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Home My WebLink AboutTR-7308Jill 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 (631 ) 765-1892 Fax (63 I) 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 I st day of construction ¼ constructed Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PE~IT NO. 7308 DATE: MAY 19 2010 1SSUED TO: THOMAS RYZUK PR~OPERTY ADDRESS: 790 NORTH SEA DRIVE, SOUTHOLD SCTM# 54-5-14 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code 0fthe Town of South~ld and in aCcordance with tho Resolution of the Board of Trustees adopted at the meeting held on May 19.2010. and in consideration of application fee in the sum of $250,00 paid bY ThOmas Rvzak and subject to the Terms and Conditions as stated in the Resolution, the Southold ToWn Board of Trustees atithorizes and permits the following: Wetland Permit to install an 18'x36' swimming pool and surrounding Patio and a 16'x20' pool house, and as depicted on the survey prepared by Peconic Su~eYors, P,C;, last dated August 12, 2009, and stamped approved on May 19, 2010. IN WII~NESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Thomas Ryzuk, residing at 790 North Sea Drive, Southold, New York as part of the consideration for the issuance of the Pennit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Pennittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents tl~t 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 HallAnnex 54375M~nRoad P.O, Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 F~x(631) 765-6641 May 19, 2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Thomas Ryzuk 790 North Sea Drive Southold, NY 11971 RE: 790 NORTH SEA DRIVE, SOUTHOLD SCTM#: 54-5-14 Dear Mr. Ryzuk: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 19, 2010 regarding the above matter: WHEREAS, THOMAS RYZUK 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 March 25, 2010, and, WHEREAS, said application was referred to the S0uthold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings. and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6, 6.3, 6.4 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the design of the pool mitigates any environmental impact, and WHEREAS, a Public Headng was held by the Town Trustees with respect to said application on May 19, 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, WHEREAS, the Board has considered all the testimony and documentation submitted conceming this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Water[ront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of THOMAS RYZUK to install an 18'x36' swimming ~)ool and surrounding patio and a 16'x20' pool house, and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated August 12, 2009, and stamped approved on May 19, 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, J;l~e~t?~-~o~a r~dd c f T~msl ees JMD/eac Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated f}r~o~r_Jo c:9.D"~ c?-0,/(9 has been reviewed by this Board at the regular meeting of ,rTZ~-.y' / ?.. '.-~o,,Oand your application has been approved pending the completioh of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ Ist Day of Construction ($50.00) __ ¼ Constructed ($50.00) ~/' Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE:$..~O~-~ BY: Jill M. Doherty, President Board of Trustees Chain'nan Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (63 I) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 14, 2010, the following recommendation was made: Moved by Doug Hardy, seconded by Greta Schiller, it was RESOLVED to SUPPORT the Wetland Permit application of THOMAS RYZUK to install an 18'X 36' swimming pool and surrounding patio and a 16'X 20' pool house. Located: 790 North Sea Dr., Southold. SCTM#54-5-14 Inspected by: Doug Hardy, Greta Schiller The CAC Supports the application and recommends the Board of Trustees address any possible over-flow issues from the saltwater pool. Vote of Council: Ayes: All Motion Carried Jill M. DohelXy, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr John Bredemeyer P.O. Box 1179 Southold. NY 11971 Telephone ( 631 ) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: C/f-'///'~' ~'-'/-~ THOMAS RYZUK requests a Wetland Permit to install an 18'X 36' swimming pool and surrounding patio and a 16'X 20' pool house. Located: 790 North Sea Dr., Southold. SCTM#54-5-14 atrea to be impact~: erWetland ~ Freshwater Wetland "~CTSound Bay Distance of proposed work to edge of wetland ~own Code proposed work falls under: .275 Chapt. 111 other Type of Applicatior~'~Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present . ~J.King ~J~.DWere: oherty .~Bredemeyer __ B.Ghosio, v D. Dzenkowski other Form filled out in the field by /..~Bergen~ Mailed/Faxed to: Date: OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Jill Doherty, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner ~ LWRP Coordinator Date: May 17, 2010 Re: Proposed Wetland Permit for THOMAS RYZUK SCTM#1000-54-5-14 S0uthhol~[ ge~rd of Trustees THOMAS RYZUK requests a Wetland Permit to install an18'X 36' swimming pool and surrounding patio and a 16'× 20' pool house. Located: 790 North Sea Dr., Southold. SCTM#54-5-14 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 INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. NOTE: The application is incomplete. The proposed setback line shows the distance to the property line, not the wetland line. The proposed setback from the proposed pool to the wetland is NOT IDENTIFIED; a minimum separation distance of 50' is required Chapter § 275-3. Findings; purpose; jurisdiction; setbacks. Please require that the applicant amend the application to meet the above policy to the greatest extent practicable. 6.4 Protect vulnerable fish, wildlife, and plant species, and rare ecological communities. Note that the parcel abuts a valuable wetland and would be located in a globally and locally rare Maritime dune habitat as described in Ecological Communities of New York State Second Edition (2002). The area in which the proposed pool and pool shed are proposed is global and state identified ecologically significant Maritime dunes habitat in the Town of Southold: Maritime dunes: a community dominated by grasses and Iow shrubs that occurs on active and stabilized dunes along the Atlantic coast. This community consists of a mosaic of vegetation patches. This mosaic reflects past disturbances such as sand deposition, erosion, and dune migration. The composition and structure of the vegetation is variable depending on stability of the dunes, amounts of sand deposition and erosion, and distance from the ocean. Characteristic species of the active dunes, where sand movement is greastest, include beachgrass (Ammophila breviligulata), dusty-miller (Artemisia stelleriana), beach pea (Lathyrusjaponicus), sedge ( Carex si#cea), seaside goldenrod ( Solidago sempervirens), and sand-rose (Rosa rugosa). Characteristic species of stabilized dunes include beach heather (Hudsonia tomentosa), bearberry (Arctostaphylos uva-ursl), beachgrass (Ammophila breviligulata ), cyperus ( Cyperus polystachyos var. macrostachyus), seaside goldenrod ( Solidago sempervirens), beach pinweed (Lechea maritima), jointweed (Polygonella articulata), sand-rose (Rosa rugosa), bayberry (Myrica pensylvanica), beach-plum (Prunus maritima), poison ivy (Toxicodendron radicans), and the lichens Cladina submitis and Cetraria arenaria). Seabeach amaranth (Amaranthus pumilus) is a federally threatened plant that is found on the dynamic foredune of some maritime dunes. A few stunted pitch pines (Pinus rigida) or post oaks (Quercus stellata) may be present in the dunes. Distribution: along the seacoast of the Coastal Lowlands ecozone. Rank: G4 S3 Revised: 2001 The global rank reflects the rarity of the community throughout its range, whereas the state rank indicates its rarity within New York State. Both of these ranks are usually based on the range of the community, the number of occurrences, the viability of the occurrences, and the vulnerability of the community around the globe or across the state, Examples: Napeague Dunes, Suffolk County; Fire Any such structures should be located immediately adjacent to the residential structure to avoid further loss of habitat and the species that occur within it. Figure 1. Subject Parcel. Wetland Boundary Figure 2. Subject Parcel. 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: Lod Hulse, Assistant To~n Attorney 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 (631 ) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only t~eaStal Erosion Permit Application tland Permit Application Administrative Permit Amendment]Transfer/Extension ~.~l~eceived Application:~ -~Keceived Fee:$ C~.~"O ~.,~r6mpleted Application~ Incomplete SEQR_A Classification: Type I Type II Unlisted Coordination:(date sent) ~ Consistency Assessment Form 4{ ~ 0 ~-.L>AC Referral Sent: q~{02ilO D~ate of Inspection: '/'4. ! i~{li} __Receipt of CAC Report:_ __Lead Agency Determination:__ Technical Review: ~--'t~Iblic Hearing Held: q! ~i[ th Resolution: NameofApplicant ~O/Y/AA ~-- //~2~/<~ Address 7qO PhoneNumber:Z.~ ~3% gXgZ /~,//' Suffolk County Tax Map Number: 1000 - o5-5t.~ ~)~"~/~/ Property Location: _5~tO'/~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: )ard of Trustees Applicat~' GENERAL DATA Land Area (in square feet): Area Zoning: Previous use of property: ,5'Br,~ ~- Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes v~'"No Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspepj~[~ by ~' No If yes, provide explanation: a governmental agency? Yes Project Description (use attachments if necessary):. of Trustees Applicat~' WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~oo~ ~.. ,o~.,~...~.,k, ~ ..~ ~ ~,,'~ Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? ~) ~) cubic yards How much material will be filled? ,/OoA/~ cubic yards Depth of which material will be removed or deposited: 7 feet Proposed slope throughout the area of operations: t/'.,) 4-c ? ~/J0'ls~ /.~ / Manner in which material will be removed or deposited: '"~ ~ Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 'PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION:-- "^~)~2 ~/C~.~,~, ~1. · Municipality 617.20 APPENDIX STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) County SEQR 5. IS PROPOSED ACTION: ,~New [] Expansion [---] Modification / alteration 7. AMOUNT OF LAND AFFECTED: Initially 1~7~) acres Ultimately ~//.~, ~ acres 8. WILL PROPOSED ACTION COMPLY WITH EX~STING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~'Residential r"~lndustrial []Commercial [~Agriculture []Park/Forest/OpenSpace ]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL A(~ENCY (Federal, State or Local) []Yes r]No If yes, lest agency name and permit/approval: ~:~/ ~ ~¢'"~ /'~~'~" 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r~Yes ~_No If list name and permit / yes, agency approvak 12. AS A RF~SULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant /~"~0r Namesignature~'~/~'~' /' ~.~ ~',//~ ~7~ ~- Date: ..~/~"// / If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANy TYPE I THRESHOLD IN 6 NYCRR, PART 6t7.47 If yes, co~dlrmte Ihe re~c~v pmcees and use the FULL EAF. I-I - B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a nagallve de~am6o~ may be sapemednd by ~ levolved agency. F-iv- []No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answe~ may be handwdife~, ff legible) C1. Existing air qua~4y, surface or groundwater quardy or quanl~y, riotse leve~s, e~sting tmffis pattern, solid waste pe~luction or disposal, potential for erosion, drainage or flooding problems? E~plale bde6y: C2. Ae~,~.,~k., agricultural, arctme~oglcal, historic, or other natural or cultural resou~ess; or community or ~ choracter? ~=~r~!,~ briefly:. ~.'~--'-'u~ or fauna, fish, ~ ..,.~, ~ ~.DJii~ species, s;O,~fi~..,~[ habitats, or Ihrea~enad or endangered species? r:~-f,1 Ixlefly: C3. C4, A ~,.i~.,.nity's ~.4s,;,.a plans or ~oals as officially ~,~(,vi~-*~. or a ,;,%-i .a~ in use o~ Intensity of use of land or ~ naleral resources? ~;,, bdefly: I,o C5. Grow~, .~ ~,v...~q,~ deve~op,,~.,~[, of retated ac~ivffles likely to be Ina.~ by fJle pm?c,~ actle~? r:vT,~_~ bdelly: C6. Long term, sh0~ term, cumulative, or other effects not iden~ed in C~!-C$? ~=,,~ ~_!n briefly: ° 07. O~er ;,~, linclndtn~ ~,,m~ in use of effher qnantit,i/or ~ of ei~ ¥ Z? F ~la!~ bdet~: I,o E. IS TI,*~,~, OR IS THERE LIKELY TO BE, CONTROVERSy RELATED TO'POTENTIAL ADVERSE ENVlRC!;M~,%'TAL IMPACTS? If ~es F""] Yes [] No! I,, PART III - f~=l ~=,~dm~TlON OF 81GNIRCANCE (To be completed by Agency) iNSTRUCTIONS: Foreachedvemeeffectidentifiedabove, detemllnewfletherltissubetential, large, importent.orofhelwisesignifiCanL Each effeof should be assessed in connection with i~ (a) setting (i.e. Urban or rural); (b) probeblli[y of encurdng; (C) duraf~n; (d) irreversibility; (e) geographic s~oe; and (f) magnitude. If uscesea~, add attechmeMs or mfarence suppo~ling materials. Eusum that explanations ~en~n suffictent detell te show that all relevant edverse impacts have been ideofified end adequately eddmssed. If question d of part II was checked ye~, the,determlnaden of slgnlficanus must evaluate the potential impact of the proposed action o~ the envlronme~al charactedstles of the CFA FAF and/or prepare a p~16ve.dedaratlen. Check this box If you have determined, based o~ the information and analy~ above and any suppod~ document, that the pmpesed dete~Tnlnaflon.WlU' NOT result. In any significant adveme environmental Impa~ts AND provide, on attachments aa neceesmy, the masons suppo~ing Board of Trustees Name of Lead Agency Jill M. Doherty P~nt or Type Name of R.~espons~ble Officer in Lead Agency ~ S/gnature of R~l~,~ible Of~e~l:nad Agency. President Date Title of Responsible Officer Signature of Preparer (ff different from responsible officer) Board of Trustees ApplicOon County of Suffolk State of New York f' e;m q3 o'/t 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 TI-IlS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signa~6r~ //~ SWORN TO BEFORE ME THIS c2'~'4~' DAYOF "Tt?a c,a. ,20/0 /q~ta~y Public LAUREN M. STANDISH Notary Public, State of New York No. 01ST6164008 Qualified in Suffo!k County Commission Expires Apri~ 9, 20~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Certified Fee ~.1 Re um Rece pt Fee i~ (Endomeme~t ReqUi ed) Address: ' ~ berg d~y swom, d~ses ~d says ~at on ~e ~ day of ~[I ,20/0, d~on~t m~l~ a ~e ~py of ~e Notice '. set fo~.in ~e Bo~d bfTmstees Application, ~ted to each of~e above rimed pe~ons at ~e ad~ses set opposite ~ere re~five ~es; ~at ~e ad~esses set opposite ~e n~es ofs~d persom me ~e ~ess ofs~d perso~ ~ shorn on ~e c~ent ~sessment roll of ~e Tom of Sou~old; ~at s~d Nofic~ were m~led at ~e United States Post Office at ~R~ ~ · , ~at s~d Notices were m~led to each of said persons by (certified) (registered) mail. Sworn to before me thisc~]g4' Day of d~__., 20/7) k.../' L blotaryPublic LAUREN M. STANDISH Notary Public, State of New York No. 01ST6164008 Qualified in Suffo!k Cou ntv__ Commission Expires April 9, 20~ NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. SCTM# /OOo -.S~y- O--(--/~/' That it is the intention of the .undersigned to_request a. Permit from the Board of Trusteesto: 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 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: 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: ~0 N~ PHONE ~: .~1-]~' ~5 ~ AGENT: MAILING ADDRESS: PHONE ~: 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 THOMAS RYZUK COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING residing at/dba 7~t~ /~t~a'~]C.C~ being duly sworn, depose and say: That on the ") day of ~o~_; { ,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. April 21~ 2010 on or about 6:00 PM. Dated: ,.~gnature) ~ Sworn to before me this oU gCday ofO04a'20~ 0 '~otfiry Public LAUREN M. STANDISH Notary Public, State of New York No, O1 ST6164008 Qua fled in Suffolk County Commission Exp res April 9, Home I Help Track & Confirm Sea ch Results Label/Receipt Number: RA48 2754 425U S Class: First-Class Mail International Service(s): Regiatered MailTM Return Receipt Status: International Dispatch Your item left the United States from ISC NEW YORK NY(USPS) at 10:17 AM on March 28,2010. Information, if available, is updated periodically throughout the day. Please check again later. ~ Er~er Label.~eceipt Number. Detailed Results: · International Dispatch, March 28, 28t0, 10:17 am, ISC NEW YORK NY(USP$) · Arrival · Acceptance, March 26, 2010, 1:25 pm, CENTEREACH, NY 11720 ~ O~tio~s Track & Confirm by email Get current event information or updates for your item sent to you er others bY email. ~ BRO0 Zon~ Iss~ EAST 1173 Fir." 0.! 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Prepare your international packages online and save time, Pay postage online and save money APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the anrt of town officers and emolovccs. Thc ourousc of this form is to orovide hd'um, ation which can alert lhe town of oosslble confltcts of mt~m~, and allow It to take whatever action ts ~ ..,2~?~.~ ry to avgid same. YOUR NAME: (Last name, fu'st name, ~aiddle initial, unless you are applying in the na,,,¢ of someone else or other entity, such as a company. If so, indicate the other 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, ineluding 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% oftbe shares. YES NO ~ lfyou answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of $outhold Title or position of that person Describe thc relationship between yourself (thc applicanffagcnt/reprasentative) and the town officer or employee. Either check the appropriate linc A) through D) and/or describe in thc space provided. Thc 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% oftbe shares of the corporate stock of the applic0nt (when thc applicant is a corporation); ___B) tbe cgal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C) an officer, director, partner, or empinyce oftbe applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitt~day 9fz% 2~ ] 2& I I 200 $ignatu~-e/(_....~,'-f~ PrintNan~ 5fhO~._ /cf' f/~d~' aC Town of Southoid 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 Waterfxont 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~ listin~ both suooortim, and non- suooortin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION scm# SH /¥ PROJECT NAME ~qO~Z ~ '7 u~ The Application has been submiRed to (check appropriate respom¢): TownBoard ~ Plann~gBoard~ Bufld~gDept. ~ Board ofT~stees ~ Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Natum andextent o,[action: Location of action: Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: (t{o/,~_~ ~ ~ag- (b) Mailing address: 7'~° ~/a0A-~3en 2)& .~vekvlb ~v (c) Telephone number: Area Code ( ) 65 ¢ 7C.(~ g,~ffZ//631 ~c/]3 -~'~o I J/c'et ( 6~/6 (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 ali proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [] Yes [] No ~-~Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III ' Policies Pages 3 through 6 for evaluation criteria [~ Yes ~ No [~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria Yes [] No ~ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES PoliCy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LwRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes [] No ~Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes ~ No [~Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not ~licable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes ~ No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [-] Yes [-] No [~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. Yes[-.] No ~ Not Applicable Attach additional sheets if necessary WORKING COAST POLIC~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes [-~ No [~Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Yes [] 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 ~ Not applicable d PREPARED BY~/~/0I~.~ ,3'~/~/Z ~Y~ TITLE 90~e/C DATE Plan * -- ''-" ~ Piping Arrangement Section A-A ~ ~ ~ EDWARDS { ARTHUR ~ PER.CRETE W~L SYSTEM [8'~' 18' ~' 12' 14' 6' 4' 5' 8' ~ ~.~ 929 Route 25A Miller Place ~ 11764 ~0'x~' ~' ~' 16' 14' 6' 4' 6' 8' ~30,0~ (631) 744-7185 F~ (631)744-0174 Test Borinq 'w'~. MACDONALD G~OSCIENCE'~;;~ 9/15/06 AREA = 38,561 sq. ft, I om fomilior with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DtSPOSAL SYSTEMS FOR SINOLE FAMILY RESIDENCES Grad will obide by the conditions set forth therein on the permit to construct, The rocotion of wells and cesspools shown hereon ore from field observations and or data obtained from others. Elevations ore referenced to on assumed datum. ,o/ EXISTING DWELL/NS NOT SHOW~ HEFTON ELEVATIONS ,¢ CONTOUR LINES ARE REFERENCED TO N.G.V.D. FLQOD ZONE AE IeL II) FLQOD ZONE FROM FIRM 5610E '0154 3 ANY ALTERATION OA' ADDITION T? ~" % '/P" ,':? ~ WOLATION OF ~-CT~N 7209 OF THE ~ YOA": ) -: E,. J 7A T/ON' LA W. EXCEPT AS PER S~CT~N 7209 - 5~C ;.3.~ 2. ¢' L CERT¢FIC~TIONS HEREON ARE V~L/¢ FOR TH~ MAP /.'/, :.Z..WES "N ;A'E3:¢ ONLY IF SAID MAP OR COP~S BEAR THE MPRE. ?ED 5E/L OF T~E SURVEYOR WHOSE SIGNATURE APPEARS HEREON. SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, fOOO-54-O5-f4 SCALE: 1'=50 NOV. 16, ~999 MAY 24, 2006 SEPT. 28, 2006(TEST HOLE * TOPO) NOV..,~ 2006 (REViSION) Nov. ", 2006 ~, ,:,f H~ OCT. $, 2007 (FNDTN LOC.) NO SUBSURFACE SEWAGE DISPOSAL SYSTEM DESIGN By~ JOSEPH FISCHETTI, P.E. /,,?PROVED BY ~F,D OF TRUSTEES ,V,'N OF SOUTHOLD Ho~Rr ROAD _ : ..... PROPOSED ~E~GE' DISPOSAL ~y¢T.TM 8 POOLS WITH ~' CLEAN :rAND ¢OLLAR 1500 G~L. PRECAST CONd~EFE SEPTIC TANK, BOTTOM OF LEACH/N'~ POOLS TO BE 2' ABOVE GROr ¢HP WATER SEPTIC SYSTEM CROSSECTION (516) 765- 5020 P O. BOX 909 1250 TRAVELER STREET SOuTHOLD, N.Y. 11977 49618 99-350