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Home My WebLink AboutTR-7824A 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 1st day of construction ¼ constructed Project complete, compliance inspection 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 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD Permit No.: 7824A Date of Receipt of Application: May 23, 2012 Applicant: Thomas Cassidy SCTM#: 97-7-2 Project Location: 280 Beebe Drive, Cutchogue Date of Resolution/Issuance: June 20, 2012 Date of Expiration: June 20, 2014 Reviewed by: Dave Bergen, Trustee Project Description: To construct a 140 square foot extension to the existing patio and resurface with on-grade concrete pavers; add a roof with solar panels and open sides; install a 16' roll-up awning to be mounted on northern roof line over the patio; replace two concrete pads that abut the wood ramp and eastern fence line; and for the existing fence and sheds. 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 survey prepared by Nathan Taft Corwin III, last dated May 14, 2012, and stamped approved on June 20, 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. Ja~emes F. King, ~resident Board of Trustees James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 TO: THOMAS CASSlDY BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated May 23, 2012 has been reviewed by this Board at the regular meeting of June 20, 2012 and your application has been approved pending the completion of the following items checked off below. __ Revised Plans for proposed project __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) XX Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: Final Inspection Fee = $50.00 TOTAL FEES DUE: $ 50.00 BY: James F. King, President Board of Trustees James F King. President Bob Ghosio, Jr. Vice-President Dave Bergen John Bredc~neyer 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/Worksession Report Date/Time: THOMAS CASSIDY requests an Administrative Permit to construct a 140 sf. extension to the existing patio and resurface with on-grade concrete pavers; add a roof with solar panels and open sides; install a 16' roll-up awning to be mounted on northern roof line over the patio; replace two concrete pads that abut the wood ramp and eastern fence line; and for the existing fence and sheds. Located: 280 Beebe Dr., Cutchogue. SCTM#97-7-2 ,~qeof area to be impacted: altwater Wetland Freshwater Wetland __Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _~Chapt.275 Chapt. 111 other Type of Application: __ Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were: J. King B. Ghosio )Q.D. Bergen, __J. Bredemeyer__ Michael Domino D. Dzenkowski __ Form filled out in the~el¢ b~.y~, ,~.5~' Mailed/Faxed to: Date: other OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southald, 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 JUN 2 0 2012 Scuthh0]d kwn Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 20, 2012 Re: Proposed Wetland Permit for THOMAS CASSlDY SCTM#1000-97-7-2 THOMAS CASSlDY requests an Administrative Permit to construct a 140 sf. extension to the existing patio and resurface with on-grade concrete pavers; add a roof with solar panels and open sides; install a 16' roll-up awning to be mounted on northern roof line over the patio; replace two concrete pads that abut the wood ramp and eastern fence line; and for the existing fence and sheds. Located: 280 Beebe Dr., Cutchogue. SCTM#97-7-2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney 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 Office Use Only Coastal Erosion Permit Application --Wetland Permit Application ~/ Administrative Permit __Amendmentfrran_ffer/Exte. nsion /l(eceived Application: ~'~1 ~d~ceived Fee:$ ~k~~ a2~pleted Application __Incomplete SEQRA Classification: Type I Type II Unlisted__ Coordination:(date sent) ..4gWRP Consistency Assessment Form CAC Referral Sent: ~Date of Inspection:_ t~ [! Receipt of CAC Report: Lead Agency Determination:___ Technical Review: ~4~ublic Hearing Held: Ip! Resolution: Name of Applicant Address ~ Suffolk County Tax Map Number: 1000- ~'~] ~)'~ Property Location: '~ ~f~D /~ ~ (provide LILCO Pole #, distance to cross streets, and location) Phone Number:( 75¢ AGENT: (If applicable) Address: Phone: GENERAL DATA Land Area (in square feet): Area Zoning: ~_~.Ch i 1-) ~ ~ '~ ~P~ Previous use ofpropeay: Intended use of property: Covenants and Restrictions:. If "Yes", please provide copy. Yes ~/No Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Yes No Will this project require any demolition as per Town Code or as determined by the Building Dept. Yes ~/~o Does the structure (s) on property have a valid Certificate of Occupancy. /Yes __No Prior permits/approvals for site improvements: Agency IDate[ -~ ~10 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? iX~ No Yes If yes, provide explanation: WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~//P ~) t4~, ~ ~/~/~ (~"]'~-~ Area of wetlands on lot: _square feet Percent coverage of lot: ~- % Closest distance between nearest existing structure and upland edge of wetlands: (400 feet Closest distance between nearest proposed structure and upland edge of wetlands: ~p O feet Does the project involve excavation or filling? P//No Yes If yes, how much material will be excavated? [,f ~: cubic yards will be filled? ~J/~ cubic yards How much material Depth of which material will be removed or deposited:$ ~'/[ ~ feet Proposed slope throughout the area of operations: 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): Boa~of Trustees Application COASTAL EROSION APPLICATION DATA Purposes ofproposedactivity: ~0~)l~J~'~(~k'l (5(1~,~) fY~-b~)~0t~, _ ./ No x// Yes Does the project involve excavation or filling? v// No Yes If Yes, how much material will be excavated? ~t ~ How much material will be filled? ~) ~ 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) PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT / SPONSOR 3.PROJECT LOCATION: 6'17.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRON MENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only To be compJeted by Applicant or Project Sponsor) 2. PROJECT NAME County $EQR PRECISE.,~LOCATION:~_~_.~Street Addess andD~/~R°ad IntersectJons.~_~ ~-~''//7'~ ~-~ (''/~ j'Pr°minent landmarks eec IS PROPOSED ACTION: [] New [] Expansion [] Modification I alteration DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres $. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ~]'Yes [] No If no, describe briefly: 9 WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply) ~;;TResidential []industrial []Commercial r-~Agbculture [] Park/Forest/Open Space [~Otber (describe) IO.'DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) E~]Yes l~No If yes, list agency name and permit / approval: T~.DO~5~.~.TqY ASPtL;I O~- IHt AL;IIO~T HAVE A CU~'VALID PERMIT OR APPROVAL? []Yes r---~No If yes, list agency name and permit / approval: 12, AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~]Yes DNo I CERTIFY THAT THE I FO ATION PROV ED ABe IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Sponsor Name ,~1~: D ate./~ /~/. If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II - IMPACT ASSESSMENT (To be completed by Lead Agency} A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. pART 617.47 If yes. ceoedinate the review process aed use the FULL EAF. r'-~ Yes ~]No B. ~6~ILL ACTION REC~VE COORDINATED REVlEWAS PROVIDED FOR UNUSTED ACllONS IN 6 NYCRR, PART 617.67 If No, a negative dedaralin~ may be superseded by another involved agency. r--~ Yes [~]No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH 11-1E FOLLOWING: (AJlswe~a may be hare'walden, # legible) Cl. F_xts~ng air quar~, sudace of groumiwaler quality or quantity, noise levels, existing traffic pattern, selH waste preduc~on o~ disposal. potential ~or erosion, drainage of floeding problems? Explain bdefly: (:2. AeC, agricultural archaonleglceL hisled~ or ofher natural or cultural reseumes: or community or aetghbedlo~d chara~ef? F_xp~n I Vege(atinn or fauna, ash, ~ei(fish or wildlife species, signlacant habitats, or Ihrealoned or endangered spedes? Explain briefly:. C4. A ~,~ ,~ii~ni~y's existing ptans or goals as ~,~aG~ adopted, or a change I~ use or intensity of use of lend or other natural fesoumes? Expia~n bdefl¥ C5. Gl'ow~h. subsequon[ develepmenL or reiated acfivihes likely to be induced by/Jle proposed ac~ On? r~.~= q briefly: ! C6. Long term. shod te~m. cumulative, or other effects not identified in CFC§? Exptain briefly: I CZ. Other Impac(s (inctuding changes in use '~'f either quan(ity or lype of euarg}~? Explain O. VVILL THE PROJECT HAVE AN iMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA~? IIf yes, explain b~efly - ut: ! I=~MINATION OF SIGNIFI~CE (To be oompleted by Ageno/) . IN~TRUC-TIO~$: Foreadladverseeffec~identifledabeve, detemlinewfle~her#lssubs~antial, large, lmpedantorolhe~seslgnlfican£ EaCh effec~ should be assessed in connection with its (a) aeWng (i.e. urt~an or rdral); (b) ~ of ooc~tff~; (c) duratlo~ (d) in'eyeShOt. (e) ~aphl¢ r,~oe; and (f) magnitude. If necessaly, add attadmlents el' reference ~ matedal~ Ensure that e~ WILL NOT result in any sig~ficant adveme eflvlronme~al Impacts AND pro,de, m~ altadlments as necessaff, the reasons suppoffing tfd. doformleaben. Board of Trustees Name of Lead Agency _ Pdn! or Type Name of Responsible Officer in Lead Agency S~atum of Responslble Officer In Lea/~Agency President TiIle of Responsible Officer Skjnatum of Preparer (If different from responsible officer} Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T*M* #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL PLAN s~t,ot a~tJo. B~¢k Cot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION l'l'l~# / WORK.,~SSESSM~_,NT I Yes No a. What is the Total Area of the Project Parcels? I Will this Project Retain NI Storm-Watar Run-Off (includeTolalAreaofallParcelslocatadwithin ~(~ ~ ~ Genereted by a Two (2') lach Rainfall on Site? r~ the Scope of Work for Proposed Construction) (This item will include all mn-off created by site (S.F. ~ Acme) b. What is the Total Area of Land Clearing cleating and/or construction activities as well as all -- and/or Ground Dlstudmnce for the proposed Site Improvements and the permanent creation of construction activity? impervious surfaces.) (s.~.,^~l 2 Does the Site Plan and/or Survey Show AIl Proposed PROVIDE BRIEF PROJECT DESCRIF~ION (P~.ae Addi~nM pagas as Nee~ Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and -- ~/f~)j~"'-l~ "~ /'r~/0~//~ Slopes Controlling Surface Water Flow. ~j(~-/~(~ C/~/~/~/~j.~T~ 3 OoestheSitePlanand/orSurveydescribetheerosion r~ and sediment control practices that will be used to control site erosion and storm water discharges. This -- ~/~"~ ~ (iA..) ~ ~'~J~ ~/~v/~:). item must be maintained throughout the Entire Construction Pedod. p~/Y'3JC' t~//"J/_t~. / ~0~~d0~ 4 Will thls Project Require any Land Filling, Gradingor (,r~t~./~~ /~.~ ~,~ .~/~¢~/~. Excavation where there is a change fo the Natural O Existing Grade Involving more than 200 Cubic Yards -- of Matedal within any Pamel? '~/~ ~-~/~/~-- /'~'~ ' 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 Coume Running through ~e Site? Is this Project within the Trostees jurisdiction~ Ger~eral DEC SWPPP Requiremeots: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required for all Construction activities involving soil Beech? disturbances of one (1) or more acres; ir,:leding disturbances of less than one acre thai 7Will there be Site preparation on Existing Grade Slopes ~ are par~ of a larger common p~en that will ultimately disturb one or more acme of land; which Exceed Fifteen (15) feet of Vertical Rise to including Construction activities levohtiog ~ disturbances of less than one (1) acre where One Hundred (100') of Horizontal Distance?~ -- the DEC has detorrn~ned that a SPDES permit is required for storm water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit i 8 Will Driveways, Parking Areas or other Impervious r'"'l thr Storm Water Discharges from Construction activity. Permit No. GP-0.t 0-00t .) Surfaces be Sloped to Direct Storm-Water Run-Off U 1. The SWPPP shall be prepared pdo~ ~o the subnfiSal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? -- ;ubmieed to the Department p6or tu the commencement of construction activity+ 2. The SWPPP shall describe the erosion and sediment centr~ practices and where 9Will this Project Require the Placement of Material, required, post-cons~ucticn srbm~ water management practices that will he used and/or Removal of Vegetation and/or the ConstaJCiton of any ii constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right.f-Way or Road ShoulderL~J -- identify potential sources of pollution which may reasonably pa expected to affect the ~lhat ~, ..._.,:.~_~: ................................................................ being duly sworn, deposes and says tha~ be/she is the applicant for Permit, And that he/she is the .... ~....~ ................................................................................................................................... Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and in the manner set forth in the application fried herewith. that the work will be performed ...~..~,~._... da~, of ...~~ ......... 9g/.O~ ............. , , Notary Publi~ -..~..~r~.~,,'~,~...~m~.~.O~.~. .................... ?.,:; ;....,~!.~ ~ . FORM - 06/10 o~}i{~ ~ s~!,~,lk coum., Corn mission3 £xp[m~ Nov. 30, James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Tow~ 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 30-YEAR MAINTENANCE AGREEMENT EROSION PROTECTION STRUCTURES CHAPTER 111-15 OF THE SOUTHOLD TOWN CODE The owners of record of property at: SCTU# OOO- C./7 - 07- in applying for a Coastal Erosion Permit for an erosion protection structure do hereby agree to a 30-Year Maintenance program for.,a s. tru. ctu~s~,cJ~e§cr, ib.e.d~,.~_ ~,~r, ~. as shown on the attached licensed survey and/or site plan for the approved structure. It is my/our understanding that we are to maintain this structure with materials designed to endure 30 years and/or equivalent to the original approved structure, Any maintenance which involves more than 50% of the length of this structure requires approval of the Board of Trustees. We fudher understand that failure to maintain the structure could result in a requirement to post a bond and/or have the rep/aj~s ordered as a lien against the property upon a finding by the Board c~--~ostees ,that ~id lack of · ' . , -~otarized signature]of owner of Cecord This maintenance agreement shall only be valid upon the attachment of a licensed land survey/and or site plan made within one year of the original construction and validated to show the final approval of the administrator. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK C ~.~f0(~c~_ t,2.1 ! !&~ .'?- , being duly sworn, deposes and says that on the ~ \ da~ of rna ~ ,20 {7.~, deponent mailed a true copy of the Notice set forth in the Board of T~ustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United S~tes Post Office at CG~CA~(~L~ ~7~. , that said Notices w~,~p~j:Ied to ~ach 9t~id,ls~ons by CERTIFIED MAIL/RETURI~ RECEIPT. //// // // // Sworn to before me this ~ [ Dayof ~{ ,20~r~- ~ No~ra~u~olic Board of Trustees Application County of Suffolk State of New York ..~/ 7"7~/t///~' J C~A~ 5/a7 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. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO/I~NSPECT THE PREMISES IN CONJUNCTION~ ~~Si~a / ~,~T/~WITH REV THISt APP ~ATI . SWORN TO BEFORE ME THIS ~}'-( DAYOF /'~O-7 ,20/2 k~Nbtary Public''-~/ NOtre,/No. 01CA~13~17 Qu~Bted in Su~ Courtly Commbslon Expirm: ~ 31, 2~/3 Boa of Trustees Application County of Suffolk State of New York ~t~ff/~/~ ~/~% / ~)q BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SFfE 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), 1F GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVI~W OF THJ~ ApP, J~ICATION. ~ ~ignature -- SWORN TO BEFORE ME THIS '.~ DAY OF ~ ~q/ ,20 / ,~ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE, FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town 0ffieess and emoloveas. The ouroose of this form is to orovide information which can alert the town of ~ossible conflicts of interest and allow it ~ lake whatever action is necessary to avoid same. (Last name, first name, ~niddle initial unless you are applying in the name of someone else or other entity, such as a company. If so, indicate, the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other', name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, 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 emNoyee owns more than 5% oft~ shams. YES NO If you answered "YES", complete the balance of this form and date,~/an/ifL~sign where Name of person employed by the Town of Southold I' [I~n Title Or position of that person indicated. Describe the relationship between yourself(the applicant]agent/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); ___B) the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); ___C) an officer, director, par{net, or employee of the applicant; or ___D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this j of Signature ....~-ge _t.~:~'~_ .~/ 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" 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- suooorfiw, 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 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. 9'7 -7 DESCRIPTION OF SITE AND PROPOSED ACTION PROJECT NAME The Application has been submitted to (check appropriate response): 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: oF o Location of action: Site acreage: Present land use: Present zoning classification: If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: ~/~ (c) Telephone number: Area Code ( (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 all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ~ Yes [] No ~-~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ~-~ Yes ~ No [--~Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LwRP Section Ill - Policies Pages 8 through 16 for evaluation criteria [-~ Yes ~ No [~Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria Yes ~ No ]l~)(NotApplicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. Yes No Not ApplOle 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. ~ Yes~ No ~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III- Policies; Pages 47 through 56 for evaluation criteria. [] Yes ~-~ No ~--~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section IH - 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[--i--~Notnpplicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section HI - Policies; Pages 65 through 68 for evaluation criteria. Yes ~ No ~-~ Not Applicable Thomas 3 Cassidy 280 Beebe Drive Cutchogue NY 631 584 5953 Dear Board of Trustees, I am writing this letter to you in an effort to have modifications done to my residence. Thc following list of projects is to be executed in phases. The first is an addition to the patio area that already exists. It is approximately 140 square feet and I have submitted photos to illustrate. I am requesting this because I am planning to have the patio resurfaced with on grade concrete pavers and would like to expand for additional outdoor living space. · The second phase is to have the on grade pavers installed on the existing patio and added 140 square foot addition. · Thc third phase will be to install a 16 foot roll up awning that will be mounted on the northern roof line over the patio. The fourth phase is to have a open area picnic gable added to the north facing roof to provide much need shelter from the summer sun and to provide an ample roof surface for a photo voltaic array to help defray the high cost of electricity. The existing concrete pad is only 15 feet in depth which will only allow for a solar panel system that would provide only 34% of my electrical needs. I was hoping to have a system of a least 50°/$ electrical capacity. To do this I would need to have two supporting columns 22 feet from the north side of my residence (seven feet farther from the patio) I have included with this letter some preliminary drawings with overlays, a Google Earth photo of my residence with an approximation of the new roof area, photos of the residence and a new survey showing all the requested updates. I want to clarify that this roof extension is to be open ak and only used as outdoor living area. The fitch and future phase is to replace the two concrete pads that abut the wood ramp and eastern fence line. Both need replacement due to several large cracks and fissures that are a result of ground settling. This work is to be completed over a two year period. Thank you for your time and consideration. Yours 1~' ? Thomas~l Cassidy 11roses J Coss~, L I I~ ...... i ~,~J~ 2BOBeebeD~ ClddlOpl NY 11935 ~ /v 3~ 69 'JO 'Oo-" NOTES: 1, ELEVATIONS ARE REFERENCED TO N.D,V,D. 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:5o FFL - FIRST FLOOR ,S, Lie, No 50467 NY,S, L~ Nathan Taft Corw n III Land Surveyor Successor To Stanley J, Isoksen, Jr LS PHONE (651)727-2090 Fax (631)727-1727 s U ~ERTIFIED TO' THOMAS CASSIDY OERMAINE CASSlDY NORTH SHORE ABSTRACT, LTD FIRST WEST MORTGAGE BANKERS, LTD UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY iS A VIOLATION OF SECTION 7209 OF THE NEW yORg STATE N/O/¢ R4$MUSSEN & SE£DE~ ~R, ,51.96, ~ 76.50Z D 64.67' 0 TOTAL LOT COVERAGE OVER UPLAND AREA (UPLAND AREA = 21,254 sq. ft.) DESCRIPTION AREA % LOT COVERAGE EXIST. HOUSE 2,045 sq. ff. 9.6% EXIST, SHED 261 sq, fl, 1,2% EXIST. ASPHALT DRIVEWAY 1,778 sq, ft. 8.4% EXIST. CONC. WALKS, SLABS 977 sq. ff. 4.4% EXIST. WOOD WALKWAYS 642 sq. ff. 3.0% EXIST. CONG. PATIO 211 sq. ff. 1.0% NOT INCLUDING PATIO AREA UNDER PROP ROOF PROPOSED ROOF 374 sq. ff. 1.8% INCLUDING PATIO AREA UNDER PROP. ROOF PROP. PATIO EXTENSION 44 sq. fR. 0.2% NOT INCLUBtNO PATIO AREA UNDER PROP ROOF TOTAL EXIST. & PROP. 6,292 sq. ft. 29.6% 212.00, ,'2 ' C) SURVEY OF LOT 32 MAP OF MOOSE COVE FILE No. 3230 FILED AUGUST 30, 1960 SITUATE CUTCHOGUE TOWN OF SOUTHOLD ',SUFFOLK COUNTY, NEW YORK I S.C. TAX No. 1000-97-07-02 I SCALE 1"=20' MAY 14, 2012 AP?PC'FED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE J v ~,'~ ~EA = 21,254 sq. ff. 0.488 ac, DRAINAGE SYSTEM CALCULATIONS: PROPOSED ROOF AREA: 374 sq. ff. 374 sq. ff. X 0.17 = 64 cu. ff. 64 cu. ff. / 42.2 = 2 verficol ff. of 8' dRY. leochin9 pool required PROVIDE (1) 8' dia. X 2' high STORM DRAIN POOL PROPOSED 8' DIA. X 2' DEEP DRYWELLS FOR ROOF RUN-OFF ARE SHOWN THUS: 32-09 /V 69.~ , °O O0 ,, NOTES: 1. ELEVATIONS ARE REFERENCED TO N.G.V,D. 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:S~ F FL - FIRST FLOOR CERTIFIED TO: THOMAS CASSIDY GERMAINE CASSIDY NORTH SHORE ABSTRACT, LTD FIRST WEST MORTGAGE BANKERS, LTD NYS. Lic No 50487 Nathan Taft Corwln III Land Surveyor PHONE (631)727-2090 Fox (631)727-1727 AND/OR EASEMENTS OF RECORD, IF AN'(, NOT SHOWN ARE NOT GUARANTEED, 69 '30 '0 - ,, U N/O/F SELDEN, JR. $7.96, rr \ o TOTAL LOT COVERAGE OVER UPLAND AREA (UPLAND AREA = 21,254 sq. ft.) o DESCRIPTION AREA % LOT COVERAGE EXIST. HOUSE 2,043 sq. ff. 9.6'/. EXIST. SHED 261 sq. ff. 1.2% EXIST. ASPHALT DRIVEWAY 1,773 sq, fl. EXIST. CONC. WALKS, SLABS 977 sq, ft. EXIST. WOOD WALKWAYS 642 sq. ff. EXIST. CONC. PATIO 211 sq. ff. 1.0% NOT INCLUDING PATIO AREA UNDER PROP ROOF PROPOSED ROOF 574 sq, ff. 1.8% qCLUB[NG PATIO AREA UNDER PROP, ROOF ~ROP. PATIO EXTENSION 44 sq. ff. 0,2% NOT INCLUDING PATIO AREA UNDER PROP. ROOF TOTAL EXIST. ~ PROP. 6,292 sq. ff. 29.6% MAY 2 3 2012 212.00, APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DRAINAGE SYSTEM CALCULATIONS: PROPOSED ROOF AREA: 374 sq. ff. 374 sq. ff. X 0,17 = 64 cu. ff. 64 cu. ff. / 42.2 = 2 verdcml fl. of 8' dim. PROVIDE (1) 8' did. X 2' high STORM DRAIN PROPOSED 8' DIA. X 2' DEEP DRYWELLS SURVEY OF LOT 32 MAP OF MOOSE COVE FILE No. 3230 FILED AUGUST 30, 1960 SITUATE CUTCHOGUE TOWN OF SOUTHOLD UFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-97-07-02 SCALE 1"=20' MAY 14, 2012 AREA = 21,254 sq. ff. 0.488 ac. leaching pool required POOL FOR ROOF RUN-OFF ARE SHOWN THUS: 32-098