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Home My WebLink AboutTR-7570 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 OFSOUTHOLD 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 % constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7570 DATE: JUNE 22.2011 ISSUED TO: HAROLD SCHWERDT & PATRICIA OSTER PROPERTY ADDRESS: 440 OAK AVENUE~ SOUTHOLD SCTM# 77-2-1 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of th~ 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 H~0Jd Schwerdt & Patricia Oster 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 construct a second-story additio~ over the existing dwelling and rebuild existing exterior walls; with the condition of a line of staked hay bales with silt fencing is installed prior to construction; and as depicted on the site plan prepared by Nancy Dwyer Design Consulting, last dated May 23, 2011, and stamped approved on June 22, 2011. IN WITNESS WHEREOF~ the said Board of Trustees hereby canses its Corporate Seal t~ be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee Harold Schwerdt & Patricia Oster, residing at 440 Oak Avenue, 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 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 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, 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 o£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, ugon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the ~aid 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 Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 June 22,2011 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Nancy Dwyer Design Consulting P.O. Box 632 Southold, NY 11971 RE: HAROLD SCHWERDT & PATRICIA OSTER 440 OAK AVENUE, SOUTHOLD SCTM# 77-2-1 Dear Ms. Dwyer: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, June 22, 2011 regarding the above matter: WHEREAS, Nancy Dwyer Design Consulting on behalf of HAROLD $CHWERDT & PATRIClA OSTER 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, in accordance with Chapter 268, said application was found to be Exempt from 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 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 approve the application of HAROLD SCHWERDT & PATRICIA OSTER to construct a second-story addition over the existing dwelling and rebuild existing extedor walls; with the condition of a line of staked hay bales with silt fencing is installed prior to construction; and as depicted on the site plan prepared by Nancy Dwyer Design Consulting, last dated May 23, 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:$100.O0 Very truly yours, 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 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: HAROLD SCHWERT & PATRIClA OSTER 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(S50.00) __ 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 ~"TC~ll;~ 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 HAROLD SCHWERDT & PATRICIA OSTER to construct a second-story addition over the existing dwelling and rebuild existing exterior walls. Located: 440 Oak Ave., Southold. SCTM#77-2-1 Inspected by: Meaghan Burke, Peter Young The CAC Supports the application with the Condition of a drainage plan and a 15' buffer area. The CAC recommends the cesspool is moved landward of the dwelling. Vote of Council: Ayes: All Motion Carried Jill M Dohetly, President Bob Ghosio, J~., Vice-President James F King Dave Bergen John Bredcmeyer P.O Box 1179 Southol& NY 11971 Telephone {631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: HAROLD SCHWERDT & PATRICIA OSTER requests a Wetland Permit to construct a second-story addition over the existing dwelling and rebuild existing exterior walls. Located: 440 Oak Ave., Southold. SCTM#77-2-1 Type.of area to be impacted: JL.~altwater Wetland Freshwater Wetland Sound __Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: "-~C~hapt.275 __Chapt. 111 other /- Type of Application: V/Wetland __Coastal Erosion .__Amendment __Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: ~"~[~.J ~lk, ('~e, 'ptA) Pr - · Doherty k~.Ghosio . __ D. Dzenkowski other Form filled o~ ~the field by Date: ~. Bergen, N LOT NUMBERS REFER TO "MAP OF GOOSE BAY ESTATES" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON NOVEMBER 13, 1934 AS FILE NO. 1176. 1.0.~ 19§ SURVEY OF PROPERTY AT SOUTHOLD TO,tN OF SOUTHOLD SUFI~OLK COUNTY, N.Y. 1000- ??'-0,~-0I SCALE: I'--BO' APRIL 7. 2011 sO .Od AREA=Il,200 $0. FT. ANY ALTERATiON OR ADDITION TO THIS SURi~EY IS A VIOLATION OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COP/ES BEAR THE IMPRESSED SEAL OF THE SURVIZYOR WHOSE S/GNA TURE APPEARS HEREON. / ~ECONIC ~I.,(~tJ,/EYORS, P.C. (631) 765-5020 FAX (631) 765-1797 P.O. BOX 909 1230 TRAVELER S77¢EETI I=MONUMENT SOUTHOLD, N.Y. 11971 I~-~ ! Photo # 1: Taken from drive; location of addition to be above porch Photo # 2: Area of proposed second floor Photo # 3: Looking at house from Cedar Avenue Photo # 4: Existing bulkhead Photo # 5: Wetlands & bulkhead continuing into neighbors yard Photo # 6: Taken from existing deck looking towards yard/bulkhead Photo # 7: Looking at house from far right corner of bulkhead Photo # 8: Dock & bulkhead Photo # 9: Back of house taken from beach Board Of Southold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. 110..5 ... DATE: Se~ t...-8 ~.-...:':1975 ISSUED TO .....Hazeold P-... Schwerdi ....................................................... Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952; and the Southold Town Ordinance en- titled "REC~ULATING AND THE PLACINC~ OF OBSTRUCTIONS IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL oF SAND, C~RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with fhe ResoJutlon of The Board adopted afa meeting held on .Sept. I~rZ~ ...... and in consideration of the sum of $.....J9..20 ..... paid by ................. Harold .P.. Schwerdt of ...... So.ui~olc[ ................ N. Y. and subject fo the Terms and Conditions listed on the reverse side hereof, of SoutheJd Town Trustees authorizes and permits the following: Permission to place 4'x6' dock, and T shaped floa~ each section being 4'x16' with 4 mooring piles in Goose Creek, directly in front of applicant's property at Ceda-~ & Oak Avenues, Southold, N..Y. all in accordance with the defaiJed specifications as presented in the origlnaflng appllcaHon. IN WITNESS WHEREOF, The s~id Board of Trustees Kere- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this,date. ............... ~ .' ~ . 6d.~'~- ............ ................................. z'""/-,,J';';;'.,: ................................... BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 July 2, 1986 TELF-.PHONE (516) 765-1892 Mr. Harold P. Schwerdt 2720 Cedar Avenue Southold, New York 11971 Dear Mr. Schwerdt: Pursuant to your request for a Waiver of the Wetland Ordinance for the construction of a deck on premises in Southold, please be advised as follows: 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 documentation submitted concerning this request, and WHEREAS, the Board made the following findings of fact: 1. By this request, appellant requests permission to construct a open wooden deck, approximately 16' x 20' to an existing residence on Cedar Avenue, Southold. Accordingly, on motion made by Trustee Smith seconded by Trustee Goubeaud it was RESOLVED that Harold P. Schwerdt be and hereby is granted a Waiver of the Wetland Ordinance as requested for the addition of a 16' x 20' open wooden deck on property located on Cedar Avenue, Southold subject to the following provisions: 1. Care should be taken so as to preclude the entry of any construction material into the wetland area. 2. Immediately following construction, all areas of exposed soil shall be protected with suitable erosion control devices and/or vegetated. Thank you for your cooperation in this matter, we look forward to serving you in the future. Should you have any further questions or concerns, please do not hesitate to contact this office at the telephone number listed above. Very truly yours, Henry P. Smith, President Board of Town Trustees ~~ r~~ RPS:iD James F. King, President Ji]l M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghasio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold. New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 March 21. 2007 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Harold Schwerdt 2720 Cedar Avenue Southold, NY 11971 RE: 2720 Cedar Avenue, Southold SCTM# 77-2-1 Dear Mr. Schwerdt: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 21,2007: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #4664 to replace 14 pilings with 6" pilings in order to adequately support the dock. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a detem~ination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:eac Appeal No. 2455 DaSd July 21, 1978 ACFION OF THE ZONING BOARD OF APPEA[~ OF TH~ TOWN OF SOUTHOLD To Harold and Loretta Schwerdt 2720 Cedar Avenue Appellant Southold, New York 11971 ( ) ................. of the Zoning Ordinance and the decL~ion oI the Building lr~pector ( ) be reversed ( ) b~. confirmed because 8:10 P.M. (D.S.T.) Upon application of Harold and Loretta Schwerdt, 2720 Cedar Avenue, Southold, New York, for a variance in accordance with the Zoning Ordinance, Article III, Section 100-31 and Bulk Schedule for permission to construct a two car garage with two rooms above the garage with insufficient side yard setback. Location of property: Oak and Cedar Avenue, Goose Bay Estate, Lots 192, 193, 194 ao.d 195, Southold, New York. 1978 SEE REVERSE SEE REVERSE lc) The variance (doe~) (doe~ not) obserte th~ splri: ol the Ordinance arid (would) SEE REVERSE ( %vould not) vEP. -A?PROVED After investigation and inspection the Board finds that the applicant requests permission to construct a two-car garage with~ two bedrooms above the garage and requires the side yard reduced to 7 feet 3 inches. The findings of the Board are that the appli- cant wishes to enlarge his present house with the garage and two bedrooms. There will be no reduction of the front yard setback. The neighbors imediately adjoining have extended their approval of this addition. The Board finds that strict application of the Ordinance would produce practical difficulties or unnecessary hardship; the hardship created is unique and would not be shared by all properties alike in the immediate vicinity of the property and in the same use dis- trict; and the variance will not change the character of the neigh- borhood and will observe the spirit of the Ordinance. On motion by Mr. Grigonis, seconded by Mr. Tuthill, it was RESOLVED that Harold and Loretta Schwerdt, 2720 Cedar Avenue, Southold, New York, be GRANTED permission to construct a two-car garage with two rooms above with insufficient side yard setback. Location of property: Oak and Cedar Avenues, Goose Bay Estates, Lots 192, 193, 194, and 195, Southold, New York, upon the following conditions. (1) The addition to the house may not be closer than 7 feet 3 inches to the easterly side yard. (2) There shall be no use of this enlarged residence for two families. (3) No cooking facilities are to be in the enlarged facilities. Vote of the Board: Ayes: Messrs: Gillispie, Grigonis, Doyen, Tuthill and Douglass. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N.Y. Certificate Of Occupancy No..Z.9.5..8 ? ........... Date .................. ,l'U.,1-y..3.3, ...... 19.79 TI-IlS CERTIFIES that the building ................................................ 2720 Cedar Avenue, Southold Location of Property t:t3~ WK ....................... '.~i ....................... klv3id County Tax Map No. 1000 Section .... 07.7. ....Block ....0..2 ......... Lot..0.ql. ............ Subdivision..G. Qc~9..l)~y./flq~l:~k~ ........ Filed Map No .... llT~Lot No. 192:.195. inclusive conforms substantially to the Application for Building Perm/t heretofore filed in this office dated ·...S.e/Rt..e~. he.~;, ~.8.,..., 19.7./{ pursuant to which Building Permit No...1~ .0.0.6.7. ............. dated ......... Dec, ember..11, ..... 1978., was issued, and conforms to all of the requirements of the applicsble provisions of the law. The occupancy for which this cerfificato is issued is ......... ...... /~DDITtON · TO 'PRT~FATE' ONB- P/%billYa¥- OWI~L~I.N(~ ........................... The certificate is issued to ...II..~. 9,L.D,. %..L~,..v-$T.TA. &..C:I31A~....ap.T, .......................... of the aforesaid building. Suffolk County Department of Health Approval .N/A ...................................... UNDERWRITERS CERTIFICATE NO. lq410936 ........................................ Rev 4/79 Building Inspector 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~ From: Date: Re: Jill Doherty, President Town of Southold Board of Trustees Mark Terry, Principal Planner LWRP Coordinator June 21, 2011 Proposed Wetland Permit for HAROLD SCHWERDT & PATRICIA OSTER SCTM#1000-77-2-1 Nancy Dwyer Design Consulting on behalf of HAROLD SCHWERDT & PATRICIA OSTER requests a Wetland Permit to construct a second-story addition over the existing dwelling and rebuild existing exterior walls. Located: 440 Oak Ave., Southold. SCTM#77-2-1 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 EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "11" which states: II. Additions to an existing building or rebuilt residential structure which results in no net increase in ground area coverage, except where the parcel is located in a coastal erosion hazard area; The proposed action is not located within a coastal erosion hazard area. Cc: Lori Hulse, Assistant Town Attorney 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 Office Use Only ~Coastal Erosion Permit Application ~J Wetland Permit Application Administrative Permit AmendmenCrrans fer/Extension ecCeivd Application: Jz~l ~ ] I| eived Fee:$ ~'~v~ ---..~C~-ompleted Applic'ation tO] I ] {.~ Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent). ~4~WRP Consistency Assessroent Form ~0 L~ ~J .,~LcAC Referral Sent: ~5 1C~ { { - ' ' ~l~e of Inspection: ~ Receipt of CAC Report~.' ' - '" Lead Agency Determination: Technical Review: , ~lic Hearing Held: {ti IO..,~ [ [ Resolution: '~ t '' Name of Appl!cant .LC/.({((2 ~l *.~tO, ~-¢Y~~ ~OO+~O ~ Phone Numb~ 70~{ Suffolk County Tax Map Number: 1000- ~ 7 ' O - ~ Prope~yLocation: ~0~,¢C ~ ~/O ~ ~gfl~C (provide LILCO Pole ~, distance to cross streets, ~d location) AGENT: }~ (If applicable) Address: PO 6~9)c Land Area (in square feet): Area Zoning: GENERAL DATA }l jJO0 ~./~. Previous use of property: ~,'~51~ ~¢~,1~, r,~a&nce_ Intended use of property: 6&flA~ 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: Agency Date Yes X No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? /R~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): 'd of Trustees Applicatio~ WETLAND/TRUSTEE LANDS APPLICATION DATA Area of wetlands on lot: Percent coverage of lot: [~ Closest distance between nearest existing structure and upland edgeofwetlands: oC'] feet % 1,9ol khe,t6 Closest distance between nearest proposed structure and upland edge of wetlands: ~'1 feet -~O [OOl ~ hta.cL 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: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: square feet (lO°ll/''l~ac~g) % 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): COASTAL EROSION APPLICATION DATA Purposes ofproposed activity: ~ ~t~, ~ ~ c~~-~ ~JO(~ 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 excavated? _(cubic yards) How much material will be filled? .(cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts to the subject property 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 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: Municipality ~O0'~0 la 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 cou. ¢oCA(L PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or provide mad SEQR IS PROPOSED ACTION: [] New ~Expan$ion [] Modification / alteration DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially O acres Ultimately O acres 8. WILL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? Yes []No If no, descdbe bdefly: WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residen6al [] Industrial ~1 Commercial F~Agriculture r--1 Park / Forest / Open Space ]Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL ~,GENCY (Federal. State or Local) [~Yes F~No If ~ist name and permit / approval: yes, agency 11.DOES AI~YA.~Y ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? F~Yes r~71~lo if yes, list agency name and permit / approval: 12. AS A LE~S~L OF PROPOSED ACTION WILL E. XISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? TIF¥ THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO IBE BEST OF MY KNOWLEDGE Applicant / Sp Date: Signature ~ ~./0'/( If the action is a Costal Aroa, and you are a state agency, complete tho Coastal Assessment Form before proceeding with this assossment 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 FAF. 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 rT]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: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain bhefly: C3. Vegetation or fauna, fish, sheiifist~ or wildlife species, significant habitats, or thraatened or endangered species? Explain bhefly: 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 bdefly: C5. Growth subsequent development or related actiwbes likely to be reduced by the proposed action? Explain briefly C§. 1 C7. Long term, short term, cumulative, or other effects not identified in C1 -C57 Explain brietiy: I Other impacts linciudin~l char~les in use of either quantit;/or t}/pe of ene~;/? Explain briefly': I, D. VV~LL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA/CFAI? IIf )'es, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain; ~ART I# - DETERMINATION OF $10N[FICANC~: {To be completed by IN$1RUO?I08$: F~reachadver$ee~ectidentifiedab~ve'deferminewhethsritissubst~nti~'~s~e~imp~r~ant~r~therwlsesi~nificant. Each effect should be assessed in connection with its (a) setting (i.e. u~ban or mini); lb) 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 moro potentially la~ge or significant adverse impacts which MAY occur. Then proceed directly to the FULl FAF 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 actiol WILL NOT result in any significant adverse environmental impacts AND provide, on atlechments as necessa~, the reasons supporting thi determination, Board of Trustees Name of Lead Agency Date Jill M. Doherty President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (If different fi.om responsible officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LU~ATIOhI: $.C,T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~ ~OO~) 270n ~ / STORI~WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN District Block Lot CI'IITIFII~I~ BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUc'IIlON ITEM # / WORK ASSESSMENT I Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within ! t Will this Project Retain Ail Storm-Water Run-Off / / O Geoarated by a Two (2') Inch Rainfall on Site'~ the Scope of Work for Proposed Construction} I - b. What is the Total Area of Land Cleadng ie.F. / Acres) (This itsm will include all ron-off created by site cleadng 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.) tS.F.,,~) 2 Does the Site Plan andlor Survey Show AIl Proposed PROVIDE BRIEF PROJ'F'C~I' DESCRIPTION (~ ~-- P~"'" N--) Drainage Structures Ingicating Size & Location? This item shall include all Proposed Grade Changes and ~(~(-O j~)O,~ c~ c:~ i~ ~'~of'~ Slopes Controlling Surface Water Flow. ~c~ I ~LIOi~ ~V(~ ~" y~t'-f O~{x 4~0,_ 3 D°es the Site Plan andl°r Survey describe tile er°si°~ and sediment control practices that will be used to control site erosion and storm water discharges. This ~.4¢~l ~ ~ Ill5 i 5J~-O~'~') C~_ ~i d ~/~ ~.~.... itce(rnnsmtmuSt2ne ~ea~ no~ined througnout the Entire 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 of Matedal within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (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 jedsdiction General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is requknd for all Construction activities involving soil Beach? SWPPP's Shall meet the Minimum Requirements of the SPDE$ General Permit 8 Will Driveways, Parking Areas or other impervious D, 2. ~e SWPPP shall describe the emsic~ and sediment cefltm/prac6ces and where 9 Will this Project Require the Placement of Material, requirnd, post-oonstrucben sform w'atsr management practices tha~ will be used and/orRemoval of Vegetation and/or the Construction of any D/ constructnd to reduce tbe p~llulants in storm water discharges and fo assure item Within the Town Right-of-Way or Road Shoulder STATE OF NEW YORK, ~UNNIE O. BUNCH COUNTY OF ........................................... SS Notary Public, State of New Yor~ NO. 01BU618~;K)50 That I ............... i~;'~;';i'i~;a"¥;;i'~ ~;~i~ ---r-~:'~;~tS' ................. being duly swtm, deposes and say~'l~[~ g~l~pl~l~l~fl II~r~ I ~-~ And that he/she is the ....................... . .~.....~.. '~i ~J~..~. Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his kmowledgc and belief; and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this;--~. ) ~ day of~'~,~ 20 [--I ' ''~ /q' ............................................. ' ........................... , . , - ................ Notary Public: FORM - 06/10 Return Receipt F~ (Endorsement Required) Restricted Deliver/Fee (Endorsement Required) PROOF OF MAILING OF NOTICE ) MAIL RECEIPTS Ofili]12011 Address: STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes and says that on the I'~'~ dayof .~on.t.-~ ,20 [[ ,deponentmailedatruecopyoftheNotice 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 ~t3-[ [~0 14 , that said Notices w~e~e mailed to each of said persons by CERTIFIED MAILfR~TURN RECEIPT. ~'-..., ,." ] ~ Sworn to befg~me this,~ ~ Day of oTI~- ,2fid/l Notary Public LAUREN M. STANDISh, Notary Public, State of New York No. 01ST6164008 Qualified in Suffolk County C~mmission Expires Apfll 9 of Trustees Applicati¢ County of Suffolk State of New York 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 CONJUNCTION WITH REVIEW OF THIS APPLICATION. Sign re~ SWORN TO BEFORE ME THIS DAY OFQ~,~J',--Q ,20 II Notary Public CONNIE D. BUNCH Notary Public, Slate of New York No. 01BU6186050 C Qualified in Suffolk Ceun,~, ommis~lo~ E~lres Aprt~ 14, 2._~_~/ SOd Of ;;~;tee; tppli~atio~ AUTHORIZATION (where the applicant is not the owner) (l~rint owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. -")/ , /'t ~7 (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tho Town of Southold's Code of Ethics omhibits confliels of interest on the nat of town officers and emoloveee. The mu'~ose of this form is to omvide information which can alert the town of ~ossible conflicts of interest and allow it to take whatever action is r~eessarv to avoid same. (Last name, fi~st name, galddle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indica~ 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 Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a patial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name &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): A} the owner of greater than 5% of the shares of the corporate stock of the applicant (when thc applicant is a corporation); ___B) thc legal or beneficial owber of any interest in a non-corporate entity (when thc applicant is not a corporation); C) an offieer, director, partner, or employee of the applicant; or __.D) thc actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this '~/ dayof ]~aV S~gnature )?_~t-?.-t~' d' j' "'J~'"~'7~'[-'~ . Print Nam6' ¢t~, ~ ,.,~ tr,' P Town of $outhold 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 ~i.,o;nifieant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail, listind both smmortin~ and non- suooorfin~ 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# .[0C)0 '~ - c~ - J PROJECT NAME ~'~ & h ~X,'o~ (~ 4- ~t 5i c2tg ~q CC., The Application has been submitted to (check appropriate response): Town.o,rd Pla..ing.o,r .ilding Dept. oara of Trustees 9C 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) F--}~. (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: ~6~fO i~ ~lqW~ lfc~ (b) Mailing address: cv%]ogO (Jg~et( ~tut¢ Coo+ho Id (c) Telephone number: Area Code (gM ~ ~- / (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~] N°'~ 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 ~Yes 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. ~ No ~Not Applicable At~ach 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 V~ Yes ~ No ~Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No'~ Not Applicable /, Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria [-~ Yes ~] NO~'Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria 7] Yes No Not App,icahlc Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not App~ble Aaach 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 AOach 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 Applieable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No~, Not Applicable Attach additional sheets if necessary WORKING COAST POLICIE~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island ,Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. Attach additional sheets if necessary Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages Policy 12. 62 through 65 for evaluation criteria. ~ Yes [] No [] Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. r~ Yes [] No ~ Not Applicable / fO PREPARED BY ~-)~tfC4A, '~//u~.61,", TITLE '~:%t~*~ DATE ~ '1 ' t( N LOT NUMBERS REFER TO "MAP OF GOOSE BAY ESTATES" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON NOVEMBER 13, 1934 AS FILE NO. 1176. SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-??-02-0I SCALE: 1'--20' APRIL 7, 2011 ~01' 195 AREA=ti,200 SO. FT. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION ?209-SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF TNE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. ~o.O°' (~zO 765-5o2o FAX (~0 26~-~7~7 P.O. BOX 909 1250 TRAVELER SmEErI BOARD Ol~ ~RU51~25 ~OWN OF SOU~r.~L~ t GOOSE CREEK U N NAM ED &TREET Doc~ 5TAI ~ - o ~ LINE O~ PROTECTIVE MA~ALE~ Z / % UP c.P. zz ~ ~ O0 k / ~ o ~..,~" 8'-0" d~ame~e~ x 4'-0" d PROPOSED SECOND OV~ ~'ISTING I 5TORY 5TRUCTU~ ! New Dwwell - 8'-0" Elaine:er x 4LC ," deep SITE PLAN SCALE: ~" = ILO'' BUILDING ENVELOPE SCTM: 1000-77-2-~ Information ~aken from : ~urvey prepared by John Metzger ~ Pecomc 5urveyor~, F.C. ~ * Sou~hold, New York ~ d da~ed April 7, 20~ I ~ PROPER~ AREAS: : Exlsbng Lof area: ~ Mouse (existing): 1423 5q.~ ~ Deck (existing): 230 5q.~. z Total ex,sting areas; I G53 5q.f~. Exi5~in~ Io: coverage; 14.7% Proposed covered stoop: 40 5q.~. To~al Areas: I Q¢3 sq,f~, s~8'~o'so"w 8o.o TOTAL LOT COVE~QE: I 5. J % Proposed new area: ~85 OAK AVEN U E :o~¢ ~x,~,~ RUNOFF CALCULATIONS: 15¢2x,IGTxT,5 = 1,981 9allons A~ulr~5 (2) 8'-0" x 4'-0" nnss NANCY D~ER HAROLD 5CHWERDT D~WING: SITE D~WING DESIGN CONSULTING, INC. SCHWERDT ¢ OSTER 2720C~OA~AWNU~ ~CA~ : A~NOT~O 50UTHOLD, NEW YORK I I 97 I PROPOSED ADDITION 50UTHOLD, NEWYORK DAT~ : 5.23,20J I G3 I -TGS-SGG7 5CTM¢ IO00-77-2-1 BY : N. D~EA PROPOSED FRONT ELEVATION JLIL J½L 31~F TF EXIOTING FRONT ELEVATION 51DE ELEVATION 5CALE: ~" ILO'' CEDAfE AVENUE ELEVATION SCALE: 4h' = iLO'' 2 NA/ATER.51 DE ELEVATION TO REMAIN EXISTING 5ASEMENT fiXIDTING GIRDER. TO REMAIN (UNDER. POST ABOVE) I 4" P. CONC. 5lAB ON COMPACTED FILL C~,WL SPACE POUR.ED CONCRETE ENTRY STOOP FOUNDATION PLAN SCALE: ¼"- ILO'' INTO ~XISTING FOUNDATION WALL ¢ NEW WALL ADbrFI lNG DIAMETER. ANCHOR. DOLT5 9// 7" MIN. DEFIH ~ 48" O,C. W/MIN. 3"X3"x~" WADHER. ~ pLATE ?OUNDATION WALL LEGEND; D(IDTING FOUNDATION WALL TO REMAIN Zzd~ PAGE: 4 0 z ~ ~ II L~F 0 CLO5~ ~ ~ CLOS~ ~ CONNE~O~TO O~ ~G I ~ ~ ENTRY ~ ) ~ WALL LEGEND: ~ B~ ~ ~ ~ ~ ~ ~ISTING WALLTO ~AIN L. BATH I e ~D FO~CH ~ CEILING MATE~AL W/ I ~" FL~OOD ~ ~ ' ~ ~ / ~ CO'MN WITH CAF ¢ "INT~O~ WALL- KITCHEN $ BATH $ ~UNDRYA~ I TO ~ ~'-~" A~OV~ FLOO~ ffl~T FLOOR PLAN PAGE: ~ SI~ING AREA ¢ ¢ BEDROOM $ECOND PLOOR PLAN I ~" X 1 4" LVL P. IDGE 12 R. OOfi PLAN PAGE: