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Home My WebLink AboutTR-7860A Jarne. s F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bmdemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 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 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765~6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7860A Date of Receipt of Application: June 27, 2012 Applicant: Barron Kidd SCTM#: 3-1-10 Project Location: 8732 Clay Point Rd., Fishers Island Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Board of Trustees Project Description: Construct an addition to the existing dwelling; extend the existing deck; construct new ramp to access the addition; and install a new sanitary system. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Kinlin Rutherfurd Amhitects, PLLC dated June 4, 2012 and site plan prepared by Richard H. Strouse dated May 22, 2012 stamped approved on July 18, 2012. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Ji e~s F. King, Pre~ nt Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Asmex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated reviewed by this Board at the regular meeting of has been 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) ~x' 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: TOTAL FEES DUE: BY: James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jr. Vice-President Dave Bergen John Bredemeyer Michael J. Domino 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 Kinlin Rutherfurd Architects, PLLC on behalf of BARRON KIDD requests an Administrative Permit to construct an addition to the existing dwelling; extend the existing deck; construct new ramp to access the addition; and install a new sanitary system. Located: 8732 Clay Point Rd., Fishers Island. SCTM#06390 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: __Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Administrative__Emergency __Pre-Submission __ Info needed: __Amendment Violation Modifications: Conditions: Present Were: g hosio J. Bredemeyer ~lichael Domino t~D. Bergen, D. Dzenkowski Form filled out in the field by Mailed/Faxed to: Date: other OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: MEMORANDUM Jim King, President Town of Southold Board of Trustees JUL I 8 2012 S0ethhold Town Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: July 18, 2012 Re: Proposed Wetland Permit for BARRON KIDD SCTM#1000-3-1-10 Kinlin Rutherfurd Architects, PLLC on behalf of BARRON KIDD requests an Administrative Permit to construct an addition to the existing dwelling; extend the existing deck; construct new ramp to access the addition; and install a new sanitary system. Located: 8732 Clay Point Rd., Fishers Island. SCTM#3- 1-10 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 Office Use Only Coastal Erosion Permit Application Wetland Permit Application. ~ Administrative Permit Amendmenffl'ransfer/Extens]on ~Received Application: ~_Received Fee:$ ,~)~.~ . ~ /Completed Application q ! _l~.-~,! ~ __Incomplete __SEQRA Classification: Type I Type II Unlisted ~ordination:(date sent)_ ,WRP Consistency A~ee~m~nt Form I~1 __~AC Referral Sent Ct v . ~Date of Inspection: ~- --~t ~ __Receipt of CAC Report: __Lead Agency Determination: Technical Review: ~.~blic Hearing Hel~:~ q ] [~g~ Resolution: JUN 2 7 2012 Sou)hbo ~J lowa Board of TrtJstees Name of Applicant Address Phone Number:( Suffolk County Tax Map Number: 1000 - Property Location: ~/~ 2. Cl-~"f ) - oo~- I ~ ~o (provide LILCO Pole #, distance to cross streets, and location) AGENT: '!~ P-~ C_~ D- (If applicable) Address: :~0 W'. ~I~,TH Phone: of Trustees ApplicationO GENERAL DATA Land Area (in square feet): ~ ~.~5 , 0 ~-'/ Area Zoning:_ ~-. ~ ~ ~ Previous use of property: Intended use of property: Covenants and Restrictions: Yes If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes ,-'" No Does the structure (s) on property have a valid Certificate of Occupancy ,'"/ Yes __ Prior permits/approvals for site improvements: Agency Date Yes ~ No No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspend/ed by a governmental agency? ,/No Yes If yes, provide explanation: Project Description (use attachments if necessary): CO, t~r~OcTtcm oW ca, sE g~i)~:~:a~ of Trustees ApplicatioO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: QO~4~'lo-s ~ea ofwctl~ds on lot: % ~ , ~ ~8 _square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: ~; ~ feet Closest distance between nearest proposed structure and upland edge of wetlands: I ~ ' - Cot~ feet Does the project involve excavation or filling? No e/ Yes If yes, how much material will be excavated? I"~ cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: ,acI feet Proposed slope throughout the area Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): ~d of Trustees Applicatio0 COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) ~d of Trustees Applicatio0 AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at .~o° ~ov OAK /_g~,t.) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. '~'~(Owner's signature) ~d of Trustees Applicatio0 County of Suffolk State of New York ~C__~ D · ~-I N LIN BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS e"~O DAY~- ,20 Nota~Publi~ ' - ~'~'HMED Notary PubliC; State of New York Registration #01AH6213245 Qualihed In Queens County Cornmissi0rt E~oires Nov 2 2015 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics nrohibits conflicts of interest on the hart of town officers and emnlovees. The nurnose of this form is to provide information which can alert the town ofnossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,~ first name, mid31e initial, unless you are applying in the name of someone else or other entity, such as a company. If so, indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, maniage, 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 ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when 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 Form TS 1 PROJECT ID NUMBER PART 1- PROJECT INFORMATION ~, APPUOANT, SPONSOR 3~PROJECT LOCATION: 61720 APPENDtX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT Ci)unty 4. PRECISE LOCATION: Street Addess and Road Inte~ecflons. Prominen! landmarks etc -or orovide mai) SEQR 6~DESCRiBE PROJECT BRIEFLY: AMou~ OF ~NO ~FECTED: 8~ PROPOSED ACTION COMPLY ~TH ~ISTING ZONING OR O~ER RESTRIC~ONS? ~ Yes HAT IS PRESENT LAND USE IN VICiNiTY OF PROJECT? (Choose as many as apply.) Ras,~en.a, ~l.dust~al ~]Commer¢lal ~Ag~cu~ure [--] Park , Forest l oPen Space ~-]Othe.(deScn'be) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOw OR ULTIMATELY FROM ANY' O1}IER GOVERNMENTAL AGENCY (Federal~ State Or LOCal) ~yes [---]No If yes, list agency name and permit ! approval: ~'~'~ ..DOES ~__SS~C~ OE TH~ ACT,ON .~VE A CU~ENT~¥ VALI~ PERMIT OR ,~,ROVAL? r-I TM I i,/JNo If yes, list agency name arid permit /apProva,: jIf~i.A.S A RESULT OF PROPOSED ACTION WILL EXISTING pERMIT/ APPROVAL REQUIRE MODIFICATION? I cERTIFY THaT THE INFORMATION PROVIDED ABOVE IS TRUE T° THE BEST OF MY KNOWLEDGE v 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 6t7.47 If yes, coordinaie the review procecs and use the FULL EAF. r""-i Yes ~]No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, · nngaUve declaration may be superseded by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answem may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levela, exis~ng traffic paltem, solid waste production or disposal, potential for emsfo~, drainage or Itoodrng problems? Explar~ briefly: ·/ L 'ag , og , , o turn orcu#urelmsccross;ercommunityorneighborho;3dcharac~er?EXplainbdefly C3~ ~, or taunt, ~a~ shali~h or ~idll~ spe~tes, ~ant h~ts, or ~rea~n~ or e~ng~ spesids? ~plain briafl~: C4. co,y,*t,unliy's exi~ng plans or goals ss ofl~cial~ adopted, or a change in ose or inten~ of use of land or other natural msourcos? Explain briefly; c5. O;o~,th. -~bsoqu,nt deve~me~t, or re~,d act~aec tik,~ ~ be ,nd~ced by me p~:a~? Ex~;, C7. O. therl,~,v.,.~=~(tncludingchangesln use ofetiharq,;~rtffiy'~*~'ofene~ Explain brt~,: ENVIRONMENTAL AREA (CEA)? tif yes, expiath b¢iaft¥: E. IS T.~HERE, OR tS THERE LIKELy TO BE~ CONTROVERSY RELATED TO POTENTIAL ADVERSE EN%qRONMENTAL IMPACT~;? Ifyos Yes [] No PART III - DETERMINATION OF SIGNIFICANCE (To be sempleted by Agenw) INSTRUCTIONS: F~rse~hadvemealfectident~edab~ve~detarminewhetherit~ssubstantia~targe~imp~ant~r~the~visesigni~ant~ Each effect should be assessed In connection with Its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibilityi (e) geographic scope; and (f} magnitude, If necessary, add attachments or reference supporting materials. Ensure that explanatious contain sufficient detail lo show that all relevant adverse impacts have been kJenfified and adequately addressed. If question d of part ii was checked yes,the determination of significance must evaluate the potential impact of the proposed action on the environmental charactedsflcs of the CEA. Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed climctly to the FULL EAr: and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporilng documentation, thai the proposed action WILL NOT result in ;[ny significant adverse environmental impacts AND provide, on attacflments as necessary, the reasons supporting thi~ determinaflon. Name of Lead Agency Date Title of Responsible Of~c. er Print or Type Name of Responsible Officer in Lead Agency Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from mspoosibts officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM pROPERTY LOCATION: S.C.T.M. ~. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A C~O ~)~ ~ ~ (~ STORM-WATER, GRADING! DRAINAGE AND EROSION CONTROL PLAN ozstn~t $~., eto~ Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. PROPOSED CON$'~llUcrlON iTEM# / WORKASSESSMENT [ Yes No SCOPE OF WORK a. What Is the Total Ama of lhe Project Parcels? ' '~ Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within the Scope of Work for Praposud Cor~stnJcflon) I~ ,C~'7, ~.~ Generated by a Two (2") Inch Rainfall on Site? (This Item will Include all run-off created by site ~,- b. Whal is the Tofal Ama of Land Clesring/'48"~%~s~,.~ ) cleedngand/oreaeatrucfionacitvitiesaswe!lasall -- and/or Ground Disturbance [ct the proposed i ~ .,L.,¢~ Site Improvements and the permanent creation of impervious surfaces.) cons~lctlon activily? ) 2 Does the Site Plan and/er Survey Show All Proposed PROVIDE- BR[F.,F PRO.}EC'T DESCEU~I']ON {Pn,,,a. ~ P,~=r.,e~*~ Drainage Structures Indicating Size & Location? This" C(3~'~"~J C.-Tt (3~.4 ~ (;~,a~ ~R)t~.CX~ /M:3~l'~l~3f4 Item shall Include all Proposed Grade Changes and ~1 t'~ ~- ~*'~"~-.~ ~ ~ ~ X.~'~"~ I,,4(~ ~ I~ ~ - Slopes Cord~olllng Surface Water Flow. ~'~'~,~.~ wo~:*'~- T-ac ,~O~T~o-~ ~.~O ~No.~r~e~ i 3 DoestheSItePlanand/erSurveydescribetheeroskxl ~ ~r-"~ ~ ~ ~-('~t~ ¢::b4 (:~ ~ ~[~'%{,.4~r o~'~J~ , and sediment contro[ pmctleas that will be used to ~ ~ ~"g~J C-'O(~){~- O~= ~, ~ ~.,¢~l. ~' *"PO control sIte erosion and strum water discha~les. This ~ ~ ,OvOO'*'~423t.4 I,,'t4~,t,a ~ CI~ '~ itemmustbemaintainedtflroughouttheEntira {::=~..(:~ .%~,O~' O~ '~i4~E. }r~=~., ~rl~,.~0 '[~ Construction Period. t~ ~--~,_;_~*ncth~ oP ~, Ne.~ uP-to ccx:~ 4 WillthisProjectRequimanyLandFilling, Gradingor Excavation where there is a change to the Natural r~ ,5,~-~.{..) c. ~.~. ~ ~ t~,J~.~ ExiMing Grade Involving more than 200 Cubic Yards (~k.i, ~ C:'~tC~ I.~ '[:~(::)~ Ci~, ~ of Material within any Parcel? t.a=,,L~Ovd'~.--O ~-~$~ ~ ~ ~,1~-'~(*,4~, ~ Wi][ this Applieafion Require Land Distorbing Ac6vities r'~ 0%,4 ~ k.~ ~ . Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface?~.J 6 ~ there a Na{uml Water Course Running through the r'~ site? is this Project withln the Trastees jurisdiction General DEC SWPPP Reeulmrnents: or wi~rn One Hundred (100') feetof a Wellanri orL~ -- ~r~tud~ancesofone(1)orrnoreacms; includlngdfS~urbancesetlessthenoneacml.~at 7 Will there be SIte preparaflon nc Existing Grade SIopes ~ ~rt o~ · I~r ~ommo~ plan that val ~ dl,tu~b on~ or mom ~m~ of I~d: whleh Ex.md Fittaan {~ §) foot of ¥~ical Ri~ to 2- ~l~e ~NPPP shaa describe the en:~m and sed~neM ¢=°n~ml Prac~ces and whe*'e 9 Will this Project Require the Placement of Matedal, co.st.~ctnd to reduce Ihe pelh~tants b storm wate~ disc~mes and to assure Item Within the Town Right-of-Way er Road Shoulder~ -- STATEOFN~W¥ORK, ~..,, ~...., ~_ COUNTY OF .............. [..t ........................ SS That I, And that he/she is the ~ .......................................... ; 'i~:fi~}: ~i~; ~'~'t'g ~5~ ~:i~.j ................................................................ Owner and/or representative of the Owner or Owners, and is duly authorized to peffom~ or have performed the said work and to make and file this application; that all statements contah~ed in this application are true to the best of hi~ knowledge and beliel~ and that the work vfill be performed in the manner set [orth in the application £ded herewith. Sworn to before mellais; , ........... ........ ' ......................................... ~o~y 'c: .~.../~&...../_/.~...~..~...~.....~,~¥.~,.xg~,~, ..... t.~.......E.t~...L ........................................ FORM - 06~ 0 Qualified in Nassau County Filed in New York County/",p 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 ~trea. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes", 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# CIO:zo [ - ~ 0 The Application has been submitted to (check appropriate response): Town Board ~-~ Planning Dept. ~ Building Dept. [-~ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) Co) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Location of action: Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: 11~-~--~<:~-4 ~ OD (b) Mailing address: ~ ~D,ode ~Oa,at~ ~ . ~. ~ (c) Telephonen~ber:~eaCode( ) (~) ~ ~ (d) Application nmber, if any: Will ~e action be directly ~de~en, require ~ding, or approval by a state or federal agency? Yes ~ No ~ If yes, which s~te 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. ~J/Yes ~'] No N Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~-~ Yes ~-~ No [--~Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [-~ Yes ~-~ No [] Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pa~es 8 through 16 for evaluation criteria ~-~ Yes [-~ No~''~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 throu~lh 21 for evaluation criteria Iq Yes Iq No ~ "lNot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluati~criteria. ~-~ Yes ~-~ Nol~ Not Applicable 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 o . Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southolfl from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. [] Yes ~ No [~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. / [] Yes[-'~ No [~/Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. S~p LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. [-~ Yes ~ No [~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town w~ters.~ See.LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~ Yes ~ No I_/_l Not Apphcable 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 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 Created on 5/25/05 11.'20 AM June 26, 2012 Town Southold Board of Town of Trustees 54375 Route 25 P.O. Box 1179 Southold, NY 11971 JUN 2 ? 2012 Southhoid Town Board of Trustees Dear Board, Enclosed for your review please find 2 sets of Architectural dwgs. prepared by Kinlin Rutherfurd Architects PLLC and 2 copies of Site Plan prepared by CME Associates Engineering, Land Surveying & Architecture, PLLC for the construction of one bedroom addition to an existing single family dwelling located at 8732 Clay Point Road, Fishers Island, New York. (Tax Map No. 1000-3-1-10). All new construction is proposed on the west side of the existing dwelling. In relation to the Fresh Water Wetlands Jurisdiction, the project is more than 100 feet from regulated NYS Fresh Water Wetlands. In relation to the Tidal Wetlands Jurisdiction, the project is landward of the 10 foot (MSL) elevation contour on a gradual, natural slope. Based on the documents submitted, we would like to request a Letter of Non-Jurisdiction from your office. Sincerely, Bruce D. Kinlin, AIA Kinlin June 4, 2012 Town Southold Board of Town of Trustees 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Dear Board, Enclosed for your review please find Architectural dwgs. prepared by Kinlin Rutherfurd Architects PLLC and Site Plan prepared by CME Associates Engineering, Land Surveying & Architecture, PLLC for the construction of one bedroom addition to an existing single family dwelling located at 8732 Clay Point Road, Fishers Island, New York. (Tax Map No. 1000-3-1-10). The new addition and the new sanitary system are proposed on the west side of the existing dwelling and more than 1 O0 feet away from regulated wetlands. Based on the documents submitted, we would like to request a Letter of Non-Jurisdiction from your office. Sincerely, Bruce D. Kinlin, SHEET DESCRIPTION A001 TITLE SHEET A020 SITE PLAN A101 FIRST FLOOR PLAN A103 ROOF PLAN A201 EXTERIOR ELEVATION MIDDLE FARMS 8732 CLAY POINT ROAD FISHERS ISLAND, NY APPROVED BY BOARD OF TRUSTEES TOW~ ~ SOUTHOm ,~UN 27 2o~ i~l $outhhotd ~own Board of Trustees MIDDLE FARMS TITLE SHEET A-O01 PROJECT: 179 SHEET: N/A I FIRST FLCOR PLAN MIDDLE FARMS CONSTRUCTION PLAN A-101 PROJECT: 179 SHEET: N/A i MIDDLE FARMS ROOF PLAN A-103 PROJECT: 179 SHEET: N/A 1 WEST ELEVATION MIDDLE FARMS EXTERIOR ELEVATION A-201 PROJECT: 179 NORTH ELEVATION 01~,~.,._~ MIDDLE FARMS EXTERIOR ELEVATION A-202 PROJECT:IT9 EAST ELEVATION MIDDLE FARMS EXTERIOR ELEVATION A-203 PROJECT: 179 SHEET: N/A // ~ENCHMARK HUB & TAG ELEVATION = 20.33' FF ELEV SF --10-- -- '- ~ WLF// ~- TH~t PROPOSED (2) FOR ROOF LEADERS 1YP. SEE DETAIL MNNTNN MINIMUM SEPARATION ~BOVE SEWER UNE 4709.02 2436.91 EEPDC TANK HOUSE ADDmON AREA PROPOSED CONTOURS STONE WALL BUILDING SETBACK LINE FROPOSED SILT FENCE 2O QUALI~ CONTROL CERTIFICATION GROUP REVIEWED DATE BLOCK 25 LOT 4 (VACANT LOT) ' EXISTING DECK - EXISTING -. RESIDENCE "F.F.= 17.0 PROPOSED DECK ESTABUSH AS 1HE UMITS OF CLEARING, GRADING AND GROUND DISll. IRBANCE: / BOX AND 4* LEACHING PROVIDE 2000 ~ PGN~ LOCATION MAP SCALE 1"=400' I CHOCOMOUN~' C O Vff / / IRON PIPE \ \ \ \ \ \ \ \ ~40NUMENT 2" MIN, ABOVE OUTLETINVERT~ FISHERS ISLAND DEVELOPMENT CORP. (VACANT LAND.) NOT TO SCALE LOCKING CASDNG TO GRADE PROPOSED GRADE INLET BAFFLE REQUIRED IF INLET PITCH EXCEEDS I/2" PER FOOT NOT TO SCALE HIGH SEASONAL WATER ENDCAP I~pE I ~ ~)NU TOLCEKTO %~ ~ ILNEGTS AND CAST CONCRETE COVER LOCKING CASTING TO TO IF DROP 'T' IS USED FINISHEB GRADE _~ CHIMNEY I /-4 x 4 12,5/12,6 C WIR: ME rNLE ~3" VENT~ 3" VENT~ ~[ r, 'N CROSS SECTION 2000 GALLON - 2 COMPARTMENT SEPTIC TANK PROPOSED RESIDENCE ~ROOF LEADER PVC WYE OVERFLOW 6" PVC CUT LENGTH BY: R. STROUSE. P.E.LS. 04-11-12 6" SDR 35 PVC SLOPE AS REQUIRED 0"-9' TOPSOIL 9"-28" SANDY SUBSOIL 28" 15' FiNE SAND SP WATER AT 13~- ELEV 1 JUN 2 7 2012 UMfi~-d Soils Classification (USC) System (from ASTM D-2487) MGic; Division: Coorse-Oroined Soils, Cleon Sond Group Symbol: SP, Poorly Eroded Bonds, little or no fines NRCS, USDA Soil Classification' ReB-RJverheod very stony 1.) RITE PLAN PREPARED FOR MR. & MRS. KIDD CPK ARCHITECTURE, ENGINEERING AND SURVEYING. REVISIONS: DATE: 5/25/0.3 DESCRIPTION; REVISED DATE: MAY 2.3, 1995. SCALE: 1"=20'. SHEET 1 OF 1. '°°mA l °R )VEl:J By - BOARD OF TRLJSTEES t I. ~ .--. g o- 1.} ~HIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEMENT, 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY. 5.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF THE LAND SURVEYOR. 4,) C:OORDINATE DISTANCES ARE MEASURED FROM U,S. COAST AND GEODETIC SURVEY TRIANGULATION STATION "NIN" 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLR TAX MAP 1000, SECTION 003, BLOCK 1, LOT 10, 6,) TOTAL AREA = 2.7J: ACRES 7.) SITE IS LOCATED IN R-120 ZONE. 8) APPLICANT; MR. & MRS BARRON KIDD C/O KIDD OIL & GAS LC ~858 OAKLAWN AVENUE DALLAS, TX 75219 (214) 244 6175 9.) SITE IS SERVICED BY MUNICIPAL WATER AND ON SITE SEWAGE DISPOSAL SYSTEM. 10.) BASE FOR LEVELS; NGVD 1929, FILTER 1" STONE OR SCREENED GRAVEL STORMWATER DRY~LL DETAIL NOT TO SCALE NE'¢~ ROOF AREA 1053 SF REQUIRED = 1053 SF X 1,0 X 2/12 = 175,5 CF 175,5 CF / 22,4 CF/VF 7 5D VF USE FOUR(G) - 6'¢ X 4' DEEP DRY WELLS MIN, 6" SOIL COVER BLOCKS AND CATCH BASIN GRATE TO GRADE /'//~(NEENAH R-2525-F) OR EQUAL B' DATE: 05/22/2012 SCALE: 1" = 20' SHEET 1 OF 1