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HomeMy WebLinkAboutTR-8208 John M. Bredemeyer III, President �*OF S�UrjyO Town Hall Annex Michael J. Domino,Vice-President �� 01 0 54375 Main Road P.O.Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Charles J.Sanders,Trustee Q �� Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1006C Date: July 17, 2014 THIS CERTIFIES that the repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach,• and repairs to the existing 9'x6' shed At 780 Private Road#17, Southold,New York Suffolk County Tax Map # 81-3-27.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 28, 2013 pursuant to which Trustees Wetland Permit#8208 Dated June 19, 2013,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repairs to the existing 9'x6' shed. The certificate is issued to LINDA S. SANFORD owner of the aforesaid property. Authorized Signature John M. Bredemeyer III,President gUFfDj,�c Town Hall,53095 Main Rd. Michael J. Domino,Vice-President ��� SGS P.O.Box 1179 James F. King y Southold,NY 11971 Dave Bergen a �� Telephone(631)765-1892 Charles J.Sanders y��l �y0 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: z 3o i Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/ constructed Project complete, compliance inspection. INSPECTED BY: TK, O _ COMMENTS: CERTIFICATE OF COMPLIANCE: • i James F. King,President gpfFO(rco Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President P.O.Box 1179 a Dave Bergen h Southold,NY 11971 John Bredemeyer y A�� Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 15} day of construction Yz constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 8208 DATE: JUNE 19.2013 ISSUED TO: LINDA S. SANFORD PROPERTY ADDRESS: 780 PRIVATE ROAD #17, SOUTHOLD SCTM#81-3-27.1 AUTHORIZATION Pursuant to the provisions of Chapter 275 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 June 19,2013,and in consideration of application fee in the sum of$250.00 paid by Linda S. Sanford and subject to the Terns and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit for repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repair the existing 91x6' shed, and as depicted on the project plan prepared by Linda S. Sanford, received on May 28,2013, and stamped approved on June 19, 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. �o�g11FF0(,�c - 41 O �e" TERMS AND CONDITIONS The Permittee, Linda S Sanford residing at 780 Private Road#17, Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: I. 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. 2. 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. 3. 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. 4. 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. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. 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. 7. 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. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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 surly Town Hall Annex Bob Ghosio,Jr.,Vice-President ,`O� �� 54375 Main Road P.O. Box 1179 Dave Bergen Southold, New York 11971-0959 John Bredemeyer Michael J. Domino :% i� Telephone(631) 765-1892 29, COU sr+, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 19, 2013 Ms. Linda S. Sanford 5 Mountain Peak Road Chappaqua, NY 10514 RE: LINDA S. SANFORD 780 PRIVATE ROAD #17, SOUTHOLD SCTM# 81-3-27.1 Dear Ms. Sanford: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 19, 2013 regarding the above matter: WHEREAS, LINDA S. SANDFORD 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 May 28, 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 has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit on structures; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 19, 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, 2 • 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of LINDA S. SANFORD for repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repair the existing 9'x6' shed, and as depicted on the project plan prepared by Linda S. Sanford, received on May 28, 2013, and stamped approved on June 19, 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 ��a�asuFFo��-i� James F. King,President H Town Hall Annex Bob.Ghosio,Jr.,Vico-President v. 54375 Route 25,P.O.Box 1179 Dave Bergen pyy` Southold,MY 11971 John Bredemeyer �!!j �� Telephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: I _l (1 �a S . Sao4 r-d Please be advised that your application dated S lubs has been reviewed by this Board at the regular meeting of 3 . and your application has been approved pending the completion of the foi owing items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 st Day of Construction ($50.00) Y2 Constructed ($50.00) JFinal 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: $ SO . DD BY: James F. King, President Board of Trustees ��gpFFO(,fc ti Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O. Box 1179 'F 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., June 12, 2013 the following recommendation was made: Moved by Jack McGreevy, seconded by Peter Young, it was RESOLVED to SUPPORT the application of LINDA S. SANFORD to re-level landing and stairs to beach which shifted during storm and to repair shed doors. Located: 780 Private Rd. #17, Southold. SCTM#81-3-27.1 Inspected by: Peter Young, Jack McGreevy The CAC Supports the application with the Condition the stairs are retractable. Vote of Council: Ayes: All Motion Carried • �r gUFFU( James F. King.President ���� Cp_ N.O.Box 1179 Bob Ghosio. Ir_Vice-President Z Southold,NY 11971 (lave BerPen Q Telephone(631 766-1892 .John Brederri Fax(63 1)766-6641 Michael.I.Domino tp Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: J_e /3 LINDA S. SANFORD requests a Wetland Permit for repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repair the existing 9'x6' shed. Located: 780 Private Road #17, Southold. SCTM# 81-3- 27.1 Type of area to be impacted: _Saltwater Wetland _Freshwater Wetland _Sound /Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 _other Type of Application: _Wetland Coastal Erosion _Amendment _Administrative_Emergency —Pre-Submission Violation Info needed: Modifications: Conditions: d AL q��� Present Were: J. King _B. Ghosio D. Bergen, J. Bredemeyer -"-Michael Domino D. Dzenkowski other Form filledut in the field by `� U Kuww Mailed/Faxed to: Date: Linda Sanford — Southold., NY House Damage RE - E 7EEMAY 2 Board of 4 {y JT 101 2 « �2r a , . . ¥© mm a � .«�� > �� ; \ \ �? . : �wa2 , �22 : ��y»< . � �\ �°�2 �`~ � » . . � /: < � � . 2 /� a ^ � � � �� � `� � �' �. . ��� - ` � — .. d . 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 Q Telephone: 631 765-1938 �0 Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM D E C E 9 V E rr� I JUN 1 8 2013 old TO To: Jim King, President r r rust. a Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 17, 2013 Re: LWRP Coastal Consistency Review for LINDA S. SANFORD SCTM#1000-81-3-27.1 A Wetland Permit for the structures was not found. LINDA S. SANFORD requests a Wetland Permit for repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repair the existing 9'x6' shed. Located: 780 Private Road #17, Southold. SCTM# 81-3-27.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed actions are INCONSISTENT with LWRP Policy 6.3 (below) and therefore, INCONSISTENT with the LWRP. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The structures described were not constructed pursuant to Southold Town Trustees review and Chapter 275 Wetlands and Shorelines permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney James F. King,PresidentQF S0 Town Hall Annex Bob Ghosio,Jr.,Vice-President �0y�l� 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer G Michael J. Domino %%' �O Telephone(631) 765-1892 ��yCOUNTi,� ' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only �astal Erosion Permit Application etland Pemtit Application Administrative Permit _AmendmenVTransf rBx rasion eceived Application: .S _Ky,eceived dA o D E � ' _Completed Application ' Incomplete _SEQRA Classification: Type IType Il Unlisted MAY 2 8 2013 _Cpyordination:(date sent) VKRP Consistency Asse m t Form 5I �AC Referral Sent ut old own ,/Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: V/Pubiic Hearing He*I ( Resolution: Name of Applicant LS Mailing Address Q (� Phone Number:ft (o2�c2 ' r�7 T�A Suffolk ounty Tax Map Number: 1000 - Q I — 0J Property Location: 7 O I�I VAIF6b �7 sou -r�a_t). N 0 11 q71 (provide LILCO Pole#, distance io cross streets, and location) n AGENT: � ` ' ( � ;� (If applicable) / Address: Phone: 3 3 - 04'0 �1 Boa*of Trustees Application • / GENERAL DATA Land Area (in square feet): Cp X I ! a X D 1 f S �X / 4/P ' '^" x+ Area Zoning: 1��l�lz l�I��I� qx�P JW dco K Previous use of property: 1Q(41 n0 1.6- " CO7 Intended use of property: �Q Covenants and Restrictions on property? Yes No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes 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? Yes __ZNo If"Yes", please provide copy of decision. Will this project require y 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? ZYes No Prior permits/approvals for site improvements: Agency Date Yom - T A � ami No pnor permits/approv ai]s for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): I it Olt. 9x Boar f Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: G , I '^ '^ - '� ��I�Yl_ C Gt I n "71 CL I I� A �I tY IJLaci X� Ak , gxiv yrs, �x7 SEepS heed, 9X� �l do Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between Rearest existing structure and upland edge of wetlands: feet re.Le � Closest distance between nearest pr ed structure and uplan edge of wetlands: f _feet Does the project involve excavation filling? No Yes bM-e I I I I n If yes,how much material will be excavated?__cubic yards How much material will be filled?_ Zcubic yards Depth of which material will be removed or deposited: 4 In J Proposed slope throughout the area of operations: 6 tJ 6 — 660 Manner in which material will be removed or deposited: d I� I nG 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): ! D d Pi PROJECT ID NUMBER • 817'20 a SEAR APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 7 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJ CT NAME �-I �ID� �• ��n1Fo�D �, VQ I �I�n1Dln �IrS �� I 3.PROJECT LOCATION: Municipality % L I v County 4.PRECISE LOCATION: StreetsnAddess and Road Intersections, Prominent landmarks etc -or provide maD U0 T64-re 1 AD 171 5OU Not-1b) 5.IS PROPOSED ACTION: ❑ New ❑Expansion Modification/alteration 6.DESCRIBE PROJECT BRIEFLY: -I I ' - ILIV dl'yqD aho�ln� 3161 'S e oako rr1 cane Dy 7.AMOUNT OF LAND AFFECTED: XX 15 Initially acres Ultimately If acres 8. PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? aes ❑ No If no,describe briefly: i 9. HAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑Industrial 11 Commercial Agriculture ❑Park/Forest/Open Space ❑Other (describe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGE Y (Federal, State or Local) s ❑No If yes, list agency name and permit / approval: j %WAI OF 1/�Okb 11.0 S ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes ❑No If yes, list agency name and pennit / approval: 1122.. AS A RE LT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? Dyes No I , I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / S o s r Namce h /�pQa'te, / SignatureJ h O( u G.J If the action is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART 11- IMPACT ASSESSMENT o be completed by Lead A en A. DTO-'E'IS ACTioN OCCEED ANY TYPE t THRESH=IN 6 NYCRR,PART 6coordinate.4? If yes,coordinate the review process anduse the FULL EAF. 1_..� - Yes Q No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 HYCRR,PART 617.6? If No,a negative Nededaretion may be superseded by another Involved agency. Yes ©No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwritten,t legbie) Ci. Etdsft air quality,surface or groundwater quality a quantity,noise levels,existing traffic pattem,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: Cz. Aesthe6a agricultural,archaeological,tkb tC,or other natural or cultural resources:or commurilly or neighborhood dtaraaen Exiplabn bdek-. C3. Vegetation or fauna,fish.she G;or wimide species.significant habitats.or threatened w endangered species?Egtaln brie6y. C4. A community's i fisting plans or goals as of iiciaay adopted,or a charge in use or intensity of use of land or other natural resources?Explain bdefly. C5. Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briery: C6. Long term,shod term,cumulative,of other effects not identified in C7 C5? Explain briefly C7:Other impacts(Including changes in use of either quantity or type of ene v -- - -- Ex Iain briefly,_ D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA(CEA)? tt 'n brie Q Yes Q No E 18 THERE.OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMP If . 0 Yes Q No - PART NI-DEIENMNATMU OF SIf31OMANCE(To be completed by Agency) klSiRUCTIONS, Foreachadverse~Ideltdfiedabove,determine whegxYlNsu sWUQUatlalge,bltpattatrtorodter Wgrti MIL Each l9ed should be assessed In connection with b(a)setting tie.urban or retch:(b)prebaWW of oocurdng;(c)durattim(d)Imavelslbltity.(a) 9OWSpIllic scopes and M megnilude. If necessary,add attadaaents or reference supporting nultedals. ElMM that elplanatoM Ceataill- suMderd decd to show OW drelevant adverse bipaci s have been kentfied and adet u&*addressed. Nqueaton d ofpartll was dhgdaed yea,ihede6errtdrtatort ofsignttcarroe mtrsteveluatelhepotentalkhytadofttepraposedadiah agthe�idharac@adatcsoftle(�A. Cherd(td9 bortyou heYe Idet18fi0d Ofleofahafe poleMtaty large ordgrt6cerdthdversa ktpadawtddn MAYooatr.Thenprooaed dMectyb tlhB EAF and/or prepare a positive dedarallim Check tole burr Ifyou•have determined.based on the informagon and analysis above and any supporting d7Z / that the proposed V41LL NOT result in any significant adverse environmental Impacts AND provide, on attachments as nreasons suppanly tihf determination. Board of Trustees J r/ Name Of Lead Age/ncy Dale F• 1` lA.1 ri President D Print or Type Name of Responsible Office m Lead Agency Title of Responsible Officer nature or Responsible 0115cer in Le Agency Slgnatufe Of PreDarer of d'dferenf frnm m<mndhln nmro.n PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 44o� a7 STATE OF NEW YORK COUNTY OF SUFFOLK /� S• (%Q residing at X ,' being duly swom, deposes and says that on th day df , 20a, deponent mailed a true copy of the Notice set fo in the Board of rustees 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 11 of a own of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this 21 Day of 2�1�_ DANIELLE a HWt��NiL �Ca�717 �Yy{{22 Commission Expl�osi f r 20a Notary"t Er n, ru Ln UM1 Ln ra Postage $ $0.46 0971 r9Certified Fee o $3.10 }. C3 (End orseRetment gequlr e) ®� Po $2.55 Here ] Restricted Delivery Fee �`•� O (EntlomemeM Required) $0.00 a spy 2 Total Postage 8 Fees $ $6.11 28/2013 O ant o ej _$treat,• ._ ��i )..D_.._. .� Si— Ir ru M1 li�l LS :? - �?.nm Lj b �'e rr-1 Postage $ $0.46 0971 Certified Fee f3.10 C3 Return Receipt Fee �o O (Endorsement Required) f2 IM %;t, tetl Delivery Fee (Entlorsement R, YF $0 ^o y�`•� O Total Postage 8 fees $ py L O LV 05/28/201 ' 0 SantTo �. rq - �f M Street,Apt:-o; - M1 • •r. . u r NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: <, )til t� 1)0 Sr �A'>�FyP1) SCTM# /E � �� _ � , . 1 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: II Sti21(5 2. That the property which is the subject of Environmental Review is located adjacent to your property and h�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: 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: N' J i' S • �fk �fi�� MAILING ADDRESS: 5 of ` r PHONE #: AGENT: MAILING ADDRESS: PHONE #: Enc: Copy of sketch or plan showing proposal for your convenience. • gpFF0144, Gy • Jamcs P. King. President N Toen I Iall_53095 Main Rd. Bob Ghosio.lr_Vice-President 1,. T 1'.O. Bos 1179 Dave Bergen d 't^ Southold.NY 11971 John Bredemeyer �7/Q ��� Telephonet631)763-1892 Michael J. Domino '1 # �' Fax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ECEIVE D BOARD OF TRUSTEES: TOWN OF SOUTHOLD H D --------------------------------------------------------------- JUN 10 2013 In the Matter of the Application of outhold Town LINDA S. SANFORD B r COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING / I/ TO RE COMPL,E"TErD,ApFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS sj I, �N S/TIV KJL�, residing at /dba 7QO- I k-K,47Y Wqj-) being duly sworn, depose • d say: That on the day of 20 t j, I personally p sted the property known as 1 lv,AT6 �� 5a � byplacingthe Board of Trustees fficial poster where it can l6asily be seen, and that I 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, June 19, 2013. Dated: �\-..,) \\\ (signature) Sworn to before me this ��'-day of ) 201 otary Pu lic MARINA KOKKOM Notary Pubf c-State of New York No. 01K0619194, Ouallfled In Suffolk County MY Comml"lon Expkea Aug.26,3016 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: LoAaa. a !SaA vrd SUBJECT OF PUBLIC HEARING: Repairs and re-leveling of existing 8'x10' steps to a 6'x13' landing with 6'x7' stairs to beach; and repair the existing 9'x6' shed. TIME & DATE OF PUBLIC HEARING: WeAne.5c ay, Tcxne I q, oo 13 • o.. or o�oc�"�•� 3OPM Ifou have an interest in this project, you are invited to view the Town file(s) which are available for inspectionprior the day of the hearing during normal business days between the hours of a.m and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 Board of Trustees Application AUTRORIZATION (where the applicant is not the owner) I, LW S , SLS-Vrca, residing at Oul 1L (print owner of property) (mailing addressl _ do hereby authorize ,1II J (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (own r' s' ature) Boa> f Trustees Application • County of Suffolk State of New York /AiA- 5 . BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. of�z�- , j dz� - Signature 9f Pr rerty ner SWORN TO BEFORE ME THIS CN DAY OF 20k MARINA KOKKIN03 Notary Public-Stata of New y otary Public No. O1 K0619194t oualNw in Suffolk Courc My Commlwkm EXPbaa Aup,Z6y .Y016 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Soutbold s Code of Ethics prohibits corinkis of interest on the part of town officers aid p] The o gpm of this form is to movide information which can alert the townof pyo sible conflicts of interest and allow it to take whatever action is necom to avoid same. YOUR NAME: (Last name,fust name,ipiddle initial,unless you are applying in the time of someone else or other entity,such as a company.If so,indicate theother person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NOy/ 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 I the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): _A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submittedt ' d o 291)' oZ�/ Signature Print Name — Form TS 1 T� own of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: s.C.T.M.p: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN -156OFF ee3—T— BI"W— K. CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. hat is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within Will this Project Retain All Storm-Water Run-OR plr the Scope of Work for Proposed Construction) Generated by i Two(27 Inch Rainfall do Site Acres) (This item will include all run-off created by site What Is the Total Area of Land Clearing (S.F.l A ) clearing andfor consbuctlon activities as well as all anttlor Ground Disturbance for the proposed Site Improvements and the permanent Creation of construction activity? AFT f ) impervious surfaces.) PROVII)E BRIEF PROJECT DESCRIPTION (Pn, a seaudw pso a N,.ad1 Z Does the Site tureslan Indicating Survey Shay All Proposed /Drainage Structures IrMfcating Size&Location?This ,�L/ ❑ Item shall include all Proposed Grade Changes and v� _ O. jli / Slopes Controlling Surface Water Flow. nI n O` 3 Does the Site Plan and/or Survey describe Me erosion — ❑ vh and sediment control practices that will be used to control site erosion and storm water discharges. This r ea item must be maintained th gho Entirely Construction Period. IBJ'f�f1 4 Excavation this Project Require any Land Filling, ding Excavation where there is a charge to the Natural Existing Crede Involving more than 200 Cubic Yards of Material within any Parcel? jm 5 Will this Application Require Land Disturbing Activities ❑ / 77 Encompassing an Area in Excess of Five Thousand Y (5,000 S.F.)Square Fast of Ground Surface? 6 Is there a Natural Water Course Running through the / Site? Is this Project within the Trustees jurisdiction v General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Subngssion of a SWPPP is required for all Construction activities involving sal Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes ❑ —// are pan of a larger common pan that wig ugMately disturb one or more some of land; which Exceed Fifteen(15)feet of Vertical Rise to including Construction activities involving sol disturbances of less than one(t)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit Is required for stonn water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General PermIt 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit Kim GP-0-1 1.) Surfaces be Sloped to Direct Stone-Water Run-OR 1.The SWPPP shall be prepared prior to the submittal of the Not.The Not shall be into and/or in the direction of a Town right-of-way? submtted to the Department prior to the commenrsrrem of construction activity. 2.The SOYPPP shag describe the erosion and sediment ocntml practices and where 9 Will this Project Require the Placement of Material, required,postconstuction storm water management practices that wit be used andlor Removal of Vegetation and/or the Construction of any constructed to reduce the Pollutants In storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the term and conditions of this permit In addition,the SWPPP shag Area?rune Item wla Nor x,wae the Im1010den of pnvewq APmm.l identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Ma W Ouesgom Ono thmugh Nice te Answered wah a Check Mark 3.All SWPPPs that require the post-constwctkm storm water management practice in a Box and the construction she disturbance is between 5,000.S.F.d 1 Awe In area, component shall be prepared by a qualified Design Professional Licensed in Newyork a Storm-Water,Grading,Drainage A Erosion Control Plan Is Required by the Town of that's knowledgeable in the principles and practices of Stone Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit (NOTE: ACheck Me*(4)andlw Maxx for each Question b Rewired for a Complete Application) STATE OF NEW YORK, i COUNTY OF...........................................SS 02r) That I,....^'.�.................... ..:.......y3.N...........................being duly swom,deposes and says that he/she is the applicant for Permit, (Name of individual si//gn',V Dcaun I� Andthat he/she is the .....�j( .nQi ....................................................................................................................... ....................(Owner,Contractor.Agent,Corporate Officer,etc.) I Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed die said work and to make and file this application;that all statements contained in this application are true to die best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; .....---......aS ....................da of....�.. . ....................... ,201-3 NotaryPublic: ..... .......... ...................:......................... .. . .. ............ . ..................... MARINA ICOKI ( gesture fApplirant) FORM - 06/10 NOtery Public-State of New York NO, 4?'1 K061 fI1 a4 4 QualMlad In Suffolk County My Cominknion EXPiree Aug.26,1016 Town of Southold • • LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. 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. 2. 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). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. Dn E Q E I V E B. DESCRIPTION OF SITE AND PROPOSED ACTION I fel ' �J 11 SCTM# 3 ,- 3 - a7,(�1 ^ MAY 2 8 2013 PROJECT NAME I� / �1 l�(�I I Y1 I 1 outhom Town toes The Application has been submitted to(check appropriate response): �{� Town Board E] Planning Board❑ Building Dept. El Board of Trustees XII 1. 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: 8� Nature and extent of action: Qv1Ih h 6 x 13 dt d, � 5 gXl6&c , 4� 74�kP5 I ^ • r Location of action: kA/r)d I h f GLI V'S 4L Site acreage: 02 a ue 5 Present land use: I D�,O' JA- � Present zoning classification: KIL 51 D E1N TI a 1" 2. 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: 4 J -D 0 S_ SAf IEQP O (b) �1MaIi_ling address: 5 POi,6 I Al ly Pa I� P liYlap �ua , U 14514 (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No If yes, which state or feder ncy? 10to ti or oy go L C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No IyNot 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 d 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 Q'Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pa es 8 through 16 for evaluation criteria ElYes ❑ No Policies 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 t7NotApplicable 21 for evaluation criteria ❑ Yes ❑ No 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 Applicat • 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 valuation 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. 1:1Yes ❑ No u 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 o outhold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeO 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 locations7SejLVMP Section III Policies; Pages 47 through 56 for evaluation criteria. F-1Yes ❑ Noot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and TowFNc rs. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 11Yes ❑ No t Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LMW Section III — Policies; Pages 62 through 65 foreval tion criteria. ❑ Yes ❑ No 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 ❑ No V Not Applicable PREPARED BY__ W M �, S- d Fo I)TITLE DATE 5 1P SURVEY OF PROPERTY SITUATED AT NOgTB BAn1E1W gOAg Q BOSI EW 171 TOWNOUTHOLD O SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-81 -03-27.1 SCALE NOj?T FEBRUARY? 18, 2002 SURVEY 44 AUGUST MARCH 22, 2002 ADDED RIGHT O 4. 2002 ADDED AF WAYL DESCRIPTION 1 VEIL Rp O i6 ° >E'a.•20. JU Y25, 2O062GARAGE FOUNDATION 005 FOUNDATION LOCATION �D n •. Yn wye E % AUGUST 16. 2006 ADDED PROPOSED POOL JUNE 25, 2007 FINAL SURVEY jW� .. A '•� 11gAR6 Q / (TO MREUNL7 23150333 a9. ff. y. NH'7S q _ _ CERTIFIED TO: N, -\- COMMONWEALTH LAND TITLE INSURANCE COMPANY Co• �a \'\_ TITLE No. RH60020120 y`1,cF \-\ EMIGRANT MORTGAGE COMPANY, ITS SUCCESSORS AND/OR ASSIGNS -\- LINDA S. SANFORD y 4 \ .�� �_dRl.pa• �. • ..: M • NOTES: N • Yo' �N W :1'" • v`�rgF 1. ELEVATIONS ARE REFERENCED TO N.G,V.D. 1929 DATUM ^ aBrR�75TJN� ►AY +° 1 �' ` 2. S.C.D.H.S. REFERENCE No. R70-03-0057 PCR/a/A. ROMAIY 444MICnpR c@ S afQ>'r 4pi S� D E baa Ry4.• �4�0 SEPTIC SYSTEM TIE MEASUREMENTS p d `zj ra• ❑A CORNER❑B gqq a• HOUSE HOUSE Ix CORNER pg g e rTANK 27' 16' w X95 s b;°s• rs, ' 'yk 35' 11' a1 .I :mss.... hocy.1'. "IoQ oz.W Hp 6. 51' 26' 0ftde, •"Y1 ` �^ YS�'lp. f 42' 2g' d'Xrsp't% �- n,,y yc 41 Dm W.z� 'Wye, yycC 4(cywY \ • • J\ •kyl pOy r \ 4 v� yS�, °f • • ' Po r COO ,•'yt 04#44f ES \ \ wE o "m \ A ,� ` ,$ /A b#""'Ib� 70.. W �, \`N B ;;hham�,. r 8)• G45. BO.00, IV �. Arm � • „ ' ,'¢��e ' �6 �°y X10 (\ / 111' •� Y N BBS � ' / \\\ r �Ov DulhDld To en 44H orb � ATy / APPROVED BY BOARD OF TRUSTEES y TOWN OF SOUTHOLD SfANMES NACCORDANCE WITH THEMINIMUM ISO• / BY THE LI NO ADOPIED DATE 13 FOR BUC E STATE UNG MIG /LY., II UI TMUE O�ZAFT o�, ye 2e Y <ANp N.Y.S. Lie. No. 50467 UNAUTHORIZED ALTERATION OR ADDITON TO THIS SURVEY IS A WOUTON OF Nathan Taft Corwin III BECTON 7209 OF THE NEW YORK STATE EOUCATON UW. COPIES OF THIS BUR'S I MAP NOT BGRINC Land Surveyor THE SSE SURVEYOR'S INKED E C OR SI TO BE ED UD SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. C0019WONS INDICTED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE rifle Survays - Subdivisions - Site Plans - Construction Layout TIME COMPANY. GOVERNMENTAL AGENCY AND LENDING INSOTUTION UBIEO HEREON. AND TO THE ASSIGNEES OF THE LENDING INS"- PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTFlOATONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RICHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS ANO/OR EASEMENTS OF RECORD, IF 322 ROANOKE AVENUE P.O. Box 1931 ANY. NOT SHOWN ARE NOT GUARANTEED. RIVERHEAD. New York 11901 Riverhead, New York 11901-0965 99-025M