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HomeMy WebLinkAboutTR-7405 Glenn Goldsmith, President so Town Hall Annex A. Nicholas Krupski,Vice President ®amu ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 C®UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1972C Date: October 30, 2022 THIS CERTIFIES that the addition of a 11'x21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/living room area; and add 24 square feet to the existing deck; with the condition of the installation of gutters to leaders to drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code Storm Water Runoff; At 1185 Fleetwood Road, Cutchogue Suffolk County Tax Map#1000-137-4-27 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 31, 2010 pursuant to which Trustees Wetland Permit#7405 Dated September 22, 2010,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the addition of a 11'x21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/living room area; and add 24 square feet to the existing deck; with the condition of the installation of gutters to leaders to dawells to contain roof runoff and in accordance with Chapter 236 of the Town Code Storm Water Runoff. The certificate is issued o Annette Cam bell owner of the aforesaid property. Authorized Signature Glenn Goldsmith, President a� Town Hall Annex > 54375 Route 25 A. Nicholas Krupski,Vice President P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly ^� Telephone (631) 765-1892 Elizabeth Peeples Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: as ZZ INSPECTED BY: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction '/2 constructed Project complete, compliance inspection COMMENTS: _k f e 4 ck1wP( 15- s /I Ar P-gr C*'%, le 13fV{ cc-C. CERTIFICATE OF COMPLIANCE: r1 S Glenn Goldsmith, President SDE so(/rTown Hall Annex A.Nicholas Krupski,Vice President ,`O� �ol� 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold,New York 11971 Michael J. Domino G @ Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 "yC4UNV,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: -3L J 1 /�]"CAMPZ��bQ��N•k� J INSPECTED BY: 1\J1 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction; haybale-.line/silt, boom/silt curtain 1st day of construction % construbted Project complete, compliance inspection COMMENTS: Nee ks �v44vs l '40 —5Irj iroo/A )s dV� G��- Ne12A d , wc1IS 7�0 rsJ�°_. CERTIFICATE OF COMPLIANCE: Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Br~demeyer Town Hall, 53095 Main Rd. P.O. Box 1179 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 ½ constructed V/Project complete, compliance inspection. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7405 DATE: SEPTEMBER 22~ 2010 ISSUED TO: ANNETTE CAMPBELL PROPERTY ADDRESS: 1185 FLEETWOOD ROAD~ CUTCHOGUE sCTM# 137-4r27 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 Seotember 22. 2010, and in consideration of application fee in the sum of $250.00 paid by Annette Camobell 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 to add an ll'x21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/livingroom area; and add 24 square feet to the existing deck; with the condition of the installation of gutters to leaders to drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff; and as depicted on the site plan prepared by Nigel Robert Williamson, received on September 27, 2010, and stamped approved on October 4, 2010. IN W1TNESS 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 ~ND CONDITIONS The Permittee Annette Campbell, residing at 1185 Fleetwood Road, Cutchogue, New York as part of the consideration for the issuance of the Permit does understand and Prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as thc 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-complianee 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 thc 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 canse unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the Said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke up0~ failure tO obtain same. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 September 22, 2010 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Mr. Nigel Robert Williamson P.O. Box 1758 Southold, NY 11971 RE: ANNETTE CAMPBELL 1185 FLEETWOOD ROAD, CUTCHOGUE SCTM# 137-4-27 Dear Mr. Williamson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 22, 2010 regarding the above matter: WHEREAS, Nigel Robert Williamson on behalf of ANNETTE CAMPBELL 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 August 31,2010, 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 Headng was held by the Town Trustees with respect to said application on September 22, 2010, at which time all interested pemons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ANNETTE CAMPBELL to add an 11'x21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/livingroom area; and add 24 square feet to the existing deck; with the condition of the installation of gutters to leaders to drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff; and as depicted on the site plan prepared by Nigel Robert Williamson, received on September 27, 2010, and stamped approved on October 4, 2010. BE IT FURTHER RESOLVED, that the existing structure is not to be demolished and if there is a reason for the structure to have to be demolished, new permits must be applied for prior to demolition. 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, Jill .~Doherty President, Board of Trustees JMD/eac Jill M. Doherty, President Jmnes F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 1t971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated/'-~O~L, ~J,, ~/O has been reviewed by this Board at the regular meeting ot'~-~,~. ~/,aand your application has been approved pending the completion of the'following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line inspection Fee ($50.00) __ Ist Day of Construction ($50.00) __ ½ Constructed ($50.00) I~ Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be Paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEES: TOTALFEES DUE:$ ~'~ BY: Jill M. Doherty, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631 ) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., September 15, 2010, the following recommendation was made: Moved by Jack McGreevy, seconded by Audrey Horton, it was RESOLVED to SUPPORT the Wetland Permit application of ANNETTE CAMPBELL to add an 11'X 21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/livingroom area; and add 24 sf. to the existing deck. Located: 1185 Fleetwood Rd., Cutchogue. SCTM#137-4-27 Inspected by: Audrey Horton The CAC Supports the application with the Condition of a drainage plan to contain the roof run-off from the dwelling. The CAC also observed a public safety issue with the location of the existing driveway. 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 Soulhold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time:"((rz~./~.[~ ANNETTE CAMPBELL requests a Wetland Permit to add an 11'X 21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/livingroom area; and add 24 sf. to the existing deck. Located: 1185 Fleetwood Rd., Cutchogue. SCTM#137-4- 27 /~_pe of area to be impacted: Saltwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: /~_Chapt.275 Chapt. 111 other Type of Application: _/C¥ Wetland __Coastal Erosion __Amendment __Ad ministrative__E rhe'rge ncy Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: __&King J.Doherty __J. Bredemeyer-,~__D. Bergen B.Ghosio, D. Dzenk--~wski other ~ -- Form filled out in the field by ~J Mailed/Faxed to: Date: OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. 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: Jill Doherty, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: September 21,2010 Re: Proposed Wetland Permit for ANNETTI= CAMPBELL SCTM# 1000-137-4-27 L ...... 8~o,'.~of. '~?_ s!e~L ........... Nigel Robert Williamson on behalf of ANNETTE CAMPBELL requests a Wetland Permit to add an 11 'X 21' covered sunroom to the southeast of the existing structure; raise the existing roof over the existing kitchen/livingroom area; and add 24 sf. to the existing deck. Located: 1185 Fleetwood Rd., Cutchogue. SCTM#137-4-27 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 denoted following Policy Standards and therefore is CONSISTENT with the LWRP provided the following: If the action is approved, to further Policy 5: Protect and Improve Water Quality in the Town of Southold and Policy 6; Protect and Restore the Quality and Function of the Town of Southold Ecosystem it is recommended that a natural vefletated buffer (width to be determined) be required landward from the edfle of tidal wetlands o preserve the existinf:l ve~ietation (trees). NATURAL VEGETATED BUFFER -- a land area of a certain length and width where existing vegetation occurs prior to the commencement of any grading or clearing activity. Vegetation shall be maintained to achieve a minimum percent ground cover of ninety-five (95) percent. To achieve the percent ground cover indigenous, drought tolerant vegetation shall be planted. Survival of planted vegetation shall be (ninety) 90 percent for a period of three (3) years. Maintenance activities within the buffer are limited to removing vegetation which are hazardous to life and property, trimming tree limbs up to a height of fifteen feet (15') to maintain viewsheds, replanting of vegetation and establishing a four foot (4') wide access path constructed of pervious material for access to the water-body 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 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 dw OaStal Erosion Permit Application etland Permit Application Administrative Permit AmendmentFl'rans fer/Eatension b/~Rece~vved Application:~ i/~.Received Fee: $o,9qFOq~ ' 7Completed Application <~1~[ Incomplete SEQRA Classification: Type I Type II Unlisted Coordination: (date sent) ~..~"~WRP Consistency Asscssme~ Form I./~AC Referral Sent: ~[ I~ ~ " ~---Date of Inspection: o~, ! [~ [~ __Receipt of CAC Report: __Lead Agency Determination:__ Technical Review: ~lic Hearing Held: q [ __Resolution: B0~rd of Trustees Phone Number:Qb) Suffolk County Tax Map Number: 1000 - Property Location: 1185 FI-£~Tlaoo~ (provid~ LILCO Pole #, distance to cross streets, and location) IO.o . 1193.f' AGENT: ]01 qt-/.- (If applicable) Address: ~.0, ~ 1'7K0 5ovru. ot.n .ct/ 11971 Phone: of Trustees Applicati¢ GENERAL DATA Land Area (in square feet): Area Zoning: ~. 40 Previous use of property: · d Intended use o f property: Covenants and Restrictions: Yes X No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals If "Yes", please provide copy of decision. Yes Prior permits/approvals for site improvements: Agency Date No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~ No__ Yes If yes, provide explanation: Project Description (use attachments if necessary): S]25I~ ~ of Trustees Applicati¢ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~ S~I~.~ ~rrmg~t~-l~ ~-ou~.~2~ Area of wetlands on lot: /~1 ~ ~ square feet Percent coverage of lot: '4 ? g % Closest distance between nearest existing structure and upland edge of wetlands: 5'1: o ' feet Closest distance between nearest proposed structure and upland edge of wetlands: ~3'~ o * feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? 1,.~ cubic yards How much material will be filled? {~ cubic yards Depth of which material will be removed or deposited: ~ '- 4~" Proposed slope throughout the area of operations: O Manner in which material will be removed or deposited: feet 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 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME County SEQR 3.PROJECT LOCATION: I1~¢ F/~rtJ~.oZ~ ~ C~r¢~iu~ ~,~. 1193£ Municipality 4. PRECISE LOCATION: Street Addess and Read Intersections. Prominent landmarks etc -or provide mae 5. IS PROPOSED ACTION: [] New r-~Expansion r---~ModificatJon/alteration 6. DESCRIBE PROJECT BRIEFLY: E , r'J 7. AMOUNT OF LAND AFFECTED: Initially acres ~31 ql Ultimately (:7. (:70 ~ acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? C~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~ Residential [~ Industrial [~ Commercial [~Agriculture r--] Park / Forest / Open Space F~ 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: .~.b~'~.~J.,O ~,~,~.t~ Z~,~41~' 'z itvr. 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ---]Yes ~;~No If yes. list agency name and permit / approval: 12. AS A RESULT OF PROPOSED ACTIDN~ WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? i--INa I CERTIFY THAT THE INF AmiCE PROViDED,ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Signature If the action is a Costal Area, and you are a state agency. ~omplete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT ~To be completed I~/Le-_~ Agency)- E:] Yas [Z].° B. WILL ACTION RECeiVE COO~,uINATED RE~EWAS PROVIDED FOR UNUSTED ACTIONS IN 6 fffCRR, PART 617.67 ff No, a negative C. COUU3 ACTION RESULT IN ANY AI~/~.c~:: EFFECTS ~IATED WITH THE FOLLOWING: ~ may be hsudwdf~en, If inglMe) C6. Long term, shqr[ term, cumulative, or other effects not ;~;;~J in 01-C57 Explain ~ NO O. 1MI. J,. THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL I F-- 18 '1':, :CP, D_., OR IS T:: F..,%.C UKELY TO BEI comOVERsy RELATED TO'POTENTIAL ADVERSE ENVIRC.'-:;.'.m.'TAL "-.;,'"A~-~"87 If PART III - ~t:, ~i,~A~ION OF SIGNIFICANCE (To be com~ by A4~MlCy) INSTRUCTIONS: F~rsuch~dvemeeffe~t~dent~edabeve~determ~ne~t~ssubstanUa~arge~mp~rtant~r~n~L Each __e~____s~?. H be e-_~_.,~_ in co~.n .e~tion wflh ~ (a) ~e~,g {i.e. umn or .~d): (b) proba~lty of occuntng; (~ dura~o.: ;d~ ~r,~- ~p~grapn scope, Il') magnltlKle If necessary, add altachments or reference ~upp~ matedab. Ensure that e.~planal~ns mdffc/en~ detail to show Ihat all relevant adveme lmpacts have been idenlifled and adequately eddresued. If que~lon d of p~ i was cbecked WILL NOT result in any dgnlflcant adve~e e~,lmrmler~d Impasts AND provide, on MtachoM~s as nee~___..~y, the mm suppo~ng ~ de~-mina~n, . Name of Lead Agency President Jill M. Doherty " . Print or Type Name of Responsible Officer in Lead Agency ~Fv Signature of R~sl~onsible ~er in Lead Agency Title of Responsible Officer Signature of Preparer (if different fi'om respons/l~e officer) Town of Southold ~ Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A J(~)~) I~ ~f ~-"~ STORM-WATER? GRADING, DRAINAGE AND EROSION CONTROL FI. AN District aectl0n 5Jock Lot CERTIFIED BY A DESIGN FROFESSlORAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUC'I'ION ITEM # / WORKASSESSMENT I Yes No a. What is the Total Area of the project Pamels? I W/ti this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within ~)~l .~.~1-_ Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction) )~ (This item will include all mn-off created by site ~. b. What is the Total Area of Land Clearing (S.F. t Acres) clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site improvements and the permanent creation of construction activity? ~"~J j ..~Z. ~--~. impervious surfaces.) (S.F, / Acres) I 2 Does the Sita Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRiPTiON (~v~d~ Additk~.~,;... N~) Drainage Structures Indicating Size & Location? This ~J~I I Item shall include all Proposed Grade Changes and ~D~:~ ~ I1'~} ~- '~1 ~ ~:~U~ ~L~I~qI~M SlopesControltingSuffaceWaterFIow. 3Does the Site Plan and/or Survey describe the erosion sO} ~ ~ ~ ?'"Jr I~. .,~O ~rt,4 ~1¥' ~ and sediment central practices that will be used ,o / control site erosion and storm water discharges. This '"rYe- ~'X '.~ f"l .~' ..)t"r/l~..lc.t'l.)~_~ ~ ~J L(~ item must be maintained throughout the Entire , Construction Pedod. ~/r~ ~lJ'T-~¢ l~ t~/~'-~-- ?~,t~-. 4 Will this Project Require any Land Filling, Gradingor · r Excavation where there is a change to the Natural [~ ~'J<t,~'/'I~..~C ~',cr"c'~;~ //-,~J/~ ~a,_~,~ Existing Grade lnvolving more than 200 Cubic YardsL~J -- ~' ! of Material within any Parcel? I 5 Will this Application Require Land Disturbing Activities ~ ~ ~,,~, Encompassing an Area in Excess of Five Thousand t (5,000 S.F.) Square Feet of Ground Surface? -- 6is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred (100'/feet of a Wetland orL~ Submission of a SWPPP is required fo~ all Conslmction activities involving soil Beach? disturbances of ~ne (1) or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes ~ are part of a larger common plan that will ultimately disturb one or mom acres of land; which Exceed Fifteen (15) feet of Vertical Rise to~ includhlg Conslruclion activities involving soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance? -- the DEC has determined that a SPDES permit is required for storm water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Pertnlt 8 Will Driveways, Parking Areas or other Impervious for Storm Water Discharges fi.om Construction activity. Permit No. GP-O.IO-O01.) Surfaces be Sloped to Direct Storm-Water Run-Off~ 1. Tile SWPPP shell be prepared pdo~ to the submittal of the NOL The NOI shell be into and/or in the direction of a Town right-of-way? -- 2. The SWPPP shall des(ripe the erosion and sediment control pracUces and where 9 Will this Project Require the Placemect of Material, STATE OF NEW YORK, / . COUNTY OF .....~.~.E][..w~.L(.~. ............. SS That I, ~..1~..~......~....~...~.......0!.~.~. ............ being duly sw6rn, deposes and says that he/.*h~s the applicant for Permit, And that hed.,4q~s the .................. ..~..~...~r2.. ................................................................................................................................ Owner and/or representative of the O'm)er or Owners, and is duly authorized to perform or have performed tl~e said work and to make and file this application; that all statemenfa contained in this application are true to the best of his lmowledge and belief; and that the work will be performed in the manner set forth in tbe application filed herewith. Sworn to before me this; FORM - 06/10 ~LANIE NOTARY PUBLIC, State of New YO~ No. 01D04634870 Oualified in Suffolk Courdv 1 - I~ommlssionE,xt~resSeptemb~'~O, 7...o ~ 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 (63 I) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ANNETTE CAMPBELL COUNTY OF SUFFOLK) STATE OF NEW YORK) I, lCttigt,. ~llg/.r L~,t.~.,~u:,3 , residing at/dba AFFIDAVIT OF POSTING ~o,s,. g,~. I~1~"~ .~u. IJ.,~ lit]71 being duly sworn, depose and say: That on the i~day ofSr~w~t4~t £ ,2010, I personally posted the property known as ~l,~P~£t.t.. ~g.t,bt:~c.g. IIB$' ,~'t~E,"l'~Oo~ P-~. G2't'C~,t~ IJ.',q. iici2..~ by pla~ing the BOard of Trustees official poster where it ca~ easily be seen, and ~at J 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.~ September 22, 2010 on or about 6:00 PM. Dated: o~_w~m to before me this ay o~20~g~ Nc~y Public[ PROOF OF M~II,ING OF NOTICE ATTACH CERTIFIED MAI1, RECEIPTS ? Postage $1.05 09~5 $2.80 14 $2.30 $6.15 09/1512010 St~£-goT;'~: ..................................................... Ci~ Stale, ZIP+4 .................................................................. Sworn to b(e~ore me this Day of,~. ¢- ,20 - , ~ng duly ~o~ d~oses ~d sa~ ~at on ~ - - ' / ~ day of~ 20/0, fl~n~t m~ a ~c ~py of ~c Notice set fo~.in the Bo~d of T~te~ ~plioafio~ ~t~ ~ ~h of ~e abo~e ~ed perso~ at the ad~esses set opposite ~e r~five vamp; ~t ~e ~s~ set opposite the nines of s~d pemo~ ~e ~e ~ of ~d p~om ~ shem on ~e c~ent ~se~sment roll of~e Tom of Sou~old; ~ ~dNofi~ w~ ~1~ ~e U~t~ S~tes Post Officeat ~rc~ ; ~. ,~ts~dNofic~w~.~l~to~chofs~dpersonsby (ce~ified) (registerS) m~l. (~/'/ Notary Public LAUREN M. STANDISH Notmy Public, State of New York No, 01ST6164008 Qua fled n Suffolk Count'/ Commission Exp res Apr 9,202U_ of Trustees Applica~n County of Suffolk State of New York /hb _~5~--~ BEING DULY SWORN OSES AND AFFIRMS Tt~T 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 BELIF. F, 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, THEI~ AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~ ..... Sig~atu'~e ' "~/ SWOR TOBEFOREmTHXS /3 Public DAY OF~20 } 0 STYLIANI V. 'PIKRAMENOS Notary Public Qualified in Nassau County, NY Commission Expires /0 I / / // IJc. No. 0115J~17488i APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE. FORM Thc Town of Southold's Coda of Ethics nmhibits conflicts of interest on th~ earl of town i~,llicors and emolovces. ~ numos~ of this form is to nrovide information which can alcrt the town of oossibl¢ conflicts of intcm~t and allow it to lal~= whatever action is nece,.ssarv to avoid same. {Last aang:, firs(name, 0aiddle initial, unle. ss you are applying in lie name of someone else or other entity, such as a company. If so, indica~ fl~ other persen's or compnny'$ name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Truslee Change of Zone Coastal Erosion Approval of plat Mooring Exemption l¥om plal or official map Planning Other (If"Olhcr", IlalOe Ihe activity.) Do you personally (or through your company, spouse, sibling, parcel, or child) havc a mlalionship with rely officer or employee of thc Town of Southold? "Relationship" includes by blood, marriage, or buginess interest. "Business. interest" means a business, including a parmcrsbip, in which tb~: town officer or cmployce has cyan a parlial ownership of(or employment by) a coq~omtion in which thc town officer or employee owns more than 5% of thc 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 I)cseribe the relationship between yourself (Ibe applicanl/agcol/represcotativc) and Ihe Iowa officer or employee. Eithes check tile appropriate lit'.c A) through D) and/or describe in tile space provided. Thc lawn officer or employee or his or her spouse, sibling, parent, or ~:hild is (check all thai apply): __.A) thc owner of grealcr Ih~al 5% oflhc shares o1' thc corlx)ralc stock of Iht apptic0nt (when thc npplicanl is a corpomlioa); __.B) Ihc legal or benclicial ows~r of nay inlcrcst in a naa-corporate entity (when thc applicant is not a corporation); __.C) aa officer, director, partner, or employee of the applicant; or __.D) the actual applicant. DESCRIVflON OF REI.ATIONSIIII' Folnl 'I'S I 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. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 13 7 PROJECT NAME ~_~q~B~£t~ ~a~g,~ ig~}C~' 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: : Locationofacfion: 1185' ~-~-t,n~ ~t~. COro-n:~t;~ I · Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code (~'l~, ~.3 7. (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] NoN If yes, which stateor federalagency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. Yes ~ No [] Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria Yes [-~ No ~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. Sec 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 X 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 App~l~ble 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 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. ~ Yes~ No ~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE~ 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 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 [] Not Applicable PREPARED BY /,J,¢G. t~o~.c- lid "(ow ~ C~EE~ k16714'00"'~V FLE £Tl,/Vn o E) ELIRVE"r' OF: PRO~R~ 51TUATE.. FLIEET~ NECK r~r CAJTCT,~ TOINN.. 5n:)ttI-HOL.P 5b~-J-. 01_1< CX)UNT'r', N'K E0i~.V'E'KE~ O,~,-1~-2OIO EOFFOLK COUNT( TAX # IOOO - I~-/ - 4- - 2-/ S EUGENE'S 112.88' CREEK N~63 oj4,00,,W FLEETWooD' ROAD TOPO REI=ERENGEI~ TO N~V'D '2q DATUM Board of Tr. stees ,area = ~l-,~q 5. F. ~RAPHIC. E~.ALE I"= ~,O' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.C ADocuments and Setfings\OwnerkMy Documents~vly Dropbox\l 0\ 10-163.pro SOUTHEAST ELEVATION Existing FLOOR PLAN AUG 3 1 PROPOSED SUNRO0!~[ FOR Mn & MFS. J. CAMPBELL 1185 FLEETWOOD ROAD CUTCHO.~UE N.(, ~1935 Extg. Kitchen Extg. Living Rm. Extg. Dining Proposed Sunroom Extg. Deck 0 Pr'