The URL can be used to link to this page

Home My WebLink AboutTR-7641 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 CERTIFICATE OF COMPLIANCE # 0737C Date April 1 lq 2012 THIS CERTIFIES that the one-story addition to the existing dwelling and removal and replacement of existing decking and railing at pool enclosure At 1435 West Rd., Cutcho~ue Suffolk County Tax Map #110-7-26 Conforms to the application for Trustees Permit heretofore filed in this office Dated 8/19/11 pursuant to which Trustees Wetland Permit #7641dated 9/21/11 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 one-story addition to the existing dwelling and removal and replacement of existing decking and railing at pool enclosure. The certificate is issued to MICHAEL & CORRINE SLADE owners of the Aforesaid property. Authorized Signature James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Brcdemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /V~...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: COMMENTS: 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. 7641 DATE: SEPTEMBER 21~ 2011 ISSUED TO: MICHAEL & CORRINE SLADE PROPERTY ADDRESS: 1435 WEST ROAD~ CUTCHOGUE SCTM# 110-7-26 AUTHORIZATION Pursuant to the provisions of Chapter 275 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 September 21, 2011, and in consideration of application fee in the sum of $250.00 paid by MiChaei& Corrine slade 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 one-story addition to the existing dwelling; one- story addition to attached garage; new basement access door; and remove and replace the existing decking and railing at pool enclosure; with a line of staked hay bales with silt fencing to be installed prior to construction; and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated August2~ 2011, and stamped approved on September 21, 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. Jill M. Doherty - Absent TERMS AND CONDITIONS The Permittee Michael & Corrine Slade, residing at 1435 West Road, Cutcho~;ue, 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 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 Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that ~y be required supplemental to this permit, which may be subject to revoke upon fgilure 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 September 21, 2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Tom Samuels Samuels & Steelman Amhitects 25235 Main Road Cutchogue, NY 11935 RE: MICHAEL & CORRINE SLADE 1435 WEST ROAD, CUTCHOGUE SCTM# 110-7-26 Dear Mr. Samuels: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, September 21,2011 regarding the above matter: WHEREAS, Samuels & Steelman Architects on behalf of MICHAEL & CORRINE SLADE 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 August 19, 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 September 21, 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 MICHAEL & CORRINE SLADE to construct a one-story addition to the existing dwelling; one-story addition to attached garage; new basement access door; and remove and replace the existing decking and railing at pool enclosure; with a line of staked hay bales with silt fencing to be installed prior to construction; and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated August 2, 2011, and stamped approved on September 21,2011. 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, Bob Ghosio, Jr. Vice President, Board of Trustees BG/ec 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 (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: MICHAEL & CORINE SLADE Please be advised that your application dated August 19, 2011 has been reviewed by this Board at the regular meeting of September 21, 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 Fina nspeotion 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., September 14, 2011, the following recommendation was made: Moved by Audrey Horton, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the Wetland Permit application of MICHAEL & CORRINE SLADE to construct a one-story addition to the existing dwelling; one-story addition to attached garage; new basement access door; and remove and replace the existing decking and railing at pool enclosure. Located: 1435 West Rd., Cutchogue. SCTM#110-7-26 Inspected by: Peter Young, Jack McGreevy, Audrey Horton The CAC Supports the application with the Condition a 10' non-turf buffer is installed along the landward side of the entire bulkhead; gutters, leaders and drywells are installed to contain run-off from the entire dwelling; and the concrete debris is removed from the area seaward of the bulkhead. Vote of Council: Ayes: All Motion Carried Jill M. Dohe~ty, Presidem Bob Ghosio. Jr, Vice-Preside~t Jatnes F King Dave Bergen John Bredemeyer P.O. Box I 179 Southold, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: ~f Il( '~-" ~4-~ ~'~-' MICHAEL & CORRINE SLADE request a Wetland Permit to construct a one-story addition to the existing dwelling; one-story addition to attached garage; new basement access door; and remove and replace the existing decking and railing at pool enclosure. Located: 1435 West Rd., Cutchogue. SCTM#110-7-26 Type of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound ,~, Bay Distance of proposed work to edge of wetland Part of 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: Conditions: Pre~nt Were: ~'"J. Doherty JB. Ghosio ~J. King ~D. Bergen, / J. Bredemeyer_ D. Dzenkowski ether Form filled out in the field by Mailed/Faxed to: Date: 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 To: Jill Doherty, President Town of Southold Board of Trustees MEMORANDUM From: Mark Terry, Principal Planner LWRP Coordinator Date: September 20, 2011 Re: Proposed Wetland Permit for MICHAEL & CORRINE SLADE SCTM# 1000-110-7-26 Samuels & Steelman Architects on behalf of MICHAEL & CORRINE SLADE requests a Wetland Permit to construct a one-story addition to the existing dwelling; one-story addition to attached garage; new basement access door; and remove and replace the existing decking and railing at pool enclosure. Located: 1435 West Rd., Cutchogue. SCTM#110-7-26 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 LWRP review provided the following best management practices are required: If the action is approved, to further Policy 5: Protect and Improve Water Quality in the Town of Southold and Policy 6; Protect and Restore the Quality and Function of the Town of Southold Ecosystem it is recommended that the Board require the creation of a landscaped buffer (Incorporating existing vegetation landward from the edge of the wetland adjacent to the residential structure). A sample definition of a landscaped buffer is provided below for your use. LANDSCAPED BUFFER -- A land area of a certain length and width which is planted with indigenous, drought-tolerant vegetation (excluding turf) similar to that found within the immediate proximity of the parcel. Vegetation shall be installed in sufficient densities to achieve 95% ground cover within two years of installation. Survival of planted vegetation shall be 90% for a period of three years. Maintenance activities within the buffer are limited to removing vegetation which is hazardous to life and property, trimming tree limbs up to a height of 15 feet to maintain viewsheds, replanting of vegetation and establishing a four-foot-wide access path constructed of pervious material for access to the water body. [Added 12-15-2009 by L.L. No. 15-2009] In addition it is recommended that a pool de-watering dry well be installed and specified. 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 Office Use Onty Coastal Erosion Permit Application ~g_Wetland Permit Application Amendment/Trans~er/~xtension ~Rece~ved Application: Y- Received Fee:$ c~.~°° ~/Completed Application __Incomplete __SEQRA Classification: Type 1 Type II Unlisted __Coordination:(date sero). ./'LWRP Consistency As~gs~sme. nt Form ~CAC Referral Sent: ~ate of Inspection: C~ [ Receipt of CAC Report! ' ' ' Lead Agency Determination:__ Technical Review: ~4~'fiblic Hearing Held: c~ Resolution: .... * ' ' Administrative Permit Name of Applicant Michael and Corrine Slade Address 1435 West Rd., Cutchogue, NY 11935 Phone Number:( ) 631-734-6405 Suffolk County Tax Map Number: 1000 - 110 - 7- 26 Property Location: 1435 West Rd. Cutchogue, NY 11935 Corner of West Rd. & West Creek Rd. Cutchogue AUG 1 9 2011 (provide LILCO Pole #, distance to cross streets, and location) AGENT: Nancy Steelman (Samuels & Steelman Architects) (If applicable) Address: 25235 Main Rd. Cutchogue, NY 11935 Phone: 734-6405 Board of Trustees Application Land Area (in square feet):. Area Zoning:. R - 4 0 GENERAL DATA 36,321 S.F. Previous use of property:. Intended use of property:. Covenants and Restrictions: Residential Residential Yes x No lf"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If"Yes", please provide copy of decision. Pending Prior permits/approvals for site improvements: Agency Date x Yes NYS DEC Non-Jurisdiction Letter No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes, provide explanation: PrQectDescription(usea~achmentsifnecessaw):.Construction of a one story living room addition, and a one story addition to an attached garage. Miscellaneous improvements include: construction of new basement access door and removing existing decking and railing at pool enclosure and install new to meet code. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Renovation and additions to an existing residence Ama of wetlands on lot: 0 .square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 19 ' - 6" feet Closest distance between nearest proposed structure and upland edge of wetlands: 5 0 ' feet Does the project involve excavation or filling? x 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: flat Manner in which material will be removed or deposited: feet Statement oft he 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): None Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergcn John Bredcmeyer Town Hall, 53095 Main Rd. P.O. Box 1179 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 & CORRINE SLADE COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and say: That on the /~day of -E~do~2,L~ 20! t, I pe~rson,~,ally, posted the property known as ,, by placing the Bo~d of Trustees official poster wh~e it c~ easily be s~, ~ that I have checked to be sure the post~ has remained in place for ei~t days prior to the date of the public heating. Date of heating noted thereon to be held Wed~ September ~ 2011 on or about 6:00 PM. Dated' Q~/ // "'~ Sworn to before me this ~ day of~p 20}~ Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Fee C. Date of Delivery ) J~/'~'- ,'~'"~'-':-, ........ I ~ - - .... ,that on the / [/S "~ ..... ~1 ~Z oftheNotice ~~~~ oven~ed ~v~-~ ' ~&esses set opposite the names Of s~ m,, ~_ ,o~s,~,~.~,~ !~_own on the current assessment roll of the Town ag Southold; that said Notices were maffod at the United States Post Office at . O,t~~,/LLt , that said Notices were mailed to each of said persons by (certified) (regist~redf'/uail. / ' / Sworn to_before me this ,~ 0 Dayof ~). ~t~, 20 ~- Notar~ubli6 - PENNY BEDELL Notary Public, State of New York No. 018E6099517 Qualified in '_~ _C~m_ ty Board of Trustees Application County of Suffolk State of New York ~'x~Cx'xm....\ ,.- o._..~¢4-,~,.. ~-~x.~&..__. 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 REV1EW OF TH1S APPLICATION. Signature / SWORN TO BEFORE ME THIS 'N~N DAY OF k'~'o,--.~,~.:k ,20 \ \ Notary Public ALICIA WALKER Nelaq ~l~ic, State of New York No. 0]WA6153064 Qualified in Suffolk Commi~o~ Ex~i~e$ Sep[ 25. Board of Trustees Application County of Suffolk State of New York /')0, ~ OeP ~.~/o~---. ~- ~orr ~ ~ ~,.~ ,.._C/o<:j e_. BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED ttEREIN 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 AGENF(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. ~/./"'"-~ SWORN TO BEFORE ME THIS DAY OF ~2~.,o,~,~>~ ,20 \\ Notary Public AI. ICIA WALKER Notary Public, State of Hew Yo~ No. 01WA6153064 Q~alified in Suffolk, County Commiszion F. xpires Sept. 25, ~ Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Michael & Corrine Slade residingat 1435 West Rd. (print owner of property) (mailing address) Cutchogue, NY 11935 (Samuels & Steelman Arch) do hereby authorize Nancy Steelman (Agent) to apply for permit(s) from the (Owner's signature) APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Nancy Steelman (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance x Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other Do you personally, (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Sonthold? "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 partial ownership of (or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES NO x Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship 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 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 of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th~t~ay of (~iur::ju-$ t:.. 2 011 Sign amre:~'////v,~, ~/~ Print N am .e(/N~fi h~r d't'~e lman APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: Michael Slade (Last name, first name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance x Special Exception I f "Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other 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 partial ownership of (or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES NO x Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship 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 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 of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this Signature: ~'"/',"~ Printl~afl~:'~Michael Slade APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER andOWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information, which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Corrine Slade (Last name, flint name, middle initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other pemon or company name.) NATURE OF APPLICATION: (Check all thru apply.) Tax Grievance Variance x Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other 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 partial ownership of (or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES NO x Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship 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 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 of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this /¢~ dayof August 2011 Signature: ~,, ,,,x._-,~)/~ ~ ,~ PrintName: ~'oz"z'ff~e ~'acl. e FAOJECT I.D. NUMBER 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only ~PART I--PROJECT INFORMATION (To be completed by Applicant or Project sponsor) SEQR ApplICANT/SPONSOR Michael and Corrinne Slade 2. PROJECT NAME Slade Residence 3. PROJECT LOCATION: M unlcll)allty Southold County Suffolk 1435 West Road, Cutchog~e, NY: & Wickham Creek- Property at inter- section of West Road and West Creek Avenue. [] New [~=.x0anslon [] MOdification/alteration 6. DSSCRIBE PROJECT BRIEFLY: Construction of a new living room addition, new basement access door and a new garage addition WILLPRO~B~ A~IONCOMP~WITH ~I~INGZONINGOROTH~EXi~ING ~ND ~ER~STRIC'TION~ []Yes [~No lfNo, des~d~br~f~ Living room addition will require a variance due to encroachment into rear yard setback and distance to existing bulkhead 9. WHAT IS "RE~ENT LAND USE IN VICiN~"Y OF PROJECT? [] Re$id®ntl&l [] Indus~ ~ Property abuts a commercial marina ~0. ~ a~ON ~NVOLVE ~ ~E~ *PPROVAL O~ ~ Y~ ~ NO If ~. list ~g~s) Town of Southold Trustees - Wetlands Permit 11. OO~ A~ AS~ OF THE A~ON ~VE A ~RR~Y V~D PERMff ~ Y~ ~ No If y~, fist ageflW 12. ~ A RESULT OF PRO~S~ A~lON ~ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE I$11~JE TO THE EE.~T OF MY Appl~s~nsor~,fl~ Na~cc~ St~e] man: a~nt OVER PART II - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. r-"~ Yes [~'~ No B. WILL ACTION RECEIVE COORDINATED REVIEWAS PROVIDED FOR UNLISTEO ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative dectsration may be superseded by another invel~l agency. [~Yes ['~No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air qus~iy, surface or groundwater quality or quantity, noise levels, existing traffic pahem, solid waste production or disposal, pothnflal for emsles, drainage or flesoing peoblems? Explain bdefly: C2. Aesthetic, egr~cultural, archaeological, historic, or other natural or cultural resources; Or community or neighherhoed charaoier? Explain briefly: I C3. Yegetotion Or fauua, fi*h, ~heittish or wllelh~ ~la,, signdicent h~bltots, or throatoned or endantiered ~pe~es? E~lain I C4. A community's existing plans or goals as officially adopted, or a change in use or intensl~/of use o[ land or other natural resources? Explain briefly: I C6. Orowth, oub.*.,~.-~luaet development, or mleted e~i~itioa likely to he induced by the propo$~ a~tion? ~lain ~'ie~: C6. Loeg torm, short term, cumulative, or other eifects not identified in C1~57 Explain brieity: I Other impacts linctudth~t chanties in use of either quantity or t}~e of ene~/? Explain bdeity: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? lif yes, explain briefl},: [~] Yes F-~No ' ' E. IS THERE, OR IS THERE LIKELY TO BEI CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? if ~'es explain: [~Yes [~NoI PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) . INS'IRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, impodant or otherwise significant. Each effect should be assessed in connection with its (al setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (el geographic scope; and (fl 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 ad~luately addressed. If question d of part ii was checked yes, the detarminatio~ of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check ~ box if you have Idsetifmd one or mare geter~ally large or signtiicent edve~e Impacts which MAY occur. Then proceed directly tu the FUL EAF and/or prepare a positive declaration. Chec~ this box if you have determined, based on the information and analysis above and any supp~ting docemardaflon, Ihat the pmpesed aoile WILL NOT msuti in any significant adverse environmental Impacts AND provide, on attachments as necessary, the masons seppodlng thi determination. Board of Trustees Name of Lead Ageesy Date Jill M. Doherty President Pflnt 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 officerl · Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM P~OPERTY LOCATION: $.C.T~M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A /~, ~/~eo.-~ 2~:~ STORM-WATER~ GRa~OING, DRAINAGE AND EROSION CONTROL PLAN Lot CERTIFIED BY A OE$1ON PROFESSIONAl. IN THE STATE OF NEW YORK. SCOPEOFWORK - PROPOSED CONSTRUCTION ITlfiM# / WORK ASSESSMENT I Yes No a. What is the Total Area of the Project Parc~.s? "] WillthisPmjectRetelnAIIStorm-WaterRun-Off (Inctude Total Area of all Parcels located within the Scope of Work for Proposed Consbuction) ~-'~,,'~2 ,~,F GeneratedbyaTwo(2")lnchRainfallonSite? b. What is the Total Area of Land Creadng {S.F. I ~) (This item will include all run-off created by site clea~ing and/or construction activities es well as all and/or Ground Disturbance for the p~oposed .~ ~ ,~' ,~_//_ Site Improvements and the permanent creation of construstion acfivi[y? impervious surfaces.} 2 ~the Site Plan and/or Survey Show All Proposed I ,Q~Z~z~:~--~ ~-"~,~,~" ¢0/,~o~. 4 Wlll~leProjeofRequimenyLandFilling, Grading~ S'TAq~ OF N]EW ¥O~K, ~', ~:t~]~ ¢OUNT~ OF ..~..S~....E~ ........... SS And that he/she is the .~. ~10 ~..'~C.~"~..~ ..... ~'" "o~."c"&'"~'d'd:"'"".~"d'"'0~"~i'~'~. ,~) ......................................... Owner and/or representative of the O~mer or Owner~, and i~ duly authorized to perform or have performed the said work and to make and file this application; that all ~tatement~ contained in thi~ application are ~rue to the best of his l~owiedge a~d belief; and that the work will be performed in the mam~ter set forth in the application filed herewitl~ Sworn to before me fids; .' ~.~ 1.3 / ...................... ................... Notary. Public: .~:..c.. '... _. ~'~:~:.Z::.:.~. ............... '--...~...~..J.~. ~. ~~......: ............ NO. 01 RIG042467 / FORM - 06/'10 Q,!~li"!ed in Suffolk Ct; ;~;~',r~ion Expires May ~3 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). lfany question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 110 7 2 6 The Application has been submitted to (check appropriate response): Town Board ~ Planning Dept. [] Building Dept. [] Board of Trustees [] gBA 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: Construction of new additions to an existing single family residence. Locationofaction: 1435 West Rd, Cutchogue, NY 11935 $iteacreag¢;_ 36,321 S.F. or .8338 Acres Present land use: Single Family Residence Present zoning classification: R- 40 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Michael and Cookie Slade (b) Mailing address: 1435 West Rd., Cutchoque, NY 11935 (c) Telephone number: Area Code ( )_ 631-734-6405 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ~] No [] If yes, which state or federal agency?_ DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ~-~ Yes ~ No ~ Not Applicable Adding to an existing residence preserves open space around the existing residence and makes efficient use of the existing structure and property. Also the addition to the property is far less than the 20% lot coverage allowed by zoninq. 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 There are no historic or archeological structures on property. Aaach 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 The addition to the existing residence is in keeping in style and scale of neiqhborinq structures. 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~l~ No ~ Not Applicable All rainwater runoff is and will be retained on site with the use of underground drywells. 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 ~ Yes [] No [] Not Applicable Ail rainwater runoff is and will be re~ained wi~h the use of underground drywells. The sanitary system for the residence meets Suffolk County Dept. of Health Services standards for sanitary waste water. The property 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 Applicable No development will take place in the "protected" or "natural indiginous environment". Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~ Yes [] No[~ Not Applicable The development will not add pollutants into the air. All construction vehicles meet the Federal standards for air pollution discharge. The mechanical systems of the residence meet the federal standards for air pollution discharae. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [~ Yes [~ No [] Not Applicable The construction and use of the residence will make use of the town's disposal and recycling center. 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 No public land involved. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold*s water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section II1 - Policies; Pages 47 through 56 for evaluation criteria. [] Yes [] No [] Not Applicable The site has an existing marina with slis for 7-8 boats- This will remain and will not be effected by the proposed construction. Attach additional sheets if necessary Policy 11. Promote sustainable use of Hying 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 N Not Applicable This project wxI1 protect and preserve the living marine resources by maintaining all rainwater discharge and sanitary flow from the residence on site by the existing sanitary system and drywells for Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [] Yes [] No ~ Not Applicable There are no agricultural lands on site. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. [] Yes [] No ~-~ Not Applicable The construction will be using equipment approved by the Federal government for energy usage. The residence will meet Federal standards for conserving enerq¥ "enerqy Star Proqram" and will use "NY State Enerq¥ Conservation and Created on 5/25/05;1.'20 AM v ~ . DATE FLOOD ZONE FROM FIRM MAP NUMBER $$105C016JH SEPTEMBER 25, 2009 ELEVATIONS REFERENCED TO N.A. V.D. The Iocaflon of eeptic sj~stem shown hereon are from field obserwtion$ snd or from data obfcllned from others. AREA=56,521 SQ. FT. TO TIE LINE .=MONUMENT SURVEY OF PROPERTY AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000--110--07--26 SCAr. F: I"--30' APRIL 19, 2011 zo~[ x N,Y.S, LIC. NO. 49618 PECONIC SURVEYORS, P.C. (631) 765-5020 FAX (651) 765-1797 P.O. BOX 909 S?REET 12~o ~AVEL~ 11-130 SOUTHOLD, N.Y. 11971 \ \ EXISTIN SIT PLAN ~ 7' [] 20'--~; \ \ \ .jNE zONE X REPLACE WITH NEW WD DECKING & RAILING TO MEET CODE SITE DATA SCTM # t000-110-07-26 PROPERTY: ADDRESS OWNER: SITE: t435 West Road Cutchogue NY 11935 Michael & Corinne Slade 1435 West Road Cutchogue NY 36,321 SQ. FT. = 0.8338 ACRES ZONING: RESIDENTIAL 40 (R-40) SURVEYOR: PECONIC SURVEYORS, P.C. 1230 TRAVELER STREET SOUTHOLD, N.Y. 11971 LICENSE# 49618 DATED APRIL 19, 2011 LOCATION MAP FLEETS NECK AP P',PL--.~E D BY j BOARD 0,* ~i'~USTEES TOWN C7 COUTHOLD .... AU6 19 So~thhold Town BoardofTrustee~ ZBA TRUSTEES NOTICE OF DISAPROVAL DRAWN BY: NS CHECKED BY: DATE: AUGUST2, 2011 SCALE: 1" = 20'-0" SHEET TITLE: SITE PLAN SHEET NO,; SP N~ ~TAIR FIRST FLOOR PLAN SCALE: tl4" = 1' -0" ;=XI~9'. ENTI~"r' EXISTING BATH ,, LAUNDRY EXI.GTING KITC, HEN i1 NtEIN I~IN, ING ~00~ EX IDTING LIVING ~00~ t~XI~T. mINE OF EXIST. NEIN LIVING ROOH ADDITION EXI~TIN~ DECK-.. REI~OVE EXIST. t:~GKJN~ e IN.5'I'AI I ~ ~ t~EC, KIN~ 21 REHOVE EXI.ST.- R~ILII'~ ,$ IhL~TAJ.J.. ~ Y~ RAILINE~ TO 'ltl:d= m' GO~E EXI.~T. POOL ZBA TRUSTEES NOTICE OF DISAPPROVAL --m mmm, = ' NS DATE: AUGUST 2, 2011 SCALE: 1/4" = 1' - 0" SHEET TITLE: FIRST FLOOR PLAN SHEET NO: 1 NDYl A]DOlTION NORTH ELEVATION SCALE: I/4" = 1'-0" SOUTH ELEVATION SCALE: 1/4" = 1'-0" NE~t AOiDITION ZBA TRUSTEES NOTICE OF DISAPPROVAL ])ATE: AUGUST 2, 2011 SCALE: 114" = 1' - 0" SHEET TITLE: ELEVATION~ SHEET NO: NE~ A~]DITION EAST ELEVATION SCALE: 1/4" = t'-0" NIXIe. AZDOlTION WEST ELEVATION SCALE: 114" = J'-0" ZBA TRUSTEES NOTICE OF DISAPPROVAL BY: NS DATE: AUGUST 2, 2011 SCALE: 1/4" = 1' - 0" SHEET TITLE: ELEVATIONS SHEET NO: 3