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HomeMy WebLinkAboutTR-7874 J Michael J.Domino,President �QF SU(/� 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 G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 IrouPm,��' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1608C Date: August 14, 2019 TRIS CERTIFIES that the as-built uncovered 5'x35' wood deck/walkway and 5'x6' wood deck with outdoor shower; At Old Mallory Road,Fishers Island Suffolk County Tax Map#1000-7-6-11 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 30,2012 pursuant to which Trustees Wetland Permit#7874 Dated August 22,2012,was issued and Amended on August 14,2019 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 uncovered 5'x35' wood deck/wallg ay and 5'x6' wood deck with outdoor shower. The certificate is issued to WCKBH,LLC owner of the aforesaid property. Authorized Signature Michael J.Domino,President QF so�Ty Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� Ol0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith [ l�i Southold,New York 11971 A.Nicholas Krupski G Q Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 olyCOUNTI,N BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 14, 2019 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: WCKBH, LLC OLD MALLORY ROAD, FISHERS ISLAND SCTM# 1000-7-6-11 Dear Ms. Moore: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, August 14, 2019: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#7874 from Simeon & Ellen Wooten, as issued on August 22, 2012; and BE IT FURTHER RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#7874 for the as-built uncovered 5'x35' wood deck/walkway and 5'x6' wood deck with outdoor shower; and as indicated on the project plan prepared by Patricia C. Moore, received on May 23, 2019, and stamped approved on August 14, 2019. 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, L Michael J. Domino, President Board of Trustees MJD/dd F EE rl �:../ ; L InTf 1 ,F ` MAY 2019 B JAMES W OKEEFE,NJR RESIDENCE TRUST B BLOCK J+-Lor tO T 1 AND A PORTION OF 2 1 9 L A N D PON D APPROVED BY (MUVK AL NATER a ���) 8 RD OF TR ES TO OLD ; DATE $(1l!}j?C�[1 T041Lt O DI7 _ { agar( ct Trll;!vns } �j pnF '� { gy N0611.5.20•E 27322' •.-'� O v-t .�; SITE o C GO cl IV / coo oJ�o ¢3 � @-Oi: N,/F B!]ICHMARK-f ROD w/7B ` `S7- JAMES W ELEVATION-42 BS OKEEFE, JR. RESIDENCE TRUST \f BLOCK 31-L( A 1 T AND A PORTION OF 1 +o MM �I (ON sf SAEAL WATFIt I �� WW ' ON SEPTIC) APPROVED. BY / l / �\ �� y LOCATION MAP —SCALE 1'=400' U -BOARD OF 1 RUSTEES PATIO/RAMP S","L4IFTYA4 � � �.a1-�` PROPOSm U""� ` ].COxwETE , TOWN OF SOUTHOLD �M1 %/ - ~� = ' --0 �` BLOCK RETAINING WALL Z(A) � i ? % EL,1 ""-"- PROPOSED PATIO , EXISTING STORALE AREA / MAP REm"CFS FES' 2� 70 BE RENOVATED SEE DAT (e '> AR007EO7IIRAL PI.NIS 1 , ��//•�� / //�� V� / / j. w COUN�XEWEROSX CAE 1 A TOWN OF SOUTHOLD.SUFFOLK /AV�.+WsT •�I f�V( 1 /% /jl �wLD< s¢A-u sl „.> 1 PREP. BY TTHEKNEW YOERK SEATE DEPMTMENFl OFF ENO EXISTING / STORAGE `. coNsmvanaN �- / / /, I1 sIDFACE `y/ - 4 PROP05E0 �'' 1\ 1 I 1)THISHEREON AUR NY EX WAS PRFPp!?r'D FOR THE PA IES AND PURPOSE INDICATED 0 W �• / / / ,o NEW ENTRY ,^ \ TOP OF BANK _) TENSION OF THE USE BEYOND MEBE PURPOSED AGREED TO Z . - } /�L / \ O rr ✓�WE7W EXISTING ` \` f' / ENGACENFN7 CU'_NT ANO THE SUflVEYOR EXCEEDS THE SCOPE OF THE stu wv30v v�Ea, W-43 Q1 1 wwo vrt PLA MP 3 / �`Y� t \ ` (sft Aur�mLxwa xe 1 2)IT IS A NOLATTDV OF THE STALE EDUCAOON LAW FO2 ANY PERSON, v¢ z ®E'.p•z.j I-` ) UNLESS ACTING UNDER THE DWECDON 0,A LICENSED LAND SURVEYOR,TO ✓✓ J', ALIEN AN ITEM IN ANY WAY („) Upy Q ].)ONLY COPIES OF TNIS SURVEY MARKED WITH THE LANG SURVEYOR'S Z LLO •J-I -I / / ` I�✓ 1 \ P E \ \\ J° I SIONAN?E ANO pN ORIGINAL EVROSSEO OR INK SEAL ARE THE PRODUCT OF LU Q TME LAND SURVEYOR a W = Q o STEPS ? / 4)COORDINATE DISTANCES ARE MEASURED FROM US COAST AND GEODETIC O m <O SURVEY TRIANGULATION STATION•NTN' M�a s o Y Q p r \ I I )aTE Is ro THE rowN a sounKa D,courlTr aF suFFOLK Tax MAP woo, }_ I 1 / / sECTON 07,BLOCK s,LOT II a U o W w / / N/F /�.^, n / -` / K 2• I cRns9 I �° M1 / J�S�a o —2, BFACN 4. Lij a � / / / GRASS \C R " / \ \ I ///•� / /r`� / /ROCKY / / G)TOTAL AREA-211* Ul F. B HARVEY, JR. 7�/ "% I I/ r / BLOCK 34-LOT 2 i/ _ _�O \ \ \\ © I I n I! I /(M10//M1M1 (SMALL 5T0•IES) / / 7)SITE IS LOCATED IN ZONE R-I20 9 0 \'-, (t I 1, / / ) LEVELS NAVO BB. O (MUNICflA!WATER //~i /J 1 '1 tux \ \ \\ \ BOULDER `1 I BL E .1 �/ (/'Jq+J� / B BASE FOR b Q ON SITE SEPTIC) \\ \ �(TiP)© 1 /•m /�/ `/ / ```/T` 9)PORTIONS OF THIS SITE LIE WIMW FLDOD Z0NE5 VE(E1.-15!12 AS L i / 6 /, I FL000 INSURANCE NATE MAP SUFF " / UI. CO."/ m I'7 b / COUMU.0"FTOWN OF SOUTHOID NUMBER 360811 PANELC]B STY0 0 6 NAP / // \ fXIUIDERO \ \ \ I I J 2a I/ ,. I t - / / / A/ ,••/ SUFFIX H MAP NUMBER] NEW YORK 610]CO ,MAP RENSEO SEPTEMBER 25 2'009 ` %/ ;6F� / % /�(TYP,—\ \ ��_— "° ` ��� � I l l / /``. / / o J .A� � f a f� DIU TO aa�yss� '�`�%' \\ \ /%f \�•,� / ��// \\p STONCS / / -- `•'-' ~"/,n• .un.rm (M501 $TDNES) / V w lo / H\o•W \ L.9Aae'R-RIDS k N er o,w` lli\•fs\ \ \ VIpI 'II: / / r'/ �// // / / � o • IOP BANK Er s25 ie ROAD /1�1/•\�\ /\�� / r�% / / / / / / O EI17a39 (UNIMPROVED) �'" ry/F \ 1 \I ).EGt2DFlSHESISLAND DEVELOPMENT C)RP (VACANT LAND (YF m a S o NOW OR FORMERLY g srSQUARE FEET 4.♦ 4• TREE TRUNK OL&METER 50-— EXISTING CONTOURSF o / / 1 , TOP BANK = e J �V WILLIAM LIKE BOSWEIl 1 / 1 // /t/ //�/ / 1aOLO STONE WALL Q k OR N F / / /-\� /Y//// / /// / / RETAINING WAIL �_ �WAL WATERT I '\_ // /T' �/ / EDGE OF LAWN N ry m 22 oN sTE sErrrc) ' 1 �7"— j/ �6////�j/ ... BRUSH ME o c ^ ♦Y, C LANDSCAPE LIGHT APPROXIMATE MEAN UNKOWN DECIDUOUS TREE HIO'WA IEA LAE G Q CHE 60 TREE DATE APRIL 23, 2012 I l//,� i //�/••• CEDAR TREE SCALE 1" - 20' ALTTY CONTROL CERTInrATION I PROJECT #2012815 GROUP1 REVIEWED MTE �'AVVraA 201 IR o m GRAPHIC® SHEET 1 OF 1 I ail Betsy Perkins <betsy.moore765@gmail.com> FW: 1000-7-6-11 - Wooten do 1 message DiSalvo, Diane <diane.disalvo@town.southold.ny.us> Wed, May 29, 2019 at 2:39 PM To: Betsy at Moore Law Offices <betsy@mooreattys.com> Cc: "pcmoore@mooreattys.com" <pcmoore@mooreattys.com> I am in receipt of your request to amend Permit#7874—You have the owner as: WCKBH, LLC. The permit is in the name of Simeon & Ellen Wooten. Do you want to transfer into the LLC? Diane From: DiSalvo, Diane Sent: Tuesday, May 14, 2019 9:53 AM To: 'Betsy at Moore Law Offices' Subject: RE: 1000-7-6-11 FYI—Apparently Pat was just in the Building Dept. and Mike Verity explained to her what needed to be done to Amend the Trustees permit in order to obtain a certificate of compliance. Diane From: Betsy at Moore Law Offices [mailto:betsy@mooreattys.com] Sent: Monday, May 13, 2019 12:37 PM To: DiSalvo, Diane Subject: Re: 1000-7-6-11 ok. i'II follow up with Mike. the owner is leaving (out of the country)on Wednesday. thank you Diane. 7 E u JUN 8 2019 Betsy Perkins LA Souti,oid Towm r o Tr;; tees SAVE A TREE-PLEASE DO NOT PRINT James F. King,President ��oF SQUryO Town Hall Jill M.Doherty,Vice-President 53095 Route 25 Peggy A.Dickerson P.O. Box 1179Southold, New York 11971-0959 Dave Bergen G John Holzapfel �O ® �� Telephone(631)765-1892 COUNIT11' Fax(631)765-6641 � EC EIVE BOARD OF TOWN TRUSTEES MAY 2 3 2019 TOWN OF SOUTHOLD Southold Town Board of Trustges APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT - DATE �Y- / 5-'17 OWNER VVC, k 6 H , LLC PHONE LI 0 ADDRESS AGENT :G;yt Co- 1 I t O ore PHONE Io 7/ ° 7(o,S - LI 3 3 O ADDRESS S_(0_7_0 &Aa 1 V MQJ, ��LC�fit C? I cl - 1 -V ((q-7 PROPERTY LOCATION `I' 60 O(d R, [ (Of, RCCJ, Fj-,jr�� TAX MAP NO. 1 DOO UWe _W C_iC 6-H � (-c- request an Amendment to Pen-nit# -7 Ste' X 3C to 11 u n Co ue rr a vJon-i d4-,,e. j Wak kwa q s ho mer Signed By: L HYYL1l.HN 1 .TRANSACTIONAL DISCLOSURE F® __UBMISSION BY OWNER and OWNER'S AGENT) The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of Town officers and employees. The purpose of this form is to provide information,which can alert the Town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: WCBKH LLC AND MOORE,PATRICIA (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company. If so,indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other Trustees X Do you personally, (or through your company, spouse, sibling,parent, or child)have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the Town officer or employee has even a partial ownership of(or employment by) a corporation in which the Town officer or employee owns more than 5% of the shares. YES NO_X Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D(below)and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of Signature: WCBKH LLC BY: Simeon Kwoot :j Patricia C.Moore AUTHORIZATION (where the applicant is not the owner) Simeon F. Wooten, III, on behalf WCBKH LLC, owner of property located 1460 Old Mallory Road, Fishers Island and designated as SCTM: 1000-7-6-11 do hereby authorize my attorney, Patricia C. Moore, to apply for permit(s) and appear before the Southold Board of Town Trustees on our behalf. (Owner's signature) y Michael J. Domino, Presid O�0 CCG Town Hall Annex John M. Bredemeyer III,Vice-Presiaent �� 2�,` _ 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 Ze A.Nicholas Krupski 0 Southold,NY 11971 Greg Williams �'y,�0 Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Q r Date/Time: V 1 Z' Completed in field by: 1-ee Patricia C. Moore on behalf of WCKBH, LLC requests a Transfer of Wetland Permit #7874 from Simeon & Ellen Wooten, as issued on August 22, 2012; and for an Administrative Amendment to Wetland Permit #7874 for the as-built uncovered 5'x35' wood deck/walkway and 5'x6' wood deck with outdoor shower. Located: Old Mallory Road, Fishers Island. SCTM#: 1000-7-6-11 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� 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/applcation completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: �GWilliams edemeyer M. Domino G. Goldsmith N. Krupski Other Michael J. Domino, Pres; rs 11fFD(�'Q •( ,j Town Hall Annex John M. Bredemeyer III,Vice-presIdent �� y,,, 54375 Route 25 Glenn Goldsmith y a P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams ? 0� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:��Ga ZO /4 Completed in field by: �'t •�- . Patricia C. Moore on behalf of WCKBH, LLC requests a Transfer of Wetland Permit #7874 from Simeon & Ellen Wooten, as issued on August 22, 2012; and for an an Administrative Amendment to Wetland Permit#7874 for the as-built uncovered 5'x35' wood deck/walkway and 5'x6' wood deck with outdoor shower. Located: Old Mallory Road, Fishers Island. SCTM#: 1000-7-6-11 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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 i 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 I Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 3 5- I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: J. Bredemeyer r6 M. Domino G. Goldsmith N. Krupski G. Williams Other Michael J.Domino,President 0f SU!/l�o Town Hall Annex John M.Bredemeyer III,Vice-President ,`O 0. 0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas KrupskiG Q � � Telephone(631) 765-1892 Greg Williams O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 0� / Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed X Project complete, compliance inspection. INSPECTED BY. COMM TS: CERTIFICATE OF COMPLIANCE: James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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 __ Ist day of construction ¼ constructed __ Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7874 DATE: AUGUST 22~ 2012 1SSUED TO: SIMEON & ELLEN WOOTEN PROPERTY ADDRESS: OLD MALLORY ROAD~ FISHERS ISLAND SCTM# 7-6-11 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 August 22, 2012, and in consideration of application fee in the sum of $250.00 paid by Simeon & Ellen Wooten and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a covered walkway (wood or stone) and provide handicap access to the new front door, and as depicted on the site plan prepared by CME Associates Engineering, Land Surveying & Architecture, PLLC, last dated on May 10, 2012 and stamp approved on August 22, 2012. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. /Bob Gho$io, Jr. ~sent TERMS AND CONDITIONS The Permittee Simeon & Ellen Wooten, residing at Old Mallory Road, Fishers Island, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work proje6t herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. 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. James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hail Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 August22,2012 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Ms. Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: SIMEON & ELLEN WOOTEN OLD MALLORY ROAD, FISHERS ISLAND SCTM# 7-6-11 Dear Ms. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 22, 2012 regarding the above matter: WHEREAS, Patricia C. Moore, Esq. on behalf of SIMEON & ELLEN WOOTEN 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 May 30, 2012, 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, a Public Hearing was held by the Town Trustees with respect to said application on August 22, 2012, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 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 SIMEON & ELLEN WOOTEN to construct a covered walkway (wood or stone) and provide handicap access to the new front door; and as depicted on the site plan prepared CME Associates Engineering, Land Surveying & Architecture, PLLC, last dated on May 10, 2012 and stamped approved on August 22, 2012. 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, James F. King President, Board of Trustees JFK/amn James F. King, President Bob Ghosio, Jr., Vic~-President Dave Bergen Jolm B rederaeyer Michael $. Domino Town Hall Aanex 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 z/V~, ~O/.~bl 2. has been reviewed by this Board at the regular mee!ing of .~rlz~ ~ 2;2, .Q~i9-- and your application has been approved pending the completion-of the following items checked off below. __ Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ Ist Day of Construction ($50.00) __ ½ Constructed ($50.00) v// 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 FEE,<:;: TOTAL FEES DUE: BY: James F. King, President Board of Trustees Cantrell, Elizabeth From: Sent: To: Cc: Subject: betsy@mooreattys.com Monday, June 25, 2012 12:47 PM Standish, Lauren; Cantrell, Elizabeth pat [FWD: support for permit application for Simeon & Ellen WooLen Old Mallory Road, Fishers Island] hi girls, can you please make this support letter part of the WooLen file. thank you!!! Betsy Perkins LA Moore Law Offices William b. Moore, Esq. 631.76§.4663 Patricia ¢. Moore, Esq. 631.765.4330 mailing & physical address: 51020 Main Road 5outhold NY 11971 fax number for both 631.765.4643 LJ L JUN 2 5 2012 ........ Original Message ........ Subject: support for permit application for Simeon & Ellen WooLen Old Mallory Road, Fishers Island From: ".1ariel Marie Smith" <smith.janetmarie@gmail.com> Date: Fri, .lune 22, 2012 8:00 am To: < Betsy@mooreattys.com > Cc: "'Sim WooLen'" <simwooten@gmail.com>, "'Currie WooLen'" <ckwooten@gmail.com> Dear Ms. Moore, ! just received your email address to send this to you, so ! apologize for the timing. ! realize the hearing was schedule for this past Wednesday, June 20, so ! hope this note is still helpful. As owners of the house across Old Mallory Road from the Simeon & Ellen WooLen property, Frederick Barton Harvey, !!! and we would like to offer our support for the permit application for a new covered entrance. We have reviewed the drawings and application and are enthusiastic about these changes and the improvements to their property. Please let us know if there is anything we can do to endorse or expedite their request for this permit application. 3anet Marie Smith (and Harvey) 443.540.1193 or 410.458.4582 631.788.7971 Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 13, 2012 the following recommendation was made: SIMEON & ELLEN WOOTEN to construct a covered walkway (wood or stone) and provide a handicap access to the new front door. Located: Old Mallory Rd., Fishers Island. SCTM#7-6-11 The CAC did not make an inspection, therefore no recommendation was made. James F. King, President Bob Ghosio, Jr. Vice-Prcsidcnl Dave Bergen John Bredemeyer Michael J. Domino P.O Box 1179 Southold. NY 11971 TeDphone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: SIMEON & ELLEN WOOTEN request a Wetland Permit to construct a covered walkway (wood or stone) and provide a handicap access to the new front door. Located: Old Mallory Rd., Fishers Island. SCTM#7-6-11 Type of area to be impacted: 8,1~'.j __Saltwater Wetland __Freshwater WetlandVSound Bay Distance of proposed work to edge of wetland P~a Town Code proposed work falls under: pt.275 Chapt. 111 other Type of Application: ~etland __Coastal Erosion __Administrative__Emergency Pre-Submission Amendment Violation Info needed: Modifications: Conditions: Present Were: M/J. King B. Ghosio__ ,¢,.,~J. Bredemeyer Michael Domino Form filled out in the field by kJ, ] ('''/ /') ~ Mailed/Faxed to: Date: ~D. Bergen, D. Dzenkowski other WOOTEN SCTM: 1000-7-6~i I https//h4 goog eusercontent.com/-oP7vqtly1831/TxikLDLtlC I/AAAAAAAADdA/Oy8tC15yl.4A/s912/DS... 4/5/2012 WOOTEN SCTM: I000-7-6_1 l https://~h3.g~g~euserc~ntent.c~m/-W~P~6aNWrG4/TxikHBuqMu~/AAAAAAAADcs/7~u5FcPFRj~/s9~2/D~ 4/5/2012 Page 1 of 1 WOOTEN SCTM: ~000-7-6-11 WOOTEN SCTM: 1000~7-6-I 1 htB>s:/!lh4 goog eusercontent com/4. Mt3E -~YeAITxikEIIg3g51/AAAAAAAADcg/NwkITznTt3c/s912/DS... 4/5/2012 Page 1 of 1 WOOTEN SC'FM: 1000-7-6-I 1 https://~h4.g~g~euserc~ntent.c~m/-uzBNwM~KF-~/TxikDEjnhn~/AAAAAAAADcc/AkDk7LzwPvQ/s9~2/D.~. 4/5/2012 Office Use Only Coastal Erosion Permit Application 7Wetland Permit Application __ Administrative Permit Amendment/Transfer/Extension ~Receiv~d Application :~..~ ...~Received Fee:$e~%~')') .-C~mpleted Application ~_! ,~ I ~ Incomplete __SEQRA Classification: Type l Type 11 Unlisted __Coordination:(date sent)_ ~.~'LWRP Consistency Assessment Form ~9 [ I ~ I "~ ~---CAC Referral Sent: (0 11 I ~ ~__.Date of Inspection: t0l~[ ~[ ~t ~ __Receipt of CAC Report: __Lead Agency Determination: __Technical Review: ~'q~ublic Hearing Held: Resolution: Name of Applicant Address Phone Number:( Suffolk County Tax Map Number: 1000 - 7 Property Location: (~)/d /w~//~t~7 ///~a4, AGENT: (If applicable) (provide LILCO Pole #, distance to cross streets, and location) ! Address: Ar; Y. Phone: Berd of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: t~'/~0C3 Previous use of property: Intended use of property: Covenants and Restrictions: If"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __Yes .~X~.. 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 .~3( No Does the structure (s) on property have a valid Certificate of Occupancy ,~/ Yes __ No Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? )(' No Yes lfyes, provide explanation: Project Description?se attachments if necessary): of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: / I Area of wetlands on lot: Percent coverage of lot: square feet Closest distance between nearest existing structure and upland edge of wetlands: '3o ' feet Closest distance between nearest proposed structure and upland edge of wetlands: ~,G' ' feet Does the project involve excavation or filling? '~ No Yes If yes, how much material will be excavated? /~]/f4 cubic yards How much material will be filled? A J/,4 cubic yards Depth of which material will be removed or deposited: A//4 feet Proposed slope throughout the area of operations:' ~7/'a4~ 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): Board of Trustees Application County of 8uffe!k. fl'th'l~Ot~J lF'~-~ '(.~} ~0'~ ~I ~ BE~GD~YSWO~ DEPOSES AND AFFI~S ~AT ~/S~ IS ~ ~PLICA~ FOR ~E ABO~ DESC~ED PE~T(S) AND THAT ALL STATE~NTS CONTA~D ~ A~ TR~ TO ~E BEST OF ~S~R KNOWLEDGE AND BELIEF, AND ~T ALL WO~ WILL BE DONE ~ THE MAWR SET FORTH IN THIS APPLICATION A~ AS MAY BE APPROVED BY ~ SOUTHOLD TO~ BOA~ OF ~US~ES. T~ APPLICA~ AG~ES TO HOLD ~ TO~ OF SOU~OLD A~ ~ TO~ ~US~ES ~ESS AND F~E FROM ANY A~ ~L DA~GES A~ CLAIMS A~S~G ~ER OR BY V~T~ OF SAID PE~IT(S), IF G~D. ~ COMPLET~G ~IS APPLICATION, I ~BY AU~O~ T~ ~USTEES, ~EIR AGE~(S) OR ~P~SE~AT~S(S), TO ENTER ONTO MY PROPERTY TO ~SPECT ~E P~MISES IN CONJ~CTION WI~ ~fF ~lS APPLI~ON. Signature SWORN TO BEFORE ME THIS DAY OF ,~.~.~f ,20 ] ~ blic Ond~ L. ROSatE~i NOTARY FUEL[(: Narford Cow'dy Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) (print owner of property) residing at Iq(::' ~O~'F (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Bo~21'own Trustees on my behalf. ~4~)wner s signamre) · BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK In the Matter of the Application of SIMEON & ELLEN WOOTEN Applicant's Land Identified as 1000-7-6-11 COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF MAILING I, Betsy Perkins, residing at Mattituck, New York, being duly sworn, depose and say that: On the(~--~ day of June, 2012 I personally mailed at the United States Post Office in South~ld, New York, by CERTIFIED MAIL, RETURN RECEIPT REQUESTED, a true copy of the attached Legal Notice in prepaid envelopes addressed to the neighbors on the attached list. Attached hereto is the white receipt post-marked by the Southold Post Office on said date. Sworn to before me this '/'-~'77'/ ,~~(/.June, 2012 ( (N~ary Public) MARGARET C. RUTKOWSK1 Nom~' Public, State of New York No, 4982528 Qualified in Suffolk County. /~ Commisaion Expires June 3, ~ ~ PLEASE list, on the back of this Affi~'g~'or on a sheet of paper, the lot numbers next to the owner names and addresses for which notices were mailed. Thank you. PATRICIA C. MOORE, ATTO~EY AT ILAW 51020 Main Road Southold, NY 11971 (631) 765-4330 email: pcmoorel @optonline.net MF~O LETTER  [~ Pleaae reply ~ No reply necessaq/ SIGNED BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK In the Matter of the Application of SIMEON & ELLEN WOOTEN AFFIDAVIT OF SIGN POSTING Regarding Posting of Sign Upon Applicant's Land Identified as 1000-7-6-11 COUNTY OF SUFFOLK) STATE OF NEW YORK) being duly sworn, depose and say that: On thc:~" ~lay of June, 2012 I personally posted the property known as Old Mallory Road, Fishers Island, New York by placing the board of Trustees official Poster where it can easily be seen, and that I have checked to be sure the post has remained in place for eight (8) days prior to the date of the public hearing. Date of Hearing to be held on Wednesday, June 20, 2012, on or about 6:00 p.m. Sworo to before me this ,r'/C'day of June, 2012 KARLA S. HEATH NOTARY PUBLIC, STATE OF NEW YORK NO. 01HE6222563 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 05/24/2014 WOOTEN NEIGHBOR LIST SCTM: 1000-7-6-11 SCTM: 1000-7-6-o ~OORE LAU O?FICES 51020 MAIN ROAD SOUTHOL~ NY 11971 JAMES W OKEEKE JR RES. TRUST 1088 PARK AVE., APT. 7F NEW YORK NY 10128 414.(Rest riot ed Delivery? la. Service Type Extra Fee) []yes CERTIFIED .~. Article Number 7192 6463 3110 0001 1856 or g] Agent) 7192 6463 3110 0001 1856 By: (Please Print Clearly) Articie Addressed To: BARTON ?F- HARVEY III JANET SMITH 3 MIDVALE ROAD BALTIMORE .MD 21210 RECEIPT 71936463311000011849 FROM: Moore Law Offices RE RECEIPT FROM: SEND TO: JAMES WOKEEKE JR RES TRUS 1088 PARK AVE APT 7F NEW YORK NY 10128 FEES: TOT~' ~A 5.75~ P~MAR~R DATE .] SEND TO: BARTON F HARVEY III JANET SMITH 3 MIDVALE ROAD ~JALT~MORE MD 21210 PATRICIA C. MOORE, A'I'~NEY AT LAW 51020 Main Road Southold, NY 11971 (631) 765~330 email: pcmoorel @optonline.net ME. MO LETTER SUBJECT SIGNED Please reply ~ No reply necessary Town of Southoid Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FOR.,~ P~Ot'~m ~' LOGATIOH: $.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORI~I-WATER~ GRADING~ DRAII~AGE AND EROSION CONTROL PLAN u~b~c~ 's~c,on atuck Lot C~K, ,rmu BY A DESIGN PROF~-~iONAL IN THE STATE OF NEW YORK. sCOPE OF WORK - PROPOSED CONSTRUCTION I'I'E,_M # / WORK 2~SF~SM~_a'h~' a. What is the Total Area of the Project Parcels? (Inctude Total Area of all Parcels located within ~_~ I Will this Project Retain All Storm-Water Run-Off the Scope of Work for Proposed Construction) Generated by a Two (2') Inch Rainfall on Site? b. What is the Total Ama of Land Cleming (s.F. / Acres)-- (This item will include all mn-off created by site cleadng and/or constmciton activities as well as all and/or Ground Disturbance for the proposed ~ Site Improvements and the permanent creation of construction activity? impewious surfaces.) (S.F. / Acres) 2 Does the Site Plan end/or Survey Show Alt Propeeed PRO~I])E B~[F~' PROJ'~CT DESC~I~']~ON (Pm,a~e~aa~.~,~=,N,,e~d Drainage Structures lndicaflng Size &Location?This Item shall Include all Proposed Grade Changes and ~------C~['~ ~ }'~/~ 1 ~-~"~-- Slopes Controlling Surface Watur FIow. ~_~ ¢_~4 ~.~ 3 O°es tho Site Plan and/or Survey descflbe the erosion - and sediment control prac~ces that will be.used to control site erosion and storm water discharges. This ~ ~[ tQ'2~¢'~ g ." ."~O.~ ~-~ TY~ 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 Matedal within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? -- 6 is there a Natural Water Course Running through the Site? Is this project within the Trustees judsdiction General DEC SWppp Requirements: or within One Hundred (100') feet of a Wetland or Submission at a SWPPP is required for all Conatmcflon aclivRies involving soil Beach? disturbances of one (1) ~- mom acres; inoluding disturbances of less than one acm that 7 Will there be Site preparation on Existing Grade Slopes ~ are part of a larger common plan that will ulllmatsF/disturb one or more ac~es olqand; which Exceed Ftheen (15) feet of Ve~cal Rise to i Including C~latmcflon activRiss inv~ving so~rdisturbances of less ihan one (1) acre where One Hundred (100') of Horizontal Distance? ~ the DEC has detsrmlr,~d that a SPDE$ permit is required for atOITn water discha~jss. SI/VPPp'$ Shall meet the Minimum Requirements of the SPDES General Pemtit 8 Will Driveways, Parking Areas or other Impervious ~or S~on11 Water Discharges from Construction activity. Permit No. GP-0-t0-00¶ .) Surfacas be Sloped to Direct Storm-Water Run-Off r'-'l t. ~he swPPP shall be prepared prior to the subelittal of the NOI. The NOI shell be into end/or in the direction of a Town right-of-way? submitted to the Depatiment p~ior to the commencement of conatmction activity. 2. ~e SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, SI'ATE OF NEW YORK, ~ ~- ~3 t ~. ~ ' coum-/OF .............. SS 'lhatI t C X-a%r~.CA..OX ~" ~r~..~Oc~x'~t~ be' dui swornI ' .............. i}~'~'~'~t,i'~/thi~.~.~ff ......... mg y , aeposes anct says mat he/she is the applicant for Permit, And that he/she is the ..............................,-...-~-~. Owner and/or representative of the Owner or Owners, mid is duly authorized to perform or have performed the said work and to make and File this application; that all statements confained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application l-fled herewith. Sworn to before me Otis; ~ ............................................................. Qualified In Suffolk County PROJECT ID NUMBER PART 1 - PROJECT (NFORMATION 1 APPLICANT / SPONSOR ~t.~.,,~/ 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) County SEQR 3.PROJECT LOCATION: Municipality ~----~/~.¢/ 4 PRECISE LOCATION: Street Addess and Road Intersections. Prominent landmarks etc -or orovide mar) 1 oo - 7- ii 5. IS PROPOSED ACTION: [] New [] Expansion []Modification / alteration 6 DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ~__.~-/ acres Ultimately ~-' / acres ! 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? r~"~Yes [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~Residential r--]Industrial ~--~Commercial E~Agriculture E~Park/Forest/OpenSpace ~Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Lo~l) ~Yes ~ No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? If yes, list agency name and permit / approval: 12 AS A RES RE ULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? No I CERTIFY THAT ~[~RMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment DART II - IMPACT ASSESSMENT lTD be completed by Lead Agency) A. DO~S ACTION EXCF--ED ANY TYPE 111-IRESHOLD IN 6 NYCRR. PART 6'17.47 If yes. cooedinate the renew ixocess and use the FULL EAF. B. WILLACTION~COORDINATEDREVIEWASPROV1DEDFORUNUSTEDACTIONSiN6NY~P~T617.~ IfNo, anegative dedamtlen may be su~ by anofher levo~ved agency. E]Yes C. COULD ACTIO~ RESULT IN ANY ADVE~ EFFECTS ASSOCIATED WITH 114E FOLLOV~NG: (AlL, wets may be handwritten, If legible) Cl. Existing air quarry, suda~e ~x grotmdwate~ quality m* quantity. ~se ~s. ~ ~ pa~. s~ ~ ~ ~ di~l. I ~. V~;~ ~ ~, ~, ~ ~ ~1~,~ ~s, ~nt ha~, or ~e~ ~ ~e~ ~? ~ b~ ~. A ~,,,,,~n~'s=~;~l~ ~als as ~y a~t~,~a ~ange~ use~u~ ~o~t~re~? ~ln ~V.. J I .......... ! I C~. ~r ~pa~s ~l~i~ ~es ~ u~ ~'~ther quan~ or t~ of ~mff E~lain bdefl~ "' ' / O. ~LL ~E PROJECT ~ ~ IMPACT ON ~E EN~ONMENT~ C~C~RIST(~ ~T ~U6EO ~E E~ABLISHM~T OF A CRITI~ ~Ye, [] Yes [Z~No E U KELy TO BE~ CONTROVERSy RELATED TO POTENTIAL ADVERSE ENVlR~..,~.:Ct.TAL ~p~ PART I~1 - Or: ~ r..e~INATION OF SIGNIFICANCE (To be ~)mpleted by IN8~$: F~rea~hadveraee~ect~denti~dab~ve~detenn~newhe~her~t~b~tantiaL~arge~mper~a~r~~L Each e~ should be a~ses~ed In (x~'me~n wl~ #s (a) setting (Le. u~o~m or rural); ~) pml~al~/of o<~utflng; (c) ~m~ (~ ~ (e) ~ NOT result I~ ~my slg~a~ adverse e~enta! Impacls AND pro,de. detesml~a~<~. Board of Trustees Name of Lead Agency Pd~ er Ty~e Hame of ~e~ponsible Office~ le Lead ~ency /Signature o sponslble Officer in~'ad Agency Date President Title of Responsible Oflice~- SignMum of Preparer (Il'different from respons/ble officerJ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovecs. The ouroose of this form is to orovide information which can alert the town of oossible conflicts of interest and allow it to take whatever action ~:~ necessary to avoid same. ( asr name, fa'st name, middle initial, unless you'aru 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.) T~x grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooting Exemption from plat or official map Planning Other (If"Other", name the activity.) Do you personally (or through your company, spouse, sibllng, parent, or child) have s relationship with any officer or employee of the Town of Southo d? Relati°nsh~p' mcindes bY blood, marnage, or basmeas interest. "Business interest- means a busmess, including a parmershJp, 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 $% of the shares. YES NO ,~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person cruployed by the Town of Southold Title or position of that person Describe the relationship between youmelf (the applican~Iagcot/rupresontative) 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 groater 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 I Submitted this ~ of ~(g.~ Signature ~_ Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 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# 7-6-11 Simeon F. Wooten & Ellen C K Wooten AGENT: Patricia C. Moore The Application has been submitted to (check appropriate response): Town Board [] Planning Dept. [] Building Dept. [] Board of Trustees X Zoning Board of Appeals []_ I Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) [] (b) Financial assistance (e.g. grant, loan, subsidy) [] (c) Permit, approval, license, certification: [] Type: Town of Southo}d LWRP Consistency Assessment Form 1 Nature and extent of action: new covered walkway into relocated entrance to existiny house. Landward of existing dwellino Location of actionOId Mallory Road, Fishers lsland Site acreage: 2.11 ac. Present land use: house Present zoning classification: R-120 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: Simeon F. Wooten & Ellen C K Wooten 196 W. Lake Drive, Annapolis MD. 21403 (c) Telephone number: c/o Pat ( 631 ) 765-4330 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No X If yes, which state or federal agency: __ DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use o fa coastal location, and minimizes adverse effects of development. See L WRP Section II1 - Policies; Page 2for evaluation criteria. Yes X No [] Not Applicable [] Discussion (if appropriate): renovation of existing dwelling: enrage conversion to living sluice front door moved and new entrance will have covered ramp$~ ~.}~4~oa~r- Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold See LWRP Section III - Policies Pages 3 through 6for evaluation criteria Yes [] No [] Not Applicable X Discussion (if appropriate): Developed property Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold See LWRP Section III- Policies Pages 6 through 7for evaluation criteria Yes [] No [] Not Applicable X Town of Southold LWRP Consistency Assessment Form 2 Discussion (if appropriate): existing house does not change visual quality or scenic resources NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section 11I- Policies Pages 8 through 16for evaluation criteria Yes X No [] Not Applicable [] Discussion (if appropriate): minor work has no impact on flooding of natural resources Policy& Protect and improve water quality and supply in the Town o. f Southold See L WRP Section Ill - Policies Pages 16 through 21for evaluation criteria Yes [] No [] Not Applicable X Discussion (if appropriate): 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 L WRP Section II1 - Policies; Pages 22 through 32for evaluation criteria. Yes X No [] Not Applicable [] Discussion (if appropriate) no impact to underwater land Policy Z Protect and improve air quality in the Town of Southold See LWRP Section lIl- Policies Pages 32 through 34for evaluation criteria. See Section III - Policies Pages; 34 through SS for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if appropriate): __ Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section llI-Policies,. Pages 34 through 38for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if appropriate): Town of Southold LWRP Consistency Assessmem Form 3 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 46for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if appropriate): no impact on public access WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if approprlate): Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62for evaluation criteria. Yes X No [] Not Applicable [] Discussion (if appropriate): Sound renoation of existing home has not impact on Block Island Policy l2. Protect agricultural lands in the Town of Southold. See LWRP Section lll- Policies; Pages 62 through 65for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if appropriate)-' Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68for evaluation criteria. Yes [] No [] Not Applicable X Discussion (if appropriate): *copy of Town form created on 2/11/06 Town of Southold LWRP Consistency Assessment Form 4 PATRICIA C. MOORE Attorney at Law 51020 Main Road Southoid, NewYork 11971 Tel: (631) 765~,330 Fax:: (631) 7654643 May 30, 2012 Board of Trustees Town of Southold P.O. Box 1179 Southold, NY 11971 HAND DELIVERED Re: WOOTEN Premises:Old Mallory Road, SCTM: 1000-7-6-11 Fishers Island Dear President King and members: With reference to the above, enclosed please find an original and two copies of a wetlands permit application together with my client's check for the filing fee. Thank you. Ve~y~yours, Moore PCM/bp encls. C: Mr. Sim Wooten dAMES W. OKEEFE, dR. RESIOENCE TRUST BLOCK 34 - LOT 10, I? AND A PORTION OF £ BOARD OF TRUSTEES TOWN OF SOUTHOLD / / JAMES W, OKEEFE, JR. RESIDENCE TRUST BLOCK 54 - LOT 10. 11 AND A PORTION OF 2 (MUNICIPAL WATER ON SITE SEPTIC) / / / / F. B. HARVEY, dR. BLOCK 34 - LOT 2 (MUNICIPAL WATER ON SITE SEPTIC) N/F ~.o~.¢o~ BENCHMARK-I. ROD E!..EVA~ON =42.65 x 20' 10' 0 20' GRAPHIC SCALE IN FEET SHEET 1 OF 1 JALI]~K CONTROL CERTIFICATION CROUP REVIEWED DATE OJECT MANAGER /7%¢B% LOCATION MAP SCALE 1"=400' WOOD ~( ~ ~ ~ / 6~~SlgL 4~1 ~ 1,) COASTAL EROSION HAZARD AREA MAP, TOWN OF SOUTHOLD SUFFOLK BURIED=AS 'F ~ ~//~ = ~ ~? .- L ~R~2E~. ~R~KL~ALE 1"=200' SHEET 59-Fr OF ~9 BATED 08/29/88 X, : ::', ~p~y /~ : :~%, X. ~TOP OF SANK / :; : ~-- 1) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE iNDICATED %~ % ~I,ING /& %, / / / COASTAL EROSION I )/ :'J / ~;~%~%~¢ CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ~ - m. ~ / V '~ ~ kk~.~ N' X X~( MAP ~EFER[NCE No1) ~) ~ : / / UNLESS ACTINO UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ~"~ .. .~_~ ~ ~J~ STEPS % ~% / } / _/~ . / 40 COORDINATE DISTANCES ARE MEASURED FROM U.S COAST AND GEODETrC ~.:2;~.~ ~- // % % ki:' 1~ t ~% ~ / . / ( ( ' > , / / / 5.) SITE IS IN THE TOWN OF SOUTHOLD. COUNTY OF SUFFOLK TAX MAP 1000. ( , : /(SMALL STONES / .>' COMMUN'~: TOWN OF SOUTHOLD NUMBER: 560815 PANEL 58 OF 1026 MAP N/F NOW OR FORMERLY SF SOUARE FEET 4" TREE TRUNK DIAMETER -- -- 50 -- -- EXISTING CONTOURS COOCCDCX::~ STONE WALL ,~ ~ UNKOWN DECIDUOUS TREE ~ CHERRY FREE DATE: APRIL 23, 2012 ~ CEDAR TREE SCALE: 1" 20' PROdECT #2012815