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Home My WebLink AboutTR-7577 Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0704C Date November 22, 2011 THIS CERTIFIES that the repair of the existing deck framing, decking and handrails and for the new stairs At 1200 Leeton Dr., Southold Suffolk County Tax Map #59-1-1 Conforms to the application for Trustees Permits heretofore filed in this office Dated 5/17/11 pursuant to which Trustees Wetland Permit #7577 and Coastal Erosion Permit #7577C dated 6/22/11 were issued and conforms to all of the requirements and Conditions of the applicable provisions of law. The project for which this certificate is being issued is for The repair of the existing deck framing, decking and handrails and for the new stairs. The certificate is issued to MARGARET MOLLOY owner of the Aforesaid property. ~t~orized Si)gnatu~re Jill M Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 l) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction ~ constructed Project complete, compliance inspection, INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375MainRoad P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE __ Pre-construction, hay bale line 1 st day of construction ~ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7577 & 7577C DATE: JUNE 22, 2011 ISSUED TO: MARGARET MOLLOy PROPERTY ADDRESS: 1200 LEETON DRIVE~ SOUTHOLD SCTM# 59-1-1 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 June 22, 2011, and in consideration of application fee in the sum of $500.00 paid by Margaret Mollov and subject to the Terms and Conditions as stated in the Resolution, the Southold Town~Bbard of Trustees authorizes and permits the following: Wetland Permit to repair the existing deck framing, decking, and handrails, and install new stairs; and as depicted on the site plan prepared by Nancy DWyer Design Consulting, Inc., last dated February 3,2011, and stamped approved on June 22, 2011. IN WITNESS WHEREOF, the said Board of Trnstees 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 Margaret Molloy, residing at 1200 Leeton Drive, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for d ,d ,d ,d ,d ,d ,d ,d ,d ,d~ges, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittec 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, requqst for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution oftbe said Board. That there will be no unreasonable interference with navigation as a result of the work herein atlthorized. 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, tQ remove or alter this work project herein stated without expenses to the'Tnwnof Sofithold. That the said Board will be notified by the Permittee of the completion of~e 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 failore to obtain same. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town HallAnnex 54375Main Road P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD COASTAL EROSION MANAGEMENT PERMIT COASTAL EROSION PERMIT #7577C Applicant/Agent: Tom Quarry Permittee: Margaret Molloy SCTM#: 59-1-1 Project Location: 1200 Leeton Drive, Southold Date of Resolution/Issuance: June 22, 2011 Date of Expiration: June 22, 2013 Reviewed by: Board of Trustees DESCRIPTION OF ACTIVITY: To repair the existing deck framing, decking, and handrails, and install new stairs. The Coastal Erosion Management Permit allows for the operations as depicted on the site plan prepared by Nancy Dwyer Design Consulting, inc., last dated February 3, 2011, and stamped approved on June 22, 2011. INSPECTIONS: Final SPECIAL CONDITIONS: (apply if marked) In accordance with Chapter 111-15 Erosion Protection Structures: __ A maintenance agreement is attached hereto and is a necessary special condition of this permit. Jill M. I~herty, President Board of Trustees Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 June 22,2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr, Tom Quarty P.O. Box1949 Southold, NY 11971 RE: MARGARET MOLLOY 1200 LEETON DRIVE, SOUTHOLD SCTM# 59-1-1 Dear Mr. Quarry: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 22, 2011 regarding the above matter: WHEREAS, Tom Quarty on behalf of MARGARET MOLLOY 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, and Chapter 111 of the Southold Town Code, Coastal Erosion Hazard Areas, application dated May 17, 2011, 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 June 22, 2011, 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 and Chapter 111 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 MARGARET MOLLOY to repair the existing deck framing, decking, and handrails, and install new stairs; and as depicted on the site plan prepared by Nancy Dwyer Design Consulting, Inc., last dated February 3, 2011, and stamped approved on June 22, 2011. 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 Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ._~/~ / ~ ~O II has been reviewed by this Board at the regular meeting of ,,~"~r~e~ ~c~; o~c~ I ! and 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) 1st Day of Construction ($50.00) __ ~ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee rgust be paid within 90 days or. re-application fees will be necessary. You will receive your permit upon completion of the above, COMPUTATION OF PERMIT FEES: TOTAL FEES DUE:$,.~)? BY: Jill M. Doherty, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 15, 2011, the following recommendation was made: Moved by Meaghan Burke, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit and Coastal Erosion Permit applications of MARGARET MOLLOY to repair the existing deck framing, decking, and handrails, and install new stairs. Located: 1200 Leeton Dr., Southold. SCTM#59-1-1 Inspected by: Meaghan Burke, Peter Young The CAC Supports the application with the Condition the area seaward of the deck is left as a non-disturbance buffer. Vote of Council: Ayes: All Motion Carded Jill M Dohe~ly, President Bob Ghosio, Jr.. Vice-President James F, King Dave Bergen John Bredemeyer P.O Box [179 Southold, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: MARGARET MOLLOY requests a Wetland Permit and Coastal Erosion Permit to repair the existing deck framing, decking, and handrails, and install new stairs. Located: 1200 Leeton Dr., Southold. SCTM#59-1-1 ~ietwf area to be impacted: ater 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: k'-~Wetland __Coastal Erosion ~Administrative__Emergency Pro-Submission ~Amendment Violation Info needed: Modifications: Conditions: ~- __Pr se * Were' ,,. hosio J. King Bredemeyer D. D%nkowski other Form filled out in the field by J/~. Bergen, Mailed/Faxed to: Date: 059 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: June 21, 2011 Re~ Proposed Wetland Permit for MARGARET MOLLOY SCTM#1000-59-1-1 Tom Quarty on behalf of MARGARET MOLLOY requests a Wetland Permit and Coastal Erosion Permit to repair the existing deck framing, decking, and handrails, and install new stairs. Located: 1200 Leeton Dr., Southold. SCTM#59-1-1 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 Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer 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 Office Use Only JCoastal Erosion Permit Application _lLWetland Permit Application Amendmenffl'rans fer/Extension ~.//Rece~-ved Application: ,~, I Q I Il ~eceived Fee:$ ~O-- ' ' *.-C~ompleted Application .'~'~ ~ Q I II Incomplete SEQRA Classification: Type I Type 1I Unlisted Administrative Permit __Coordination:(datesent). {" ] 7 7011 ~/L-WWRP Consistency Assessgaent Form ~4L'cAC Referral Sent: (~ !.'~ Il ~ate of Inspection: ~ [I ~H Receipt ofCAC Re~o~ ' Lead Agency Dete~ination: Tec~ical Review: ~blic Heahng Held: ~ Resolution: Phone Number:0'~6) Suffolk County Tax Map Number: 1000 - O~"c'/ - / - ! Property Location: /_9_rgd ~,~..~, ~.-,~,~_ ,(~r~.72~..[',~ Az',-/ / (provide LILCO Pole #, distance to cross streets, and location) (If applicable) ~ -- - / Address: /'?'¢P--/ Phone: Board of Trustees Application Land Area (in square feet): Area Zoning:. GENERAL DATA Previous use of property: Rag ) aP. eu 77~k l Intended use of property: ~at../~. ~;r ~ Covenants and Restrictions: Yes / 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. Prior permits/approvals for site improvements: Age~,~ Date Yes /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): z~57~.~...~.... ~,..~;'/--'-,.;,.,~J ,~-- Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: -~,- Area of wetlands on lot: /~(j~'t2 square feet Percent coverage of lot:./~ % Closest distance between nearest existing structure and upland edge of wetlands: ~ot, /n.z,r feet Closest distance between nearest proposed structure and upland edge of wetlands: ,4t',* /,'~ 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? '/ cubic yards Depth of which material will be removed or deposited: ...~-"' .... feet Proposed slope t~oughout the area of operations: Manner in which material will be removed or deposited: Statement of the _efl~c[~ if any, On ~h9 wet_!_ap.d.s, arnr[.tid~l_ wa__ters_ Pf the town that may_ res_u!t_ b_y. reason of such proposed operations (use attachments if appropriate): Board of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? ~'"/No Yes Does the project involve excavation or filling? -~No Yes If Yes, how much material will be excavat~(-e~bi'c yards) How much material will be filled? ~ (cubic yards) Manner in which material will be removed or deposited: Describe the nature ired extent of the environmental impacts to the subject propcxty or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 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 SEQR 3.PROJECT LOCATION: 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map IS PROPOSED ACTION: [] New [] Expansion ~ Modification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 6. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? E~Yes [] No if no, describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) F:~Residential [~ Industrial F--] Commercial E~Agriculture F'] Park / Forest / Open Space E~ Other (describe) 10. DOES ACTION iNVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~Yes r--'~No if yes, list agency name and permit / approvak OYes []No If yes, list agency name and permit / approval: CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Spo Name '~,~Z ~/.~'~,':"~ 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 617.4? ~f yes, coordinate the review process and use the FULL EAF. F--'] Yes r~No B WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. ~]Yes r-~'] No c. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1.Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation 0r~fauna, fi~:'~hellfisb or wildlife species, significant habitats, or threatened or endangered species? Explain b~elty: I ,,, ,I C$. Growth, aubsequent development~ or re ated actti~t es Lely to he induc~l by the propo~:l acfion? Exp am briefly: CO. koeg term, short term, cumulative, or oth~r effects not idenii~r~d in Ct-C$? Ex~lein brisfly: I C?. Other impacts (including chan~es in use of either quant~ or t~pa of enemy? Explain brietil/: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? (If yes, explain bdefl~,: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If)'es explain: I--lYes rT-1 NoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve~determinewhetheritissubstan~a~~~arge~imp~rtant~r~therwisesigni~cant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irroversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or raferanco supporting materials. Ensure that explanations contain suffident detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box if you have identified one or more potentially large or signfficent adverse impacts which MAY occur. Then proceed directly to the FULt EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actior WILL NOT result in any significant adverse environmental impacts AND preside, on attachments as necessary, the reasons supporting thi~ determination. Board of Trustees Name of Lead Agency Jill M. Doherty Print or TyI~ Na. Ja~ of Respp~sible (~Ricer in Lead Agency Signal~ of Respons'lM'e"Ofticer in Lead~ency Date President Title of Responsible Officer Signature of Preparer (If different f~om responsible officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C TM ~' THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ¢e¢~n .~ i_/ot~'/ STORM-WATEP,w GRADING, DRAINAGE AND EROSION CONTROL PLAN ore,ct CERTIFIED BY A DESIGN PROFESSIONAl. IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION l'I'lt~VI # / WORK ASSESSMEN~ I Yes No a. What ~s the Total Area of the Proj~t Parce!s7 /~- ~] ~ ~/t;' 1 Will this Project Retain All Stonn-Watar Run~Off {InOuda Total Area of all Parcels located within the Scope of Work for Proposed Construction) ~ Generated by a Two (2') Inch Rainfall on Site? (s F/Acres) (This item will i~clude all mn-off created by site ~/ il b. What is the Tota~ o~ CJe~ and/or Ground Disturbance for the proposed Stie Improverneo[s and the permanent cma§es of (s F ~ Ac~s) impor~,fous surfaces.) 2 Does the Site Plan and/or Survey Shew All Proposed PROVIDE BRIEF PROJEL~ DESCRIPTION (pro,~. ~ ~ ~ t~.~) Drainage Structures ledicating Size & Location? This g Item shall include all Pref3osed Grade Changes and '; 3 Does the Site Plan and/or Survey describe the erosion :~,--Y, .... t~,,*~.~/,.~ ~, /~'..,..~.//[~,~j and sediment control practices that wirl be used to / ' ' contTol site erosion and storm waler discharges. This ' ' ~ ' ) _~?~._ ~..~..- item must be maintained throughout the Entire · ' Construction Pealed. A /'~'.. · 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change ~o the Natural N Existing Grade involving more than 200 Cubic Yards __ of Ma eha with n any Parcel? 5 Will this Applicagon Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand]~} L,/ (5,000 S.F.) Square Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the TnJstees jurisdiction~ General DEC SWPPP Reflul~ecnents: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required ~or all Ccnstmcben activit~s involving so~ Beach? including Construction aclJvi~es involving soil disturbar~ces et less than one (1) acre where One Hundred (100) of Horizontal Distance? ~ -- required, post-construction storm water management practices thai '¢~ be used and/or Removal of Vegetation and/or the Constructfo~ of any r~ STATE OF NEW YORE, (, ~ ~ Own¢r and/or t cp]'¢scntaave of the Owner or Owe)ers and is duly authorized to [)ed~)rm or have pe[fom~cd thc sad wo~. and to make and file this application; that all statements contained in this application are true to d~e best of his knowledge and belief; and that the work will be perfolmed in the manner set [~}llh th the application filed herewith. FORM - 06/10 Jill M Duherl~, Prc~idcm Bob GIiosk~. Iown Ihdl, y, 311g5 Main Rd p O Box I 17g Soulhold. NY IIg71 Fclcphonc (6~ I I ?05-1Nq2 J ax (631} 7654)64t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRt. SFEES TOWN OF SOUTHOLD In the Matter oFth¢ Appticatiou of MARGARET MOLLOY COUNTY OF SUFFOL, K) STATE OF NEW YORK) '-~__.~q~.~__ AFFID,,.~VIT OF POSTING being duly sw}mk depose and s~y: 'l'lmt on the,,l~day of V~ .201[, I personally posted tile property known as by placing tile Board of Trustees official poster where it can easily be seen, and that 1 have checked to be sure the poster has remained ill place for eight days prior to the date of the public hearing. Date of hearing holed thereon to be hekl Wed~ June 22~ 21)11 on or about 6:00 PM. Dated: ~,orn It) before me this day of .~2011 Notary Public CATHERINE CHAUDHUR! ~ Pul~Ic, l~e State of New Yo~ No. 01CH4926005 F MAILING OF NOTICE ,RTIFIED MAIL RECEIPTS Address: STATE OF NEW YORK COUNTY OF SUFFOLK ~c~o~\'e'-~ q ~,.~_ ~ , residing at , being duly sworn, deposes and says that on the ~dayof ~ ,20 1[ ,deponentmailedatmecopyoftheNotice the Board of Tm~ees Application, directed to each of the above named persons at the addresses set o~posite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~,_t~a~ ~.[~ P,~ Q'~, that said Notices were mailed to each of said persons by CERTIFIED MAILPI~]E-TURN RECEIPT. Sworn to before me this Day of tlq~.~ ,20 Notary Public NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: SCTM# That it is the intention of the undersigned to request a Permit from the Board of Trustees to: 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: DATE: ,~,..o You may contact"ff~e 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:/~/ J"~a,,.,~ PHONE#: 5-14:-7,-/1_ 17.3'7 (-.?/ >~" / q'/2. " / Eric: Copy of sketch or plan showing proposal for your convenience. -{-I I'0: OLLOY m CeHifled Fee ~ $2.85 ~ (Endomement Requ~d) i'rl rtl (Endorsement Required) ;$ or PO Box NO. OFF C~AL USE OFFICIAL USE [::3 [:::] (E~dorsemenlR~qulmd) '$ tBoerd of Trustees ApplicOn County of Suffolk State of New York ~ ~,"~/~;~2'~ BEING DULY SWORN DEPOSES AND AFFIi~vls :rHA/IrHE/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), JIF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THE1R AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. C~Sig~n~ture SWORN TO BEFORE ME THIS DAYOF~)~ ,20 ~l Notary Public QuMtfied m Suffolk,Co~Jnty,., . 06/~7170~g Bl:]l p.1 (where the applicapt is not the owner) ~,~?.,~1~ /).:' )!~,/ I'~- -' '~ [pzin~ ~er ~ 9ro~rtY) {mailing -a~) ( Aqent ) to apply for ~it[s) fr~ the Southold Board of Town Trllstees on my behalf. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONA.L DISCLOSURE FORM The Town of Southold's Code of Ethics vrohibits conflicts of interest on the oart of town officers and emolovees. The numose of this form is to omvide information which can alert the town oft~ossible conflicts of intore~t and allow it to take whatever action is necessary to avoid semen,, ~ ~ (Lhsi name/first name, r~iddle initial, unless you arc applying in the name of someone else or other entity, such as a company. If so, indicate, the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other /j . ~, (if"Other", name the activity.)~/~.~z~-4 ~ ~ .~/~,,--x~ Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? Re at nosh p mc udes by b nod, mart age, or bus ness nterest. Bus ness interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO f If you answered "YES", complete thc balance of this form and date a~n where indicated. Name of person employed by the Town of Southold Title Or position of that pemon ~-f/ Describe the relationship between yourself (tbe applicant/agent/representative) and the town officer or employee. Either check thc appropriate linc A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% oftbe shares of the corporate stock of the applic0nt (when the applicant is a corporation); B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ___C) an officer, director, paxtner, or employee of the applicant; or ___D) the actual applicant, DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this Signature Print Name ___day of 200 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. Thns~ each answer must be explained in detail~ listing both supporting and non- supporting 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# 6~ :>"'q - / - PROJECT NAME .J~7~/o'~,.', ~'7 The Application has been submitted to (check appropriate response): Town Board [] Planning Board [] Building Dept. [--] Board of Trustees 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: 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) Name of applicant: Co) Mailing address: (c) Telephone number: Area Code ( (d) Application number, if any:. Will the action be directly undertaken require funding, or approval by a state or federal agency? Yes [-~ No [-~' If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. / ~Yes ~ No ~NotApplicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southoid. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria V1 Yes No Not Applicahlc Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout thc 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 Pag/es 8 through 16 for evaluation criteria ] [ Yes II No ~ v t 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 throug~r21 for evaluation criteria ~ Yes ~ No[7-]/tgzl 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. Xes No AOcable 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 F--] 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. [] YeJ---] No ~/Not Applicable Attach additional sheets if necessary .... C~ WORKING COAST POLI P~licy 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 l[--]/~"~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pa. ges 65 through 68 for evaluation criteria. ~ Yes ~ No ~Not Applicable PREPARED BY TITLE DATE 5,URVE'r' OF: PROPERTY' 51TUATE-, 50OTHOLD TOP, IN: ~LP 51,E=POLK COUNTY', NY f~JI~VS'KSD: 0~-25-2011 E:~IFFOLK C, OUNT'Y TAX # I000- ~- I - I JAMES T. MOLLOY NOTED: · HONUI"iENT FOUND C. ONTOUR LINS~ tP. EF~NC.E NHVD '2q PAT'UI"t FEb'iA FLOOD ZONE ANNOTA'T'EP FI~.OI'4 FIRH HAP :1, ~,~1ODC. OI54- H PTI2 HAY 4, Iq<;l~ 6OASTAL Et;~.O~ION HAZARD LINE ANNOTATED FROH DE(~, PHOTO # .~.-.~26-~ ~Jr~T ~ OF ~ DTD ~/2q/~ AREA : l&,.Sq5 5.F. OR O.D610 AC. RE GRAPHIC., c-'~._.ALE t"= DO' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 F~x 3694287 REF.C:kDocumcnts and Setlings\OwnefXMy DocumentsXMy D~opbox\l I\l 1-114.pro I ,,,~, r.,F~ O~~ '~, , ........ ~OW~ O~ SOo, , ~ ~ ,/~z ';- __/ ,/ [ ~ TO REMAIN ;' ~ ~ -I NUMBdR OF T~D5 - WATERSI DE ELEVATION d- E SCALE: ~'~ = I LO" ~Z ~ ~ , Z~% II JOIDT NEW 2" X I 2" JOIST ~ I ZzZ~ FOOTING $ F~ME P~N DETAIL "A" ~CALE: 4 = 3