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Home My WebLink AboutTR-7579 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765.1892 Fax (631) 765-6641 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD CERTIFICATE OF COMPLIANCE # 0736C Date April I0, 2012 THIS CERTIFIES that the swimming pool, spa and pool fence At 350 Lakeside Dr., Southold Suffolk County Tax Map #90-3-15& 16 Conforms to the application for Trustees Permit heretofore filed in this office Dated 6/1/11 .pursuant to which Trustees Wetland Permit #7579dated 6/22/11 was 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 swimming pool, spa and pool fence. The certificate is issued to MARC SOKOL owner of the Aforesaid property. A th ' ' ~ James F. King, President Bob Ghosio, Jr., Vice-Pr~ident Dave Bergen John Bredemeyer Michael J. Domino 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 DATE OF INSPECTION: f--~.j~ r r_),/ ~-0! 2- '~/' Ch. 275 Ch. 111 INSPECTION SCHEDULE __ Pre-construction, hay bale line/silt boom/silt curtain 1st day of construction ½ constructed Project complete, compliance inspection. INSPECTED BY: -'~)'/~! '/_~ t~_,~_~0 COMMENTS: CERTIFICATE OF COMPLIANCE: 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 1st day of construction ~ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7579 DATE: JUNE 22~ 2011 ISSUED TO: MARC SOKOL PROPERTY ADDRESS: 350 LAKESIDE DRIVE~ SOUTHOLD SCTM# 90-3-15 & 16 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 Marc Sokol 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 install a swimming pool, spa, patio on grade, and pool fence; and as depicted on the site plan prepared by MCH Design Services, last dated May 29, 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 Marc Sokol, residing at 350 Lakeside 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 damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as 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 Permittec 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 faihfm to obtain same. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. I~ng 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. Mark Boeckman P.O. Box 1453 Mattituck, NY 11952 RE: MARC SOKOL 350 LAKESIDE DRIVE, SOUTHOLD SCTM# 90-3-15 & 16 Dear Mr. Boeckman: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, June 22, 2011 regarding the above matter: WHEREAS, Mark Boeckman on behalf of MARC SOKOL applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the $outhold 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 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 have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of MARC SOKOL to install a swimming pool, spa, patio on grade, and pool fence; and as depicted on the site plan prepared by MCH Design Services, last dated May 29, 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, JiltS.'.' 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 TO: Please be advised that your application dated ~--(.,~e_ ~, c~O I~ has been reviewed by this Board at the regular meeting of ..._T~j r~_ c~P,; ~ 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) __ Ist 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 rpust 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: 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 bIARC SOKOL to install a swimming pool, spa, patio on grade, and pool fence. Located: 350 Lakeside Dr., Southold. SCTM#90-3-15&16 Inspected by: Meaghan Burke The CAC Supports the application with a detailed drainage plan for the pool backwash and the vegetated buffer is expanded to at least 10' between the patio and the wetlands. Vote of Council: Ayes: All Motion Carried Jill M. Dohe~ly, President Bob Ghosio, Jr, Vice-President James F King Dave Bergen John Bredemeyer PO Box 1179 Somhold, NY 11971 Telephone (631 765 - 1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: MARC SOKOL requests a Wetland Permit to install a swimming pool, spa, patio on grade, and pool fence. Located: 350 Lakeside Dr., Southold. SCTM#90-3-15&16 Type-of area to be impacted: ~...~altwater 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:__ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: J. Doherty V'B. Ghosio__ __J. Bredemeyer D. Dzenkowski Form filled out in the field by ~ Mailed/Faxed to: Date: J. King __ D. Bergen, other N~CK ............ 090 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 MARC SOKOL SCTM#1000-90-3-15&16 Mark Boeckman on behalf of MARC SOKOL requests a Wetland Permit to install a swimming poor, spa, patio on grade, and pool fence. Located: 350 Lakeside Dr., Southold. SCTM#90-3-15&16 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 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only ~__~wOaStal Erosion Permit Application etland Permit Application Adminis~ative Permit Amendmentr~ransfer/Extension ~/~ece~vved Application: (~ ~ ] } ~[ ~/'Received Fee:$~ ~k'~' ' ~,~ompleted App~Za~on 09 [ I ! I ! __Incomplete ' ' - __SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) ~ ~MI~WRP Consistency ~sqes~ment Form ~) ~AC Referral Sent:/~[~JJ~__r~ - ~IJate of Inspection: '[~11 Receipt of CAC Report: ~'~:~ ~ .r Lead Agency Determination: Technical Review: ,_.~Wublic Hearing Held:~/_ Resolution: Name of Applicant Address 2 0/~1 Phone Suffolk County Tax Map Numbs: 1000 Prope~y Location: (provide LILCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: d of Trustees Applicatio~ GENERAL DATA Land Area (in square feet): '~:5. ~_ % L~ Area Zoning:. [~- b~ Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals If "Yes", please provide copy of decision. Yes >~' Date Prior permits/approvals for site improvements: Agency No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspejaded by a governmental agency? ./ No Yes If yes, provide explanation: Project Description (use attachments if necessary): I ~d of Trustees Applicatio~ WETLAND]TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ~ _square feet Percent coverage of lot: ~ ~ % Closest distance between nearest existing structure and upland edge of wetlands: ~-)~. '2.. feet Closest distance between nearest proposed structure and upland edge of wetlands: '7_~I feet Does the project involve excavation or filling? No V~ Yes If yes, how much material will be excavated?_~7.~cubic yards How much material will be filled? '~"'- cubic yards Depth of which material will be removed or deposited: ~ feet Proposed slope throughout the area of operations: ~ 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): ~d of Trustees Applicatio~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: ~.u,,ai ~.4 ~ t gitI Pa>or.. Are wetlands present within 1 O0 feet of the proposed activity? No '~ Yes Does the project involve excavation or filling? No {~ Yes If Yes, how much material will be excavated? How much material will be filled? t~> Manner in which material will be removed or deposited: (cubic yards) (cubic yards) ~---~ 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 t - PROJECT INFORMATION 1. APPLICANT / SPONSOR 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2, PR~Ej~ _ SEQR 3.PROJECT LOCATION: (..~tE..OAr4. ~i¢,~'?' ~)~.~. County Municipality 4. PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 5. IS PROPOSED ACTION: [] New [] Expansion ~'~lodification / alteration 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EX[STING ZONING OR OTHER RESTRICTIONS? ~-~'-'~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE iN VICINITY OF PROJECT? (Choose as many as apply.) [~esidential [~]lndustrial r--]Commercial r--]Agriculture [~Park/Forest/OpenSpace r~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGE._~CY (Federal, State or Local) L....~Yes []No If yes, Ist agency name and permit / approval: 11.DOES ANY~YI~ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes E~No If yes, list agency name and permit / approval: 12. AS A RE~il~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ~'~A~ Date: Signature ~.~. .~//. ~ I:~ ~.~ "I 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 A~lency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL FAF. ['-]Yes ['~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 haodwdtten, if ~=gible) C1. Existing air quality, surfaco or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposel, potential for erosion, drainage or flooding problems? Explain bdefly: C2. Aesthetic, agricultural, archaeological, histodc, or other natural or cultural resources; or community or neighbmhoed character? Explain bdefiy: I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain bdefly: I Ct. A cornmunity's existing plans or goals as officially adopted, or a change in use or ~ntens~ty of use of land or other na ufa resources. Explain bnefly: , C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term, short te~rn, cumulative, or other effects not identified in C1-C57 Explain briefly: C7. Other impacts (including chanties irt use of either ({uantit¥ ~r i~'~ ~f energy'? Explain briefi;/: 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 brier)': E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: F~reachadversee~ectidenti~edab~ve,determinewhetheritissubstantia~~~arge~imp~rtant~r~therwisesigni~cant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probebility 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 determinafion of sig nifica ncs must evaluate the potential impact of the proposed action on the environmental characteristics of the C EA. Check this box if you have identified one or more potentially Imge 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 actio~ WILL NOT resufi in any significant adverse environmental impacts AND provide, on attachments as necessary, 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 trom responsible officer) - Town of Erosion, Sedimentation & storm-water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.~T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATBR, GRADING, DRAINAGE AND EROSION CONTROL PLAN ~ etstilct section Block L~t CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT I Yes No a. What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within Generated by a Two (2") Inch Rainfall on Site? the Scope of Work for Proposed Construction} (This item will include all mn-off created by site b. What is the Total Ama of Land Clearing (S.F. I Acres) cleadng andlor construction activities as well as all and/or Ground Disto~bance for the proposed Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F. / Acres) 2 Does the Site Plan and/or Survey Show All Proposed PROVidE B~]~F PROJEC~ DESCRZFT[ON {Pro~ ~.~ ~. ~ Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. C.,ar~5 l-tzoc~'F ~,~t' 0 3Does the Site Plan and/or Survey descdbe the erosion ~c:~ooL,. ~'~l ~ "]' ~'~ ~ ~'F" andsedimentcontrolpmcticesthatwitlbeusedto [ control site erosion and storm water discharges. This P',e~,'-'~ o e3t.-~ (~'i ~-A~'3/~_ ~"~L~'~ item must be maintained throughout the Entire Construction Period. P,,'3,r~,L F'r~J..~,' ., ,,.l;, ~ (--.~mT._. 4Will 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 jurisdiction~ General DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- dislurbances of one (1) or mom acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are pall of a larger common plan that will ultirnatsly disturb one or more acres of land; which Exceed Fifteen (15) feet of Ver~cal Rise to ~ 2. The SWPPP shall describe the erosion and sediment contr~ practices and where 9 Will this Project Require the Placement of Material. STATE OF NEW YORK, ~---%~ ~_t~.Z~ ~ Nota~ Pub#c, State of New York COUNTY OF .......~'"..¥.~..t.....D~.~............~'~ -- ........... SS No. 01BU6185050 Qualified in Suffolk Court ~ · ,4 _ ~ ..... I Comml~lon F-.,~lre~ April 14. That I ....~...~.k-~}~........~....?..~..l~...~ ............... being duly sw6m, deposes and says that he/she s the appl cant'for Permit, And that he/she is the ".......4~1~.~i.~...~. ri.'~... ........................................................................ Owner and/or representative of the Om]er or Ovmers, and is duly authorized to perform or have perforated the said work and to make and file this application; that ail statements contained in this application are tree to the best of his k~owtedge and belief; and that the work will be performed in the mmaner set forth in the application fried herewith. Sworn to befgre me this; .~...~.~.~/'~ ...... ................. d,, y ...................... o..l.I Notary Public: ..~.~...~ ........ t~-~....c~.....(:.__~... ............................. .~ ............. FORM - 06/10 Jill M. Doheriy, Presidenl Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Brcdemcycr Town Hall, 53095 Main Rd. P.O. Box l 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of MARC SOKOL COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING , residing at/dba being duly sworn, depose and say: That on the '-} day of J ~. ,201k I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place ibr eight 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: Sworn to b~'ore me this -~1t day of..Jt.~20 t / Notary Public (signature) -- - -. t,u~blic S ate of New York Registration #01 KI6041757 Qualified in Suffolk County My Oommission Expires May 15, 2 ~ rd of Trustees Applicatio0 AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at_ '2~31 ~/~ (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owne signature F r'olll: FRO~I : ~c~ckman 12:34 #7Ol P.002/002 2011 82;ggPH P2 Coun~ of Suffolk State of New Yodc ,3- BEING DULY SWORN DEPOSES AND AFFIRMS THAT ~SHE m ~ DESC~BHD ~(S) ~ ~AT ALL STAT~ CO~A~ H~EIN TRU~ TO ~ B~ OF HIS~ ~O~EDGE AND B~F, AND T~T ~L WO~ BB ~P~O~ BY TH~ SO~HO~ TO~ BO~ OF ~U~S. ~E APPLICANT AG~ TO HOLD THE TO~ OF SO--OLD AND '~ TO~ T~UST~HS ~ESS ~D F~EE FROM A~ AND ALL D~O~ A~ CLA~S UNDER OR BY V~E OF S~ PERM.(S), ~ G~. ~ COOL. lNG THIS APP~CATION, I HE.BY A~O~E THE ~US~, T~ AG~(S) REP~SE'~AT~(S), TO ~K O~O ~ PR~ TO ~SPE~ THE P~SES IN CON~CTION Wrrfl ~VI~W OF THIS APP~CA~ON, / SWORN TO B~FORA ~ TH~ ~ ~ ,_DAY OF ~'~ _,20~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Thc Town of Southold's Code of Ethics nmhibits conflicts of interest on the hart of town Officers and emnlovees. The om'nose of this form is to provide information which can alert the town of oossiblc conflicts of interest and allow it t~ take whatever a~ion is ~id same. (Last name, fast name, galddle initial, unless you are app y' g in the name of someone else or other entity, such as a company. If so, indicate thc other person's or company's name.) NAME OF APPLICATION: (Cbeck all that apply.) Tax grievance Building Variance Trustee b Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you persenally (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 thc 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% oftbe shares. YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe thc relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either cheek 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, o~ Child is (check all that apply): A) the owner of graater 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, partner, or employee oftbe applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this Signature Print Name day of I ~. ( ~ 2.00 __ Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Water~ont Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local 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 expla'med in detail listin~ both supporting and non- suooorting 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 Lo: o qo I scm# PROJECT NAME ~ o The Application has been submitted to (check appropriate response): TownBo,ra [--] PlanningBo,ra~ BnilaingOep*. [~ Bo~raofTr,s,ees 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: ,1"1 Present zoning classification: ~'~ ~' If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: ~.~ (b) Mailing address: 7-0~i. (c) Telephone number: Area Code ( ) ~lL.'qq7 · (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 [--~--~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 Southoid. See LWRP Section IH - Policies Pages 16 through 21 for evaluation criteria ~-~ Yes ~-] No [] Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. No Not Ap~ble Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. [] Yes [] No ~] Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~-~ Yes ~ No [~ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational usc 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 WORKING COAST POLICIE~ Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. ISee LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [--] Yes [] Nor-~ 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 adclitional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [-~ Yes [] No [~ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes ~ No ~ Not Applicable PREPARED BY~ TITLE ~t~,..~'7'"' DATE ~4 7g'50 00 ~. Bu S.C. TAX No. 1000-90-03-15 LOT ~ N 79"16'50,, W TAX No. 1000-90-05-16 LOT ~ O 22 '26'00" W 80.,39' SURVEY OF PROPERTY SITUATE BAYVIEW TOWN OF SOUTHOLD SUFFOLK COUNTY, N£W YORK S.C. TAX No. 1000-90-03-15 1000-90-05-16 SCALE 1"=20' MAY 4, 2001 NOVEMBER 15, 2001 ADDED TOPOGRAPHICAL SURVEY, PROP, ADDITION & SEPTIC SYS. dUNE 12, 2002 REVISED PROP, 2 STY, ADDITION, ADDED TEST HOLES & ADDED PROP, SEPTIC SYSTEM SEPTEMBER 16, 2002 REVISED SEPTIC SYSTEM AUGUST 7, 2006 FINAL SURVEY OCTOBER 15, 2009 UPDATE SURVEY JANUARY 28, 2010 ADD PROPOSED RELOCATION OF DEER FENCE APRIL B, 2010 REVISED PROPOSED DEER FENCE TOTAL AREA = 59,736 sq. ff. (TO TIE LINE) 0.774 CERTIFIED TO: MARC SOKOL DEIRDRE SOKOL FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK ~VOTES. 1. LOT NUMBERS SHOWN THUS: LOT(BO) REFER TO MAP OF CEDAR BEACH PARK~ FILE IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON DECEMBER 20, 1927 AS FILE No. 90 2. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 8). FLOOD INSURANCE RATE MAP No, 36105C0169 0 ZONE AE" BASE FLOOD ELEVATIONS DETERMINED 3, S,C,D,H,S, REFERENCE No. R10-02-0165 UNAUTHORIZEO ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD. IF ANY, NOT SHOWN ARE NOT GUARANTEED, FOR SUCH USE BY THE N LAND TITLE ASSOCIATION No. 50467 Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 Fox (631)727 1727 g6-384 DRYWELL FOR BACKWELL PATIO DRAINAGE POOL EQUIPMENT 2" BLUESTONE PATIO '.-".:: :~:":~ , GRADE LAWN OR 'va??':~::?:'''~' 4 ."~ ' ~" c~oNc:.~;LA~B~'^ ^ , 4 ~v~ '[II,!I~(iII, I[~II!/AII~IdlI~IIII/PLANTING BEDS ' GRAVEL 4" PERFORATED PIPE [ ~, JUI,a -1 2011 DECK ABOVE Ey~S'T~NG EXISTING FRAMED GARAGE PATIO ON )OOL FENCE EXISTING STONE DRIVEWAY /'~-O O L FENCE EXISTING S LATE PATIO [SCREENE£ lIN PORCP 2 STY. STUCCO FRAMED HOUSE PATIO ON · GRADE POOL FENCE PLEASANT INLET 97.75' N 83~-~'6' O"W 80.39' N 77° 14' o"w N 79° 16' 50"W 32.73' SIT PLAN CEDAR POI NT SCALE: 1" = 10' M R H www c esi err' s.com phone: (631) 298-2250 e-maik mlchael~mchde.sig nserv[ces.con 0 0 DRAWN BY: MH May 29, 2011 SCALE: SEE PLAN SHEET NO: