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Home My WebLink AboutTR-7868A James F. King, President ��a SO(/j�o Town Hall Annex Bob Ghosio,Jr.,Vice-President ,�O l0 54375 Main Road Dave Bergen ,�{, P.O. Box 'R � Southold, New Yorkk 11 11971-0959 John Bredemeyer G Michael J. Domino '�` �O Telephone(631) 765-1892 OU '� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0844C Date: March 4, 2013 THIS CERTIFIES that the extension of the existing wood frame deck by 36 and removal of existing stairs adiacent to the deck extension and replacement with new deck section At 7055 Indian Neck Lane, Peconic New York Suffolk County Tax Map # 86-6-26.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 8/2/12 pursuant to which Trustees Administrative Permit#7868A Dated 8/22/12, was issued and Amended on 10/17/12 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 extension of the existing wood frame deck by 36"• and removal of existing stairs adiacent to the deck extension and replacement with new deck section. The certificate is issued to JANET CARRUS owner of the aforesaid property. Authorized Signature Jill M. Doherty, President of sooryo Town Hall Annex James F.King,Vice-President ,`0 54375 Main Road Dave Bergen P.O.Box 1179 Southold,New York 11971-0959 Bob Ghosio,Jr. G John Bredemeyer '.� �� Telephone(631) 765-1592 �yCo ' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: A �l Zv13 7 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 151 day of construction W constructed ✓/Project complete, compliance inspection. INSPECTED BY: A4 ,T- COMMENTS: CERTIFICATE OF COMPLIANCE: James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town HsllAnnex 54375MainRoad P.O. Box 1179 Southold, NewYork 11971-0959 Telephone(631) 765-1892 Fax(631) 765-6641 October 17, 2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Peter Stoutenburgh Environment East, Inc. PO Box 197 Peconic, NY 11958 RE: JANET CARRUS 7065 INDIAN NECK LANE, PECONIC SCTM# 86-6-26.1 Dear Mr. Stoutenburgh: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 17, 2012: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Administrative Permit #7868A to remove the existing stairs adjacent to the deck extension and replace with new deck section; and as depicted on the revised site plan prepared by Environment East, Inc., last dated September 6, 2012 and stamped approved on October 17, 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 call our office at (631) 765-1892. Sincerely, James F. King President, Board of Trustees JFK:amn ,lames F King. President Bob Ghosio. Jr, Vice-President Dave Bergen John Bredenleycr Michael J. Domino PO Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Datet-l-ime: {. o [ro Environment East on behalf of JANET CARRUS requests an Administrative Amendment to Administrative Permit #7868 to remove the existing stairs adjacent to the deck extension and replace with new deck section. Located: 7055 Indian Neck Lane, Peconic. SCTM# 86-6-26.1 Type of area to be impacted: )4:SaltwaterWetland __Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland P~a~rt of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment ~Administrative__Emergency Pre-Submission Violation Info needed: Modifications: Conditions: Present Were: J. King B. Ghosio,%~ D. Bergen, J. Bredemeyer.__ Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: 14:42 7656641 ~O~RD OF 1RUSTEE5 ~r~. uz J~mes F. King, President Bob Gho~io, Jr., Vice-Pres/dent D~ve Bergen John Bredem~yer M/dmel J. Domino · BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P-O. Box 1179 --*' 8ou. thold, New York 11971-0959 Telephone (631) 765~}892 APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT PnOP~mc^"no~ '"105'5' f~O~A~ r4tx::~¢- LA~6 Environment East, Inc. 2885 Indian Neck Lane P.O. Box 197 Peconic, New York 11958-0197 631-734-7474 Fax: 631-734-5812 Concermng Permit # 7868A Carrus Residence 7055 Indian Neck Lane August 31, 2012 Please find attached a request to amend this permit. When Peter met with the customer this morning she decided to remove a few redundant steps and fill them in with decking. I have attached two copies of the site plan and the deck plan with the revisions noted. Thank-you, Joan Chambers 8EP 1 2 20t~_ ~ 1 X 8-3/4" VERSATEX TRIM BRICK 2X6 ACQ SILL 1/2" ANCHOR 5/4 X 4 MAHOGANY DECKING 2X8 @ 16~C JOISTS ~/~ 2- 2 X 12 GIRDER ,MASONRY FOUNDATION TO MASONRY FTG. @ 3'-0" BELOW GRADE HAND DUG FTG, SECTION OF DECK EXTENSION 1/2" = 1'-0" t~"V. 8.31.12 D BY USTEE$ I 21'-2' CARP, US DECK PLAN OF PROI~OSED DECK EXTENSION ENVIRONMENT EAST INC. 114'= 1'-0' 7.24.12 REV. 82.4.12 REV. g.6.12 T ® ® TIE DISTANCE C) N59'18'10'E 209.91' ® 573' 7'oo's 342.79' 274.10 (~) S26'28'50'E 225.0' ! N/F TRUST "B" U/LW&T OF VINCENT J. FREDA, CAROL URY FREDA AND AETHUR 0. URY, CO-TRUSTEES N 90'O0'O0"E Ot~tL / // -- / /// '%. \ \ / \ \ \ \ \ \ \ \ · ' · / / / ... / / / ,..' / / / .. / / / / / / / / / / / / / / / / / / , \ :: / / / / / / \ : / / // / \ : / / /. / \ : / / / / I : / / / / : / / / J : / / / / I . : / t / / / I : / / / ,/ : // / / / ~/ ~/ .." / / / / · , / / / / / ~1 ... ~.~..-//. , // / / I' / / / ,/ / / / / / / ~..,. ,,. / / / / .--- / / / / ......- --' / / / / /.,..-- / / ../ \/. ? / / // / / / / / / 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 1 st 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.: 7868A Date of Receipt of Application: August 2, 2012 Applicant: Janet Carrus SCTM#: 86-6-26.1 Project Location: 7055 Indian Neck Lane, Peconic Date of Resolution/Issuance: August 22, 2012 Date of Expiration: August 22, 2014 Reviewed by: Dave Bergen, Trustee Project Description: To extend the existing wood frame deck by 36". 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 site plan prepared by Environmental East, Inc., received on August 2, 2012 and stamped approved on August 22, 2012. Special Conditions: None 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. James F. King, President Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen $olm Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, HY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated ,4O,~lt.L--('-Jb ~-t ?_~1 ¢- has been reviewed by this Board at the regular meeting of ,/.~.~u~-~ 2Z.t?..-Vl¢-- and your application has been approved pending the co~n'p~tion 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) ~ Constructed ($50.00) 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 for[h 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 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: JANET CARRUS requests an Administrative Permit to extend the existing wood frame deck by 36". Located: 7055 Indian Neck Lane, Peconic. SCTM#86-6-26.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: __Chapt.275 Chapt. 111 __other Sound /V~Bay ~y_~e of Application: Wetland __Coastal Erosion __Amendment dministrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: J. King B. Ghosio ~ D. Bergen, J. BredemeyeE__ Michael Domino D. Dzenkowski __ Form filled out in thr~ field by Mailed/Faxed to: Date: other Exist. deck to be extended ( looking North-East) Exist, deck to be extended (looking south-west) Bob Day 88 Wyckoff Street BroOklyn, NY 11201 LETTER ! Conse~ation OF NON-JURiSD CTIOh May 17, 2001 Re: 1-~738~02874/00001 Day ~.~y . .$CT~['ff.¥000-86'-6-26.1 - f Dear Mr. Day: 4)' Based on .the information you have submitte ~l,.the New York State Department of Er, vimnmen~{ Conservation has determined that:. · - · T~e pmpe _n'y landward of the 14. foot elevati( ~_ ... ~_ ...... m property ,ne an(] · contour line at the westa " ' continuing in a northeasterlydire~n.aleno i ~ i.e. ~ ele.~ co~3ur.line and-below the existing bdck patio, where the line continuing to the northem .p~ {itiel~ ~L~-~:-the't6 foot elevation contour' Wetlands). The elevation contbul~ lines.~.~ h~'~l~''''~°f-~cle-25 (Tidal P.O. last revised on 4/5/0t. , ~w~'~l-,~ae~.~'vreY,pmpared. by Peconic Survey,ers, . _L~.nd Use u ations 6NYCRR Pa~ ~J:~[-~JsJ~d, however, that no ~:~{~:~.award of the tidal ~:a-~ "t{Js your responsibility to ~.~.. a~y~[a3l~n or other alteration I" .l~lat~/'.~:J~.risdiction which ma? ai[Tta~~.~..e work area betw,;el~ i~e, a~.l:'5'Tto~0~ ~tde constr~cUon area)~' Wetlead ~g.e,refore, in ac. cordance with the ~,n~,,+ ~ ]) no permit ~s required under the"-T:'"~l'~'~ ,c..o_n.,s_t_m,cti.on; s~.e~.!mentation, or distaff w~uanos Junsa~ctmonal bounda.ry, .a~;1odi~ ensure that all n~..essary precautiohs are~ ta. or disturbance to th.e ground su~faae Or yaig~l result from your p. ro~ec..t. Such pre~lul;ion~' t..h.e^t.~a!_w:etla, nd JU'~sd,~onal I~,.u~ary u. ~,~ung a ~empomry ~ence, barrier, or'hay Please be fuff. he.r advised that this letter dn~Anf .~,'~',,., ,,.., r)ec. essary perm,ts or approvals from othe~'~ ;'~i~''~'''' '"" of the responsibility df obtaining a~' ,.,,.,,.~/truly youm, ~'~n~. W~eland - .eP~'~E 'Administrator CC: P. Moore BMHP File 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 From: Mark Terry, Principal Planner LWRP Coordinator Date: August 16, 2012 Re: Proposed Wetland Permit for JANET (;ARRU$ SCTM#1000-86-6-26.1 Environmental East, Inc. on behalf of JANET CARRU$ requests an Administrative Permit to extend the existing wood frame deck by 36". Located: 7055 Indian Neck Lane, Peconic. SCTM# 86-6-26.1 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 provided that: 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 Applica0O~ ~Wetland Permit Application ~ Administrative Permit Amendment/Transfer/Extension JRec~--ved Application: 7Received Fee:$ ~q) Completed Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordinafion:(date sent) LWRP Consistency Assessment Form ~at C Referral Sent: e of Inspection: ~Recaipt of CAC Repor~ ' ~Lead Agency Determination: Technical RevieW. public Hearing ~Resolution: Name of Applicant .~ ANI ~.'[' CZ/~,{~. (9.. ~ 5'. O<~SI/kB~S& I,,1~ Phone Number:( )~[4~ ~cl ] - [{~O' Suffolk County Tax Map Number: 1000- g6e-'- ~)(o-- '2&- (' Property Location: "~'0{~~' I/OC>~/k~J ~___~C/~ /..~['~,~ (provide LILCO Pole #, distance to cross streets, and location) (If applicable) Phone: of Trustees ApplicationO Land Area (in square feet): Area Zoning: Previous use of property: Intended use of property: Covenants and Restrictions: Yes If "Yes", please provide copy. GENERAL DATA '3 '2o q{o3. Does this project require a vahance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes 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 x/~ Yes Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspen/ded by a governmental agency? ~ No Yes If yes, provide explanation: No No Project Description (use attachments if necessary): of Trustees ApplicationO COASTAL EROSION APPLICATION DATA Purposes of proposed activity: Are wetl~ds pre~nt ~in 100 feet of ~e proposed activin? No ~ Yes Does the project involve excavation or filling? ~ No Yes If Yes, how much material will be excavated? tQ ~c How much material will be filled? /~J Pt - Manner in which material will be removed or deposited: (cubic yards) (cubic yards) 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) t/Otc&.. of Trustees ApplicationO WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: 9.~-1 ~>~ c[(0 5 square feet Percent coverage of lot: ~) 7 % Closest distance between nearest existing structure and upland edge of wetlands: "~ 5 '-E)t~ feet Closest distance between nearest proposed structure and upland edge of wetlands: q 'Z J- C>u feet Does the project involve excavation or filling? ~ No Yes If yes, how much material will be excavated? I,J P~ cubic yards How much material will be filled? ~J ~r cubic yards Depth of which material will be removed or deposited: /KI/~ Proposed slope throughout the area of operations: IQ 0 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): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be compJeted by Applicanl or Project Sponsor) SEQR I 1. APPLICANT / SPONSOR 12. PROJECT NAME 4. PRECISE LOCATION: Sff~t Addess a~ Road In~ecaons. Prominent landmass etc - ~ Dr~lde ~ 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [~Yes [] No If no. describebrlef'r/,. 9 WHAT tS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as mary as apply.) ~ReslGential r'"]lndustda, ~lComrnemlal ~']Agriculture F--IParklForest/OpenSpace []Other(describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal. Stateor Local) [~Yes [-'-]No If yes. list agency name and perntti / approval: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? I~Yes r~No I! yes. list agency name and pemfit / approval: iI~::],~eSsA ~.~U~LT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? /I CERTIFY THAT THE iNFORMATION PROVIDED AEOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name Date: If the action is a Costal Area, and you are a state agency, complete the Coaatal Assessment Form before proceeding with this assesBment PART II - IMPACT ASSESSMENT (To be completed by Lead A~lenc¥) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.47 If yes, coordinate the review process and use the FULL EAF. [] e.s [].o WILL ,~CTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.67 If No, a rmgafive dectaretion may be supe~led by another involved agency. C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED W1TH 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 probtems? Explain beefly: C2. Aesthetic, agricoltura[, archaeological, historic, or other natural or cultural resources; or community or neighboi'hood charactsr? Explain hdefly: C3. Vegetation or fauna, fish, shellfish or wildlife species, significant habitats, or threatened or endangered species? Explain bdef~y: C4. A community's existing plans or goals as officially adopted, or a change in use or intensi~y of use of land or other natural resources? Exp a n I~tefly: G§ Gre~dh. subsequent development, or related activities likely to be induced by ~he prope~d action? Explain briefly: I C6. Long term, shod term, cumulative, or other effects not identified in C1 -C57 Explain bdefly: C7. O. WtLL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA ICEA~? Ill yes, explaio briefly: []Yes [~No E. IS THERE, OR IS THERE LIKELY TO BEl CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? r-]Yes r~No If yes explain: PART III - DETERMINATION OF SIGNIFICANCE (To be corepletsd by Agency) INSTRUCTIONS: F~reachadvereee~ectidenti~edab~ve~dete~Tninewhetheritissubstantia~lerge~imp~rtant~r~thenvisesignificant~ Each effect should be assessed in connection with its (a) setting (i.e. ud~an or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (0 magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detsil to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination of significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. Check this box If you have Identified one or more potentially laPge or signirmant edveme Impacts which MAY occur. Then proceed directly to the FULL FAF and/or prepare a positive declaration. Check this box ffyou have determined, based on the Information and analysis above and any suppndiog documentation, that the proposed aciior WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi.~ determination. Board of Trustees [] Name of Lead Agency Date President [] Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer (if different from responsible officer) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. a: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATEI~ GRADINO~ DRAINAGE AND EROSION CONTROL PLAN ols~t sKuon ek~Ck L~t C,~i mri~.~ BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION J'll~ # / WORK ASSESSMENT I Yes No a. WhatisthaTotalAraaoft~PmjsctPam~ls? ~'(~' ~-~' -1 WillthisProjectRetsfe.~lstorm-WatsrRun-Off ~0 ('l~is itsra will inolade all run..off craatad by site b. What is the Total ^raa of Land Clearing I cfeadng and/or construction activities as well as all and/~r Ground Disturbance for the proposed ~ {~) ,,~ Site Improvements and the permanent ~eation of construction activity? impervious surfaces.) (s.F.~) 2 DoestheSItePlanand/orSurveyShowAIIPregosed I~O~/ PROV]DE B~[E~ PRO,rE, CT DESCE[FT[ON (P~,.~ ~ Pm- ~.,~,d) Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and ~qt::;~:) ~ [.~----'-(-~ I~ ~- D~-.J~I~.-~ Slopes Controlling Surface Water Flow. [~'~'( .'~l--C~11. < "~*~ /~C)"[-- 3 DcestheSitaPlanandl°rSurveydescripetheer°si°n ~/['~ and sediment control practices that will be used to ~ ' control site erosion and storm water discharges. This ~ [ ~)/f ~ IJ~ ~, ~ .~~O item must be maintained throughout the Entire Construction Pedod. 'T~ (~t~(J ...~' ) 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving moro than 200 Cubic Yards~ __ of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities ~'~ Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Squaro Feet of Ground Surface? -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction ~3eneral DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required for all Construction activities involving soil Beach? -- disturbances of one (1) or mom acres; including disturbances of ~s than oee acre that 7 Will there be Site preparation on Existing Grade Slopes are part ct · la.er common plan Ihat will ullimate~y dlsturb one or more acres of land; which Exceed Fifteen (15) feet of Verlical Rise to indudk~g Construction act/v/lies involving soil disturbances of less than one (1) acre where One Hundred (100'} of Horizontal Distance'~ the DEC has de[ermined that a SPDES permit is required for storm water discha~es. SWpPp'$ Shall meet the Minimum Requirements of the SPDES GeneraIGp.0.t0.001.)Permit 8 Will Driveways, Parking Areas or other Impewious ~or Storm Water Discharges from Construction activity. Permit No. Surfaces be Sloped to Direct Storm-Water Run-Off ~,~ I. ~1® SWPPP shall be prepared prior fo the submiaal of ~e NOI. T!~e NOI shall be fetO and/or in the direction of a Town right-of-way? submitled to Ihe Department pdor lo the commencement of construction activity. 2. Trte SWPPP shall descdbe the erosion and sediment control p~ctlces and where 9 Wtil this Project Require the Placement of Material, required, post-=onstrucfion storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any r'~ construct~l to reduce the pollutants In storm water discharges and tu assure Item Within the Town Right-of-Way or Road Shoulder V sT4 ' OF ¥orm, ....... Ss ¢_--q~,~-~3 ___~.~[.{~, ~"['~0~ bain dui swom de sos and sa that he'she i ' ~ g'~'~, ............... i}~./,~.~.(i.~li~ffdfii.~.fi.~;;6 .................. g y , po ys / s me appncant mr term/t, =/~c~at he/she IS the .................................... ~~~.....~... ............................................. ,~ ~.~ (Owner. Contractor, Agent, Corporatu Officer, sfo.) .................. ~Cl~l~r and/or representaOve of the Ovmer or Ovmen, and ~s duly authorized to perform or have perforated the said work and to .~ land file this apphcaaon; that all statements contained in ~his application are true to the best of his knowledge and belief; and ~t_e t. ~e work will be performed in theAnanner set forth in the application filed herewith. ~S~ro..h to before me ~his; / ..~ ~ ~ '"O'"'~'" ~"~"" ~'"31" ?Y Puh,ic: ~ ~-~ ~// ~' ~-~~ '~"' ~' Notary FORM - 06110 Jul 24 12 11:09a Judy E nvironme~[iEast Inc 631 ~oard of Trustee~ Al~lioat/on p.2 AUTHORIZATION (wh~e th~ ~uplicant is not the owner) So,~thold Bowd o~ Tow~ Trustees on my behalf. (.~/(Ox, roWs signature) Aug 07 12 04:05p AUg. U I. Z U1;~ AW 0'~ 121 Judy Environmeli~ll~st Inc 0~:35 ~M ~ Judy E.vim~ment East ~nc 914 $5812 1 p.2 PAGE. 1/ · '? 1 of Trustees ApplicationO County of Suffolk State of New York ~)~_.~ ~.. ~13~O~.~ BE1NG 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. 1N 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 WI~ON. ~ -- Signatt~re SWORN TO BEFORE ME THIS ~kO-4'~ DAY OF Q2~ ,20 J ~- Notary Public CONNIE D. BUNCH Notary Public, State of New York No. 01BU6185050 Qualified in Suffolk Counb/ Commission Expires April 14, ~_O~lk~, 3 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oat of town Officers and emnlovees. The ouroose of t~lis form is to orevide in forinatinn which can alert the town of onssible conflicts of intere~tt and allow it to take whatever action is necessary to avoid same. ¥O NAME: ,30AmJ m. (B~t n~me, first uame, ~iddle initial, ~rfiess y6u ~se ~plying Jn the n~e o~ anemone el~ or offer enlily, such ~ a company. If so, indicate, the nther 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 ~vith any officer or employee of thc Town of Southold. Relationship includes by blood, marriage, or business lnteresL 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~ of the shares. YES NO If you answered "YES", complete the balance of this form and date and sign where indicated. Name o f 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 thc appropriate line A) through D) and/or describe in the space pmoided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): __:A) the owv~r of greater than 5% oftbe shares of the corporate stock of thc applicant (when the applicant is a corporation); B) thc legal or beneficial owner of any interest in a non-corporate entiLy (when the applicant is not a corporation); __.C) an officer, director, partne~',.or employee of the applicant; or __D) the actual applicant.. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this ~~.~ Signature Print Name 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 sup~plement 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 Sonthold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detail, listing both supporting and non- supporting facts. 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 f website (southoldtown.northfork.net), the Board of Trustees local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 7_..¢,/. PROJECT NAME ~L~ The Application has been submitted to (check appropriate response): Town Board Sout,l,:ok~ :ow~ / [~ Planning Board [--] Building Dept. ~-~ Board ofTrustees ~' Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: 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: (c) Telephone number: Area Code ( ) ~( --"~4 '"-"~4 '~ 4 (d) Application number, if any: ~ ~ Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No ~ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide ali proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southoid that enhances community character, preserves open space, makes efficient use of infrastructure~ makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria [] Yes~ No~5~ Not Applicable ( Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section Ill - Policies Pages 6 through 7 for evaluation criteria 73 Yes 71Nop NotApp.cahle Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LwRP Section III - Policies Pages 8 through 16 for evaluation criteria ~ Yes 71 No'Not Applicable Attach additional sheets if necessmy Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section Iii - PoliCies Pages 16 through 21 for evaluation criteria [] Yes No l ot*pplieahle 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 HI - Policies; Pages 22 through 32 for evaluation criteria. Yes No 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 Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~] Yes ~ No ~Not Applicable 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. [] Ye? No.[~- Not Applicable Attach additional sheets if necessary WORKING COAST POLICIESO 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 56 for evaluation criteria. ~'~ Yes ~ No.~/Not Applicable ARach additional sheets if necessary 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 62 for evaluation criteria. ~ Yes ~-~ No ~Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. Yes No NotApplieahle Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energ~ and mineral resources. See LWRP Section HI - Policies; Pages 65 through 68 for evaluation criteria. ~-~ Yes ~ No ~ Not Applicable PREPARED BY DATE ® ® DISTANCE 209.91' S75'37'00'E 342.79' 274.10 S26'28'50"E 225.0' N/F TRUST '8' U/LW&T OF VINCENT J. FREDA, CAROL URY FREDA AND b~THUR G. URY, CO-TRUSTEES N 90'00'00"E 305.00' / / / \ \ \ \ l \ \ I I \ I / I I / / ~/ / / / / : : : : : .' / / / / / / / / / / / / / / / / ,/ / / \~,/ // / / / / / / / / / / / / / / / / / / / / / / / / // / / / / / / / / / / / ./ / / / / / / / // / / / / / ..... / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / // , g.OlXO_-//~/ TIE DISTANOE (~ NSg'?8'?O"E 209.91' (~ S75'57'00"E 342.79' N89'31 '50"E 274.10 S2fi'2S'50"E 225.0' WELL N/F TRUST "B" U/LW&T OF VINCENT J. FREDA, CAROL URY FREDA AND ARTHUR G. UR¥, CO-TRUSTEES N 90'00'00"£ 505.00' ?0 FOOT WIDE UTILITY EASEMENT UTILITY POLE POLE EL 14 // / iiiiII END FENCE / APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE ,,~, ~- ~ ~/ ~KIS'I"ING DECK ?1'-2' CARRUS DECK PLAN OF PROPOSED DECK EXTENSION ENVIRONMENT FAST INC. 1/4" = 1'~" 7.24.12 7# ® ® 225,0' N/F TRUST "B" U/LW&T OF VINCENT J FRED& CAROL URY FREDA AND ARTHUR O UR¥, CO-TRUSTEES WELL N 90'00'00"E pOLE 505.00' SALT F, LOOD/ . MARSH S 85'$3'20"E 242,54 SURVEY OF PROPERTY SITUA T£ PECONIC IOWN OF SOUTHO/D SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-86-06-26.1 SCALE 1"=40' MAY 17, 2006 OCTOBER 5. 2007 FINAL SURVEY AREA = 305,746 sq. ff. 6.973 ac, CERTIFIED TO: JANET CARRUS AUG 2 2012 ' ' UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF pREPARED iN ACCORDANCE WITH THE MINIMUM STANDARD5 FOR TITLE SURVEYS AS ESTABLISHED Nathan Taft Corwin III Land Surveyor PHONE (631)727-2090 Fox (631}727-1727 62 168