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Home My WebLink AboutTR-7929ESOUTH OLD TR'US THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD. N;Y. 11971 TEL.: 765-1892 SURVE'r' OF LOT cl ~ PART OF LOT 8 MAP OF RE'r'DON SHORES, INC. FILED JUL'r' 2, Iq~l, HAP No. &~l SITUATE: BAh~/IEIN tOHN~ ~OUTHOLD 5UI=FOLK ~OUNTT, N~ ,?:~)RVET'ED O&-18-2OO5 .SUFFOLK COUNT'r' TAX # IOOO-80-I-46.1 Alex,ruder Sznumwski N + W ~'~ E S · MONUMENT FOUND A~A = IO,~,qO 5.F. or 0.250 A~e 62' ~ONT) FO~ BXISTIN~ ~AO~ ~Z (~ F~ ~ED ~ ®f:~,APHI C, SCALE LOT C, OYERACE C, ALCULATION5 EXI~TIN® HOUSE I,..~40 5.F. OP. I2.D% PROPOSED CARAFE ~6¢ 5.F. OR ~,~'~ TOTAL ~.?:~t)LTIN® LOT C, OVERA®E 15.(2% JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Server\c\pros\05\05-269.pro FILED JULY 2, Iq~,l, HAP No. 6BI .% -~ W~ E 5ITt)ATE, BA'rVIEIN 5URVEYED SUFFOLK C, OUNT'¢ TAX ~ IOOO-~O-I-4~2.1', .~Uex~ud~r Szu,a'owaki NOTE~: .... _ __ 62' (FONT) FOR EXISTIN~ 5,ET'BA(,,K5 62' (FONT) FOR I~,OFO~ED ®I~.APHIC, SCALE I"= 20' LOT OOVEF:~.A®E OALC.,ULATION~ EXISTIN~ HOU.~E 1~4-O 5.F. OR PROPOSED '~AF~k~E ~,(28~ 5.F. OR -~.~ TOTAL t~ESULTIN~ LOT OOVE~.E JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Server\c\pros\05\05-269.pro 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 HURRICANE SANDY EMEGENCY APPLICATION Valid thru June 1, 2015 Permanent Mailing Address: Phone Number(s)~? Property Address: Suffolk County Tax Map Number: 1000- Agent (if applicable) .~,,~///)~',,3¢ ~'~,,~"~ Address: ~~/' ~ ~ Phone Number(s): Board of Trustee Permit Number(s): Will any part of this project require a Building Permit? How much fill will be required? ,/~,0~0 /Z.~ ~ Project Description: of Trustees Applicationl County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES 1N CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF _,20__ Notary Public James F. King, President Bob Ghosio, Jr., Vice-Pr~sident Dave Bergen John Bredemey~r MieAmel J. Domino Town Hall Annex 54375 Ma/n Road P.O. Box 1179 ~outhold, Hew York 11971-0959 Telephone (~1) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRU$'riiES TOWN OF SOUTHOLD Office Use Only __CoasUfl Erosion Permit Application ~Wetland Permit Application __ Administrative Permit AmendmenvTram ferfExtension Received Application: Keceived Fes:$ Completed Application Incomplete SEQRA Classification: Type I Type II Unlisted Coordinafion:(datc sent)_ LWRP Consistency Assessment Form CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: __ Resolution: Name of Applicant MailingAddr~s '~ ~Z Phone Suffolk Co~ty T~ Map N~b~: 10~ ~p~y Lo~tion: ~/~ (provide LILCO Pole #, distance to cross streets, and location) //771 AGENT: (If applicable) Address: Phone: tard of Trustees Application Land Area (in square feet): Area Zoning: GENERAL DATA 6 9o Previous use of property: Intended use of property: Covenants and Restrictions on prope~. __Yes No If"Yes", please provide a copy. / Will this project require a Building Permit as per Town Code? Yes If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. / Does this project require a variance from the Zoning Board of Appeals? __Yes __No If"Yes", please provide copy of decision. Will this project require~nnolition 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? t/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__ If yes, provide explanation: Y~ Project Description (use attachments if necessary): Bo~a~d o£ T~ustees &pplication WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of thc proposed operations: Area of wetlands on lot: Percent coverage of lot: ~uare feet cubic yards feet Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure ami upland edge of wetlands: feet Does the project involve excavation or filling? No ~es If yes, how much material will be excavated? How much material will be filled?~]9~0/.. ~cubic yards Depth of which material will be removed or deposited: Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetiands 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 1. APPLICANT I SPONSOR Mun~cipe~y 617.2{) APPENDIX C STATE ENVIRONMENTAL QUALrTY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by.~ flicant or Project SponsoQ 2. PROJECT NAME SEQR 4. PRECISE LOCATION: Street Addess and Road In~eniectio~s. Prominent landmarks et~ -or movfde mar> 6. DESCRIBE PROJECT BRIEFLY: 7. AMOUNT OF LAND AFFECTED: Initially ac. ms Ultimately acres 8. NLL PROPOSED ACTION COMPLY WiTH EXISTING ZONING OR O~-IER RESTRICTIONS? r--~Yes [] No If no, descfibebfleJly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choo~e as rnany as apply.) ~Residentlal [] Indu-~rtal [] Commercial r~Agflcuitum [] Par~lFOmstl Open Space [] Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal. State or Local) ---]Yes []No If yes, fist agency name and perm[~ I approval: 11. DOES ANY ASPECT OF THE ACTION RAVE A CURRENTLY VALID PERMIT OR APPROVAL? ]Yes []No If yes, let agency name and permit I approval: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE , If the actto~ is s Costal ,Area, aed you ara a state agenay, complete the Coastal Assessment Form before proceeding with this assessment Town of Southold Erosion~ Sedimentation & Storm-Water Run-off ASSESSMENT FORM SCOPE OF WORK - PROPOSF_,]) CONb'i'IRUCTION lrll. lrSM# / WORKASSF_,SSMENT Y~ No n. Whntistht~To~lAmao~llmPmje~Parcels? I W~l~thlsF~ojec~RelainNIStnrm-Wat~Run-OIf (Include Total Ama of all Parcels located within Get.rated by a T~o (2') Inch Rainfall mt Site? Ihe Scope of Won~ f~- Proposed ConsblJc~n) ~nlis Iteat wll Illclude all ilz~off a~=~J by sits r~ (s.s. i ~) 2 Does the Site Plan and/or Suwey Show AJI ~Pre'~~=~ Slopes Contmillng Sur f~e Wate~ Flow. 3 Does the Site Plan and/or Suwey describe lhe erosion 6 Is the~e a Natural Water Course Running Ihmush the fflWI'E OF NEW YORK, COIJNrl'y OF ........................................... SS That l, ................................................................................ being duly r~v6m depots and ~a~ that h~she is the applicant [or Permit, And that he/she is the ........ , ......................................................................................................................................................... O~mer and/or representative of the Owner or Owners, and is duly authofi*e~l to pert'onn or have p~onned the ~id work and m make and file thi~ applim~ion; that all ,m~n~n~ contain~ in thi, application a~ m~ m the I~st of his lmowl~e and beJi~t'; and that the work MIl I~ p~rformed in the manner set forth in the application t-d~.~l herewith. Sworn to before me thi~; ............................................... day of ...................... : ...................... 91) ..... Nom'y Public: .......................................................................................... FORM - 061t0 Bo~d oE T~us~ees &ppl~c&t~on County of Suffolk State of New York 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, 1 HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS '~ I DAYOF OCT ,20 I(pQ Notary Public VICKI TOTH Notary Public.State of New York No. 01T06190696 Qualified in Suffo k Countv. Commission Expires July 28, 20 I~ Bird o~ T~ustee~ AUTHORIZATION (where thc applicant is not the ownex) (print owner of property) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tnx grlev~ce Building · Varianco Tmstce Clmnge of Zone Coastal F~oskm Approval of pint Exemption from plat or officinl map Planning Other 0f"Ofl~" nnn~ the activity.) Do you pemoanlly (or through your company, spouse, sthhng, parent, or child) hav~ a ~lationship Jsvlth any officor or ~nploy~ of the Town of Southold? "Relationship" includes by blood, ramiage~ or including a pe~ership, in which the ~own officer or ~mplo¥ce h~s ~vcn a partial own~hip of (or 'employment by) a corporation in which the town officer or cmployce owns mor~ than 5% of the shar~s. YES NO lf.y0u answered 'YES", compiele the balance of Ibis form and da~ and sign where indic~t~l. N nme of person employed by lhe Town of Southold Title ~r position ofthet person lkserihe the relationship hetw~en your~lf(the applieanffagem/rep~cen~ve) and ~he 1own officer or employee. E~ther check the ~0wpriate line A) through D) and/or dcscdhe ia the space proVided- The ~own officer or employan or his or her spouse, sibling, pare~L of child is (check nil lliat npply): .. A) the owner of g~.ater than 5% of the shares of the corporat~ s~cek of the applic~t (whan ~ applicant is a ~poration); __ B) the legal or beneficial owner of any interest in a v~corpotate entit~ (when the npplic~t i~ not a coqx)mtian); C) an offi~a', director, partnei', or employce of the npplie~nt; or , D) the actual applicant DESCRIPTION OF RELATIONSHIP ForinTS I Submitted this Signature Print Name day of__ 200 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS All applicants for permit* inoluding Town of Southold agenoies, ~hal! compl~t~ this CCAF for proposed actions tha~ are subject to the Town of Southold waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of $outhold agency in making a determination of censistancy. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. Before ~ the questiom in Section C, the p~parer of this form should review the exempt minor action list, policies and explanations of each policy co~ta!-~d in the Town of Southold Local Waterfront Revitalization Program. A orooos~xt a~tion will be evaluated, as tO RS simxificant · ~eial and adve~so effeets uoon the coastal ~irea (which in, lades all of Southold Town). 3~ If any queslion in Section C on this form is ~ "yes" or '~no", then the proposed action will affect the achievement of the LWRP policy standards and conditions coniained in the consistency review law. Thus~ ~eh_ am~ver must be explain~l in detail~ listing both monorfin~ and non- sunoorii~ facts, ff an action cannot be certified as consistent wilh 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.nortlffork.net), the Board of Trustees Office, the Planning Department, all . Iocatl libraries end the Town Clerk's office. DESCRIPTION OF SITE AND PROPOSED ACTION scm#/oar) 6'D / -'/b, / The Applleation has been submitted to (cheek appropriate response): TownBoard V-'] PianningBoard[~ BuiidingBept. [] BoardofTrusteea Category of Town of Sou/hold agency action (cheek appropriate response): (a) Action undetiakan directly by Town agency (e.g. capital [] constriction, p]annin_o aclivity, agency r~golation, land tramaction) [] Co) F!noncial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, eeaification: Nature and ex~nt of action: Locationofa~on: '~/~ ~'(J' Present zoning ci~dtleafion: /~' Z] ~) If an application for the proposed aaion Ires been filed with the Town of Southold agency, the followha~ information shall be provided: (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes F--] 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 pokey. 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 Sputhoid that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and mlninliz~q adverse effects of development. See LWRP Section IH - Policies; Page 2 for evaluation criteri~ Yes [] NO ~Not Applicable Attach additional shoets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section HI ' Policies Pages 3 through 6 for evaluation criteria r'] Yes [] No ~/Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of $outhold. See LWRP Section HI - Policies Pages 6 through ? for evaluation criteria N Yes N No [] No, Xppli b*e Attsch additional sh~ts if necessary NATURAL COAST POLICIES Polio/4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section HI - Policies Pages 8 through 16 for evalualion criteria ~ Yes [] No ~ Not Applicable Attach additional shects if necezsary Policy 5. Protect and improve water quality and supply in the Town of $outhold. See LWRP Section IH -Policies Pages 16 through 21 for evaluation criteria Attach additional sheets if neces~ry 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; Page~ 22 through 32 for evaluation criteria. Yes No Not Applicable Aoach addilional sheets if nece~ary Polley 7. Protect nnd improve nh' quality in the Town of Sonthold. See LWRP Section m - 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 snbstances and wastes. Sec LWRP Section III - Policies; Pages 34 through 38 for evaluatioD criteria. ~ Yes [] No~ Not Applicable PUBLIC coAST POLICIES Policy 9. Provide for public access to, and recrentional use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section IH -- Policies; Pages 38 through 46 for evaluation criteria~ ~ Y~] No~ Not Applicable Attach additional sheets if necessary WORKING COAST POLICI~.S Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent ~ses in suitable locations. See LWRP Section m- Policies; Pages 47 through 56 for evaluation criteria. Attach additional sheets it'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 ~'~ Na~Not~ Applicable ' Attach additional sh~ts if necessary Poliey 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 6~ for evaluation criteria. yes 71No No, A.liea,,e Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LV~ Section ITl - Policies; Pages 6~ through 68 for evaluation criteria. Yes [] No ~] Not Applicable DATE~c~ Chapter 55 PUBLIC HEARINGS, NOTICE OF § 55-1. Providing notice ~f public hearings. [HISTORY: Adopted by the Town Board of the Town of Southold 12-27-199~ by L.L. No. 25.-1995. Amendments noted where applicable.] § 55-1. Providing notice of public hearings. [Amended 6-~-2003 by LJ~ No. 12-2003] Whenever tl~ Code callz for a publio hearing this section shall apply. Upon determining that an application or petition is complele., the board or commission reviewing the san~ shall fix a time and place for a public hearing thereon. Notice relating to a public hearing on an application or petition shall be provided as follows: A. Town responsibility for PUblication of notice. The reviewing board or commissi°n shall cause a notice giving the time, date, place and nature of the hearing to be published in thc official newspaper within the period prescribed by law. B. Applicant or petitioner responsibility for posting and mailing notice. An application or petition, initiated, proposed or requested by an applicant or petitioner, other than a Town board or commission, shall also be subject to additional notice requiremants set forth below: (1) The applicant or petitioner is required to or~t the sign provided by the Town, which shall be prominently displayed on the premises facing each public or private street which the property involved in the application or petition abuts, giving notice of the application or petition, the antum of the approval sought thereby and the tim~ and place of the public hearing thereon. The sign shall be set back not more than 10 feet from the prolnnXy line. The sign shall be displayed for a period of not less than seven days immediately preceding the date of the public hearing. The applicant, petitioner or his/her agent shall file an affidavit that s/he has complied with this provision prior to commencement of the public heating. (2) The applicant or petitioner is required to send notice to the owr~rs of record of every property which abuts and every property which is across from any public or private street from the prope~y included in the application or petition. Such notice shall be made by certified mail, retura receipt trqnestod, posted at least seven days prior to the date of the initial public heating on the application or petition and addressed to the owners at the addresses'listed for them on the local assessment roll. The notice shall includa description of thc street location and area of the subject pwporty, nature of relief or approval involved, and date, time and place of hearing. The applicant, petitioner or agent shall file an affidavit that s/he has complied with this provision prior to commencement of the public hearing. 55:1 os - 01. ~o06 OTHER POSSIBLE AGENCIES YOU MIGHT HAVE TO APPLY TO N.Y.S. Dept. of Environmental Conservation (DEC) SUNY, Bldg. 40 Stony Brook, NY 11790-2356 '~on. (631) 444-0355 , Wed., Fri., 8:00 AM-3:00 PM Suffolk County Dept. of Health Se~ices 360 Yaphank Ave., Suite C Yaphank, NY 11980 852-5700 U.S. Army Corp. of Engineers New York Distdct 26 Federal Plaza New York, NY 10278 917-790-8007 N.Y.S. Dept. of State Coastal Management 99 Washington Ave. Albany, NY 12231 518-474-6000