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HomeMy WebLinkAboutTR-7601 John M. Bredemeyer III, President o~OOffal/( CG Town Hall Annex Michael J. Domino, Vice-President 2*1' 54375 Route 25 James F. King = P.O. Box 1179 Charles J. Sanders yr Southold, NY 11971 Dave Bergen Telephone (631) 765-1892 1 All Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0957C Date: March 7, 2014 THIS CERTIFIES that the demolition of the existing roof addition 5'-6" wide on the south side of the existing dwelling over the first and second-floors, new porch on south side of dwelling; installation of drywells, non-turf buffer beginning parallel along existing gravel walkway seaward At 950 Oak Street, Cutchogue, New York Suffolk County Tax Map # 136-1-37 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 3, 2011 pursuant to which Trustees Wetland Permit #7601 Dated July 20, 2011, 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 demolition of the existing roof addition 5'-6" wide on the south side of the existing dwelling over the first and second-floors, new porch on south side of dwelling-, installation of drywells; non-turf buffer beginning parallel along existing gravel walkway seaward. The certificate is issued to MICHAEL MACCO owner of the aforesaid property. Authorized Signature 0 0 James F. King, President QFF Town Hall, 53095 Main Rd. O\pS ~~Q Bob Ghosio, Jr., Vice-President Gy P.O. Box 1179 Dave Bergen 119 { Southold, NY 11971 John Bredemeyer Telephone(631)765-1892 Michael J. Domino Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /7 /~l _ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction %a constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS. NO D~irnFNsiu~~ d~ Ali N r ,//r f d f pz • 1c 40/Ct Z/A'KD y Y /O G r~ ~l~ W, leo CERTIFICATE OF COMPLIANCE: / CC 0: C144MM COUNTY CLERK'S OFFICE STATE OF NEW YORK COMM OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 0310VA14 under Libor DOW12765 and Page 724 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and aMxed the seal of said County and Court this 03/06/2014 sarTorx COUNTY CXZM Ju DrtH a,,.~r.E EAR 7 2014 SEAL l 111111 IIII IIII ill Iilil IINI VIII iilll 111111111 IIII 111111(IIII (IIII IIII INI SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 03/05/2014 Number of Pages: 6 At: 09:29:50 AN Reo"Pt Number : 14-0026523 LIBER: D00012765 PAGE: 724 District: Section: Block: Lot: 1000 136.00 01.00 037.000 ESAlMM AND CHARGED AS FoLLONS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $30.00 NO Handling $20.00 NO COE $5.00 NO NYS SRCHG $15.00 NO TP-584 $0.00 NO Notation $0.00 NO Cert.Copies $7.50 NO RPT $60.00 NO Fees Paid $137.50 THIS PAGE IS A PART OF THE INSTRUNENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County DO Number of page. This document will be public record. Please remove all Social Security Numbers prior to recording. Deed / Mortgage Instrument Deed ! Mortgage Tax Stamp Recording / Filing Stamps 3 FEES Page / Filing Fee ~u _ Mortgage Amt. _ Handling 20. 00 1. Basic Tax - TP-584 2. Additional Tax _ Sub Total _ Notation Spec./Assit. or EA-52 17 (County) _ Sub Total 5 0 U Spec. /Add. EA-5217 (State) TOT. MTG. TAX _ RP.T.S A. G 0 Dual Town _ Dual County_ 0 Held for Appointment Comm. Of Ed. 5. 00 Transfer Tax _ Affidavit Mansion Tax _ Certified Copy -7 5 C> _ The property covered by this mortgage is or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total k-1 J O Other YES or NO Grand Total 1 D If NO, we appropriate tax clause on page # of this instrument. 4 Dist. 2686931 1000 13600 0100 037000 5 Community Preservation Fund -1 ~pgg~ryy~I~pII~~~ ~p _ Rear Property / P TLWI Tax Service I R S II~~Ig111~1~p~~8ry Consideration Amount $ Al 11~~~1 MddIgYIARRW IIN Agency 05-MAR-1 Verification CPF Tax Due $ 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address Improved RECORD & RETURN TO: Vacant Land ry" C)r Azu T `My?CCc~ TD \3S ~IUe Lgwu ~c,. S., \zLi TD S TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Com an Information 310 Center Drive, Riverhead, NY 11901 www.suff0lkcountyny.g0v1clerk N Title # 8 Suffolk Count Recording & Endorsement Page L1 : This page forms part of the attached CoJCVY1v~~ .E ~,u S hycAy% made by: (SPECIFY TYPE OF INSTRUMENT) m tC\^4~L J YV~ y~-~~.C~ The premises herein is situated in SUFFOLK COUNTY, NEW YORK. TO In the TOWN of S0v '~'Hp 1..Q In the VQ,LAGE or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTM IN BLACK INK ONLY PRIOR TO RECORDING OR MJNG. nowuamu (over) IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, 'You will now need to contact Your local Town Tax Receiver _ that you may be billed directly statculs=' foall future ..r•,periv tax Local Property taxes are payable twice a year: on or before January 10th and on or before May 318t. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Taz Receiver with any questions regarding property taz Payment. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst, N.Y. 11757 Riverhead, N.Y. 11901 (631) 957-3004 (631) 727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes One Independence Hill Shelter Island Town Hall Farmingville, N.Y. 11738 Shelter Island, N.Y. 11964 (631) 451-9009 (631) 749-3338 East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street East Hampton, N.Y. 11937 Smithtown, N.Y. 11787 (631) 324-2770 (631) 360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington, N.Y. 11743 Southampton, N.Y. 11968 (631) 351-3217 (631) 283-6514 Islip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Street Islip, N.Y. 11751 Southold, N.Y. 11971 (631) 224-5580 (631) 765-1803 Sincerely, a. Judith A. Pascale Suffolk County Clerk »-o,w.. ae/omm DECLARATION OF COVENANTS AND RESTRICTIONS DECLARATION made this 6'^ day of February, 2014 by MICHAEL J. MACCO, now residing at 950 Oak Street, Cutchogue, New York 11935, as owner, herein after referred to as the "Declarant". WITNESSETH: WHEREAS, the Declarant has title to certain land situate, lying and being at 950 Oak Street, Cutchogue, Town of Southold, Suffolk County, New York 11935, SCTM # 126-1-37, said land being more particularly described in Schedule A which is attached hereto; and WHEREAS, the Property is situated in or adjacent to lands activities upon which are regulated by the Town of Southold Board of Trustees pursuant to Chapter 275 of the Town Code of the Town of Southold, as may be amended, and various activities conducted upon the property are subject to the jurisdiction, regulation and approval or disapproval of the Trustees prior to being conducted; WHEREAS, the Declarant has applied to the Town of Southold Board of Trustees for a Wetland Permit for approval to undertake such regulated activities on the property described in Schedule A and known as SCTM # 136-1-37 and as depicted on the survey prepared by Peconic Survey, dated May 2, 2011 and stamped approved on July 20, 2011; WHEREAS, the Town of Southold Board of Trustees, as conditions for the issuance of such Wetland Permit, required certain covenants and restrictions be placed on the property as shown on the aforesaid plans. NOW, THEREFORE, this Declaration witnesseth: 'that Declarant, for the purpose of carrying out the intentions expressed above does hereby make known, admit, publish, covenant and agree that the said property herein described shall hereafter be subject to the following covenants which shall run with the land and shall be binding on all purchasers and holders of said premises, their heirs, successors, and assigns, to wit: 1. The grant of a Wetland Permit to demolish the existing roof addition construct a new porch on the south side of the existing dwelling, shall be conditioned upon the installation of drywells to contain roof run-off on the property as shown on the above-referenced plan and identified as SCTM 136-1-37, within perpetuity. 2. The grant of a Wetland Permit for the demolition of the existing roof addition and construction of a new porch shall be conditioned upon establishing and maintaining thereafter a non-turf buffer area parallel to and seaward of the existing gravel walkway, as shown on the above referenced plan and identified as SCTM No. 136-1-37. 3. These covenants and restrictions can be modified only at the request of the then owner of the premises with the approval of the Town of Southold Board of Trustees after a duly noticed public meeting. Adjoining property owners shall be entitled to notice of such public meeting by publication or as otherwise deemed sufficient by the Board of Trustees but their consent to such modification shall not be required. 4. It is the responsibility of any party having any right, title or interest in the Property to consult Chapter 275 of the Town Code of the Town of Southold, as may be amended, and to obtain from the Town of Southold Board of Trustees review and such approvals as may be required by Chapter 275 for activities regulated therein on the Property. 5. Declarant grants the continuing right in perpetuity to the Town of Southold or any of its designated representatives to enforce the conditions and restrictions of the covenants. THE FOREGOING covenants and restrictions shall bind the Declarant, its heirs, successors and assigns, and any and all person or persons who shall succeed to the ownership of said premises of any pact thereof bINK LF3. erwise. IN WITNESS WHEREOF, the Declaracuted this Declaration the day and year first written above. BY: ACCO STATE OF NE W YORK) COUNTY OF SUFFOLK) ss: .~V! dnW1,A On the? day offebratQy, 2014, before me, personally appeared Michael J. Macco, known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. Siwm to before me this 3 day of , 2014. lotary Iblu SANIWAN S. GREENE Notary Public, State of New Yolk NO. 01GRO172195 Qualified In Suffolk Count~y Commission Expires Auguaie. UkS WESTCOR Rca -.~C1 -LE;1\"1RANCE COMPANY TITLE CERTIFICATION Title No.: SS#213 WESTCOR LAND TITLE INSURANCE COMPANY, hereby certifies to THE COUNTY OF SUFFOLK that it has searched the records in the Suffolk County Clerk's Office for a period of 20 years last past for the purposes of determining patties who must consent to the filing of Covenants and Restrictions affecting the premises described in Schedule A amexed hereto. Based on said records, the Company has determined that the only parties who must consent to said filing would be as follows: 1. Michael J. Macco Fee Owner By deed in Liber 12383 page 299 2. Mortgages, Judgments and Liens None District: 1000 Section: 136.00 Block: 01.00 Lot: 037.000 The liability of the Company under this search is limited to Five Thousand Dollars ($5,000.00). Schedule "A" attached herewith Dated: Febtcar; . 201n WESTCOR LAND TITLE INSURANCE COMPANY Rtc reziusi-Unde criting(Ansel 777 Westchester Avenue - Suite 100 • White Plains, NY 10604 • Phone: 914 • Fax. 914 WESTCOR T17] SCHEDULE "A" Title No.: SS4213 ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Village of Cutchogue, Town of Southold, County of Suffolk and State of New York, which on a certain map entitled, "Map of Eugene Heights owned by Jacob F. Bowers situate at Cutchogue, New York" filed in the Office of the Clerk of Suffolk County as Map No. 856 on October 29, 1928, are known and designated as and by the Lots 38, 39 and 40 and which are more particularly described as follows: BEGINNING at a point on the Easterly side of Oak Street where the same is intersected by the division line between Lots 40 and 41 on said map, said point being distant 55.72 feet Southerly as measured along the Easterly side of Oak Street from the comer formed by its inters:ction with the Southerly side of Pierce Drive; RUNNING THENCE along said division line North 82 degrees 01 minutes 10 seconds East 262.31 feet to the mean high water line of East Creek (Eugene's Creek); THENCE Southerly along said mean high water line on a tie line of South 12 degrees 35 minutes 14 seconds East, 75.24 feet to the division line between Lots 37 and 38 on said map; THENCE along the division line between Lots 37 and 38, South 82 degrees 01 minutes 10 seconds West 268.35 feet to the Easterly side of Oak Street; THENCE along the Easterly side of Oak Street North 7 degrees 58 minutes 50 seconds West 75.00 feet to the point or place of BEGINNING. WESTCOR LAND TITLE INSURANCE COMPANY 12u4rPr&25ost - Undem ting Co sel 777 Westchester,Svenue • Suite 100 • White Pla'ms. NY 10604 • Phone, 914 • Fax: 914-428.1110 0 ITECNOLOGIES ARCHITECTURE PLANNING CONSTRUCTION SERVICES 13405 Main Road, MatLauck, New York 11952 631.298.1129 fax: 631.298.1128 P.O.Uox 93 February 14, 2012 Board of Trustees Town of Southold 53095 Main Road P.O. Box 1179 Southold, N.Y. 11971 Re: Mr. Michael Macco 950 Oak Street Cutchogue, N.Y 11952 S.C.T.M # 1000-136-01-37 To Whom It May Concern: Attached please find a copy of the revised survey from Peconic Surveyors. It indicate that the entire septic system is beyond the 100' setback from the wetlands line. When the original survey was submitted to Trustees, the entire septic was designed outside the 100' setback. The Health Department subsequently requested that the septic tank be changed from 1,000 gallon to 1.500 gallon. When the Surveyor made that change, they inadvertently put one of the leaching pool into the wetlands jurisdictional setback. This has been corrected on the revised survey. If you have any additional questions regarding this request please give us a call at (631) 298-1129. Please send all correspondences to: Frank Notaro P.O. Box 93 Mattituck, N.Y. 11952 Thank you, Frank Notaro R.A. 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 February17,2012 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Frank Notaro, R.A. Architecnologies 13405 Main Rd. Mattituck, NY 11952 RE: MICHAEL MACCO 950 OAK ST., CUTCHOGUE SCTM#136-1-37 Dear Mr. Notaro: The Board of Trustees reviewed the survey prepared by John T. Metzger last revised February 3, 2012 and determined the proposed sanitary system to be out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff and/or wetlands jurisdictional boundary, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary best management practices are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, ames~lng, Presiden~ JBoard ~f Trustees~' ,?' JFK:lms N dm~ I~ereo~ ere ko~ 8eld o~se'vdions end or [rom dele ob/e/bed from o/hers. Therefore Iheir Iocali~ns end or ex[slence is n~l 9~wenteed. LOT NUMBERS REFER TO "MAP OF EUGENE HEIGHTS" FILED IN THE SUFFOLK COUNTY CLERK'S OFF/CE ON OCTOBER 29, 1928 AS FILE NO. 856. ELEVATIONS ARE REFERENCED TO N.A.V.D. '88 FLOOD ZONE FROM FIRM MAP NUMBER 36103~0163H SEPTEMBER 25, 2009 LOT 40 ~.o 3o.o' SCDHS Ret. # RIO 11-00,~7 RAIN RUNOFF CALCULATIONS HOUSE, PORCH & PATIO - 1757 $~/.fi. I757 x I · 0.17, E99 cu.R. 299/4E.£ = 7VF PROVI~ J DW 8'~ ~ 4' I om fomilior with the STANDARDS FOR APPROVAL AND CONSTRUC770N OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ond' iWJ/l"bbide by the conditions sef forth therein ond on the permit ' fo construct. LOT~ D WrZLLING ) sEPTiC ~ocA T~ON uNKNOWN LoT 39 S82'01'10"W LoT 37 ~p'nC LOC~O~ u~KNOWN AREA=19,900 SQ. FT. TO TIE LINE SURVEY OF PROPERTY A T CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-136-01-37' SCALE: 1'--30' NOVEMBER 3, 2010 dUIV~ I0, 2011 ~rev~om ~ Y Z5~ ZO{I (revisions) OCT. 5, 2011 268..35' LINE PROPOSED NEW SEPTIC SYSTEM ( 6 l~F_O~OOId~ MAX.) I- PRECAST 1500 GAL. SEPTIC TANK ~- 8'~ * ~-' DEEP LEACHING POOL S WITH $' SAND COLLAR ( SW ) 3' ABOVE GROUND WA TER, REMOVE OR FILL IN EXISTING CESSPOOL. TO SCDHS SPECS. ANY ALTERA~7ON OR ADDITiON TO THIS SURVEY IS A VIOLA770N OF SECTiON 7209OF 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 SURVEYOR WHOSE SIGNATURE APPEARS HEREON. TEST HOLE DA TA McDONALD GEOSGIENCE ~o/m/~o PECONIC (630 765- P.O. BOX · =MONUMENT 1230 TRAVELER STREET ~ =~ETLAND FLAG SOUTHOLD, N.Y. 11971 49618 765-1797 RE**~,,,~ ,A~ NOT s~O,N ~o. 10 226 TO BE REMOVED Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemcyer Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: MICHAEL MACCO Please be advised that your application dated June 3, 2011 has been reviewed by this Board at the regular meeting of July 20, 2011 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) XX Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) XX The Permittee is required to previde evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be previded within ninety (90) calendar days of issuance of this permit. 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: FinallnspectionFee-$50.O0 ,~ iOl~ll( TOTAL FEES DUE: $.50.00 [3 C.~k q~r~ BY: Jill M. Doherty, President Board of Trustees Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O, Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 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. 7601 DATE: JULY 20~ 2011 ISSUED TO: MICHAEL MACCO PROPERTY ADDRESS: 950 OAK STREET~ CUTCHOGUE SCTM# .136-1-37 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 July 20, 2011, and in consideration of application fee in the sum of $250.00 paid by Michael Macco 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 demolish the existing roof addition 5'-6" wide on south side of existing dwelling over first and second-floors, new porch on south side of existing dwelling, and install drywells to contain storm water run-off; with the condition that a non-turf buffer is installed beginning parallel along the existing gravel walkway seaward and to be maintained; and as depicted on the survey prepared by Peconic Surveyor, P.C., last dated May 2, 2011, and stamped approved on July 20, 2011. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affuxed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittec Michael Macco, residing at 950 Oak Street, Cutchogue, 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 Tmstecs 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 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 oftbe 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 Pennittee 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 came unreasonable obstmction to free navigation, the said Permittea will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said 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 Hall Annex 54375MainRoad P.O. Box 1179 Southold, New York 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 July 20, 2011 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Frank Notaro P.O. Box 93 Mattituck, NY 11952 RE: MICHAEL MACCO 950 OAK STREET, CUTCHOGUE SCTM# 136-1-37 Dear Mr. Notaro: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, July 20, 2011 regarding the above matter: WHEREAS, Frank Notaro on behalf of MICHAEL MACCO 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 3, 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 July 20, 2011, at which time ail 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 MACCO to demolish the existing roof addition 5'-6" wide on south side of existing dwelling over first and second-floors, new porch on south side of existing dwelling, and install drywells to contain storm water run-off; with the condition that a non-turf buffer is installed beginning parallel along the existing gravel walkway seaward and to be maintained; and as depicted on the survey prepared by Peconic Surveyor, P.C., last dated May 2, 2011, and stamped approved on July 20, 2011. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Jill ~11. Doherty ~/ Presid" ' ne t, Board of Trustees JMD/eac Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O~ Box I 179 Southold, NY 11971 Telephone (631 ) 765 - 1892 Fax (63 I) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., July 13, 2011, the following recommendation was made: Moved by Meaghan Burke, seconded by Derek Bossen, it was RESOLVED to SUPPORT the Wetland Permit application if MICHAEL MACCO to demolish the existing roof addition 5'-6" wide on south side of existing dwelling over first and second-floors, new porch on south side of existing dwelling, and install drywells to contain stormwater run-off. Located: 950 Oak St., Cutchogue. SCTM#136-1-37 Inspected by: Meaghan Burke, Peter Young The CAC Supports the application with the Condition of a non-turf buffer seaward of the gravel walkway and the installation of gutters, leaders and drywells to contain the roof run- off. Vote of Council: Ayes: All Motion Carried Jill M Doherly, P~esident Bob Ghosio. Jr, Vice-President James F Krug John Bredcmcyer PO. Boxl179 Southold, NY 11971 Telephone (631 765 1892 Fax {631 ) 765 6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: MICHAEL MACCO requests a Wetland Permit to demolish the existing roof addition 5'-6" wide on south side of existing dwelling over first and second-floors, new porch on south side of existing dwelling, and install drywells to contain stormwater run-off. Located: 950 Oak St., Cutchogue. SCTM#136-1-37 T~e 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 __Administrative__Emergency Pre-Submission __ __Amendment Violation Info needed: f',o'~ Modifications: Conditions: Present Were: ~ Doherty //B. Ghosio ~King __/D. Bergen, /--J-. Bredemeyer D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: Board of Trustees 44 July 20, 2011 seaward, there is a gravel walkway that now goes along the base of the patio, that is about a two-and-a-half to three-foot wide gravel walkway. It was our intention to request the entire area, a line would go parallel to that walkway to the edge of the property. That area seaward. It was not a very large amount of grass there. It was just a small amount on either side of the walk. MR. NOTARO: My client is actually here, Michael Macco, and we can address that. I mean, anything that would help the environment. TRUSTEE BREDEMEYER: We thought it was a good -- TRUSTEE KING: There is so much fertilizer it killed the grass. MR. NOTARO: I just thought it was the trees, honestly. MR. MACCO: Michael Macco. It's not the fertilizer. I don't know what killed the grass. The grass is not dead now. TRUSTEE BREDEMEYER: Someone was nice and fertilized it for you. The granules were there. TRUSTEE GHOSIO: And it's such a high concentration. MR. MACCO: I don't have of a landscaper. TRUSTEE DOHERTY: In any case we are requesting this become a non-turf area. MR. MACCO: I don't know what that means. TRUSTEE DOHERTY: It means no grass. Plant it up like the rest of the property. MR. NOTARO: Michael nodded affirmative on that. I would still like to know who put down the fertilizer. TRUSTEE GHOSIO: There was a lot of it, too. MR. MACCO: I don't think it's fertilizer. I think it's salt. TRUSTEE GHOSIO: It's purple and yellow. MR. MACCO: I have no problem. TRUSTEE BREDEMEYER: If you are in agreement, that's fine. Any additional comments on this? Members of the Board? (No response). I'll make a motion to close the hearing in this matter. TRUSTEE KING: Second. TRUSTEE DOHERTY: All in favor? (ALL AYES). TRUSTEE BREDEMEYER: I would make a motion to approve this application, subject to a non-turf buffer to be installed seaward of the existing gravel walk. So moved. TRUSTEE BERGEN: Second. TRUSTEE DOHERTY: All in favor? (ALL AYES). TRUSTEE GHOSIO: Number seven, Costello Marine Contracting Corp. on behalf of PETER & JOAN FRITZ requests a Wetland Permit to construct 111' of new bulkhead; construct 4' wide access stairway to beach; fill void areas landward of new bulkhead with clean trucked-in sand, approx. 60 cy.; and re-vegetate areas with Cape American beach grass. Located: 755 North Parish Dr., Southold. The Board was out there on pre-inspection as well as formal inspection. So we have all seen it. The Conservation Advisory OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, IffY 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: Mark Terry, Date: Re: Jill Doherty, President Town of Southold Board of Trustees Principal Planner LWRP Coordinator July 15, 2011 Proposed Wetland Permit for MICHAEL MACCO SCTM#1000-136-1-37 Frank Notaro on behalf of MICHAEL MACCO requests a Wetland Permit to demolish the existing roof addition 5'-6" wide on south side of existing dwelling over first and second-floors, new porch on south side of existing dwelling, and install dp/wells to contain stormwater run-off. Located: 950 Oak St., Cutchogue. SCTM#136-1-37 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-Pres/dent 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 ~x_Wetland Permit Application Administrative Permit Amendmen'dTransfer/Extcnsion Rece~vved Applieation:~/ d~_Rec¢ived ree:$ ~'~ompleted Application Incomplete ~SEQ~ Classification: T~e I T~c Il Unlisted  Coordination:(date sent) , W~ Consistency Assessment Fo~ CAC Refemal Sent: q]l / ~atc of Inspection: Q '~'l ~ I Receipt ofCAC Rcpoh: ~ad Agency Dctc~ination: Tcc~ical Review: ~ublic Hear~g Held~ ~ ~Resolution: ' ~ ' Name ofApplicant "~. Phone Number:( Suffolk Cowry Tax Map Numbs: 1000 - Property Location: ~I.~t~ ~5~..~ ,~~/~fl~:~,~. (provide LILCO Pole #, distance to crt~ss streets, and location) "~ AGENT: (If applicable) Address: of Trustees Applicati, GENERAL DATA Previous use of property: Intended use of property: Covenants and Restrictions: Area Zoning:. ~ Yes / No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals If ....... Yes , please prowde copy of dec, stun. Yes No Prior permits/approvals for site improvements: Agency Date J No prior permits/approvals for site improvements. any permit/approval ever been revoked or suspend~y a governmental agency? Has V/ No Yes If yes, provide explanation: Project Description (use attachments if necessary):. of Trustees Applicati, WETLAND]TRUSTEE LANDS APPLICATION DATA Area of wetlands on lot: ~square feet Percent coverage of lot: Closest distance between nearest existing ~xucture and upland edge of wetlands: '~ [' feet ~-- -- Closest al,stance between nearest proposed edge of wetlands: '~ [' feet ~.,~.~{.~.s~ Does the project ,nvolve excavation or fi No / Yes If yes, how much material will be excavated? l ~ cubic yards How much material will be filled? 1~ cubic yards Depth of which material will be. removed or deposited: Proposed slope throughout the area of operations: ~l*...' feet 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 appropri.ate): ~rd of Trustees Ap~}licati~ COASTAL EROSION APPLICATION DATA Purposes of proposed activity: ~,~'~ ~ I~'~ .~ ~ -~--'1~.~. "~~s~ Ar~ithin 1 O0 f-~t of the proloosed activity? [~ ~ - ~ No &// Yes Does the project involve excavation or filling? No / Yes If Yes, how much material will be excavated? I ~ (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: 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) 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 Sout~hold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 30-YEAR MAINTENANCE AGREEMENT EROSION PROTECTION STRUCTURES CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE I(We) I~11~[..-' The owners of record of property at: 1'~¢~ SCTM# O00- ' in applying for a ~astal Erosion Permit for an erosion protection structure do hereby agree to a 30-Year Maintenance program for a structure as described: °n the a"ached licensed sure) and/or ~t~l~ for t~e approved struc~' ' ~ -- ' It is my/our understanding that we are to maintai~'~s ~tructu~ ~ with materials designed to endure 30 years and/or equivalent to the origi~al~p~roved ;tructure Any maintenance which involves more than 50% of ~e ~e~,~ ~, - ~* .... ~[ ..... approval of the Board of Trustees. We fu,her u~e~ta'" ~ structure could result in a requirement to post a~o~d a~j~l ive the repaim ordered as A lien against the properly upon a f nding by the[Board ~ ~ ~es that sa d ack of maintenance would risk life, properly or impoda~t n~tur~ ~ rca features. ,, ~ ~ · Notar~e~ s~a~ of owner of record LYNN ?,~ b~,R OvVSKI Notary Public, State of New York No. 46555~2 C Qualified in Suffolk County on~m,-sfon Expii'e~ Februa~'t 29, ~l/J~ This maintenance agreement shall only be valid upon the attachment of a licensed land survey/and or site plan made within one year of the original construction and validated to show the final approval of the administrator. PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by A 31icant or Project Sponsor) SEQR 1. APPLfCANT / SPONSOR PRECISE LOCATION: S~reet Addess and Road Intersection 2. PROJECT NAME Prominen[ landmark~ e~c -or ~)rovide map New J'~ Expansion ' ~ModtiicaUo n / 'era ,ion 7, AMOUNT OF LAND AFFECTED: Initially ~,, ~1 acres Ultimately · ~[ acres 8. VV~LL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR OTHER RESTRICTIONS? ~Yes ~'~ No if no. describe briefly: ReAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as rnany as apply.) $idential [--]Industrial [~Commercia] [~]Agriculture ~'-~Park/Forest/OpenSpace ~-~Other (descdbe) ) S ACTION INVOLVE A PERMIT APPROVAL. OR ~ (Federal State or Local) FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL es ~"-~No tf yes. list agency name and permit / approval: 11.DOES ANY~PECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? J~]Yes [ v~No If yes, list agency name and permit/ approval; 12. AS A REr.~LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~]Yes ~ No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Appticant / Sponsor Name ~_~ ~.~%,~_.~;~ Date: ~.,.,, Signature ~ -- ~- If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART Ii - IMPACT ASSESSMENT (To be completed by Lead Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAF. E]Yes ['~No B. WILL ACTION RECEIVE COORDINATED REVlEWAS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative dectaretirm may be superseded by another invelved agency. r-'] Yes r~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quan~y, noise levels, existing traffic pettem, solid waste production or disposal, potential for erosion, drainage or floodieg problems? Explain briefly: I C2. Aesthetic, agricultural, archaeological, historic, or other natural or cottural resources; or community or ne~hborhond chamctar? Explain briefiy: I C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: I C4. A community's existing plans or goals as officially adopted, or a change in use or Intensib/of use of land or other natural resources? Explain bfielly: I ,I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain bfiefiy: ........ C6. Long term, short term, cumulative, or other effects not identified in C1~;57 Explain briefly: I ! C7. Other impacts (includin~l changes in Use of either cluantil~ or ~pe of ecerl[I)'? Ex~lain briefl}/; D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRON MENTAL AREA (CEA)? (If yes, explain brier;/: E. IS THERE, OR IS THERE LIKELY TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If ~/es explain: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, ledge, important or otherwise significant. Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f} magnitude. If necessary, add attachments or reference supportiog 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 envirenmental characteristics of the CEA. Check this box if you have identified one or more potentially large or stgni6cant adversa Impects which MAY oncur, 'l~en proceed direcfly te Ihe FULl FAF and/or prepare a positive declaraflon. Check this box if you have determined, based on the information and analysis above and any supporting dsotJmentsflon, that the proposed acflor WILL NOT result in any significant edveme environmental impacts AND provide, on attachments as necssse~y, the masons suppor~ieg thi= deten'ninafion. Board of Trustees Name of Lead Agency Jill M. Dohert¥ Pfi]~ Nam~in Lead Agency /~Signature of REsponsible ~er in Lead Agency President Title of Responsible Officer Signature of Preparer (If different fi.om responsible officer) Jiq M Dohert? Pre~i&nt [to~ Gl ,~sio, Jr.. Viccdh-esidem James F King Town Hall. 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631} 765-0641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of MICHAEL MACCO COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING being duly sworn, depose and say: That on the,~ day of ~Ot.,t-f ,201~ I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that 1 have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wed~ July 20~ 2011 on or about 6:00 PM. Dated: ~'. ~'o I1 Sworn to before me this q day of0/~/20// Notary Public PATRICIA RICHERT Notary Public, State of New York No. 30~474H54 Qualified in Nassau / Suffol~ Counties Corn mission Expi res ~t,'/~ff~ PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS NaiTle'. Address: STATE OF NEW YORK COUNTY OF SUFFOLK , residing at~.~. '~5'~1~ '~'. IM,~I"~.~ ~', being duly sworn, deposes and s/ays that oi~ t~e [ / ~ day of'~o ~-"f ,20 ! t , deponent mailed a true copy of the Notice set t'6rth 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(reg~s~et~ext)~ L/~r~;i~'~'~" , that said Notices were mailed to each ofsaidpersonsby (certified) Sworn to before me this Day of ;~)F~c~t~~ , 20 Notary Public PATRICIA RICHERT Notar7 Public. State of New York No. 30-4;'41154 Oualifled in Nassau / SuffoA Cou, ntj,~ Commission Expires ard of Trustees Applicatil AUTHORIZATION (where the applicant is not the owner) I, b4~L~, f~A~-~ residing at '~I'~ ~,~..~. (print owner of property) (mailing address) [ ~ ~roan~./~ ~:::~, t'~ do hereby authorize ~ ~1~~-~/ ~.,.~'. WTt{7 (Agent) South n Trustees on (own X\ to apply for permit(s) from the my behalf. ~d of Trustees ApplicatioO County of Suffolk State of New York ~ ~e'T~ BEING DULY SWORN DEPDSES AND AFFIRMS THAT ~IE/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. SWORN TO BEFORE ME THIS Signature DAY OF ¢..~"~ ,20 [[ BARBARA H. TANDY Notary Public, State Of New York No. 01TA6086001 Qualified In Suffolk County ~ ~., Commission Expires 01/13/20 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of £thics orohibits conflicts of interest on tho oart of tOWn 6fficars and emolovees. ~e ouroose of this form is to ~mvide information which can alert the town of ~ossible conflicts of fotemat and allow it to te~a whatever action is someone cls~ or bthcr entity, such aa a aompany. If so, indicate, the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) .: i:i Tax grievance Building , , ./ Vasianc¢ Trustee ~,,/' Change of Zone Coastal Erosion Approval of peat 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 0f Southpld? "Relationship" includes by blood, marriage, or budinass interest. "Business interest'~ m~ans a business, including a partnership, in which the town officer or employee has even a partial own¢~hlp of(or amploymcnt by) a corporation in which thc town officer or employee owns mom than 5% of the shares. YES NO lfyou answered "YES", complet~ the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title br position of that person Describe thc r~lationship hetwcen yourself (the applicant/ag{:nt/repms~ntat iva) and thc town officer or employee. Eithar chock thc appropriate line A) through D) and/or descdbc M the apace prm/id~d. The town officer or employee or his or her spouse, sibling, parent, o~ ~hild is (chcck all that apply): __.A) th~ owner of greater than 5% of the shams of thc corporate stock of tho applic~n~ (whah tho applicant is a coq~oratiou); , B) g~ legal or beneficial own~ of any interest in a non-corpoeat~ entity (when the applicant is not a not. ration); __~) an officer, director, partner, or amployee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submi'tted this Signature Print Name day of ~ ~ 200 l_~t Town Of Southold _Erosion, Sedimentation & Storm-Water Run-off a-~SESSMENT FOR! b. What is the Total Area of Land Cioadng and/or Ground Disto;bonce for tbe pmpaSed construction actMty? __ PROVIDE BRIEF PROJECT DF-3CRIPTION ~ # / WORK A~$ESS~ENT Will this Project Retain Att Storm. Water Run-Off Ganerated by a Two (2") Inch Rainfall on Site? (This item will Include all ran-off created by site 4 5 6 2 3 clearing and/or cor,.strec~on activities as well aa all Site Improvements and the permanent creation of impervious surfaces.) Does the ~ite Plan and/or Survey Show.NI Proposed Drainage Structures Indicating Size & Location? This Item shall Include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. Does the Site Plan and/or Survey describe the erosion and sediment co~rol practices that will be used to control site erosion and storm water discberges. This item must be maintained throughout the E~ire Construction Period. Will this Project Require any Lar~ Filling, Grading or ExcavaUon where there is a change to the Natural Existing Grade Involving more Ihan 200 Cubic Yards of Material within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S,F.) Square Feet of Ground Sudace? Is there a Natural Water Course Running through the Site? Is this Pre~ect within Ihs Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? 7 8 Will Ddvoways, Perking Areas orother Impervious Surfaces be Sloped to Direct Storm-Wa~r Run-Off loto andlor In the direction of a Town Hght.of-w~y_ ? 9 Will this Projact Reqolre the Plaoemont of Matorial, Removal ol' Vege~tion and/or the CoestructJon of any Item Within the Town Right-of-Way or Road Shoulder Will there be Site preparallon on Existing Grade Slopes which Exceed FItteon (15) feet of Verlical Rise to One Hundred (100') of Hodzontal D/stance? El'ATE OF NEW YORK, COUNTY OF ........................................... SS That I, ...~~,~G~..~....~. ~ being duly swbrn de- ses and .... . . ~"~J-~6 .................... / , l-,,, says mat he/she is me applicant for Permit, ...................... .H.. . make and file this application; that all statements contained ii) this application are true to die best of his knowledge and belief; and that the work will be performed in the manner ~t fo~h in thc application filed herewith. Sworn to before me this; ~-' ' da of f'~/"),k ~ ,I ................................ //C.' aaYl°' ....... !..:..~f~.. _~ ............ ~).1.1 Qualified In Suffolk County Commission Expires 01/13/20 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 Waterfiont Revitalization Program. A proposed action will be evaluated as to its si~ifieant 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, listin~ both supporting and non- ~. 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 The Application has been submitted to (check appmprlate response): Town Board [-~ Planning Board [] Building Dept. ~ Board of Trustees 1. 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, certficafion: [~ Nature and extent of action: Location of action: Site acreage:. Present land use:. Present ~g cl~sifi~fion: 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: (c) Telephone number: Area Code ( ) (d) Application number, if any: Will the actio~/4irectly undertaken, require funding, or approval by a state or federal agency? Yes [] No I~ 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 Southoid. See LWRP Section III -~s Pages 3 through 6 for evaluation criteria ~] Yes ~-~ No I sq Not Applicable . Attach additional sheets if necessary Policy 3.. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L~p Section III - Policies Pages 6 through 7 for evaluation criteria ~ Yes [] No ['-] Not Apphcable Attach additional sheets if necessary ~ NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Se[~III - Policies Pages 8 through 16 for evaluation criteria t~a Yes [] No ~'~ Not Applicable Attach additional sheets if necessary Policy $. 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 Southoid 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 Ap~b~le Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section HI - Policies Pages 32 through 3~valuation criteria. ~-] Yes ~-~ No I ~'~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and w~See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [-~ Yes [-~ No t v I Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southoid. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ~Not [] Yes~ No 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~e 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 E~Yes and Town waters. See LWRP Section HI - Policies; Pages 57 through 62 for evaluation criteria. ~] No [-~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for~tion crlteria. [] Yes ~ No IvI Not Apphcable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies 65 t. hrough 68 for evaluation criteria. [] Yes [~ No I vi Not Apphcable PREPARED BY~'~ ~ ~-)~ TITLE__~~DATE N LOT NUMBERS REFER TO "MAP OF EUGENE HEIGHTS" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON OCTOBER 29, 1928 AS FILE NO. 856. ELEVATIONS ARE REFERENCED TO N.A.V.D. '88 FLOOD ZONE FROM FIRM MAP NUMBER J610JCO16JH SEPTEMBER 25, 2009 LOT 41 (DWELLINg) sEPTlC !..oCA770N uNKNOWN SURVEY OF PROPERTY AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-156-01-$? SCALE: 1'=30' NOVEMBER J, 2010 MAY 2, 2011 (PROPOSED ADD/DONS) LOT 38 ~. ~z' ,e~ S82'01 10 W om familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions set forth therein and on the oermit to construct, The location of we/is and cesspools shown hereon ore from field observations and or from data obtained from others. / 268.55' AREA=19,900 SO. FT. TO TIE LINE zoNE LINE TEST HOLE DA TA McDONALD GEOSOIENOE ~o/2r/~o PROPOSED N~ [-- I' flARK 8ROItN LOAM OL EI¢ SEPTIC SYSTEM r--- LOT 57 ( · 8EZ~ROOM$ MAX. t--- 3' a~omvcL~rEr$.evo sc (DWELUNG) sEPTiC LoCATiON uNKNOWN h-I" PRECAST~.~ . IE' DEEpIO00 LEA.~C~V~,6AL' ~EPTICpooLTANKFllTH mJ /~EO~Ntd-~IR VE YOR S, P. a ANY ALTERADON OR ADD/DON TO THIS SURVEY IS A t,1OLAITON DP SECDON 7209OP THE NEW YORK STATE EDUCADON LAW. ;[_~.J1) :765--5020 FAX (631) 765-1797 EXCEPT AS PER SECDON 7209-SUBDItRSION 2. ALL CERDFICADONS ' '-~ . BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR · =MONUMENT 1"~0 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. f =WETLAND FLAG sOUTHot-D,' N.K 11971 I WORK-OUT RM, MECH, ROOM BASEMENT PLAN 'j SECOND FLOOR PLAN BATHROOM M BEDROOM STUDY DECK DINING RM, LIVING RM DEMOLITION LEGEND CONSTRUCTION LEGEND FIRST FLOOR PLAN KFrCHEN BATHROOM SK-7 OFFICE SET 10.27.10 A-1 .CP NORTH ELEVATION EAST ELEVATION SOUTH ELEVATION PROPOSE£ WEST ELEVATION SK-7a I OFFICESET 10.27,10 A-3