HomeMy WebLinkAboutTR-8149 James E King, President
BOb Ghosio¢ Ir., Vice-Pfi~ident
loire Bredemeyet
Michael I. Domino '
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Rd.
- P.O. Box 11.79
Telephone (631) 765-1892
Fax (63 l) 765-6641
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
__ Pre-construction, hay bale line
1 ~ day of construction
__ Y~ constructed
Project complete, compliance inspection
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
PERMIT NO. 8149 DATE: APRIL 17~ 2013
ISSUED TO: DANIEL T. CHRISTIANSON
PROPERTY ADDRESS: 1220 DEEP HOLE DRIVE~ MATTITUCK
SCTM# 115-12-17
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 April 17, 2013, and in
consideration of application fee in the sum of $250.00 paid by Daniel T. Christianson or authorized waiver of
Town Board 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 replace 31.5 linear feet of 36" wide existing timber catwalk
using non-treated lumber and thru-flow decking over the wetlands; the existing
additional catwalk, 36"x12.5' ramp, 6'x20' float, and small bench on north side of
catwalk to remain; with the condition to install 6" diameter piles through wetland area;
and as depicted on the site plan prepared by Jeffrey Patanjo, last dated April 22, 2013,
and stamped approved on May 10, 2013.
1N 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 Permittee, Daniel T. Christianson, residing at 1220 Deep Hole Drive, Mattituck, 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 Permit-tee
assumes full liability with respect thereto, to the complete exclusion ~fthe Board of
Trustees oftbe Town of Southold.
That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved, but should circumstances warrant, request for
an extension may be made to the Board at a later date.
That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved, to provide evidence to anyone concerned that
authorization was originally obtained.
That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution oftbe 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 Iow water marks.
That if future operations of the Town of Southold require the removal and/or alterations in
the location oftbe work herein authorized, or if, in the opinion &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 Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
James F. King, President
Bob Ghosio, Jr., Vice-President
Dave Bergen
John Bredemeyer
Michael J- Domino
Town 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
April 17, 2013
Mr. Jeffrey Patanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
RE: DANIEL T. CHRIS'I'IANSON
1220 DEEP HOLE DRIVE, MATTITUCK
SCTM# 115-12-17
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, April 17, 2013 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of DANIEl- T. CHRISTIANSON 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 March 8, 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 recommended that the proposed application be
found Inconsistent with the LWRP, and,
WHEREAS, the Board of Trustees found that the proposed application be Consistent
with the standards of the LWRP, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on April 17, 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 DANIEL T.
CHRISTIANSON to replace 31.5 linear feet of 36" wide existing timber catwalk using
non-treated lumber and thru-flow decking over the wetlands; the existing additional
catwalk, 36"x12.5' ramp, 6'x20' float, and small bench on north side of catwalk to
remain; with the condition to install 6" diameter piles through wetland area; and as
depicted on the site plan prepared by Jeffrey Patanjo, last dated April 22, 2013, and
stamped approved on May 10, 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: $ 792.50
James F. King
President, Board of Trustees
JFK/amn
lame~ F. King, President
Bob Ghosio, Ir., Vice-President
Dave Bergen
$ohn Bredemeyer
Michael 1. 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
reviewed by this Board at the regular meeting of ~ 17 ] °aennd
your application has been approved pending the co p ' n of {he ~ollowing 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
Southoid, 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:
TOTAk FEES DUE: $~
BY: James F. King, President
Board of Trustees
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., April 10,
2013 the following recommendation was made:
Moved by Audrey Horton, seconded by William McDermott, it was
RESOLVED to SUPPORT the application of DANIEL T. CHRISTIANSON to remove and
replace 31.5 If of 36" wide timber catwalk damaged by storm, using non-treated lumber
and flow-thru decking over wetlands. Additional catwalk, ramp and float to remain
undisturbed.
Located: 1220 Deep Hole Dr., Mattituck. SCTM#115-12-17.1&17.2
Inspected by: Peter Young, Audrey Horton, William McDermott
The CAC Supports the application with the Condition of a 10' non-turf buffer and gutters
and drywells are installed to contain roof run-off from the dwelling.
Vote of Council: Ayes: All
Motion Carried
.lames F Kiilg. President
Bob ghosio..Ir. Vice-President
Dave Bergen
John Bredemeyer
Michael J Domino
PO Box 1179
Southold, NY 11971
Felephone (631 765-1892
Fax (63 I) 765-6641
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time: ~//~/o/3
Jeffrey Patanjo on behalf of DANIEL T. CHRISTIANSON requests a Wetland
Permit to replace 31.5 linear feet of 36" wide existing timber catwalk using non-
treated lumber and thru-flow decking over the wetlands; the existing additional
catwalk, 36"x12.5' ramp, and 6'x20' float to remain. Located: 1220 Deep Hole
Drive, Mattituck. SCTM# 11 5-12-17
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland
Sound 'V~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
Modifications:
/
Present Were: -/J. Ki~j ~___B. Ghosio ,¢-"D. Bergen,
,~k Bredemeyer. -/ Michael Domino D. Dzenkowski
Form filled outAin t12~ field
Mailed/Faxed to:
Date:
other
Photo I
Photo 2
Photo 3
I 2
@
April 23, 2013
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179
Southold, New York 11971
RE:
1220 DEEP HOLE ROAD, MA'rl'ITUCK
SCTM NO.: 11X)0-115-t2-17.2 & 17.2
PLANS PER MEETING
ECEIVE
APR 2 9 2013
,~,o~thold Town
Board of Trustees
Dear Amanda:
Attached, please find plans which have been revised in accordance with the public
headng
If you should have any questions or require anything further, please do not hesitate to
call me at 631-484-9332.
Very truly yours, f
J r yPatanjo
106 Hewitt Blvd.
Center Moriches, NY 11934
Cantreil, Elizabeth
From: Randolph, Linda
Sent: Friday, April 12, 2013 10:26 AM
To: Cantrell, Elizabeth
Subject: LWRP's
Hi
I just spoke with Mark. He said to tell you all the LWRP's this month can be
marked "inconsistent."
Linda
Office Use Only
~wOaStal Erosion Permit Application
etland Permit Application Administrative Permit
/ __Amendment/Trans fq~r/E~tension
i/l~ceived Application: ~ [~ II ~
coCeivedFee:$
mpleted Application ~< ! ~ !~ ~
Incomplete
SEQRA Classification:
Type I Type Il Unlisted
at°°rdinati°n:(date sent)
WRP Consistency As~essm,ent Form
C Referral Sent:
e of Inspection: ql~b! !~
~Receipt of CAC Report:
Lead Agency Determination:
blic Hearing Held:
Resolution:
MAR - 8 2013
$outhotd
Name of Applicant l~,~n~ '-ff E. ia~[~-~/,~as~r~
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:
(If applicable)
Address:
Phone: 6'fil-q ~q-ct53~-
Boar~of Trustees Application
Land Area (in square feet):
Area Zoning: ~ e 5
Previous use of property:.
Intended use of property:
Covenants and Restrictions:
GENERAL DATA
Yes ~ No
If"Yes", please provide copy.
Does this project require a variance from the Zoning Board of Appeals Yes ~" No
If "Yes", please provide copy of decision.
Will this project require any demolition as per Town Code or as determined by the Building
Dept. Yes ~ No
Does the structure (s) on property have a valid Certificate of Occupancy ~ Yes No
Prior permits/approvals for site improvements:
Agency Date
__ No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a govemmental agency?
~ No Yes
If yes, provide explanation:
Project Description (use attachments if necessary): R¢r~v. ~ ~ ~_~l~e ~_
31,Y L~' ~,~' ~/," t~.~,/~ 4,.,~e~ r,,4~-,s. ClL~ d,~b7
Boargof Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purposeoftheproposedoperations: g,,~,,,~e. ~,~,9_r¢/l,(tc ~t,,.c' t..~ t~f- ~$,t ~,~.,d(..- "l',,,,~-/'t._
e,..)c,,.,,,.Oc A,n,~,,.q,,~ b,.l ,t]~ro,.~n¢ 5,,,n,i~,7, ,.-,'.~ ,,n-~'~'r'r~.,-~¢o. -/',n,~be/Z
~ l . ~ ~ .-to ~r t' ,'r~,~ ~ a
Area of wetlands on lot: ~,(~ square feet
Percent coverage of lot: Q.., ~ %
Closest distance between nearest existing structure and upland
edge of wetlands: o feet
Closest distance between nearest proposed structure and upland
edge of wetlands: o feet
Does the project involve excavation or filling?
-/ No Yes
If yes, how much material will be excavated? ~/ cubic yards
How much material will be filled? ~ cubic yards
Depth of which material will be removed or deposited: ~/ feet
Proposed slope throughout the area of operations: t ~,
Manner in which material will be removed or deposited: ~'~ I ~
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):
8EqR
9. WHAT 18 ~ ~ USE IN ~ OF PRO, ECT? (Ckxiil~n,afly#N~ly.)
PART II - IMPACT ASSESSMENT (To be completed by Lead Agency)
A~ ODES AC'T1ON EXCEED ANY TYPE t THRESHOLD IN 6 NYCRR. PART 61T.47 If yes. coomlnate the ro~c~v process aDd'use the FULL EAF.
B. WILl. ~.CTION RECEIVE COORDINA'I~D REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 6t7.67 If No. a negative
declaration ma3¢ be superseded by m',o~her i~v~ved age~.
C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (.NIswers may be haa6'ca~on. If legible)
Cl. Existing air qua~, sur[ace or gro~edwate~ qna~y er quanl~y, noise levels, existing traffic paffem~ $O~KI waste pr~xluctio~l or disposal,
gete~ial fer emalon, drainage er Ileodleg problems? Explain briefly:
(;2. Aeslhetio, ag~=ultural, ~rchaealoglcal, histe{lc, er ether natural or cultural resemces'; ~ communk~ er nalghberhond character? Exile bdetiy:
c3. Ve~ut=6u, or fauna, fish, sheti~sfi or wildlife spoc~es, s~jmficant beb~tats, o¢ ~hreatened er ~'aog;~md species? Ex, lain briefly:
C4. A communitY's existing plan~ or goal~; olf~Jail~ ~dopted:'o~-Tchange~k; use ;r-i;tensity of us~ ~)~i~"d or &er natural resources? Explain bde~l¥:
C5. Growth. ~ubsequent developmen, or related activities likely to be induced by he proposed act on? Explain bdefly.
I
C6. Long term. shot1 term. cumulative or olher effects no den fled n C1-C57 Explain briefly:
C7. Other impacts (includinc.~ chan~]es in use oi~either
WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL
ENVIRONMENTAL AREA ~CEJ~,~? (If ~'es. explain briefly:
PART III - ut= i i=K~INA'IION O~ SIGNIFICANCE (To be (xmtple~:l bY
.I~TRUCTIONS: F~-ead~adve~see~ec~de~tit~edabeve~determthewhetherit~$s~ta~tia~a~ge~imp~ta~s~n~L E~=ch
e~re~ sho~lld be assessed in comlection with lis (a) setting (i.e. urban or rural); (b) Ixobabtf~ o~ oocunthg; (=) duration; (d) l~rever~oltrltlq, (e)
ye~ the delermlaation of ~lCmance must evaluate~he pofential Impac~of the preposed ac~on eo the ent4ruflmental ~haracte~stics of the ~
Check this I~x If Y°"~ h~e Iden61ied ena er inure I~aotiatiY la~e or algfliticant adve~e Imcac~s whleh MAY ecc~r. 'l~e~ proceed direc~y to the FULl
EAF addle- prepare a ges~ve declaration.
C~ec~ ~s hex ff~ have detanalned, based eo Ihe Infom~tioo and analysis abeve and any sup~ng documentation, that the proposed ac~er
WILl. NOT result In any slgeificant adveme environmental Impec~s AND provide, on attachments as necessa~/, the masons supporting
Board of Trustees
Name of Lead Agency
Pdnl or Type Name of Responsible Officer in Lead Agency
,~ignature of Responsible Officer in Lea~gency
Date
President ~
Title of Responsible O~cer
Signature of Preparer (If different from responsible officer)
PROOF OF MAILING OF NOTICE
ATTACH 'CERTIFIED MAIL RECEIPTS
STATE OF NEW YORK
COUNTY OF SUFFOLK
y
~ day o f~,~tg}"'/I
, residing at/~) ~:~ "-~°/,01 t'C--- ~_~lVtS~.
, being duly sworn, deposes and says that on the
,20l,,~, deponent mailed a true copy of the Notice
set forth in the Board ~f Trustees 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
~Effi;~;;l E~D ~Ai L'~/R£ ~/~U IrRN~ REC~cEh~;s;jd Not.~. ices were maile~d to ea/~ c~ersons by
Swom to before me this ~ fi'[/v
Day of
Putblic
Nora pLu~n Pa~-i°
~ua!'.~ed_Ln, ~_Gounty .
No: u~PA6150~;I- ,,I
Commission Expires 0~)07/20/_.~'
James ]:. King. Prcsidcnt
Bob Ghosio. Jr., Vic¢-Presidenl
Dave Bergen
John Brcdcmcycr
Michael J. Domino
I'm~n Hall. 53095 Main Rd.
P.O. Box I 179
Southold. NY 11971
Telephone {63 I) 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
DANIEL T. CHRISTIANSON
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
TO BE COMPLETED AFTER POSTLYG REMAINN 13; PL'ICI:' FOR EIGIIT DA YS
'. &"~'~ ~:~.'"]~ O, residing at/dbaJ~}/_~
being duly sworn, depose and say:
That on the ,"7 day of ,~c'Dr') / _ , 2015. I personallv posted the prooerty known as
/,0,.90 ,Z o 4ti31e D' c44 4L '/,3)/
by 'l~l'acing the B6ard o'f Trustees official poster where it can easily be seen. and that t have checked
to be sure the poster has remained in place for eight days prior to the date of the public hearing.
Date of hearing noted thereon to be held Wednesday~ April 17~ 2013.
Dated: s'~re)
Sworn to before me this
'-'/day o~:~rt 2013
Notary Public
NOTICE OF HEARING
NOTICE IS HEREBY GIVEN that a public hearing will be held by the
SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road,
Southold, New York, concerning this property.
OWNER(S) OF RECORD~i¢~'~.
SUBJECT OF PUBLIC HEARING:
To replace 31.5 linear feet of 36" wide existing timber catwalk using non-treated lumber and thru-flow decking over the wetlands; the
existing additional catwalk, 36"x12.5' ramp, and 6'x20' float to remain.
TIME & DATE OF PUBLIC HEARING:
· If you hav.e, an inter.est in t.h. is pro. ject, you are invited to view the Town file(s)
wb.ch are available for ,nspect~onpnor to the day of the hearing during normal
bus~ness days between the hours of'8 a.m and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631)765-1892
Boa~of Trustees Application
County of Suffolk
State of New York
Oar, ~e,l.. '-r. Ch cl5'l'~o Saw BEINGDULY 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,q-IER 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 IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
Signature
SWORN TO BEFORE ME THIS O~ DAY OF ~'1~1~.~ ,201~.~
Notary Public
Lodann Patanio
Notary Public 81ate of l~lew Yo~k
Commiss~ F_xpkes 08/07/20J_~
Boar~of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
(print owner of property)
residing a[ I~,~o
(mailing address)
,Vln p-h %oc ll t ~a ~ t l 6 S~ do hereby authorize
(Agent)
Southold Board of Town Trustees on my behalf.
(Owner's signature)
to apply for permit(s) from the
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics orohibits conflicts of interest on the part of town officers and employees. The uumose of
this form is to orovide information which can alert the town of nossible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME:
(Last name, first name, middle initial, unless you are applying in the name of
someone else or other entity, such ~s 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 pemonally (or through your company, spouse, sibling, parent, or child) have a relationship with any offi~r or employee
of the Town nf Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business,
including a partnership, in which the town officer or employee has even a partial ownership of(or employment by) a corporation
in which the town officer or employee owns more than 5% of the shares.
YES NO J
If you answered "YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself (the applicant/agent/representative) and the town officer or employee. Either check
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% oftbe 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-coq~orate entity (when the
applicant is not a corporation);
__.C) an officer, director, partner, or employee of the applicant; or
__D) the actual applicant.
DESCRIPTION OF RELATIONSHIP
Form TS 1
SignatureSuhm acd this ay
Print Name
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERT~ LOCATIOH: $.C.T.M. ~: 'THIE FOLLOWING A~11ON8 MAY REQUII~E 'rile SUBMISSION OF A
J $~) II ~' ) ~- I'1.! ~1~. ~" STORM.WA'rER~ BRA~ING~ ~RAINAGE AND EROSION CONTROL pLAN
D~ SK.Ofl B~o~ ' LOt CEKTIFIED BY A DESIGN PROFESSIONAL IN THE 83'ATE OF NEW yCHcK.
$COPE OF WORK - PROPOSED CON~"i'KU~JrtON iTEM# / WORKASSES$1~ENT
Yes
No
a. What is the TofalArea of the Project Parcels? ' ]. '~ Will this Project Retain NI Storm-Water Run-Off
(include Totsl Aras of all Pemeis located wllhln ~. ~/~')0/~. ~'l~ Gecerated by a Two (2") Inch Ralr~all an Site? .//r'~
the Scope of Work for Proposed construction) ~s.~. i ~..} (This item will include all run-off created by site
b, Wha! is the Total Ama of Land Cleating deering and/or c~siruclian aslivitins as well as all
and/or Ground Dlsluthance tar the proposed q~/~ ~,~, Site Improvements and Ihe permar~r~ creation of
construction acliv~y? [ {S,F,,'.~) 2 Does the Site pisn and/or Sun, ay Sh0w N] Proposed
Item shall Include all Pmlx:~ed Grade Charl.g as and
,~ ~ r~.. ~ ~.. ~,* '~ ,-' ~ L I C I[ $~'~- 3 DoastheSitePlanartd/orSurveydesedbetheerosian
and asdimant control practices that will be used to
contro~ slte eroalon and stann watsr discberges. This --
J. e C ~ '~ I ~,~'I *'~ [ i/ ~ ~ '~'£ ~* Jt~,g~ itemmustbemainlainedthroughouttheErfim
Conslructinn Padod.
--f ~,,4 J~¢ ~ 4 Will this Project Require any Land Filling, Grading or
Excavatlan wbere there Is a change t° the Natural
fixi~fing Orade In'~htin§ mom than 200 Cuhl~ ¥~m~
of Material wilhln any parcel?
(5,000 S.F.) Square Feet of Ground Surface?
6 Is there a Natural Waler Course Running through the
Site? is this PmJast within the Tms~eas Jurisdiction
[~aeeral BEC ~WPPP R~3ubemeMs: of wig, In One Hundred (100') fast of a We~and or --
ale part of a lalger common p~n that wB ultlmalely dlstud3 erie or more ac,~ ~1 which Exceed Rftoan (15) taet of Vertical Rise to
~'PpP's 8hill meel the M~nlmum Requlrernenta of the SPDE$ General Pemgt 8 Will Orlvaways, Parldng Ames or other Imperious r~
I. 11m SWPPP ebelt be prepared prior ~ Ihe subndffal of the NOI. l~e NOI sbell beinto and/or in the diras'don of a Town right-of.way? --
2. The SWPPP M dm~-ibe the em~ltm end sadiment ~ql~ol practices and w~ere 9 Will this Pro]asr Require the Pincement of Mateital,
STATE O~ N[W YORK, ~., , ('.~ !
CO~'Y O~ , .'.'~..t ~..1~..~,. ,V;C ~ .............. SS
And ¢"u~t he/'shc is thc ............ ~.** .............................................................................................................................
Owner and/or ~eprcsen~fiv~ o£thc Owner or Owners, an(] Js duly authorized to peff'orm o£ have perforraed thc saki work and
ma[c a~d t-dc this appJlcatio~; that ali sla[cmcnts court,cd in rl~s app~cado~ ~c fmc to thc bcs[ o£his k~ow~cc~ m~d bcJ~c£; and
that the work will be performed in thc manner set forth in the application filed hereu4th.
Sworn to before me this;
FORM - 06/10
L..*..-., P.l.,~
Notan~ Public Slate of'~le~ York
No: 0
Commissiofl Expires
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 BuiMing Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of Southold Town).
If any question in Section C on this form is answered "yes", then the proposed action may affect the
achievement of the LWRP policy standards and conditions contained in the consistency review law.
Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a
determination that it is consistent to the maximum extent practicable with the LWRP policy
standards and conditions. If an action cannot be certified as consistent with the LWRP policy
standards and conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: onl~'s
website (southoldtown.northfork.,n_,e.t), the Board of Trustees {~1~ ~,~e~tar~g t.~p~l~ ~
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 115~ . 17.. . I-'t,i ~1 .~ I -
I $outhold Tom
L Board of Tmste~
The Application has been submitted to (check appropriate response):
Town Board ~ Planning Dept. [] Building Dept. [] Board of Trustees [~
Category of Town of Southold agency action (check appropriate response):
(a) Action undertaken directly by Town agency (e.g. capital
construction, planning activity, agency regulation, land transaction)
(b) Financial assistance (e.g. grant, loan, subsidy)
(c) Permit, approval, license, certification:
Nature and extent of action:
Location of action:
Site acreage:.
Present land use: f2. ,, t,, tA e~r~e~ '-C
Present zoning classification: ~ ¢ 5
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 ( ) b 31 . ~ 'l $ - 6 ~ ~ o
(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? N~{$ D6:~
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 POLICII~S
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Section III - Policies Pages 8 through 16 for evaluation criteria
~ Yes ~ 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 7q No [3 otApp,icable
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 Applicable
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. Sec LWRP Section IH - Policies; Pages 38 through 46 for evaluation
criteria.
[] Ye~ 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 III - Policies; Pages 57 through 62 for evaluation criteria.
[-~ Yes [~ No ~//Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages
62 through 65 for eva~ation criteria.
~ Yes I [ Nol'~ I Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energ~ and mineral resources. See LWRP
Section III - Policies 65 through 68 for evaluation criteria.
[7~ Yes [] No~l~l Not Applicable
Created on 5/25/05 11:20 AM
March 2, 2013
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179
Southold, New York 11971
RE:
1220 DEEP HOLE ROAD, MATTITUCK
SCTM NO.: 1000-115-12-17.2 & 17.2
REVISED PERMIT APPLICATION
Dear Ms. Cantrell:
Per your phone message, attached please find three copies of the completed Wetlands
Permit Application for the above referenced property. In addition, please find three
additional copies of the proposed plan.
As previously mentioned, the proposed project includes replacing the damaged catwalk
section of the dock which was previously permitted under dock permit No. 1103. If you
should have any questions or require anything further, please do not hesitate to call me
at 631-484-9332.
Very truly yours,
106 Hewitt Blvd.
Center Moriches, NY 11934
Southold Town Board - Letter Board Meeting of March 26, 2013
RESOLUTION 2013-280
ADOPTED
Item # 5.44
DOC ID: 8695
THIS 1S TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2013-280 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
MARCH 26, 2013:
RESOLVED that the Town Board of the Town of Southold hereby waives Trustees' permit fees
for any repairs or construction, that in the sole discretion of the Board 'of Trustees, are
determined to be related to Superstorm Sandy, until May 1, 2013.
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Jill Doherty, Councilwoman
SECONDER: William Ruland, Councilman
AYES: Dinizio Jr, Ruland, Doherty, Talbot, Evans, Russell
DANIEL T CHRISTIANSON OR 2162
BARBARA B CHRISTIANSON
1~O DEEP HOLE DRIVE
MAI IIIU~ NY 110~2-~Q09 --,]._ ~-~._~ ~'~ 30-7426/~t,i0
~)a. y to the -'~ ! _
For
Page 2
I ~O^,D OF TRUSTEES I - - - - - - - -
. .: 2~0.35'
~E UNE ~ ~ ~ ~ I
~i ' ~ * * ~ ~_~ ~ ~ fl ~_~ ~ //~1111111~
~T I ~ u.~ ~ ~ wi ~. ~ ~ ~ ~ ~ ~ ~111111111
I . I ~ ~
: ~ I 227.60'
/
/ S 84'52'10"W ~ ~/~ ~ PA~ ~ ~ ~ ~
ECEIVE
APl{ 2 9 2013
Southold Town
Board of Truetees
NOTES:
1. ELEVATIONS REFER TO NGVD 1929
2. LOT AREA: 22,510 S.F. / 0.517 ACRES
3. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY:
JOSEPH A. INOEONO
P.O. BOX 1932
RIVERHEAD, NY 11901
DATE SURVEYED: MARCH 22, 1999
PROPERT¢ OWNER:
DANIEL T. CHRISTIANSON
1220 DEEP HOLE DRIVE
MATrlTUCK, NY 11952
PREPARED BY:
JEFFREY PATANJO
106 HEWlTT BLVD.
CENTER MORICHES, NY 11934
631-484-9332
REVlSED 4(/22(/15 PER TRUSTEES MEETING COMMENTS
PROPOSgD REPAIR PLAN
EXISTING DOCK PERMIT #fl03
I~,~0 DEEP HOLE DRIVE
MATTITUCK, TOWN OP $OUTHOLD
SUP$'OLK COUNTY. NY
IAX MAP NO. ~000-~$-~,~-17. I ~ I?.P,
SCALE:
1 "=30'
DATE:
02-26-2013
.~HEET:
1 OF1
NEW SUFFOLK AVENUE
~o;,~m~ac; I)/dON~ E PA1RICI MECEt ~'YLCHIr~-I1AN0
S 8~19'20'E //// ~ m
: 230.55'
'nE UN£ ! * * i '"'"'
R&MP TO m ./ .~ '~: REPI),C[ [](ISLING ~6' ~IDE STORM
I~1 \ ,.. fl .4/ /d
227.60'
S 8,4.'52'10"W tN~ N/F OF pA.Tl~ak SUSkq ac ,JOHN
ECEiVE
~R 2 ~ ~013
Sou~old Town
Board of Trustees
NOTES:
1. ELEVATIONS REFER TO NGVD 1929
2. LOT AREA: 22,§10 S.F. / 0.517 ACRES
3. PORTIONS OF SffE PLAN FROM SURVEY PREPARED BY:
JOSEPH A. INGEGNO
P.O. BOX 1932
RIVERHEAD, NY 11901
PROPERTY OWNER: RE'ViSED 4(/22/15 PER mUSTERS MEETING COMMENTS
SCALE:
PROPOSED REPAIR PLAN 1'=3o'
EXISTIN~ DOCK PERMIT 111103 DATE:
02--26-2013
1220 DEEP HOLE DRIVE
MATTITUCK, TOItfN OF SOUTHOLD
SUFFOLK COUNT)'. NY SHEET:
DANIEL T. CHRISTIANSON
1220 DEEP HOLE DRIVE
MATrlTUCK, NY 11952
PREPARED BY:
JEFFREY PATANJO
106 HEWlTr BLVD.
DATE SURVEYED: MARCH 22, 1999 CENTER MORICHES, NY 11954
631-484-9332
~7
~7
,7
0
~7
D7
S 87'19'20" E
DWELLING
S 84- 52 ~
DWE. LLtNG
NEW SUFFOLK AVENUE
7
~ N/O/p
YOLANDA ROBBIN$
0 Ex,~,~ ~oo~ 230.35'
227.60'
N/o/'F j.
MATH~AS N. BREWI k EVELYN
7
0
SURVEY OF PROPER, Y
SITUA TED A T ,,
MATTITUCK
TOWN OF SOUTHOLD,",i~;~,
SUFFOLK COUNTY, NEW
S.C. TAX No. 1000-115-12-17
SCALE 1"=20'
JULY 7, 1996
OCTOBER 11, 1996 TOPO & TREE LOCATIONS
AUGUST 4, 1997 LOCATED SURROUNDING WELLS & CESSPOOLS
NOVEMBER 15, 1997 ADDED FLOOD ZONE
MARCH 22, 1999 FINAL SURVEY ON HOUSE
AREA 22,510.88 sq. ff.
TO TIE LINE 0.517 ac.
UNATHORJZ~D AL~RAT~ON OR ADDITION
TO THIS SURVEY I$ A VIOLATION OF
NOTES:
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM.
2. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP COMMUNITY-PANEL No. 360815
ZONE A4 (EL 8). AREAS OF IO0-YEAR FLOOD: BASE FLOOD ELEVATIONS AND
FLOOD HAZARD FACTORS DETERMINED.
ZONE B: AREAS BETWEEN LIMITS OF THE IO0-YEAR FLOOD AND 500 YEAR FLOOD;
OR CERTAIN AREAS SUBJECT TO IO0-YEAR FLOODING WITH AVERAGE DEPTHS
LESS THAN ONE(l) FOOT OR WHERE THE CONTRIBUTING DRAINAGE AREA IS
LESS THAN ONE(i) SQUARE MILE; OR AREAS PROTECTED BY LEVEES FROM
THE BASE FLOOD.
0116
N Y,S. Lic. No. 49668
Joseph A. Ingegno
Land Surveyor
PHONE (516)727-2090
Fox (516)722-5093