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Home My WebLink AboutTR-7569 Glenn Goldsmith,President QF S0!/jTown Hall Annex Michael J.Domino ,`O� �� 54375 Route 25 P.O.Box 1179 South John M.Bredemeyer III old,New York 11971 A.Nicholas Krupski v' _ G Q Telephone(631) 765-1892 Greg Williams O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE-OF COMPLIANCE 1760C Date: September 28,2020 THIS CERTIFIES that the conversion of existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area;with the ndition that=aline'o£staked hay bales with silt fencing is installed urior to construction; At 1580 North Bayview Road, Southold Suffolk County Tag Map#1000-70-12-34 Conforms to the application for a Trustees Permit-heretofore,filed in'this office Dated June 1,2011 pursuant to which Trustees Wetland Permit#7569 Dated June 22,2011 was issued and conforms to alt of the requirements and conditions of the applicable provisions of law. The project for which this,certificate is being issued is for the conversion of existing attached garage into living space within the existing buildingenvelope nvelope and construct a new two-car garage on the existing parking area:with the condition that a line of staked hay bales with silt fencing is installed prior to construction. The certificate is issued to Michael&Ellen Carbone owners of t4p aforesaid operty. Authorized Signature of Glenn Goldsmith, President *QF SO!/T Town Hall Annex Michael J.Domino,Vice-President ,`Qypo 54375 Route 25 III P.O. Box 1179 John M. Bredemeer Y #L �[ Southold,New York 11971 A. Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 COur,��' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION,: INSPECTED BY:` V/ 'Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt -boom/silt curtain 1 st day of construction constructed Y Project complete, compliance inspection COMMEN S: 61 CERTIFICATE OF COMPLIANCE: John M. Bredemeyer 111,President e�uFFO(�-CO Town Hall,53095 Main Rd. Michael J.Domino,Vice-President ,�� Gy P.O.Box 1179 James F. Kingy Southold,NY 11971 Dave Bergen Telephone(631)765-1892 Charles J.Sanders y�Ol � Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: IN L' 9 f V f 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: ® r�__ • CERTIFICATE OF COMPLIANCE: e 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 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 __ Ist day of construction ~ constructed __ Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7569 DATE: JUNE 22~ 2011 ISSUED TO: MICHAEL & ELLEN CARBONE PROPERTY ADDRESS: 1580 NORTH BAYVIEW ROAD~ SI~IJTHOLD SCTM# 70-12-34 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 $250.00 paid by Michael & Ellen Carbone 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 convert existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area; with the condition that a line of staked hay bales with silt fencing is installed prior to ~onstruction; and as depicted on the site plan prepared by Frank W. Uellendahl, Architect, last dated June 1, 2011, and stamped approved on June 22, 2011. 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 Michael & Ellen Carbone, residing at 1580 North Bagview Road, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation perfomaed pursuant to this permit, and the said Pennittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said F~mdttee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Pennittce of the completion of the work authorized. That the PeBnittee.will obtain all other permits and consents that may be reqffired supplemental to this permit, whii:h may be subject to revoke upon faiIute to obtain same. 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. Frank W. Uellendahl, Architect P.O. Box 316 Greenport, NY 11944 RE: MICHAEL & ELLEN CARBONE 1580 NORTH BAYVIEW ROAD, SOUTHOLD SCTM# 70-12-34 Dear Mr. Uellendahh The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, June 22, 2011 regarding the above matter: WHEREAS, Frank W. Uellendahl, Architect on behalf of MICHAEL & ELLEN CARBONE 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 June 1, 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 Headng 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 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 Water[rent Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of MICHAEL & ELLEN CARBONE to convert existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area; with the condition that a line of staked hay bales with silt fencing is installed prior to construction; and as depicted on the site plan prepared by Frank W. Uellendahl, Architect, last dated June 1,2011, 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:S100.00 Very truly yours, Jill~. Doherty // Pr~ident, Board of TrUstees JMD/eac Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Brcdemeyer Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: MICHAEL & ELLEN CARBONE Please be advised that your application dated JUNE 1, 2011 has been reviewed by this Board at the regular meeting of JUNE 22, 2011 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project XX Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) XX 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: Pre-Construction Hay Bale Line Inspection Fee = $50.00 Final Inspection Fee = $50.00 TOTAL FEES DUE: $100.00 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., June 15, 2011, the following recommendation was made: Moved by Meaghan Burke, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of MICHAEL & ELLEN CARBONE to convert existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area. Located: 1580 North Bayview Rd., Southold. SCTM#70-12-34 Inspected by: Meaghan Burke, Peter Young The CAC Supports the application with the Condition the size of the non-turf buffer is increased and gutters, leaders and drywells are installed to contain roof run-off from the garage. Vote of Council: Ayes: All Motion Carried Jill M Dohcrty, Prt'sident Bob Ghosio, J~, Vice-President James F King Dave Bergen John BI edemeyer P.O Box 1179 Southold, NY 11971 Telephone(631 765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report MICHAEL & ELLEN CARBONE request a Wetland Permit to convert existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area. Located: 1580 North Bayview Rd., Southold. SCTM#70-12-34 T<lOf area to be impacted: twater Wetland Freshwater Wetland Sound __Bay Dista~r~e of proposed work to edge of wetland P.a~'0f Town Code proposed work falls under: '~hapt.275 Chapt. 111 other Type of Application: ,-' Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: ~J. Doherty B. Ghosio J. King ,riD. Bergen, bJ. BredemeyeL__ D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: CARBONE RESIDENCE 1580N BAYVIEW ROAD SOUTHOLD, NEW YORK WETLAND PERMIT APPLICATION JUNE l~ 20~11 CARBONE RES)DENCE 158(~ N BAW~EW ROAD SOUTHOLD, NEW YORK WETLAND PERI, iT APPLICATION JUNE l, 201 ~ OWNER TOWN OF SOUTHOLD STREET / ,-, (..) FORMER OWNER.. , RE~/~ ~ ~s~s. VL, IMP. NORMAL TOTAL LAND FARM Tillable Wo~land M~adowland Hou~ Plat Tota~ ~ FARM DATE BUILDING CONDITION BELOW ABOVE Value Per Value Acre PROPERTY RECORD VILLAGE E ?., ~ I ¸7' COMM. CB. MICS. Mkt. Value REMARKS CARD SUB. LOT DOCK FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD ACR. i , ", , TYPE OF BUILDING COLO~ TRIM 1st 2n~ ,~ F~LL CCMBO &te~ns~°n ~ x' ~ ~.~ ! ~ ~,~ ~ Basement ~L ~ Floors Kit. Extension Ext. Wails Interior Finish L.R. Extension Fire Place ~ Heat DR. Patio Woodstove BR. Porch Dormer ~ths Deck /~D ~ ~ 0~ · ~ /.~ Doc~ Faro, A:C. Garage ~ ~ =,~ [,~ (~ O,B. 2~0· DESCRII:?F D PROPERTY SOUI'HOLD, TO~/ OF SOUTHOLD ~'IIFFOtK COUN1): N K OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: 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 MICHAEL & ELLEN CARBONE SCTM#1000-70-12-34 Frank W. Uellendahl, Architect on behalf of MICHAEL & ELLEN CARBONE requests a Wetland Permit to convert existing attached garage into living space within the existing building envelope and construct a new two-car garage on the existing parking area. Located: 1580 North Bayview Rd., Southoid. SCTM#70-12-34 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 I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Coastal Erosion Permit Application ~ Wetland Permit Application __ AmendmentdTrans fsr/]gxtension ~ Received Application:~ ~ Received Fee:$~'5-O l/,Completed Application ~t~[ Incomplete SEQRA Classification: Type 1 Type II Unlisted Coordination: (date sent) ~D, EWRP Consistency Assessment Form ,--C-AC Referral Sent:~,~ - ' ' ~te of Inspection: __Receipt of CAC Report: Lead Agency Determination:__ Technical Review: ~blic Hearing Held: __Resolution: Office Use Only Administrative Permit JUN - 1 2011 $outhhold lowu Beard of Trustees Name of Applicant Address /~ ~ iA)~ tlO~l PhoneNumb~:( Suffolk County Tax Map Number: 1000- Prope~y Location: (provide LILCO Pole AGENT: (If applicable) Address: /2~ ~d of Trustees Applicatio0 Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Yes ~/No Does this project require a variance from the Zoning Board of Appeals __ If"Yes", please provide copy of decision, fi:>~73,2~/AJ~ Prior permits/approvals for site improvements: Agency Date ~'/Yes No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen~ by a governmental agency? V' No Yes If yes, provide explanation: Project Description (use attachments if necessary):. of Trustees Applicati¢ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: _/ Area of wetlands on lot: ?9 square feet Percent coverage of lot: ~2~ % Closest distance between nearest existing structure and upland edge of wetlands: ~2., ~3 feet Closest distance between nearest proposed structure and upland edgeofwetlands: ~ ~'C7 feet 'lc9 t~SA'?'~_~ Does the project involve excavation or filling? No ? Yes If yes, how much material will be excavated? ~ How much material will be filled? /~ Depth of which material will be removed or deposited: cubic yards cubic yards feet Proposed slope throughout the area of operations: ~-2.-..~7- Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): of Trustees Applicatio0 COASTAL EROSION APPLICATION DATA Purposes of proposed activity: 7~dT/~OS~Z~ Z)6'7-~C~I~ Are wetlands present within 100 feet of the proposed activity? No V~ Yes Does the project involve excavation or filling? No V/ Yes If Yes, how much material will be excavated? <~ (cubic yards) How much material will be filled? /12( (cubic yards) Manner in which material will be removed or deposited: 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 PROJECT ID NUMBER APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 - PROJECT INFORMATION ( To be completed by Applicant or Project Sponsor) 1. APPLICANT / SPONSOR / 2. PROJECT NAME Municipa ity ! County SEQR 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or arovide mai) 5. IS PROPOSED ACTION: [~ New [] Expansion [~odification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately ~, O/../~, acres 8. WILL PROPOSE..D ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? F-~Yesr~v/'Lv~ No If no, describe briefly: (~7~..7~/.~__~ ..~- ~_~..,~'~i~_)77_~7-- ~~ 9, WH IS PRESENT ~ND USE IN VIC~NI~ OF PROJECT? (Ch~se as manyas apply.) ~dential ~lndustrial ~Commercial ~Agric~lture ~ Park / Forest / Open Space ~Other(descdbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) [~.'Y~es ~ No If yes, list agency name and permit / approval: ---~ 11. DOES ANY~AS~ECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [~Yes If yes, list agency name and permit / approval: o 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REOUIRE MODIFICATION? Signature If tho action I~ a Co~tal Area, and you ar~ a ~tat~ ¢omplot* th~ Coastal A*~o~mont Form beret* pro¢~ding with thi~ =ART II - IMPACT ASSESSMENT (To be completed by Lead A~lencyI A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF, B, WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. ;. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if tegible) 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 bdefly: C2. Aesthetic, ~ri(~lturai, archaeoiogiCal, I~istori~i' or other naturai or cultural reso~rca~i o;' community or neighborhood character? Explain bdefly: I C3. Vegetation or fauna, fish, sheltfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain bdefly: I C6. Long term, short term, cumulative, or other effects not identified in C1-C57 Explain br~efly: I D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEAI? (If ;/es, explain briefly: E. IS THERE, OR IS THERE L[KELY TO BEr CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If }/es explain: r-]E3NoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient 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 significant adverse impacts which MAY occur. Then proceed directly to the FULl. 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 actio~ WiLL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi~ determination. Name of Lead Agency Date Title of Responsible Officer Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Offioer in Lead Agency Signature of Preparer (If different from responsible officer) O 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 /~'~O ~ /~-- ,-~'~ STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN District s*ction e~ock cot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUc'I'ION ri'EM# / WORK ASSESSMENT I Yes No a. What is the Total Area of tho Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Pamels iocated within 2~,, ~:~ ~.~,~,c:: Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.F. / Acr~) (This item will include all mn-off created by site b. What is the Total Area of Land Cleadng 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? impervious surfaces.) (S.F. / Aa',) 2 Does the Site Plan and/or Survey Show AIl Proposed P~*O~[~)E BF'~ P~.O,~r~ D~C~]3rr[o[*~ (Provide Additional pages as Neede¢~) Drainage Structures Indicating Size & Location? This item shall include all Proposed Grade Changes and ~_~p~___~ ~___ ~ ~__~.~.~lit:~/~_.~ Slopes Controlling Surface Water Ftow. and sediment centrel practices that will ha used to z-~ //--%~,Z::)~:~- /___.~r~~ -/~ 3 Doee the Site Plan and/or Survey describe the erosion V control site erosion and storm water discharges. This -- ,Z),~ 4,~i~/~:/_.~ item must be maintained throughout the Entire Construction Pe fled. 4 Will this Project Require any Land Filling, Grading or~ Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards[~J __ of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand V (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 Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or Submission of a SWPPP is required fo~ alt Construction activities involving soil Beach? dislurbances of o~e (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 ultimathiy disturb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to I I V including Constmclion activities involving soil disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance? the DEC has determined thai a SPDES permit is required for stem~ water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious r'--'l for storm water Discharges from Construction activity - Peri, lit No. GP./J-t0-00t.) Surfaces be Sloped to Direct Storm-Watar Run-Off V 1. The SWPPP shall be prepared pdor lo the submiltal of the NOI. The NOI shaJl be into and/or in the direction of a Town fight-of-way? -- submitted to the Department prior to the commencement of construction activity. 2. The SWPPp shall describe the erosion and sediment coatml practices and whem 9 Will this Project Require the Placement Of Matadal, STATE OF NEW YORK, ~ -- couNn'~ OF .,....~.~....P..~ ........ SS That I, .~..~/.?..~.......~...~..ff../.~.~.~..].~]..~.i .......... being duly swtm, deposes and says that he/she is fl~e applicant tbr Permit, And that he/she is the .... ...-~..~...~..4~../.~: ..~.... ....................................................................................................................... Owner and/or representative of the Ovmer or Owners, and is duly authorized to perform or have performed the said work and to make and file lhis application; that all statements contained in this application m'e true to the best of his lmowledge and belief; and that the work will be performed in the manner set fo~ in the application filed herewil h. Sworn to before me this; / '~'......~. .. day o£ ~...~....~.....~... .................... ~20.../../ FORM - 06/10 NOTARY PUBLIC, State of New York No. 01 ~6020932 Qualified in Suffolk County/.---- Term Expires March 8, 20.~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Nanle~ Address: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at 1'2~ ~2Lx~T~( tz~t~l-6~(~X7/~: ~y , being duly sworn, deposes and says that on the [~'~t dayof '~c~/xJ~ ,20¢( ,deponentmailedatmecopyoftheNotice set forth, in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at ~t2.L~_~iZI (certified) (registered) n~ail. , that said N°~i.~_ lmi~d to each of said persons by Sworn to before me this ~e. Day of W~ nA~ ,20. Notary Public FAISAL CHAUDHARY Nota~ Public, State of New York No. 01CH62t 0962 Qualified in Queens County Commission Expires Sept. 8, 2013 r,- ~.44 Total Postage & Fees $ ~/15/2011 Lr--""'-'t: ..... iiill ,-3 $0.~ $2.85 92.30 $0.00 95.59 0~44 06/15/2011 · Gomp~te ~ems 1, 2, mind 3. A~o compete ~am 4 ~ RasUtc~ed D~Na~y tm deak~d. · PHnt your name and ack~mma on the revere so that we can r~turn the card to you. · At~m~m t~ crud to ~e back of ~e m=llp~ce, or on ~e fiont ff space pe~n~s. ~YE~ ~,,t~ da~m,y auVlmss b~ow~r~ No O~ 0 ~om Re.pt f~ ~v~,~e [] Imazed Mall [] C.O.D. 4. Reet~c~ed Deliver? ~a Fee) DYes 2..Nttcle Number PS Form 3811, Febr~_, Jill M. Dohcrty, President Bob Ghosio, Jr. , Vice-President Jmnes F. King Dave Bergen John Brcdcmcycr Town Hall, 53095 Main Rd. P.O. Box tl 79 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 MICHAEL & ELLEN CARBONE COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING ~ at/dba ' / . bein~ d~ly swo~, depose and say: That on the~l~day of D~ ,2011, l personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that l have checked to be sum the poster has remained in place tbr ei~t days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed~ June 22 2011 on or about 6:00 PM. Dated: :.~ (sig ature) ,~wom to befbre me this ~t'> day of~n-~-20 Il Notary Public h LAUREN M. S'~,NDt~;~, otary Public, State of New ~br~ ^ ..N.o. 01ST6164008 ~lualified n Suffolk Courtly ./ Commission Expires April 9 ?~),j ';b of Trustees Applicati~ AU'r~ORI ZATION (where the applicant is not the owner) I~I(J41~IF---L (-~I'~C~'X~t.f---TM residing at ~0 ,~3 ~q~/~ (print owner of property) (mailing address) do hereby authorize ~r~-b(~ ~~q~ (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner ' s signature Board of Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT AI,L 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 CI~AIMS ARISING UNDER ORBY 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 ~ al~otary Public MARINA.KOKKINOS NotE7 Publlo. State of New York No. 01KO6191941 Qtilli~ld In Suffolk County My C~ntmleilon EXplr~ August 25, 2012 ~oard of Trustees ApplicatiOn County of Suffolk State of New York '~"~)t,:~ ~4~_Zd..eVA~OJ¢ ~ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONIUNCTION WITH REVIEW OF THIS APPLICATION. iv Signatt~re SWORN TO BEFORE ME THIS /~7- DAYOF ~V_,'~ ,20 // LYND^ M ~ NOTARY PUBLIC, State of New York No. 01~1;il6020932 Qualified in Suffolk Coup.tyke-- Term Expires March 8, 20 ~ APPLICANT/AGENTfI~ F. PRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Efldcs mohairs conflicts of~ on the tort of town office~s and emolovms. The ma-nose of this form is to movide inform~ion which can ~ ~h~ town of nn~ihl~ CC. aflle~ of info. St and allow it ~o talin wha~vor action is ne ~o avoid . (Last name. first name, ~ldle ini~l, unless you ~e a~lying in the name of somcona else or o~lga, entity, anch as a compnay. If an, indic~ lira other pe~on's or company,s hang.) NAME OF APPLICATION: (Check all fluit apply.) Tax grievance Building Variance Trustee Change of Zona Coastal Erosion Approval of plat Mooting F~xomption from plat or official map Planning Other (If "O0acr-, name thc activity.) Do you personally (or through your company, gpouse, sibling, pol~nt, or child) have a mlatiomhip with amd officer or employee of the Town of Southold? "Relationship" includes by blood, manSagn, or bnaim:zs inten~ "Business inte~st'~ means a Imsinags, including a partnership, in which thc town officer or cmptoyc~ has even a paRial ownership of (or employmca~t by) a corporation in which the town officer or employee owns more thna 5% of the shares. YES NO ~ If you answe~d ~¥ES", complet~ the balm of this form ~ d~e and sign where indicated. Name of per,on eanployed by the Town of Sonthold Title Or position oftlmt pemon Describe the relationship hetw~en yo~lf {fl'~ appli~t/~genlh~pre~ntative) and th~ town officer or employs. Eitl~ check the appmpeiat~ lina ^) through D) ~nd/or de~cfihe in the ~ pmvidud. The town officer or emplo¥~ or his or ~ ~, ~bling, p~t, or Child is (cl~a:k all that apply): A) tbe owr~r ofg~r than 5% of tbe ~ of ~ corpor~ ~[ock of ti~ a~liclmt (when the appli~at is a corporation); __B) the ~ or beneficial own~ of any inter~t in a no~-co~orate ~tby (wh~ tl~ applicant is not a narpomtiod); __C) an officor, dire~ztor, p~rto~i', or emplo~ of the applicant; or __D) the actual ~t~pli~ant. DESCRIPTION OF RELATIONSHIP Form TS I Subm' this ~O4C~ 2O0 Print Name k~i. t ~L.t ~ (~_.L APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the ~ of town officers and emnlovces. The numose of t~his form is to nrovide information which can alert the town of ~ossthle conflicts of h~t~.~t and allow it to take whatever action ~ec~ssary to avoid same. YOURNAME: ~kJY..- L4-~/.,,L~f~)~,?~--- , ~4~'17'~:~"~ (Last name, f~t name,~niddle initial, unless you am applying in the nmne 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 (If"Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southoid? "Relat~oush~p' includes by blood, marriage, or business interest. "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 coq~oration in which the town officer or employee owns more than,5%/~he shares. YES NO If you answered "YES", complete the balance ofthls form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line 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): __3) the owner of greater than 5% of the shares of the corporate stock of the applic0nt (when the applicant is a corporation); __J~) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); __.C) an officer, director, parmer, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 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 detafl~ listin~ both suooorfin~! and non- suooortin~ facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold ' s website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION PROJECT NAME ~ AE ~OA-2~ .~_.~__....~ ~~ 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) [-~ Co) 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: ~'~--~:~/'~2>~Z~7'~9 Present zomg cl~sificafion: If ~ application for ~e proposed action h~ been filed ~ ~e To~ of Sou~old agency, ~e follo~g i~o~atiun shill ~ pro~ded: (a) N~eofapplic~t: ~'~ ~-~~ / ~l~ ~) M~l~g address: (c) Telephone number: Area Code ( )/ ,1(~.3~,/ (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 ~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 ~N°tnpplicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria S /Yes [] No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LwRP Section III - Policies Pages 8 through 16 for evaluation criteria [] Yes [] No ~Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria t22 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 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 ~ot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes./See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [-~ Yes [] No~l "l 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. ~No ~ Yes~ No tApplicable 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 Iocations~f/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 Peconie Estuary and Town wat/0rs.[T.p/ See.LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~-] Yes ['~ No l "1 Not Applicable Attach additional sheets if necessasy Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evalu~on criteria. ~-~ Yes [] No lVT>/-I Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies 65 through 68 for evaluation criteria. Yes I I No IWl Not Applicable PREPARED BY '~3~ ~/-J_.~A//'~,~A/~ TITLE -~H,~Tff~F DATE ARM SUMMARY ~WGARAGE ]I.~ F~ ~ FF~ fi ~,tl f~ '--', / LOT AR~ c0.22,904 100.00% ~ ~ CONVERSION = AND D)~ ~ ~" ~ ~ ~ ~ ~ ~x,s~.~,~. ~ow~=c~. =~ s~ ,~.~ ~ ~o~os~ 'L~. ~ ~~ ~ ADDED BLDG. COVERAGE = co. 506 SF" NEW GARAGE TOTAL BLDG. COVERAGE = co. 3,885 SF 16.97% JLJ~,~ - 1 2<~ MAX. ALLOW. COVERAGE = cd. 4,581 SF 20.00% South,old lown, PROPOSED 2-CAR GARAGE [~ EXISTING STRUCTURE ~ RESIDENCE SURVEY BY PECONiC SURVEYORS, P.C. ~ SOUTHOLD, NY DATED: MAY 19, 2011~ ~ 1580 N. ~WlEW RD CAMERA LOCATION FOR PHOTO VIEW ~2 ~ ARCHITECT · ,,,,,,, LEADER CONNECED TO DR~ELL ~ ~2~m*NXC[N~UE~L[NDAHL I GU~ER ~ ,.O.BOX ~ 6REENP~, ~ 11944 ~L: 631-477 ~ OWNERS umw) ))LLL ~ ~H~D, NY 11971 m J i ~ ~L: 917-275-65~ ~ ' PROPOSED GARAGE EL~AIION ~ "ARD Or TRU2i[ ' ' = = PROPOSED SITE P~N ~ ';OWN OF SOUTHOLD SCTU~ 1000-70-12-34 SITE P~N .... ~ ~ .... ~----- - GARAGE CONVERSION TO RESIDENTIAL SPACE, NEW 2-CAR GARAGE F ~~ND PERMIT APPLICATION ~ ~ A-1 ~ ~. NO JUNE 1, 2011 SCALE: 1"= 50' ~o. oo~04~9 SURVEY OF PROPERTY A T SOUTHOLD TOfCN OF SOUTHOLD SUFFOLK COUNTY, N.Y. I000-?0-12-$4 SCALE. 1'=$0' $UGUST 11, 2006 MA Y 19, 2011 FLOOD ZONES FRO~Z FIRM 36103C0166H. 9- 28- 09 CBR$ 11-t6-1990 am familiar with the S, TANDARDS FOR APPROVAL ~ AND CONSTRUCT/ON OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAM/LY RESIDENCES and w/ii ob/de by the cond/Uons set forth therein and on the permit to construct. The IocoUon of wells ond cesspools shown hereon ore from field observoUons ond or from deto ohio/ned from others. ANY ALTERATION OR ADDITION TO THiS SURVEY IS A VIOLATION OF SECT/ON 7209 OF THE NEW YORK STATE EDUCATION LAM EXCEPT AS PER SEC770N 7209-SUBDIVISION 2, ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COP/ES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE S/GNA TURE APPEARS HEREON. AREA=22,90# SQ. FT. TO TIE LINES · =PIPE 2O.02 ,¢ (651.) 765-5020 FAX (631) 765-1797 P.O. BOX 909 1230 TRAVELER STREET sooT~o~o, N. ~ ~7~ 04--236