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Home My WebLink AboutTR-7443Jilt 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 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 PEP~IIT NO. 7443 DATE: DECEMBER 15.2010 ISSUED TO: ED & ARLENE FOX PROPERTY ADDRESS: 2503 CAMP MINEOLA RD., MATTITUCK SCTM#122-9-9.4 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 December 15. 2010 in consideration of application fee in the sum of $250.00 paid by Ed & Arlene Fox to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct additions to the existing dwelling and modifications to the existing sanitary system, and as depicted on the site plan prepared by Thomas C. Samuels dated November 17, 2010 and stamped approved on December 15, 2010. IN WITNESS 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, Ed & Arlene Fox, re~;idine, at 2503 Caren Mineola Rd., Mattituck, NY, 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 fi.om 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. o 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 all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 December 15, 2010 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Thomas C. Samuels Samuels & Steelman Architects 25235 Main Rd. Cutchogue, NY 11935 RE: ED & ARLENE FOX 2503 CAMP MINEOLA RD., MATTITUCK SCTM#122-9-9.4 Dear Mr. Samuels: The Board of Town Trustees took the following action during its regular meeting held on Wed., December 15, 2010 regarding the above matter: WHEREAS, Samuels & Steelman Architects on behalf of ED & ARLENE FOX applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance, application dated November 16, 2010, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 15, 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 concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, and, 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, and, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees has found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVES the application of ED & ARLENE FOX to construct additions to the existing dwelling and modifications to the existing sanitary system, and as depicted on the site plan prepared by Thomas C. Samuels dated November 17, 2010 and stamped approved on December 15, 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, Jill k~ooherty, Preside~ Boartl of Trustees JMD/Ims 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 Thurs., December 9, 2010, the following recommendation was made: Moved by Meaghan Burke, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of ED & ARLENE FOX to construct additions to the existing dwelling and modifications to the existing sanitary system. Located: 2503 Camp Mineola Rd., Mattituck. SCTM#122-9-9.4 Inspected by: Derek Bossen, Jack McGreevy, Audrey Horton, Meaghan Burke The CAC Supports the application with the Condition of a drainage plan, the Iow-spot on the property remains natural, and effort is made to save, transplant and/or replace trees. Vote of Council: Ayes: All Motion Carried Jill M. Dohe~ty. President Jmnes F. King. Vice-President Dave Bergen Bob Ghosio. Jr. John Bredemeyer P.O. Box I 179 Southnld. NY 11971 Telephone (63 l) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: /_..~,' v<~'~/~ ED & ARLENE FOX request a Wetland Permit to construct additions to the existing dwelling and modifications to the existing sanitary system. Located: 2503 Camp Mineola Rd., Mattituck. SCTM#122-9-9.4 TyP~al~wf area to be impacted: ater Wetland Freshwater Wetland Sound __Bay Dista,0ce of proposed work to edge of wetland Pa, C/of Town Code proposed work falls under: ,/Chapt.275 Chapt. 111 other Type of Application:/",,/'"'Wetland __Coastal Erosion ._Administrative__Emergency Pre-Submission __ ~Amendment Violation Info needed: Modifications: Conditions: Present Were: ~/.~ing__~J.Doherty. __J~. Bredemeyer ~D. Bergen__ B.Ghosio, D. Dzenkowski other Form filled out in the field b.~_ Mailed/Faxed to: Date: BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6878 DATE: MAY 21~ 2008 ISSUED TO: EDWARD FOX PROPERTY ADDRESS: 2503 CAMP MINEOLA RD.~ MATTITUCK SCTM#122-9-9.4 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 May 21, 2008 in consideration of application fee in the sum of $250.00 paid by Edward Fox and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits ti following: Wetland Permit to construct additions to the existing residence and modify the existing sanitary system, and as depicted on the plan prepared by Samuels & Steelman Architects dated March 8, 2008. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 23, 2008 Thomas C. Samuels, Architect Samuels & Steelman 25235 Main Rd. Cutchogue, NY 11935 RE: EDWARD FOX 2503 CAMP MINEOLA RD., MATTITUCK SCTM#122-9-9.4 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wed., July 23, 2008: RESOLVED, that the Southoid Town Board of Trustees APPROVE the Amendment to Permit #6878 to install two (2) 8'X 2' leaching pools, remove the existing septic tank and install a new 1500 gallon septic tank, and relocate two (2) 8'X 2' leaching pools, and as depicted on the plan prepared by Thomas C. Samuels last revised May 14, 2008. This is not a determination from any other agency. Sincerely, President, Board of Trustees JFK:lms New York State Dep ent of Environmental Conserva Division of Environmental Permits SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Telephone (631 ) 444-0404 Facsimile (631) 444-0360 Alexander B. Granni$ Commissioner July 10, 2008 Mr. Edward Fox 445 East 80t}' Street, Apt. 8E New York, NY 10021 RE: 1-4738-02395/00003 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, Darleen M. Gerbino Environmental Analyst DMG/ls Enclosure NE~V YORK STATE OEPA~IENT OF ENVIRONMENTAL CONSEROON Facility DEC ID 1-4738-02395-- PERMIT Under the Environmental Conservation Law (ECL) Permittee and Facility Information Permit Issued To: EDWARD FOX 445 EAST 80 ST APT 8E NEW YORK, NY 10021 (212) 755-5390 Facility: FOX PROPERTY 2503 CAMP M1NEOLA RD ISCTM 1000-122-09- 9.4 MATTITUCK, NY 11952 Facility Application Contact: SAMUELS & STEELMAN ARCHITECTS 25235 MA1N RD CUTCHOGUE, NY 11935 (631) 734-6405 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Mattituck Facility Principal Reference Point: NYTM-E: 708.3 NYTM-N: 4540.8 Latitude: 40059'30.4'' Longitude: 72°31'25.1'' Project Location: 2503 Camp Mineola Road - SCTM # 1000~122-09-9.4 Authorized Activity: Construct a one-story addition, a two-story addition including a garage, porches, relocate existing septic tank, replace stone paving in-kind, and expand gravel driveway. All work must be in accordance with the attached plans stamped NYSDEC approved on 7/9/08. Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-02395/00003 New Permit Effective Date: 7/9/2008 Expiration Date: 7/8/2013 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: GEORGE W HAMMARTH, Deputy Regional Permit Administrator Address: NYSDEC REGION I HEADQUARTERS ]/g'tlb SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: ~~~)~ Date Page 1 of SITE DATA SCTM # I000-t22-&9.4 PROPERTY: 2503 CAMP MINEOI.A ROAD EXT. ADDRESS MATI'IIUCK, HY OWNER: ED & ARLENE FOX 455 EAST 80th ST. APTSE NEW YORK, NY 10021 ZONING: R-40 SURVEYOR: NATHAN TAFT CORWIN III PO BOX 1931 RIVERHEAD, NY 11901 LICENSE# 50467 NOTES: JUNE 24, lm COVERAGE S~EAREA EX. HOUSE& POOLHOUSE EX. POOL & STONE P~YIH~ EX. COVERAGE 63,993 SF · 1.469ACRES 2,107 SF 3,297 SF 5,404 SF = 6.4% PROPOSED t,740SF ADD'ONS PROPOSED 2165F PORCHES PROPOSED 7,360 SF · 11.5% COVERAGE K ~ I. IIE ELEV'ATION IO.O~- ' X I~11~1~,~.~ ~ ~,~l f II~R.A~ '~l. IO' IMI/I"T l, L~IN 2' t"f~ I' MIN 2' Iv~AX EPTIC PROFILE ~A ~ . LOCATION MAP i,i = U.I )K~,WN UY: TCS ~'~$~ HOL~. DA?A EL 2.O' MI~7 ~AN~, LOAM (~ CLAY IqA'l'~ IN MlXl~:7 ~a,~7, LOAM ( CLAY IqA'ri~R IH ~0)'~1BO~, Pt: lo' 1~° lqA'r'~R IN !~:71~4 CLA'¢~' BO~ Pt. I~IAI'~R IN (d~' GLAY'L~Y ~,AI~ ~G ..... · ""UST ~ I~$pe. ctod By The Water Ltnet~) LV~-- u~olk County U~pt. -.~ Call 852-5700, GREAT PECONIC OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY MAIl.lNG ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIT. ATION PROGRAM COORDINATOR TOWN OF SOUTHOLD To: Jim King, President Town of Southold Board of Trustees From: Scott Hilary, LWRP Coordinator Planner Date: May 7, 2008 Re: Chapter 268: Waterfront Consistency Review Wetland Permit for ED FOX SCTM#122-9-9.4 Samuels & Steelman Architects on behalf of ED FOX requests a Wetland Perrff~t to construct additions to the existing residence and modify the existing sanitary system. Located: 2503 Camp Mineola Rd., Mattituck. SCTM# 122-9-9.4 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 following LWRP policy standards and therefore is CONSISTENT with the LWRP. 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. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all ,4ndros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. To further LWRP policy standards~ the following Chapter 275 compliance standards may be required. § 275-11 Construction and operation standards. A. General The following standards are required for all operations within the jurisdiction of the Trustees: Drainage upgrade. Applicants for a permit for any form of construction may be required to upgrade the site's drainage system such that all surface water generated from impervious surfaces shall be kept onsite through infiltration or retention. Applicants proposing grading or filling operations will be required to submit a drainage plan for the entire site at the discretion of the Trustees. See ~ 275-6A(14)for requirements. Erosion control Installation of an erosion control structure is necessary during any building, grading, landscaping or site work activity within Trustee jurisdiction. This structure may include, but is not limited to, installation of a silt fence, hay bales, wood chip berm and silt booms. The placement of the erosion control structure(s) shall be determined by the Trustees or their designee. All intertidal construction and excavation requires the installation of a silt boom that will retain all suspended sediments within the immediate project area. Albert J. Krupski, President James King, Vice-President Henry Smith Attic Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application ~'~etland Permit Application ..,/Major Waiver/Amendment/Changes --~eceived Application: ./-Keceived Fee: $ ~.) / ~"Completed Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent)._.~ ~452AC Referral Sent:' I I ----qSate of Inspection: Receipt of C AC Report: Lead Agency Determination:__ Technical Review: ~---l~ublic Hearing Held: !_34 1 ~' I/,0 Resolution: Name of Applicant Address Minor VhoneNumber:( ) ~/{~.. Suffolk County Tax Map Number: 1000- 19.~ -- OC~ - Property Location: ~..~0.3 C)r~p ~q ~/~-0~ ~),. Tgl~tX (provide LILCO Pole #, distance to cross streets, and location) A~NT: 'Y~{o~ ~~ O, ~c~(.~ (If applicable) ' Address: ~o~ /~}{~ ~Dfl~D~ gO0 I'ZoO ~ 30,5 Phone: ~1~%b ' 69405 Board of Trustees Application Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Intended use of property: Prior permits/approvals for site improvements: Agency _ Date I /17 /oo __ No prior permits/approvals for site improvements. Has any permiffapproval ever been revoked or suspended by a governmental agency? V/ No Yes If yes, provide explanation: Project DeScription (use attachments if necessary): ~'~,~0 ~DO[]'lOkt~ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area ofwetlands on lot: 47~.~ .square feet Percent coverage of lot: 7~ 4 % Closest distance between nearest existing structure and upland edge of wetlands: J ~S feet - ~>00k [~/)0~q Closest distance between nearest proposed structure and upland edge of wetlands: ~'7~ feet ~ ~ ~ /~-DD(II Ot~ 'TO Does the project involve excavation or filling? No l/ Yes If yes, how much material will be excavated? I1~ cubic yards How much material will be filled? /,J~ik)~ cubic yards Depth of which material will be remo:ved or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: [}q_ge 14/ NIC[J,4. l(cflgkTI OAj 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): CT Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: ~D[~ I-g D[~ ~ ~e wetlands present within 100 feet of the proposed a~ivity? ~ No Yes Does the project involve excavation or filling? No ~ Yes If Yes, how much material will be excavated? How much material will be filled? Manner in which material will be removed or deposited: (cubic yards) (cubic yards) Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM FOr UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by Applicant or Proiect Sponsor 1. APPLICANT/SPONSOR 2. PROJECT NAME 3. PROJECT LOCATION: Mu.,cipa. I ?aT dK cou. oooFFe y.. 4. PRECISE LOCATION (Street address and road intersections, p;'ominent landmarks, etc., or provide map) 5. PROPOSED ACTION [] New I'vl' Expansion [] Modification/alteration DESCRIBE PROJECT BRIEFLY: t oo , {) tFlOtq6 TO :SlPe-t,,fe p 7. AMOUNT OF L~ND AFFECTED: Initially {~)~ ~r3 acres UltimateJy ~)~ ~-~ acres 8. WILL~PR/OPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING ~ND USE RESTRICTIONS? ~ Yes ~ No ff No, descd~ briefly 9. ~AZ~RESENT ~ND USE IN VJCINI~ OF PROJECT? ~ Resldential ~ Industrial ~ Commercial D Agriculture D Pa~ForesFOpen Spa~ ~ ~her Descd~: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (F,~ED~%aJ_, STATE OR LOCAL)? L.~ Yes [] No If Yes, list agency(s) name and permit/approvals: 11. DOES ANY ASPECT OF/THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [~No ff Yes, list agency(s) name and permit/approvals: 12, AS A RESULT OF PR,..~POSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? [] Yes L~ No . , . I CERTIFY~T ,HAT ??E. IN_FORMATIO~N PROVIDED A~BOVE IS TRUE TO THE BEST OF MY KNOWLEDGE . ~ppiicant'sponsorname: '-{'~/~/~ O- ~",' r...~/[ 0 bO~'L, ~ Date: ~ IO I If the actiOn is iIn the Coastal Area, and you are .a state a~lencY, complete the I II Coastal Assessment Form before proceeding with is assessment I OVER 1 PART II. IMpAcT ASSESSMENT (To be completed by Lead AgencY). IA. DOES ACTION EXCEED ANY TYPE I 'I¥1RESHOLD IN 6 NYCRR. PART 617.4? ff yes, eooedlnate the m~ ix, oce~s and use the FUi i EAF. B. WlLLACTIONRECEIVECOORD~NATEDREVIEWAS PROVIDED FORUNUSTEDACTIONSIN6NYCRR, PART617.67 IfNo, s negative I-iv-' 171.o C. COULD ACTION RESUCT IN ~ ADVERSE EFFECTS ASSOCIATED ~ THE FOLLOV~NG: (Answers may be haadwfltla~, If legible) C5. GI:OW~, ~ueot de~li~,~ or re~ated a~iM r~ lik~y te be ibdu(~ by b~e pn)pesed 8c~? F-x~hl bflotly: I,,° , C6. Long term, ~ tem~, cumulative, ~ other effects not ide~ti~-~l in 01-C57 Ex~a~ I~tefly: . ' · ~1.1 'I~IE PROJECT HAVE AN IMPACT ON THE F-.N~RONMENTAL CHARACTERISTICS THAT C~USED ~ ESTABLISHMENT OF A cRm( ENVIRONMENTAL AREA (CEA~? IIf 1/esl explain briefly: , E. ffi THERE, OR 18 THERE UKELY TO BE~ CONTROVERSY RELA'I~ED T0'PO~ ADVERSE ENVIRONMENTAL IMPACTS? If .I PAKT m - D.-~<~I~tA~3N OF 81GNmCANGG (To be completed by Age.y) ~ should ha a~_ ~_ _~d In coflnec~ofl ~ i~ (m) 8etffng (i.e. U~o~fl ~' ru~); (b) prohablllly of Cc4~rrlng; (~) cl~ratten: (d) ifl'eve~ofll~, (e) geographic scope; and (f) magnitude. If ne~ssary, add attednmente or roferen~e supporting matedets. Ermure Ihat explanaticns mdadeof detail to show Ihat all mtevent adverse impacts have bee~ ident~ed and adequately addressed. If question d of prat II was checked yes, fha,determination of significance must evaluate Iha potentlallmpa~ofthe proposed ac~)n on the en~l characteristics of the CEA. FAF and/or prepare a positive.declaration. WILL NOT result In any sigfiif~ant adverse e~vlrordmmtal Impaots AND prodde, on atta~xrmnts as necessmy, the masons supposing Ihl determlna~on.. Board of Trustees Name of Lead Agency Jill M. Doherb/ Date President T~e of Responsible Officer 81gnotum of Preparer (If dtiferent from respons/ble officer) 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 BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of ED & ARLENE FOX COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING residing ~ .~(B. qlLI4J~')-';+~°~//n'~/q being duly sworn, depose and say: T~../(t on the~O, day of ~ ,, 2010, 1 personally posted the pro,[~rtyAkfi, own 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., December 15~ 2010 on or about 6:00 PM. Dated: Sworn to before me this ] ~-'day ofD-t&_20/O (signtture) OF MAILING OF NOTICE IRTIFIED MAIL RECEIPTS Ceffifi~d Fee ~ Return Receipt Fee r'"l (Endorsement Required) F{es dcted D e[ive~J Fee (Enclorsement Requ rod) Total postage & Fees jSE O3 12/06Z2010 Address: Dr. STATE OF NEW YORK COUNTY OF SUFFOLK ~ r/~ ~ - - , being duly sworn, deposes ~nd says that on the · CO day of~ 20/0 , deponent mailed a tree copy of the Notice · set forth in the Board of Trustees Application, directed to each of tiie above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said p~rsons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at fV~f~u~.~ I ~ , that said Notices were mailed to each of said persons by (certified) (registered) mail. ' Swom to before me this Day of _~)~. ,20 / Not, Pu ic COTY NGAI Notary Public, State of New York No. 01-NG 60413S9 Qualified in Suffolk Coun~ ~ ,// Commission Expires May Ed Fox PO Box 596 Mattituck, NY 11952 March 5, 2008 I hereby authorize Thomas C. Samuels of Samuels and Steelman Architects or 25235 Main Road, Cutchogue, NY, to apply for all required permits from the Town of Southold, Suffolk County and State of New York, for my project at 2503 Camp Mineola Road, Mattituck, NY 11952. Sincerely, Ed Fox Board of Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRI]3ED PER/VlIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF FIlS/HER KNOWLEDGE AND BELI]BF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF Notary Public Suffolk County ~xpires May 30,~2 The Town TEANEACTIONAL DISCLOSURE ~URH interest on the part of town officers and emploY_~s. The ~rpoee of this form is to pro¥ide information which can alert the town of possible conflicts of inheres5 end allow it to take whatever aotion is neoeeeary to avoid same, (b~et dame, f~ret name, midd./e initial, unless you ac~ applying in ~h~ nam~ off someone else Q~har ~ntf~y, muuh ~s a company. Iff ~o, Indicate %ha o~her p~rson's or eompany'e name.) NATURE OF APPLICATION~ (Ch~uk all that apply.) Variance A~p{~al of pl~ Ex~ptio~ from plat or official map (If "othgr~" name the aeblvlby.) ..... . ,_,., intereo~" means a business, Including a partner~hlp~ In which ~he town offiuer ur employee ha~ even a partial o~nerehip or (or employment by) a corp.ora~fon in vhic]l the town of liter or employee owns mote than 5~ of the dat~ and nigh where indicated, Nam~ or per,un ~mpluy~d by th~ Town or Ooscrib~ the relationship between yourself (~h0 applicant) and the town ~ffle~r er employee, Either cheek appropriate lin. A) through D) and/ur d~sortb~ provided. The town officer or employes Or his Or her 8pous~ parent, or child Is (chock all that apply)~ __A) the owner of greater then 5% of tho shores of 5he corporate atd~k of the applicon5 (when the applicant' . la a corporation); B) the legal or bbnefleial owner of any interact t. non~orpora~e'ent~y (when ~he appLi~an~ la no~ a __C) an cffioer~ director, applicant/ or D) tho actual applicant. or emplOyee, of tho 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 Water~ont Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfi'ont 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", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 Deparm~ent, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 122 09 9.4 The Application has been submitted to (check appropriate response): TownBoard [] Planning Dept. ~ Building Dept. ~ BoardofTrustees [] Category of Town of S outhold 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: Additions to existinq residence, and relocation of existing septic tank (Leaching pools to remain) Locationofaction: 2503 Camp Mineola Rd (R.O.W) & Great Peconic Bay Site acreage: 1.469Ac Present land use: Single Family Residence Present zoning classification'. R- 40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: Thomas C. Samuels (For Ed Fox) (b) Mailing address: 25235 Main Rd, Cutchogue, NY 11935 (c) Telephone number: Area Code ( ) 631-734-6405 (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? NYS DEC 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 Adding to an existing residence preserves open space around the existing residence and makes efficient use of the existing structure and property. Also the addition to the property is far less than the 20% lot coveraqe allowed by zoninq. Attach additional sheets if necessary Policy 2. Protect and preserve historic m~d archaeological resources of the Town of Southold. See LWRP Section HI - Policies Pages 3 through 6 for evaluation criteria [] Yes [] No [] Not Applicable There are no historic or archeological structures on property. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section HI - Policies Pages 6 through 7 for evaluation criteria [] Yes [-~ No [] Not Applicable The addition to the existin9 residence is in keeping in style and scale of neiqhborinq structures. Attach additional sheets if necessmy 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 Ail rainwater runoff is and will be retained on site with the use of underground drywells. During construction hay bales placed temporarily between the construction and shore will k~mp runoff spoils on site. 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 I~All YeSrainwaterl~ No r~unNo?fA~pgliaCnadblewill be retained wit the use of underground drywells. The sanitary system for the residence meets current Suffolk County Dept. of Health Services standards for sanitary waste water. The property is 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 HI - Policies; Pages 22 through 32 for evaluation criteria. [] Yes [] No [] Not Applicable No development will take place in the "protected" or "natural indiginous environment". 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. The development will not add pollutants into the air. All construction vehicles meet the Federal standards for air pollution discharge. The mechanical systems of the residence meet the federal standards for air pollution discharge. 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 The construction and use of the residence will make use of the town's disposal and recycling center. Ail waste water "sanitary" will be discharged into an approved ~CD~ ~anitary system. 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. [] Ye~ No [-~ Not Applicable NO public land involved. Littoral access unimpeded. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ~ Yes [] No [] Not Applicable There are no public or commercial activities or uses on site. Historically this property and neiqhborinq properties are residential in use and will r~m~in r~id~ntia] 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 This project will protect and preserve the living marine resources by maintaining all rainwater discharge and sanitary flow from the residence on site by approved SCDHS sanitary system and drywells for rainwater runoff. 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 There are no agricultural lands on site. 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 The construction will be using equipment approved by the Federal government for energy usage. The residence will meet Federal standards for conserving enerqy "enerqy Star Proqram" and will use "NY State Enerq¥ Conservation and PREPARED BY JI20~m~ Createdon5~5~5 . S A M U E L S & S T E E L M A N November 17, 2010 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 RE: ADDITIONS TO THE FOX RESIDENCE 2503 Camp Mineola Road Mattituck, NY 11952 TAX MAP # 1000-122-09-9.4 Dear Sir/Madam: We are requesting a Permit for the above reference project, for additions to an existing single family residence, and the modification to the existing sanitary system beyond the 100 foot setback. Please notethatTrustees permit#6786was previously granted, but has nowexpired. Foryourreviewwe are submitting the following documents: 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Trustee Application Shod Environmental Assessment Form Application Affidavit (2) LWRP Consistency Assessment Form (3) SITE PLANS prepared by Samuels & Steelman Architects Copy of original Trustees permit #5084 Copy expired Trustees permit #6878 Copy Trustees amendment dated 7/23/08 Copy NYSDEC permit #1-4738-02395 Copy SCDHS permit #R10-08-0036 Current Survey Letter of authorization from Owner Check for $250 Please call us with any questions or concerns. If application is complete, please schedule a public hearing and notify our office about posting the site and notifying the neighbors. Sincerely, SAMUELS & STEELMAN ARCHITECTS ~~ls, Architect enc. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 ~631) 734 6405 FAX (631) 734-6407 ZON~ VR {EL. 6) ptlCOI~IC 2 I/2 STORy ~RAME HOUSE I I I .~ I I I I I I I I .'55.79. !. "' . 84'50'50" W / / ~UND CONC _NOT~S: 1. ELEVATIONS ARE REFERENCED TO N.G.V,D, 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:~ 2. WETLANDS IF ANY ARE NOT SHOWN S. FLOOD ZONE INFORMATION TAKEN FLOOD INSURANCE RATE MAP No. 561D$CD482 G ZONE AR: BASE FLOOD ELEVATIONS DETERMINED ZONE VE. COASTAL FLOOD WITH VELOCg'( HAZARD (WAVE ACTION), BASE FLOOD ELEVATIONS DETERMINED ZONE X*: AREAS OF BOo-YEAR FLOOD, AREAS OF 10B-YEAR FLOOD WITH AVERAGE DEPTH OF LES5 THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE, AND AREAS PROTECTED BY LEVEES FROM IO0--YEAR FLOOD, 4. THIS PROPERTY IS SHOWN AS LOT 2 ON MINOR SUBDIVISION MAP FOR PETER F. KREH FILED AT THE SOUTHOLD TOWN PLANNING BOARD. 5. SEPTIC SYSTEM MEASUREMENTS SUPPLIED BY OTHERS. SURVEY OF PROPERTY SITUA TED A T MATTITUCK TOWN OF SOUTHOLD SUFFOLK S.C. TAX AUGUST 2, AUGUST 30, 1999 JANUARY COUNTY, NEW YORK No. 1000-122-09-9.4 SCALE 1"=30' JUNE 24, 1999 1999 ADDED PROPOSED HOUSE SET LATH FOR N.Y.S.D.E.C. INSPECTION 12, 2000 REVISED SITE PLAN JULY 11, 2000 ADDED PROPOSED WATER SERVICE JANUARY 30, 2001 UNDER CONSTRUCTION SURVEY APRIL 8, 2002 FINAL SURVEY JUNE 14, 2002 REVISED CESSPOOL MEASUREMENT JULY 31, 2002 REVISED CESSPOOL MEASUREMENT AUGUST 19, 2002 ADDED ROOF OVERHANG AT POOL HOUSE JUNE 27, 2003 SET MONUMENTS A RE-BARS JUNE 16, 2004 SET RELOCATE H.W.M. & SET RE-BARS AT 75' & 100' SETBACKS DECEMBER 7, 2007 UPDATE HIGH WATER MARK LOCATION & STAKE 100' SETBACK AREA = 63,995 sq. ft. (TO TIE UNE) 1.469 ac. CERTIFIED TO: FIRST AMERICAN TITLE INSURANCE COMPANY OF TITLE No. 151-S-8577 NORTH FORK BANK EDWARD M, FOX NEW YORk THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. Lic. No. 50467 Nathan Taft Corwln III Land Surveyor PHONE (651)727-2090 Fax (631)727-1727 99-401] TEST HOLE DATA 1~-5'1 HOLE DUG BY McDONALD GEOSCIENCF ON JUNE 2, 1999 at 11 AM SITE DATA SCTM # 1000-122-9-9.4 EL. ,~, // PROPERTY: 2503 CAMP MINEOLA ROAD EXT. EL. 2.0' ~,~^~.Lo^M, ~L^~ '~ £ ~. O~ ADDRESS MATTITUCK, NY .^~ ,, M,~ ~^~, Lo^M, ~^~ /' ~r/o~ ~ OWNER: ED & ARLENE FOX Fr~.r. r4M ,i*. ~'A~O 10' 13' 20' 23' 29' 455 EAST 80th ST. APT 8E NEW YORK, NY 10021 ZONING: R-40 7 ZONE AE ~ ZONE 4 GREAT PEC SITE PLAN 7 5 4 SCALE: I" = 30' -0" SURVEYOR: NATHAN TAFT CORWIN III '. PO BOX 1931 ,.-"". S..* ,'55._79.'' ,. ' ' * ': . .., ."~".:., ',, :"''... ,' ,' "--*, ' "':,,,.' ' ,:", . .- .,,.,. · . :7. :-' :, .:, .. . m~ LICENsERIVERHEAD# ~' :',~:046'"NY 11901,, ri 00' '50" W 70. . . B4"50 NOTES: JUNE 24, 1999 AUGUST 52 1999 ADDED PROPOSED HOUSE AUGUST b, 1999 SET LATH FOR N.Y.S.D.E.C. INSPECTION JANUARY 12, 2000 REVISED SffE PLAN dULY 11, 2000 ADDED PROPOSED WATER SERVICE JANUARY 30, 2001 UNDER CONSTRUCTION SURVEY APRIL 8, 2002 FINAL SURVEY JUNE 14, 2002 REVISED CESSPOOL MEASUREMENT dULY 31, 2002 REVISED CESSPOOL MEASUREMENT AUGUST 19, 2002 ADDED ROOF OVERHANG AT POOL HOUSE JUNE 27, 2003 SET MONUMENTS & RE-BARS JUNE 16, 200'1. SET RELOCATE H.W.M. & SET RE-BARS AT 75' &.100' SEm~.CKS DECEMBER 7, 2007 UPDATE HIOH WATER MARK LOCATION & STAKE 100' SETBACK 1. ELEVATIONS ARE REFERENCED TO N.S.V.D. 192~ DA'IMM EXISTING ELEVATIONS ARE SHOWN 1HUS:~ 2. WETLANDS IF ANY ARE NOT SHOWN 3. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 36103co482 O ZONE AE: BASE FLOOD ELEVATIONS D~dlNED COVERAGE SITE AREA 63,993 SF = 1.469 ACRES EX. HOUSE & POOL HOUSE EX. POOL & STONE PAVING 2,107 SF 3,297 SF EX. COVERAGE 5,404 SF = 8.4% PROPOSED ADDITIONS PROPOSED PORCHES 1,740 SF 216 SF PROPOSED COVERAGE 7,360 SF = 11.5% BUILDING ~ALL .... '~' $OUTHO/D FF +ll.&&J /--~RADE LINE ELEVATION IO.O' / / / J/ / . ~1 HIN2 HAX / . ~I'HIN2'HAX ' '""-' ' '~'~ ,/~"~T . , . I [--TO~ o~ ~OOb ~.o4' 5' 1,,II N SEPTIC PROFILE LOCATION MAP ONIC BAY CRffAT PECONIC BA: DRAWN BY: TCS CHECKED BY: SHFET TITLE: SITE PLAN SHEET NO: '