streets, and location) of Trustees Applicati GENERAL DATA rea Zor ng: gV t ahO Previous use of property: Intended use of property: / Covenants and Restrictions: Yes V/ 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? if No Yes If yes, provide explanation: ~d of Trustees ApplicatioO WETLAND/TRUSTEE LANDS APPLICATION DATA Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between n~.rest existing structure and upland edge ofwetlands: ~0, ~) feet / [~01~~) Closest distance betwe~earest proposed structure and upland edge of wetlands: rj~ feet Does the project involve excavation or filling? No : Yes If yes, how much material will be excavated? 3~ 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: ~[~'/0~ Manner in which material will be removed or deposited: ~f~ ~///~! Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by mason of such proposed operations ~ use attachments if appropriate): PROJECT ID NUMBER 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only SEQR PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) PLICANT,SPO OR 2. PROJECT 4. PRECISE LOCATIONf/Street Addess and Road Intersections. Prorninent./'~retc~'-or provide mad /3 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~es [] NO If no, describe briefly: IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) dential [~lndustdal ~]Commercial E~Agriculture ~'~Park/Forest/OpenSpace []Other(describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~Yes [~No if yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE(./A CURRENTLY VALID PERM': OR APPROVAL? [~Yes j-~'No If yes, list agency name and permit / approval: 42. AS A RESULT OF PROPOSED ACT,ON WILL EXIST, NC PERM,T~ APPROVA, REOUIRE MOD,P,CAT,ON? E~e* F'INo I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Nam? Date: ~/.f the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLO IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. [~Yes r~No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. ~]Yes r~lNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible} C1. Existing air quality, sun'ace or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, egflcoltural, amhaeological, historic, or other natural or cultural resources; or community or neighbothood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially ado[~ted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C6. Growth, subsequent development, or related acti~ties likely to I~ induced by the proposed action? Explain hriafly: C~. Long term, short term, mmulat~ve, or other *ffects not identified in Ct ~fi? Explsln ~hefly: C7. Other impacts lincludin~ chanties in use of either ({uantit)' or t~/pe of enerl~/? Explain D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAl ENVIRON MENTAL AREA ICEA/? /If yes, explain briefly': E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If)'es explain: r---~ Yes r~No PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstantia~,~arge~imp~rtant~r~therwisesigni~cant~ Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (bi probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (fi magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain suffident detail to show that all retevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which ~IAY occur. Then proceed directly to the FULl FAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actim WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessarT, the masons suppo[ting thi= determination. Board of Trustees Name of Lead Agency Jill M. Doherty Priit ~ ~Type..N~ame~r in Lead Agency ~ Signatbre °f R~p°nsible Of~Tr in Lead Agency Date President Title of Responsible Officer Signature of Preparer (If different from responsible officer) (Endorsement (Endomemen Required) (Endorsemen ~ [~ Re~Jr~ Recelp Fee (Endomemen D (Endorsemerfl r'u rlj STATE OF NEW YORK COUNTY OF SUFFOLK '~4x~,, ~,~-~'~f2~_, "~]/L~.O) , being duly swom, deposes and sa34,4hat on tl~ / /" day of cf/~-~-f/57' ,20/g?, deponent mailed a tree copy of the Notice set forth, in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment g611 of,~he Togrn of Southold; that said Notices were mailed at the United States Post Office at j~ , that said Notices were mailed to eafl~ of said pe~o..~gns-by~ (certified) (registered) mall __ ~ ~D ,~ ~ Sworn to before me this t'c~ ~' Day of ~4Ca[j ,20./0 Notary Public LAUREN M STANDISH Notary Public S~te of New York No. 01~T6164008 Qualified b Suffo k County Commiss on Expires April 9, Board of Trustees Application County of Suffolk State of New York BE OD YSWO 1 ' . DE~'O~g§ ~ ~Frms m~T m/sm ~s ~ ~euc~ Fo~ ~ ~o~ DESC~ED PE~T(S) ~ ~T ~L STA~TS CO~D ~m ~ ~ TO ~ BEST OF ~S~ ~O~DGE ~ BEL~F, ~ ~T ~L WO~ ~L BE DO~ ~ ~ ~R SET FOR~ ~ ~S ~PLICATION ~ AS ~Y BE ~PRO~D BY ~ SO--OLD TO~ BO~ OF TRUSSES. ~ ~PLIC~ AG~ES TO HOLD ~ TO~ OF SO--OLD ~ ~ TO~ ~US~S ~ESS ~ F~E ~OM ~ ~ ~L D~GES ~ CL~S ~S~G ~ OR BY ~ OF S~ PE~T(S), ~ G~. ~ CO~LET~G ~S ~PLICATION, I ~BY A~O~ ~ ~US~ES, ~ AG~(S) OR ~P~S~AT~S(S), TO E~R O~O ~ PROPERTY TO ~SPECT ~ P~SES ~ CON~CTION ~ ~ OF ~S ~PLICATION. Signat~e SWORN TO BEFORE ME THIS /o2-~ DAY OF ~OQ- ,20/0 ary Public LAUREN M. STANDISH N~tary Public, State of New York No. 01ST6164008 Qualified in Suffolk County Commission Expires April 9, 20 [/ ~' ' ~rd of Trustees Applicati~ (print owner of property) ..2 A~T~ORIZATION (where the applicant is not the owner) residing at ~]~/~' ~Po ~7'~'/~ ~. ( ~ailing addresW) do hereby authorize ~/~ ~/~ ( Agent ) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. n~ s signal.,re) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of Southold's Code of Ethics umhibits conflicts of interest on the hart of town officers and emnlovees. Thc nuroosc of this form is to nmvidc information which can alert thc town of ~oss~ble conflicts of u,tc,~?, and allow ~t to t~akc what. w, action i~ (Last n~me, fu~t name, ~iddl¢ initial, unless ltou are applying in me fanuc or someoan e sc or other entity, such as a company. If so, indicate:the other person's or company's name.) NAME OF APPLICATION: (Ch~:k all that apply.) Tax grievance Building ~'/ Variance Trus~:e )~ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other Of"Other-, na~e the activil~.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Soathold? "Relationship" includes by blOOd, marriage, or business interest "Bnsiness interest" means a business, including a partnership, in which the town officer or employee has ~ a pa~ial ownership of (or employment by) a corporation in which thc town officer or employee owns moro than 5% of ~di~es. YES NO /~ If you answerod "YES", complete the balance of this form and date and sign whero indicatod. Name of person employed by the Town of $outhold Title Or position of that person Desoribe the relationship batw~n yourself (the applicant/agcn~/roprosontativ¢) and the town officer or employee. Either cbeck thc appmptiate line A) through D) and/or describe in tho space provided. The town officer or employee or his or her spouso, sibling, parent, or child is (check all that apply): __~) the owner of groater than 5% oftbe shams of the co~orote stock of the applicont (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non. corporate entity (when tho applicant is not a corporation); C) an officer, dirocter, pruner, or employee of thc applicant; or __.D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this _~d~y..o_f, ~ 20~__ Signature ~/yt4,~,s~cc, ., Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building, Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail~ listing both supporting and non- suooortine 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. SCT #/ PROJECT NAME The Application has Town Board [] DESCRIFrION OF SITE AND PROPOSED ACTION been submitted to (check appropriate response): Planning Board ~ Building Dept. r~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Co) (c) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) Financial assistance (e.g. grant, loan, subsidy) Permit, approval, license, certification: Nature and extent of action:~/~f ~/9 ~ Pfi~/~ ,.~.' ~- ~/~ .~ ~ 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: (b) Mailing address: (c) Telephone number: Area Code ~] ~¢~' qf/t ~ (d) Application number, if any:. Will ~tion be directly undertaken, require funding, or approval by a state or federal agency? Yes IVI No~-~ Ifyes, which state or federal agency? ./D/~C! fd~). 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 HI - Policies; Page 2 for evaluation criteria. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~-] Yes ~ No ~7~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LVOIP Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes [-~ No ~-~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section IH - Policies Pages 8 through 16 for evaluation criteria Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section HI - Policies Pages 16 through 21 for evaluation criteria ~ Yes [~ No ~/Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section IH - Policies; Pages 22 through 32 for evaluation criteria. Yes No ~/~ot Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section IH - 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 IH - 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.[_~ ~ ~//N Yes, No ot Applicable Attach additional sheets if necessary WORKING COAST POLICIE~ Policy 10. Protect Southold's water-dependant uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section HI- Policies; Pages 47 through 56 for evaluation criteria. Yes [] No [;f ot 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 HI - 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 HI - 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 HI - Policies; Pages 65 through 68 for evaluation criteria. [--] Yes ~ No [] Not Applicable SEPTIC SYSTEM DETAIL (NOT TO SCALE) - CAST IRON COVER TO GRADE ELEV 13 5' FINISH GRADE ELEV ~3 O' / --TOP EL TEST HOLE DATA HOUSE MIN. 4" DIA, ELEV, 7 0 FORC[ SEPTIC TANK APPROVED PIPE 6 O' 5.7'NOT EL 5A'~'~"~'"~10' ' I a~' DISTRIBUTION POOLS 5 POOL SYSTEM SEPTIC TANK (1) MINIMUM SEPTIC TANK CAPACITIES FOR 3 BEDROOM HOUSE IS %250 GALLONS, 1 TANK, 10' DIA, 3,5' DEEP CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 ps~ AT 28 BAyS WALL THICKNESS SHALL BE A MINIMUM OF 5', A TOP THICKNESS OF 6" AND A BO~'OM THICKNESS OF 4" ALL WALLS, BOI~OM ANB TOP SHALL CONTAIN REINFORCING TO RESIST AN APPUEB FORCE OF 500 psT, ALI JOINTS SHALL BE SEALED So THAT THE TANK IS WATERTIGHT, THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A MAX TOLERANCE OF :~1/~") ON A MINIMUM 5" THICK BED OF COMPACTED SANO OR pEA GRAVEL A 10' rain, DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL ~3E MAINTAINED BOT EL 6 5' GROUND WATER CLEAN COLLAR LEACHING POOLS (5) 1 MINIMUM LEACHING SYSTEM FOR 3 BEDROOM HOUSE IS 250 sq ft SIDEWALL AREA NOTES: / / / / SURVEY OF PROPERTY SITUATED AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-65-01-2,3 SCALE 1"=20' AUGUST 1, 2005 AUGUST 51, 2009 UPDATE MAP OCTOBER 2, 2009 REVISE PROP DECK NOVEMBER 19, 2009 REVISED AS PER SCD.HS NOTICE 10/19/09 FEBRUARY 26, 2010 REVISED AS PER S.C.D.H S. NOTICE JANUARY 22, 2010 AREA = 27,672,05 sq. ff. (TO TIE LINE) 0.6,55 cc. 1. ELEVATIONS ARE REFERENCED TO N,G.V.D. 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS: x~ EXISTING CONTOUR LINES ARE SHOWN THUS: ~ FFL - FIRST FLOOR TW ~ TOP DF WALL 2. FLOOD ZONE iNFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 56105C0166 O ZONE AL' BASE FLOOD ELEVATIONS DETERMINED ZONE X: AREAS DETERMINED TO BE OUTSIDE 500-YEAR FLOODPLAIN. $. ANY WETLAND BOUNDARIES SHOWN ARE SUBJECT TO VERIFICATION BY NEW YORK STATE AND/OR OTHER REGULATORY AGENCIES. 4. MINIMUM SEPTIC TANK CAPACITIES FOR A 1 TO $ BEDROOM HOUSE IS 1,000 GALLONS. I TANK; 8' LONG, 4'-5" WIDE, 6'-7" DEEP MLNIMUM LEACHING SYSTEM FOR A 1 TO 3 BEDROOM HOUSE iS 250 sq ff SIDEWALL AREA. 5 POOLS; 2' DEEP, 8' dim (,~.¢~'&\ PROPOSED EXPANSION POOL PROPOSEB LEACHING POOL PROPOSED SEPTIC TANK EXISTING CESSPOOL TO BE PUMPED CLEAN AND EITHER REMOVED OR FILLED WITH CLEAN 32 cu. yds. OF MATERIAL SHALL BE EXCAVATED FOR THE SANITARY SYSTEM, SAND. LOT COVEPJGE DATA DESCRIPTION AREA % LOT COVERAGE EXISTING HOUSE 635 sq. fi. 2.3% EXISTING DECKS %050 sq, ft, $.8% EX[STING SHED 170 sq. ff. PROPOSED DECK lO5 sq, fi, 0.4% TOTAL 1,960 sq. ff. 7.1% ~AR - 1 2010 THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED, Nathan Taft Corw n III Land Surveyor Fox (651)727-1727 ~3-g61