The URL can be used to link to this page

Home My WebLink AboutTR-7858A Michael J.Domino,President O��r3F so�ryol Town Hall Annex John M.Bredemeyer III,Vice-President O 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • �Q Telephone(631) 765-1892 Greg WilliamsO Fax(631) 765-6641 �y00UIdT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 13, 2019 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: ANN AGUANNO & GERALD GLEASON 2085 BAY AVENUE, EAST MARION SCTM# 1000-31-17-3 Dear Mr. Herrmann: The following action was taken at the Southold Town Board of Trustees,regular meeting held on Wednesday, February 13, 2019: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Administrative Permit#7858A from David Korchin & Joan Rentz to Ann Aguanno & Gerald Gleason, as issued on July 18, 2012. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Michael J. Domino, President Board of Trustees MJD/dd ti(aw so,& Town Hall Annex Michael J.Domino,President lo 54375 Route 25 John M.Bredemeyer 111,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 DEC 48 BOARD OF TOWN TRUSTEES am TOWN OF SOUTHOLD L -—------ APPLICATION FOR A TRANSFER OF A WETLAND PERMIT 58 Pleasant Ridge Road DATE December 13, 2018 OWNER Ann Aguanno &Gerald Gleason PHONE 917-992-59,04 MAILING ADDRESS 525 West 238th Street.,Apt 1 L, Bronx, NY 10463 AGENT En-Consultants PHONE 631-283-6360 ADDRESS 1319 North Sea Road, Southampton, NY 11968 PROPERTY LOCATION 2085 Bay Avenue, East Marion TAX MAP NO. 1000-31-17-3 I/We En-Consultants for Ann Aguanno &Gerald Gleason request a Transfer of Permit# 7858A from David Korchin &Joan Rentz to Ann Aguanno & Gerald Gleason Signed By: Robert Wewmann, Coastal Management Specialist EN-CONSULTANTS PERMIT TRANSFER REQUEST December 13, 2018 C � r, Town of Southold Board of Trustees (I (y° �! �"i Post Office Box 1179 Oft 201 � Southold,New York 11971 Attn.: Elizabeth Cantrell Southold Town f A Re: Permit#7858A 2085 Bay Avenue, East Marion SCTM#1000-31-17-3 Dear Board of Trustees: Please accept this letter as a request to transfer the above referenced permit from David Korchin &Joan Rentz to the current owners of record, Ann Aguanno & Gerald Gleason, whose address is 525 West 238th Street,Apt. 1L, Bronx, NY 10463. An application for Transfer of Wetlands Permit, copy of Permit#7858A, copy of Certificate of Compliance#0777C, and transfer fee of$50 is attached. Sin erely, Robert E. Herrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 1 f 631.283.6136 www.enconsultants.com environmental consulting t {/ ��1 `r L Michael J Domino, Presiden rot�Q CP Town Hall Annex John M. Bredemeyer III,Vice-Presutent �� 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski p� Southold,NY 11911 Greg Williams ® aTelephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: '2AI �� Completed in field by: ANN AGUANNO & GERALD GLEASON request a Transfer of Administrative Permit#7858A from David Korchin & Joan Rentz to Ann Aguanno & Gerald Gleason, as issued on July 18, 2012. Located: 2085 Bay Avenue, East Marion. SCTM# 1000-31-17-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D_material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public'Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_,5 years: Y/N Wetland Line by: C.E.H.A. Line , Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 12 f I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J..Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other 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 CERTIFICATE OF COMPLIANCE # 0777C Date July 24, 2012 THIS CERTIFIES that the as-built wood deck At 2085 Bay Ave., East Marion Suffolk County Tax Map #31-17-3 Conforms to the application for Trustees Permit heretofore filed in this office Dated 6/13/12 pursuant to which Trustees Wetland Permit #7858A was issued on 7/18/12 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 as-built wood deck. The certificate is issued to DAVID KORCHIN & JOAN RENTZ owners of the Aforesaid ferty~7~~ Authorized Signature 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.: 7858A Date of Receipt of Application: June 13, 2012 Applicant: David Korchin & Joan Rentz SCTM#: 31-17-3 Project Location: 2085 Bay Ave., East Marion Date of Resolution/Issuance: July 18, 2012 Date of Expiration: July 18, 2014 Reviewed by: Trustee John Bredemeyer Project Description: As-built wood deck. 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 as-built wood deck as depicted on the survey prepared by Nathan Taft Corwin III dated May 26, 2012. Conditions: The land area along the waterward side of the existing picket fence shall be preserved as a non-disturbance buffer. 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. Jame .~King, pi e~sisid6~ Board of Trustees James F King. President Bob Ghosio, Jr. Vice-President Dave Bergen John Bmdemeyer Michael J. Domino P.O. Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax ( 631 ) 765 -6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: ? Meryl Kramer on behalf of DAVID KORCHIN & JOAN RENTZ requests an Administrative Permit for the as-built wood deck. Located: 2085 Bay Ave., East Marion. SCTM#31-17-3 of area to be impacte .¢~ Type __Saltwater Wetland Freshwater Wetland __Sound Bay Distance of proposed work to edge of wetland Pac~r~haf Town Code proposed work falls under: pt.275 Chapt. 111 other Ty/~ of Application: Wetland __Coastal Erosion __Amendment ,/Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: 4:~)/~- 7/'ac' ~--'- d'~l J,-1 - Pres/e,fft'Were: J. King B. Ghosio __ *'J. Bredemeyer. Michael Domino D. Bergen, D. Dzenkowski other Form fil? oz~t in t/h2..fi, eld by ,_/ , Mailed/Faxed to: Date: OFFICE LOCATION: Town Hail 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 To: Jim King, President Town of Southold Board of Trustees LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM From: Mark Terry, Principal Planner LWRP Coordinator JUL I 6 2012 / Southhold towfl Board of l~ostees Date: July 13, 2012 Re: Proposed Wetland Permit for DAVID KORCHIN & JOAN RENTZ SCTM#1000-31-17-3 Meryl Kramer on behalf of DAVID KORCHIN & JOAN RENTZ requests an Administrative Permit for the as-built wood deck. Located: 2085 Bay Ave., East Marion. SCTM#31-17-3 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 INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP: Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The structure was constructed without a permit pursuant to Chapter 275 Wetlands and Shorelines of the Southold Town Code. Additionally, if the action is approved and to further Policy 4.2 Protect and restore natural protective features and Policy 6; it is recommended that natural vegetated buffer incorporating existing vegetation {trees) landward from the wetland to the picket fence preserving the existing vegetation. An example definition follows: NATURAL VEGETATED BUFFER -- a land area of a certain length and width where existing vegetation occurs prior to the commencement of any grading or clearing activity. Vegetation shall be maintained to achieve a minimum percent ground cover of ninety-five (95) percent. To achieve the percent ground cover indigenous, drought tolerant vegetation shall be planted. Survival of planted vegetation shall be (ninety) 90 percent for a period of three (3) years. Maintenance activities within the buffer are limited to removing vegetation which are hazardous to life and property, trimming tree limbs up to a height of fifteen feet (15') to maintain viewsheds, replanting of vegetation and establishing a four foot (4') wide access path constructed of pervious material for access to the water-body. 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 James F. King, President Bob Ghoaio, 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 Office Use Only Coastal Erosion Permit Application Wetland Permit Application ~Administrative Permit Amendment/Transfer/Extension ~Received Application:~.~ ,~"~eceived Fce:$ [ ',--C"oompleted Applicatio~ Incomplete SEQRA Classification: Type I Type II Unlisted Coordination:(date sent)_ -/L'WRP Consistency Assessment Form CAC Referral Sent: -~Date oflnspection' ~-~[ ~I~I~L__ Receipt ofCAC R ._ Lead Agency Determination: Technical Review: ,~ffolic Hearing Held: ~ ! ] ? ! I '~' Resolution: Name of Applicant .~V~C) Address ~ Phone Number:( Suffolk County Tax Map Number: 1000 - Property Location: ~OSS 6'7_q 'L_ (provide LtLCO Pole #, distance to cross streets, and location) AGENT: (If applicable) Address: PO Land Area (in square feet):. Area Zoning: [2 -40 Previous use of property: Intended use of property: Covenants and Restrictions: If "Yes", please provide copy. GENERAL DATA Yes 7 No Does this project require a variance fi.om the Zoning Board of Appeals ~/ Yes No 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 __No Prior permits/approvals for site improvements: Agency Date y No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ~ No Yes If yes, provide explanation: Project Description (use attachments if necessary): .~ P4)}b"~ Bo~d of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: WOO D Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between neares~ existing structure and upland edgeofwetlands: 2~-%.<~' feet Closest distance bet~eel~ nearest proposed structure and upland edge of wetlands: ~ '(~l ~ feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? J cubic yards How much material will be filled? '~ cubic yards Depth of which material will be removed or deposited: ~ Proposed slope throughout the area of operations: - Manner in which material will be removed or deposited: feet Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): w Town of Sou hold ~ Erosion, Sedimentation & Storm.Wate,r Run-off ASSESSMENT FORM ROPER~r LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A [is~i=t~-.-~ iR 0~'~ STO''WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN $ic ~octmn BlOCk Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION r.t'EM# / WORKASSE.SSMENT I Yes No a. What is the Total Area of the Project Parcels? (Include T°tal Area °f all Parcels I°cated within 4q ,~'~ I Will this Pr°ject Retain All Storrn'Water Run-Off the Scope of Work for Proposed Construction) ~ Generated by a Two (2") Inch Rainfall on Site? (S.F. ! Acres) (This item will include all run-off created by site What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/er Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activibj? impervious surfaces.) (S.F. t Ac~) 2 Does the Site Plan and/or Survey Show All Proposed ! PROVIDE BA]W..F PROJ-ECT ])ESCEI~qAON {Pn~d. ~daa~.~ Pag..~e~ Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and J~ ~J~L..~"" ~ D~-' Slopes Contrelling Surface Water FIow. · ' ' 3 andD°es the Site Plan and/or Survey desmibe the erosion sediment control practices that will be used to control site erosion and storm water discharges. This -- item must be maintained throughout the Entire Construction Pedod. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural ~ Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities r~ Encompassing an Area in Excess of Five Thousand (5 000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction~ General DEC SWPPP Requirements: or within One Hundred (100') feet of a Weiland or -- Submission of a SWPPP is required for alt Construction activities involving soil Beach? disturbances of one (1) or mom acres; including disturbances ot less than one acm foal 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately dJslurb one or more acres of land; which Exceed Fifteen (15)feet of Vertical Rise to r~ including Constmctisn activities ~nvolviog sol disturbances of less than one (1) acre where One Hundred (1 Off) of Horizontal Distance? the DEC has determined that a SPDES permit is required for stom~ water discharges. · SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways, Parking Areas or other Impervious ~ -- Ior Storm Water Discharges from Construction activity o Permit Nb GP-0-t 0-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1. The SWPPP shall be prepared prior fo/he submittal of the NOL The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department p/tot lo the commencement of consb~Jctisn activity. 2. The SWPPP shall desc~be the erosion and sediment control practices and where 9Will this Project Require the Placement of Material, required, post-construction store3 water management pmctlces that will be used and/or Removal of Vegetation and/or the Construction of any ~ constructed to ~educe the pollutants i~ storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder STATE OF NEW YORK, .,- t' t-_ .~ coum'v OF ...................... SS idual signing ~)~[~ &~'t') .................... that he/she is the Owner and/or representative of the Ovmer or Owners, and is duly authorized to peffono, qr I~gl:~Nt~l}~lsald work and to make and file this application; thai all statements conta/ned ill this application are tTue !o ~el~.~J~d belief; and that the work will be performed in the manner set forth in file application filed 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) 1. APPLICANT/SPONSOR~2. PROJECT NAME MERYL KRAMER-DAVID KORCHIN AND JOAN RENTZ ! KORCHIN RENTZ RESIDENCE / 3. PROJECT LOCATION: Municipality EAST MARION County SUFFOLK 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 2085 BAY AVE., EAST MARION 5. PROPOSEDAGTION IS: [] New [] Expansion [] Modification/alteration 6. DESCRIBE PROJECTBRIEFLY: AS BUILT PERMIT FOR EXIST1NG WOOD DECK 7, AMOUNT OF LAND AFFECTED: Initially .002 acres Ultimately .002 acres 8. WILL PROPOSED ACTION COMPLY W~TH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No If No, describe briefly SOUTHEASTERN SIDE YARD SETBACK DOES NOT MEET MIN. REQUIREMENT 9. WHAT IS PRESENT LAND USE IN VICIN TY OF PROJECT? [] Residerltial [] Industrial [] Commercial [] Agriculture [] ParkJForest/Open Space [] Other Descdbe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes [] No If Yes, list agency(s) name and permit/approvals: TOWN OF SOUTHOLD ZONING BOARD OF APPEALS, TOWN OF SOUTHOLD TRUSTEES 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERM T OR APPROVAL? ]Yes [] NO If Yes, ~ist agency(s) name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MOD FICATION? []Yes []No CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicantJsponsorname: M~.YLKRAM__F~ m__~_ ,, Date: 5/23/12 S~gn~: OVER PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) 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. [~] Yes [~]No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If NO, a negative declaration may be supemeded by another involved agency, [~Yes [~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, arcl~aeological, historic, or other natural or cultural resources'; '~r ~munity or neighborhood character? Explain briefly: C3. Vegetation or fauna, fi;h',' Sh;il~sh Or Wildlife ~peci~ai';ignificant h~bitats, or threatened or endangered species? Explain briefly: I I C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or othei naturai resources? Explain briefly: ! I C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain brieflyi C6. Long term, short term, cumulative, or other effects not identified in C1~C57 Expiain brieflyl D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA ? E. [~ yesIS THERE, eRraND I_IS THERE LIKELY TO BET CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If yes explain:I PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, 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) irmversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of signiflcence must evaluate the potential impact of the proposed action on the environmental charactedstice of the CEA. Chec~ this box if you have identified one or mom potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FUL EAF and/or prepare a positive declaration, Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio, WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the masons supporting thi determination. Board of Trustees Name of Lead Agency ~ . Pdnt or T/V.I~ Name of Responsible Officer in Le~d Agency Siglum of Responsible Officer in Lead Age~ Date President [] Title of Responsible Officer Signature of Preparer (If different from responsible officer) David Korchin and Joan Rentz 57 Montague Street Brooklyn, NY 11201 May 23, 2012 We hereby authorize MERYL KRAMER, ARCHITECT to act as our agent in obtaining all permits required by TOWN, SUFFOLK COUNTY and NEW YORK STATE for the renovation of our home located at 2085 Bay Avenue, East Marion, NY Date Date APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) The Town of Southold's Code of Ethics urohibits conflicts of interest on the vart of Town 9ffleers and emnlovees. The oumosc of this form is to ~rovide information, which call alert the Town of vossible conflicts of interest and allow it to take whatever action is necessary to avoid ~ame (Last name, flu'& ~a~[ m~ddle initial, u~less 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 [ Special Exception [ If "Other", ~ uame 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 parmcrship, in which the Town officer or employee has even a partial ownership of (or employment by) a corporation in which the Town officer or emplo)~ee owns more than 5% of the shares. YES l I NO I V' I Complete the balance of this form and date and sig~ 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 thc space provided. The Town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): I [ [ ] A) the owner of greater than 5% of thc shares of thc corporate stock of the applicant (when the applicant is a corporation); I m 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 [nwn of Sot]thold LWRP CONSISTENCY ASSESSMENT FORM INSTRUCTIONS All applicants [or permits* including Town of Southotd agencies, shall complete this CCAF for proposed actions that are sul~iect to the Town of Southold Waterfi'ont Consistency Review Law. Tbis assessment is intended to supplement other inlbrmation used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building, Permits' and other miniweria/ permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this tbrrn should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A p~bposed action will be evaluated as to its significant beneficial and adverse effects npon the coastal area (which includes ail of' Southold To;vn). If any question in Section C on this ibrm is answered "yes". then the proposed action may aflkct the achievement of thc 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 thai 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 [WRP is available in the lbllowing places: online at the Town of Southold's website (southo d own.northfork.net), the Board ct Trustees Office, the Planning Department, alt local libraries and the Town Clerk's office B, DESCRIPTION OF SITE AND PROPOSED ACTION The Application has been submitted to (check appropriate response): Town Bna,-d [];~-] Planning Dept. [ ri Ih,ihlin~ Dep,. ~ Bnard of Trustees ¢_~ Catch, or} of Town of Southold agency action (check appropriate response): Action undertaken directly., hr. "low ~ ~ gency. (e.g. capital ~ .... ~ construction, planning actlvi~,, agency regulation, land transactiorl) l'inanciaJ assistance (e.g. grant, loan, gtlbsid) ~ (c) Permit, approval, license, certification: Nature and extent of' action: '2. Present zoning classilicalion: ~'~ .Z.~) _ . If an application for the proposed action has been filed with the Town of Southold agency, the tbllowing intbrmation shall be provided: (b) iVlaiting address: ~/~ (c) Telephone number: A rea CoSc( ) .......... ~ ~2J~ ~L~<~''- '0~'-' %~*"',~(¢-~ ×" (d) Application namber, il any: Will the action be directly undertaken, require fimding, or approval by a state or f'ederal agency? "/cs! ] No~' Ityes, which state or federal agency? .................... DEVELOPED COAST POI.,ICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient ase of infrastrnctnre, makes beneficial use ora coastal location, and minimizes adverse effects of development. See LWRP Section Ill - Policies; Page 2 for evaluation crileria. i YeS I ! Nn , (Noi Applicable - please explain) Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See I,WRP Section Ill - Policies Pages 3 through 6 for evaluation criteria , ] Yes [..-r No Not Applicable - please explain) Attach additiot*al sheets if necessaw Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See IJWRP Section Ill - Policies Pages 6 through 7 for evaluation criteria ~ Yes [~_ No [_~] (Not Applicable- please explain) ~\ttach additional sheets if necessa9, NATURAl. COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resonrces from flooding and erosion. See LWRP Section III - Policies Pages 8 through 1 6 for evaluation criteria x es .... No (Not Applicable - please explain) Policy $. Protect and improve water quality and supply io the Town of Sonthold. See LWRP Section II1 Policies Pa~oes 16 through 21 for evahtafion criteria '[ ~ ~es [~ No I~' (NolApplicahle please explain) Policy 6. Protect and restore the quality aud function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 ~hrough 32 for evaluation criteria. Yes !~j No! ;¢ (Not Applicablc-please explain) Attach additional sheets if necessm¢ Policy 7. Protect and improve air quality in the Town of Southold. See I.AVRP Section I11 - Policies Pages 32 through 34 for evaluation criteria. See Section !I1 - Policies Pages; 34 through 38 tbr evaluatiou criteria. Yes [~] No~(Not Applicable- please explain~ Aaach additional sheets if necessa~ Policy $. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See 1,WRP Section III -- Policies; Pages 34 through 38 tbr evaluation criteria. ...... Yes , No Nol Al~plicable - please explaia) PUl/ JIC COAST POLICIES Policy 9. Provide for public access to, anti recreational use of, coastal waters, public lands, and public resources of the Town of, onthold. See LWRP Section 111 - Policies; Pages 38 lhrough 46 lbr evaluation criteria. ~ ~ I ~ %:/ Ye~ J No',/2~ (Not ApplicutH¢ - pleasl~ explains) Attach additional sheets if necessac,, WORKING COAST POLICIES Policy 10. Protect Soutbold's water-dependent uses and promote siting of new water-dependent uses in snitable locations. Sec I,WRP Section Ill -- I'olicies: Pages 47 through 5fi fur evahmtion criteria. i hey ~ ; No ~ (NoiA[q}licable- {)leasetxplain) Attach additional sheets if necessa0 Policy 11, Promote sustainable use of liviog marine resonrces in Loog Island Sound, the Peconic Estuary and Town waters. See LWRP Section Ill - Policies: Pages 57 through 62 liar evaluation criteria. i~¥es ~ No ~ Not Applicable- please explain 4ttach addilio~al sheets if necessaD, Policy 12. Protect agricultnral lands in tile Town of Sonthold. See LWRP Section I11 - Policies; Pages 62 through 65 fur evaluation criteria. i ! '~es [~, 19o [V'~N~-.! Applicable- please explain Mtac[1 additional sheets if necessat-, Policy 13. Promote appropriate use aud development of energy and mineral resources. See LWRP ~';eclion HI Policies;~ Pal~es 65 ll~rnn~/h 68 for evaluatiCm criteria. [ ~ i Ves i [ Nu~,~ Not Applicable- please explain NI £ R Y L K R A M E R a r c h i t e c t June 14, 2012 Lauren Standish Board of Town Trustees Town of Southold Town Hall, 53095 Main Road P.O. Box 728 Southold New York 11971 RE: Korchin Rentz Residence Tax Map # 1000-31-17-03 Dear Lauren: I am requesting an as-built permit for the deck and shed for the above referenced property. For your review I am submitting the following documents: % Three copies of Completed Application for Permit including General Data, Wetland/Trustee Land Data, LWRP form, Part 1 of Short Environmental Assessment Form and Transactional Disclosure Forms and Authorization Letter, and photographs of the house and property 2. Three surveys 3. Application fee of $100.00 If yo~~ease don ot hesitate to call me. Cc: DavidKorchin and Joan Rentz 218 FRONT STREET P.O. BOX 683 GREENPORT, NY 11944 63J.-477-8736 WWW.MKARCHITECT.COM x~ x~ x~ APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE SURVEY OF PROPERTY SJTUA T£ EAST MARION TOWN OF SOUIHOLD SUFFOLK COUNIY, NEW YORK S.C. TAX No. 1000-31-17-O3 SCALE 1 "=1 O' MAY 26, 2012 TOTAL LOT AREA = 4,943 sq. ff. Ua TIE LINE) 0.113 ac. UPLAND AREA 4,827 sq. ff. WETLAND AREA = 116 sq. fi. (TO TIE LINE) NOTES: 1, ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 EXISTING ELEVATIONS ARE SHOWN THUS:~ EXISTING CONTOUR LINES ARE SHOWN THUS: 2. THIS PROPERTY IS IN FLOOD ZONE AE (EL, 6) FLOOD INSURANCE RATE MaP No. 36103C0177H ZONE AE: BASE FLOOD ELEVATIONS DETERMINED DATUM .NN,,?046~ ~ N,Y,S r v Lic No 50467 Nathan Taft Corwmn III Land Surveyor Successor To, Stanley d. Isoksen, Jr LS Joseph A. Ingegno LS PHONE (631)727-2090 Fox (631)727-1727