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HomeMy WebLinkAboutTR-8110 James F. King, Presideat Bqb Ghosio, Jr., Vie~Piesideat · Dave Bergeu .... John Bredemeyer Michael I. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Sou0~bld, FIY 11971 Telephone (631) 765-1892 Fax (631) 7654641 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 __ 1s~ flay of construction ~ constructed __ Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8110 DATE: MARCH 20~ 2013 ISSUED TO: MICHAEL & KATHRYN RUSSO PROPERTY ADDRESS: 775 OAKWOOD DRIVE, SOUTHOLD SCTM# 90-4-22 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on March 20, 2013, and in consideration of application fee in the sum of $250.00 paid by Creative Environmental Design and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to raise the low lying area of the property with approximately +/-50 cy. of fill to prevent flooding; with the condition the project does not cause run-off effect to neighbors and is in accordance with Chapter 236 of the Town Code-Storm Water Runoff; and as depicted on the site plan prepared by Creative Environmental Design, last dated March 15, 2013 and stamped approved on March 20, 2013. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittec Michael & Kathryn Russo, residing at 775 Oakwood Drive, Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the stmcture or project involved, to provide evidence to anyone concerned that authorization Was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Pennittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President Bob Ghosio, Jr. Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 March 20, 2013 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. David Cichanowicz Creative Environmental Design PO Box 160 Peconic, NY 11958 RE: MICHAEL & KATHRYN RUSSO 775 OAKWOOD DRIVE, SOUTHOLD SCTM# 90-4-22 Dear Mr. Cichanowicz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 20, 2013 regarding the above matter: WHEREAS, Creative Environmental Design on behalf of MICHAEL & KATHRYN RUSSO applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated February 27, 2013, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on March 20, 2013, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of MICHAEL & KATHRYN RUSSO to raise the Iow lying area of the property with approximately +/-50 cy. of fill to prevent flooding; with the condition the project does not cause run-off effect to neighbors and is in accordance with Chapter 236 of the Town Code-Storm Water Runoff; and as depicted on the site plan prepared by Creative Environmental Design, last dated March 15, 2013 and stamped approved on March 20, 2013. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, James F. King President, Board of Trustees JFK/amn James E King, President Bob Ghosio, Jr., Vic~-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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Please be advised that your application dated Z / 7-7/I ~ I I has been reviewed by this Board at the regular mee!ing of ' 51 ~._D/I.5 and your application has been approved pending the completion of tl~e 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) 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: TOTAL FEES DUE: $. BY: James F. King, President Board of Trustees Mark Melillo 2037619590 p.2 March 15, 2013 Mark & Susan Melillo 685 Oakwood Court Southold, NY 11971 Call: 20:~-243-2272 Town of Southold, Board of Trustees Southold, NY 11971 Facsimile: 63:L755-$641 I will not be able to attend the March 20~ proposed project open meating. I just received the Notice to Adjacent Property Owner; SCTM # 90-4-22. I am the owner of the home at 685 Oakwood Court and to the right facing the street and NW of the Proposed Landscape Plan for our neighbors the Russo's. I am not opposed that the grade be changed within the proposed area. However, this is with the assumption that it does not divert tidal water or storm sur[es over to my property. This can force water to a higher than natural level on my property and create potential flooding in my dwelling. AS Jong as this potential issue with water diversion extending into my property is protected, than I am comfortable with the proposal. I expect no liabiliw for this if the grading creates any associated flood related issues. Mark S. Melillo Owner of 685 Oakwood Court Southold ECEIVE MAR I 8 2013 ---' Sou/hold Town Board of Trustees Mark Melillo 2037619590 p.3 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEE$~ TOWN OF SOUTHOLD In the matter of applicant: YOU ARE HEREBY GIVEN NOTICE: 1. That it islhe intention of the undersigned to request a Permit from the Board of Trustees to: 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 3 That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: gz t3 You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: MAILING ADDRESS: PHONE #: AGENT: Creative E~vl,-o~3~atai Deai_t. MAILING ADDRESS: PHONE #: ~,'~1 - ~7"5 H--~ c/;~ BOX Peconic, NY ll~Jg Enc: Copy of sketch or plan showing proposal for your convenience_ Mark Melillo 2037619590 p.4 PI~OFOgED ELEVATION t ~dsc~ P~an: 2-11-13 Russo Creative Environrnentaf Design Mark Melillo 2037619590 p. 1 Facsimile: To: Town Of Trustees, Attention Ama nda From: Mark Melillo 203-243-2272 Regarding: Notice of Adjacent Property Owner SCTM# 90-4-22 Russo's Creative Environmental Design Fax# 631-765-6641 Pages-4 Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., March 13, 2013 the following recommendation was made: Moved by John Stein, seconded by Doug Hardy, it was RESOLVED to NOT SUPPORT the Wetland Permit application of MICHAEL & KATHRYN RUSSO to raise Iow-lying area of property to prevent flooding. Located: 775 Oakwood Dr., Southold. SCTM#90-4-22 Inspected by: John Stein The CAC does Not Support the application because allowing this would be a detriment to the entire area and cause flooding onto the adjacent properties. This is a wetland area that should be vegetated with native wetland species. Vote of Council: Ayes: All Motion Carried James F King, President Bob Ghosio, Jr. Vicc-Presidenl Dave Bergen John Bredemeyer Michael .I Domino PO Box 1179 Southold, NY I t971 Telephone (631 765-1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/VVorksession Report Date/Time: Creative Environmental Design on behalf of MICHAEL & KATHRYN RUSSO request a Wetland Permit to raise the Iow lying area of the property to prevent flooding. Located: 775 Oakwood Drive, Southold. SCTM# 90-4-22 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound 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: .~.,~-~,- ¢o ~ ~ lZ~',/-2~c-~---z4~*~-~ .,~ ~ Present Were: ~J. King ~B. Ghosio -/CD. Bergen, v//J. Bredemeyer / Michael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date: N OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: From: MEMORANDUM Jim King, President Town of Southold Board of Trustees Mark Terry, Principal Planner LWRP Coordinator Date: March 19, 2013 Re: Proposed Wetland Permit for MICHAEL & KATHRYN RUSSO SCTM#1000-90-4-22 Creative Environmental Design on behalf of MICHAEL & KATHRYN RUSSO request a Wetland Permit to raise the Iow lying area of the property to prevent flooding. Located: 775 Oakwood Drive, Southold. SCTM# 90-4-22 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 the Board consider: 1. Establish a landscaped (vegetated) buffer (width undetermined) in filled area. 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. YAng, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Halt 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 $OUTHOLD Office UseOnly ~Coaslal Erosion Permit Application Wetland Permit Application Administrative Permit __Amendmenffrrans fq'/Ex tension _~_P).eccived Application:.~L.~ ,~R.~ceived Fee:$__~_._~g~__I ~g~ompleted Application ...... Incomplete SEQRA Classification: Type l_.__Type 11 .... Unlisted ~2oordination:(datc sent) ] ] ~I~WRP Consistency Ass~.s~n-~;-~;rm ~1. f]~- -'~fC..AC Referral Sent: _'g /) 1~3 t ~_~)ate of Inspection: .... ___Receipt of CAC Report: Lead Agency Determination:__ _,Jechnical Review: ~/Pubtic Hearing Heid: Resolution: Name of Applicant Mailing Address B27 3 i__ Board of t'tosLct~s Phone Number:(~L-IO _"~?'~L ~ t~C~o~ Suftblk County Tax Map Number: I000 - Property Location: '"'} '~' F)~t._~-~l.Of~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: '-~<L~/', ~-. E ~.~,~.l~h~',tO ~{.7) (If applicable~v~ ~~ ~ Address: 119 Phone: '7'~/- ?~ ,,',T3 Boa~of Trustees Application GENERAL DATA Land Area (in square feet):_ Area Zoning: ~ .~(3 Previous use of property: ~e~: ~4q Intended use of property: ~-~%:ctg,l Covenants and Restrictions on property? If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes L~No 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? If"Yes", please provide copy of decision. Yes WillthisprQectrequire/anydemolitionasperTownCodeorasdeterminedbytheBuilding Dept? ..... Yes ___b/ No " Docs the structure (s) on property have a valid Certificate of Occupancy? ~/Yes Prior permits/approvals for site improvements: No Agency Date __ No prior permits/approvals tbr site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?_ ~o If yes, provide explanation: Yes Project Description (use attachments if necessary):__ ~ ~2JrT~ M_ [_0 ~ Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ~'2 ~ ~ z.~ ~ ~.~ ~¢~.,~, Area of wetlands on lot: [~G. X9 square feet Percent coverage of lot: , / { % Closest distance between nearest existing structure and upland edge of wetlands: 6v~.~ feet Closest distance between nearest proposed structure and upland edge of wetlands: {~,~ feet Does the project involve excavation or filling? No '/// Yes If yes, how much material will be excavated? How much material will be filled? 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: cubic yards cubic yards 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): I PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 1. APPLICANT I SPONSOR 3.PROJECT LOCATION: Municipality 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) 2. PROJECT NAME 4. PRECISE LOCATION: Street Addess and Road Inter~eclJons, Prominent landmarks etc -or orovide mad SEQR 5. rs PROPOSED ACTION: [] New [] Expansion ~a~diflcalJefl / alteration 6. DESCRIBE PROJECT BRIEFLY: 7 AMOUNT OF LAND AFFECTED: Initially acces Ultimalely acres 8 W1LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? [] Yes [] NO If no, describe briefly: nPRESENTLAND USE IN VICINITY OF PROJECT? (Choose es many as apply ) rial r~lndu~tnal []Comme,cial ii]Agriculture [~ Park / Forest / Open Space []Other (describe) 10 DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING. NOW OR ULTIMATELY PROM ANy OTHER GOVERNMENTAL AGENCY (Federal, Stale or Local) ]Yes []No If yes, list agency name and permit / approval: 11. DOES A~ECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? r~Yes ~,,]mo if yes, list agency name and permit / approval: 12 AS A R~ESU~ OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? []Yes I CERTIFY THAT THE IN. FORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE SignattJr; PART II - IMPACT ASSESSMENT ~To be completed by Lead Agency). A. OOESAC'TIONF_XCEEOANYTYPEtTHRESHOLDIN6NYCRR. PART61T.47 ff yes. coo~k3ate the review p~'ocess aflduse the FULL EAF. [--'] Ye.s r~-] No s. v~LL~&`CT~NREcE~v~c~RD~NATE~REViE~AsPR~V~DE~F~RUNL~STEDAcT~NS~N6NYCRR~PART617-6? IfNo. anegative dedacatio~ ma~ ~e superseded by another iovel~l agencT. r-]Yes [Z]No C. COULD ACTION RESULT IN ANY AOVERSE EFFC--CTS ASSOCIATED WITH THE FOLLOWING: (Answers ma)' be haodwrltteo, If legible) C1. E.,dsting ak quality, surface or grouedwator quality of quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, dm~lage of flooding p~al~ems? Exlflain beefly: C2. Aesf~lebe, 8gricu(L~'al, amlmeological, historic, or other ~atuml or cultural reseu~ces; or mmmunt{y or neighborhood character? F_x~al~ bdeOy: C3. Vegetation ~r fa . ~sh. shall6sh or w~ dli~e species, slg~d~can habitats, o¢ threatened o~ endangered species? Exp!a n bdefly: C4. A community's existing plans 0¢ goals as o ff..laity adopted or a cflange in use or intensity o1' use of land or o(her natural resources? Exp(ain tsleOy: I C5. Growth. ~ubsequent development, or related activE[es likely to be induced by lhe proposed action? Explain briefly: I C7.- Other impacts (including chan[les in use of either (]uantit}~ or type of ener~;¢? Explain bring;/: .... ENVIRONMENT/M-AREA(CE. Al? (ff yes, explain briefly: F_ IS__.~ERE, ORIS THERE UKELy TO BEt CONTROVERSY RELATED TO POTENTIAL A~SE ENVIRONMENTAL IMPACTS? Ifyes PART I~ - Dr: I r_.~IINATION OF 81GNIFICANCE (To be completed bY Agency) .INSTRUCTIONS: F~ead~adversee~ect~de~ti~edab~ve~de~em~inewhe~t~r~tissubstae~aL~a~.~nt~n~nL Each effect should be a~essed I, mnneclion with its (a) se~ng (i.e. urban o~ mrarJ; Co) probability of o~urring; (c) duration; (a') irreversibl[~. (e) geogralfltlc scope; end (f) magnitude. If ne°essary, add altachments or reference suppling mate~ab. Ensta~ that explanations co, rain ye~. the de~,mlnalion ofs~, ~lfican~e must evaluatethe potential Impactof the proposed action eh, Ihe environmental ;haractenls6cs of Ihe CEA. Chedc this box ffyou ha~(e Idenflfed one or more potentlallylarge or significant edverse impeds which MAy occ~.. '[l~en peoceed akectly to gle FULt EAF a~/'or prepare a poal6ve declara~on. Check tills box if you ha~ determined, based on Ihe Information and analysis alcove and any s~opo~ing documentation, (hat the proposed WILL NOT re. suit in a~y sigalfica~l ed~rse environmental impacts ANO provide, on attachments as necessa~, the reasons suppo~r~3 Ih{., determination. Board or Trustees Name of Lead Agency ~- Date Pdn( or T~ Name of Res~ns~ble Offi~r in Lea~ Agen~ Title ~ ~ ~ of Responsible Offi~r S~ of ~sponsib~ 0~ in ~ad A~ Signature of Preparer (If different kom responsible officer) PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes and says that on the I.~ day of Iv~xO~ ,20 } 3, deponent mailed a true copy of the Notice set forth in the Board of Tm~tees 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 States Post Office at DC/ ~', r_~ 't 1~'~5~ , that said Notices were ma~aid persons by Sworn to before me this Day of ~",1~o,~ C~ ,20 Notary Public -,, t'~NIE D. BUNCH Nota:y PuMJc, State of Nev~' ' York t~o 015U6185050 " Ioxxll Ilall. 5309q Main Rd P.(). Box 1179 Southold. Nh' 11971 I dcphonc (631 } 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of MICHAEL & KATHRYN RUSS() COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING 7'0 BE COMPLETF. D ,I I,'?'ER POSTlY,'G RE'q,II,¥S 13/I'LqCE t:OR E/GIlT being duly sworn, depose and sa>,: That on the day of ,201 , I personally posted the property knov, n as by Ol~cing the Bom'd of Trustees official poster where it can easily be seen. and that I have checked to be sere tine poster has remained in place tbr eight days prior to tine date of thc public hearing. Date o f hearing noted thereon to be held Wednesday~ March 20~ 2013. Dated: ~ ~~ (s~e) ~ --~ Sworn to before me this day of~015 Notary Public CONNIE D. BUNCH Note,',/Public, State of New York No. 01 BU6185050 Ouaiiiied in Suffolk County Corem ;s', oc Expires Ap,i!Z, l, 2~1 NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be hel.d by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Ma~n Road, Southold, New York, concerning this property. OWNER(S) OF RECORD:/~W.~.~.l ~ K~-~,r~ SUBJECT OF PUBLIC HEARING: To raise the Iow lying area of the property to prevent flooding. TIME & DATE OF PUBLIC HEARING: If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Board of Trustees Application County of Suffolk State of New York ,~-/-/~r~ ~ (~Ccss0 BEr~ DULYSWO~ DEPOSES A~ APFI~S TItAT H~SHE IS THE APPLICANT FOR THE ABOVE DESCmBED PEmlT(S) ~D T~T ALL STA~mN'I'S CONTAINED HElm A~ TRUE TO T~ BEST OF HIS/~R ~O~EDGE ~D BELIEF, AND THAT ALL WO~ WILL BE DONE IN THE MA~ER SET FORTH IN THIS APPLICATION AND AS MAY BE ~PROVED BY THE SOUTHOLD TO~ BOA~ OF TRUSTEES. THE APPLICANT AGREES TO HOLD T~ YO~ OF SOUTHOLD AND ~E TO~ 'I~USTEES .~mL~SS ~N~ ~ F~O~ ~NV ~ ~ ~r~S ~D ClaMS ~mS~ UNDER OR BY VIRTUE OF SAID PE~T(S), IF G~TED. ~ COMPLET~G THIS ~PLICATION, I HE.BY AUTHO~ZE THE TRUSTEES. THEIR AGENT(S) OR ~P~SE~TATIVES(S), TO ENTER ONTO MY PROPERTY TO ~SPECT THE PREMISES ~ CONJUNCTION WITH ~VIEW OF THIS APPLICATION. SWORN TO BEFORE ME THIS //(~x DAYOF '~'~ ,20.~? CLAIRE L. GLEW Pubic, State of New York No, 01GL487g~)5 ~!,,a~ied in Suffolk CoontlL _ mi~sio~ Expires Dec. 8,~.-~ / Board of Trustees Ap~l±cat±on AUTHORIZATION (where the applicant is not the owner) 1, ~r-,/~ I ,,~sc;c~ residingat 2q5 (~(~,,-i {print owner of property) (mailing address) do hereby authorize David Cichanowicz, Pres. (Agent) Creative Environmental Desiqn _to apply for permit(s) from the Southold Board of Town Trustees on my behalf. / :/ 3 (Owneffs signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Town of Southold's Code of Ethi~ orohibi~ conflic~ of in~ on &~ ~ of ~ offi~ ~d emolo~. ~ ~ of fo~ ~ ~ ~vi~ i~ti~ whi~ ~ Mc~ ~ to~ of~ible ~fli~ of A~ ~ albw it to ~c ~ ~ is (~ ~, f~ ~,~le ~iti~, ~1~ you ~ ~1~ in ~ ~ of ~ el~ or o~r en~, such ~ a ~m~y. I f ~, i~i~ ~ o~er ~n's or ~m~y's NAME OF APPLICATION: (Check all that apply,) Tax grievance Buikiing Varianc~ Trustee Chang~ of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf "Other", nara¢ 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 businass interesL "Business interest" means a business, including a partnerehip, in which the town officer or employee has even a partial ownership of(or employment by) a corporation in which thc town officer or employee owns more than 5% of the shares. YES NO ~ If you answered "YES", complete the balance of this form and date and sign where indicated. Name of parson employed by thc To v,~n of Southold Title or position of that person Dcscrihe thc relationship between yourself (the applicaat/agen~representative) and the town officer or employee. Either check the appropriate linc A) through D) and/or descrihe in the space pwvided. 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 applic0nt (when thc applicant is a corporation); __B) the lc:gal or hem:ficial owner of any interesl in a non-corporate entity (when the applicant is not a corporation); C) an officer, d/rector, partner, or employee of thc applicant; or __D} the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitted this~ ~'~200 __ Signature I ~~ ~ ~' ~,~ Print Name ~'~ ~,~'t'( /f', '~ ~" ~L Town of Sout- old Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM THE FOLLOWING ACTION~ MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING~ DRAINAGE AND EROSION CONTROL PLAN C~:Kt-lflED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUctiON ITEM# / WORK ASSESSMENT ~ a. What is the Total Ama of the Project Pameis? (thdude Total Ama o~ all Paine, s located within the Scope of Work for Pmpo.~d C~nsbucllon) b, What is the Total Ama of Laed Clearing (&F. / Acres) aed/or Ground Disturbance for the proposed ts.F, Will this Project Retain All Sthm~Water Run-Off Generated by a Two (2') Inch Rainfall on Site? (This item will include all mn-off created by s~ts clearing and/or cons/ruction ac~ttas as well es all Site Improvements and the permanent creation of impend<XlS surfaces.) PROVIDE BRIEF PROJECT DE~CRII~ION 0'~,a~m~ General DEC SWPPP Re~Imrner~: Subl/tiss~t of a SWPPP iS r~uired fo~ MI ConsEucfion activi~es involving so~l disturbances of o~e (t) o~ rn~ a~s; inc~udi~XJ disturbances o~' less than oee ac~e that 2 ~oes the ate Plan and/o~ Survey Show All Proposed Drainage Structures Indloaltng Size & Location? This Item shall Include all P~ Grade Changes and Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion 8 Will Driveways' Parking Areas °r cther Impervious J~lJJ 9 Will Ihis Project Require the Placement of Matsfial, __ / CONN!E D. -~UHCH STATE OF NEW YORK, Notary Public, State of New York .,._COUNTY OF ........................................... SS No. 01BU61850.,50 ~ ,~ ,' ~ - , Qualified in Suffolk C.eunt7 O~cr ~or rcprcscnmdvc o[ ~c O~lcr or O~]¢rs, ~d is duly autoread lo ~do~ or }ave ~domicd d~¢ ~d ~rk ~d m m~e mid rite ~s applicahon; ~at MI statements con.ned hi dlis application ~e ~e to Ore best of his ~mwledge ~d ~fiefi ~d · at ~e work ~11 be ~ffo~ed in ~e m~ner set fo~ in Ole application filed here~6~. Sworn to before me ~is; FORM - 06/10 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. 3~ 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 evahmtod 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. Thns~ each answer must be explain/,d in detaii~ listing both suooortin~ and non supporlinll 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 Of local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION scm# PROJECT NAME The Application has been submitted to (check appropriate response): Town Board FEB 2 7 2013 Southold Town Board of Trustees ~ Planning Board ~-~ Building Dept. ~ BoardofTrusteea ~ 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: Locationofaction: ~'~.~ ~/_k'kl~L~. '~f' ~'Z~ck-~Ol~_ Site acreage: ;'~ ~t ¢d'~ Present land ~ .c~'U.I~ tL[ Present zoning classification: ¢ -~'5 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall bc provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code ( )_ (d) Application number, if any:. Will the actio~_~rectly undertaken, require funding, or approval by a state or federal agency? Yes [] No ~Zl 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 IH - Policies; Page 2 for evaluation ria. [X~] Yes D 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 neeessar~ Policy 3.. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRPyection 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 Sectio)rIII - 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 Ill - Policies Pages 16 through 21 for evaluation criteria I~t Yes ~ No []Not Applicable 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 Applical~ 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 Ill - Policies; Pages 34 through 38 for evaluation criteria. R Yes ~-] NoI--3/I ~ 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 e~-] No ~ Not Applicable Attach additional sheets if nacessary 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. /~es ~-] No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Yes and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ~-~ No [] Not Applicable Attach additional sheets ifnecessaxy Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for eval~u~tion criteria. ~ Yes ~ No~./q'Z-~/Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; ~ages 65 through 68 for evaluation criteria. ~ Yes [--] Noi---u/~ Not Applicable" PREPARED BY '~', ~. f--~/~O.~c~',r?__ TITLE -~'~',~-~ Creative En,/i~n~ De.,s~gn PO Box 160 ~econic. ~ 11958 DATE PP-.OPOS ELEVATION NEW SFFD PROPOSED ORIGINAL CCEADE 6" SANDY LOAM FILL STAKE APPROVED BY ~BOARD OF TRUSTEES TOWN OF SOUTHOLD I~ERIvEABLE BL, STONE PATIO EXISTIN© LAWN EOCqE OF WETLANDS- ' A,t--I,W.M, COIRL SANE SCTIV¢ 1000-90-4-22 Revision#: Date: 3/15/2013 Scale: Landscape Plan: 2-11-13 Russo Landscape Design by: Davi, Creative Environme