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TR-8286
John M.Bredemeyer III,President �*rjf SO(/TiyO Town Hall Annex Michael J. Domino,Vice-President ,`O l0 54375 Main Road P.O.Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Q 'enc► �� Telephone(631)765-1892 Charles J.Sanders,Trustee ycouPm Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1004C Date: July 14, 2014 THIS CERTIFIES that the replacement of existingrotting otting locust footings with 3' deer concrete footings under existing cottage; raise cottage+/-2'; and replace all windows. At 65490 Route 25, Breezy Shores Cottage#25, Greenport,New York, Suffolk County Tax Map# 53-5-12. Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 6, 2013 pursuant to which Trustees Wetland Permit#8286 Dated September 18, 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 replacement of existing rotting locust footings with 3' deep concrete footings under existing cottage; raise cottage+/-2'; and replace all windows. The certificate is issued to IDO MIZRAHY owner of the aforesaid property. droc— pq_W_ Authorized Signature John M. Bredemeyer III,President Q��gtlffD(,�co Town Hall,53095 Main Rd. Michael J. Domino,Vice-President �� G� P.O.Box 1179 James F. King y Southold,NY 11971 Dave Bergen G 4 ! Telephone(631)765-1892 Charles J.Sanders y��1 �y0 Fax(63 I)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: QACL of a' s'o lcu q --IQ y O O y Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed 4ZI-P"roject complete, compliance inspection. INSPECTED BY: COMMENT ®® 1 Wave at cA �1 o w6 V1 e V c; W o le Cc 61r AD :a CERTIFICATE OF COMPLIANCE: • James F.King,President ypfF01 Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President 0� P.O.Box 1179 Dave Bergen Southold,NY 11971 W John Bredemeyer �f. Telephone(631)765-1892 Michael J.Domino 1 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-constriction, hay bale line 1$tday of construction % constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK i PERMIT NO. 8286 DATE: SEPTEMBER 18.2013 ISSUED TO: IDO MIZRAHY PROPERTY ADDRESS: 65490 ROUTE 25,BREEZY SHORES COTTAGE#25, GREENPORT SCTM#53-5-12.6 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 September 18,2013, and in consideration of application fee in the sum of$250.00 paid by Frank W. Uellendahl 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 rotten locust footings with 3' deep concrete footings under the existing cottage and to raise the cottage+/-2' to code complaint ceiling height; and replace all windows; and as depicted on the site plan prepared by Frank Uellendahl,R.A., received on August 6,2013,and stamped approved on September 18, 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. cco '� '�' TERMS AND CONDITIONS The Permittee, Ido Mizrahv, residing at 65490 Route 25, Breezy Shores Cottage#25, Greenport,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. Tharthe 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. 0 0 James F. King, PresidenthoOF so Town Town Hall Annex Bob Ghosio,Jr.,Vice-President 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer co Michael J. Domino % Telephone(631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 18, 2013 Mr. Frank Uellendahl, R.A. PO Box 316 Greenport, NY 11944 RE: IDO MIZRAHY 65480 ROUTE 25, BREEZY SHORES COTTAGE #25, GREENPORT SCTM# 53-5-12.6 Dear Mr. Uellendahl: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 18, 2013 regarding the above matter: WHEREAS, Frank Uellendahl, R.A. on behalf of IDO MIZRAHY 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 August 6, 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, in accordance with Chapter 268, said application was found to be Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on September 18, 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, z • • 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 approve the application of IDO MIZRAHY to replace rotten locust footings with 3' deep concrete footings under the existing cottage and to raise the cottage +/-2' to code complaint ceiling height; and replace all windows; and as depicted on the site plan prepared by Frank Uellendahl, R.A., received on August 6, 2013, and stamped approved on September 18, 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 F. King,President y 'town Hall Annex Bob Ghosio,Jr.,Vico-President 54375 Route 25,P.O.Box 1179 Dave Bergen �i t Southold,MY 11971 John BredemeyerTelephone(631)765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD TO: Frank 11e,l Ip n J 6L I A Please be advised that your application dated & 31 1 has been reviewed by this Board at the regular meeting of . and your application has been approved pending the completion of thb following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 �t Day of Construction ($50.00) '/2 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 comple0on of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 'SD' DU BY: James F. King, President Board of Trustees gpFFO( .lames F. king,President C P.O.Box 1179 Bob Ghosio„Jr.,Vice-President Southold.NY 11971 Dave Bergen Telephone(631 765-1892 John Bredemeyer a Fax(631)765-6641 Michael] Domino F 4, Southold Town Board of Trustees Field Inspection/Work Session Report LAI Date/Time: TEf // A11 Frank Uellendahl, R.A. on behalf of IDO MIZRAHY requests a Wetland Permit to replace rotten locust footings with 3' deep concrete footings under the existing cottage and to raise the cottage +/-2' to code complaint ceiling height; and replace all windows. Located: 65490 Route 25, Breezy Shores Cottage #25, Greenport. SCTM# 53-5-12.6 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: Present Were: J. King _B. Ghosio --'�'D. Bergen, _ &TBredemeyer .�ichael Domino D. Dzenkowski other Form filled out in the field by Mailed/Faxed to: cl K Date: .. ol oo 40, or� 'i � Iy _ ��.12�8L201 215 UG 6 2013 Y :+.0 i .+/+ •Ill r t� xc ? 6 r kf 4 4. 1. PROPOSED � ADDITION e 38'-6 1/2' Y-10' f_8 u Y-11 I/7 { TGE COT17C IIi GREENPORT NY 25 BREEZY SHORES MMH REF. SHOWER HI T �. s 11 POWDER RW 316 00 T,631,Rr 8924 8624 FMN - - - — m;WI-m w 00 KITCHEN 226 E Dd SIpEIc 0 Yw w 189m 9EL 618-498-ttA6 �RF_D q UEtze ENCLOSED PORCH BEDROOM 2 SUN ROOM * �L• � 02 HEIGHT OF WALL: 5'-11" \F •i IY_1• -10' 6'-91/2' A S-P ,� 13'-5' ,� 33'-4 1/2" 919E: 081"1 FLOOR PIAN ac SAS-BUILT a? CAMERA LOCATION FOR PHOTO VIEW #21A-1 EXISTING FLOOR PLAN w_I+1n-t-1 v SCALE: 1/4' = 1'-0' 3� 3 '• t' ' i`e mm�• � 5 f• 0 ay t ..a � • ♦"Y � .r •, iLI r. arm a� 1' ♦� � x fa �J :r r f,?r ,'ff Y k f 4� ♦ t�, fr �� k• 4l 9 k kr ` `a 9 t t�` y x f 4; k3 �, ♦y ,► r xx It . y u M. • • ( ( ! � ^ vwaa 9 ecwm �.amw, es.nm � '- c - xonv CdIH1V OF SUFFIXI( © �. ernwm �wweb =Se Aw ♦ e b7 c a Oa f I 1 a • rO 1 of I V 56URo "L,ND ""TER criox � _ _ RplPmpely TQ Betio,/iprry OFFICE LOCATION: �q SOUjho MAILING ADDRESS: Town Hall Annex ,�O l� P.O. Box 1179 54375 State Route 25 # 41 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) y Telephone: 631 765-1938 Southold, NY 11971 G. • �O Fax: 631 765-3136 7 01 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM L L: IU SEP 1 7 2013 " To: Jim King, President Town of Southold Board of Trustees suumom7cwn fT From: Mark Terry, Principal Planner LWRP Coordinator Date: September 13, 2013 Re: LWRP Coastal Consistency Review for IDO MIZRAHY- Breezy Shores Cottage #25 SCTM# 1000-53-5-12.6 Frank Uellendahl, R.A. on behalf of IDO MIZRAHY requests a Wetland Permit to replace rotten locust footings with 3' deep concrete footings under the existing cottage and to raise the cottage +/-2' to code complaint ceiling height; and replace all windows. Located: 65490 Route 25, Breezy Shores Cottage #25, Greenport. SCTM# 53-5-12.6 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 to this department as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "B" which states: B. Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site (inplace), including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without a permit and shoreline erosion control structures (including, but not limited to, groins, jetties, bulkheads, filled piers) located within Great Peconic Bay, Cutchogue Harbor, Little Peconic Bay, Hog Neck Bay, Noyack Bay, Southold Bay, Shelter Island Sound, Pipes Cove, Orient Harbor, Gardiners Bay, Long Island Sound, Fishers Island Sound and Block Island Sound (excluding all creeks); The proposed action(s) are not located within the CEHA. 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 • ��SgFFD(,�CQ • Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish, Secretary P.O. Box 1179 Southold,NY 11971 Telephone(631)765-1892 Tax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., September 11, 2013 the following recommendation was made: Moved by William McDermott, seconded by John Stein, it was RESOLVED to SUPPORT the application of IDO MIZRAHY to replace rotten locust footings with 3' deep concrete footings; raise cottage 2' to code compliant ceiling height; and replace windows. Located: 65490 Route 25, Breezy Shores, Greenport. SCTM#53-5-12.6 Inspected by: William McDermott Vote of Council: Ayes: All Motion Carried BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson �a�F $�!/jy0 53095 Main Road•P.O.Box 1179 Eric Dantes AT A y Southold,NY 11971-0959 l�[ T Office Location: Gerard P.Gcehringer N Town Annex/First Floor,Capital One Bank George Homing !';j • �O� 54375 Main Road(at Youngs Avenue) Ken Schneider to Southold,NY 11971 http://southoldtown.northfork.net REC I� VED , ZONING BOARD OF APPEALS �IJQaJ/L� TOWN OFSOUTHOLD !7 Tel.(631)765-1809• Fax(631)765-9064 1*4�4 - Southold Town Clerk FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JULY 25, 2013 Z13A FILE: 6660 NAME OF APPLICANT: Breezy Shores Community, Inc. ( Ido Mizrahy) SCTM 1000-53-5.12.6 PROPERTY LOCATION: 65490 Main Road Cottage 925 (aka State Route 25 and Sage Blvd.) (adj. to Shelter Island Sound), Greenport, NY SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODF: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated May 15, 2013 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated June 24, 2013. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation that the proposed action is CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. PROPERTY FACTS/DESCRIPTION Subject parcel, also known as Breezy Shores, is located in the R-80 zone and contains 82.6 acres. It is improved with three dwellings, a brick building, two garages, 28 seasonal cottages and 20 sheds. The access to the property is via a private road (Sage Boulevard), and the property is adjacent on the south to Shelter Island Sound. The Breezy Shores community is a unique property deeply rooted in the history of the Town. The multiple cottages on the property are a pre-existing, non-conforming use that was established prior to zoning by the Sage family in the early 1900s. The cottages originally housed employees of the Sage family brick factory until it ceased operations, and subsequently, then were rented as seasonal cottages. In 2000, a real estate cooperative, Breezy Shores Community, Inc., was established by the group and shares were offered as an ownership interest in the Cooperative. The cottage at issue in this application is known as Cottage no. 25, and is owned by Ido Mizrahy. This cottage is shown on the survey drawn by Howard W. Young, sheets 1-3, dated March 04, 2013, and building plans drawn by Frank W. Uellendahl, Registered Architect, sheets Al-3, dated April 30, 2013, with latest revision dated July 11, 2013 to shown all proposed additions, and the proposed increase in size from the building existing footprint. Page 2 of 3-July 25,2013 ZRA 46660-arecey Shores Community,Inc(Mivaby) SCI'M41000-53.5-12.6 BASIS OF APPLICATION: Request for Variance from Article XXIII Code Section 280-123A and the Building Inspector's March 7, 2013 Notice of Disapproval based on an application for building permit for additions and alterations to an existing seasonal cottage at; 1) a nonconforming building containing a nonconforming use shall not be enlarged, reconstructed, structurally altered or moved, unless such building is changed to a conforming use. RELIEF REQUESTED: The applicant requests a variance to renovate the seasonal cottage#25, including a 5.8 sq. ft. new addition for the placement of a water heater, with new Code conforming stepped landings for the entrances, and foundation alterations that will result in a 0.92 increase in the building footprint, and an approximate 16 inch increase in overall building height in order to conform with current building Code relating to interior wall height. AMENDED APPLICATION: During the hearing, the applicant was asked to bring the plan into more conformity with the code. The applicant on July 15, 2013 submitted a plan reducing the size of one proposed stepped landing for a double door entry from 6 x3 ft.to 5 x 3 ft.,dimensions that conform to the minimum size required by building code. ADDITIONAL INFORMATION: Representatives of the Breezy Shores Community expressed support for the Applicant's proposed renovations. FINDINGS OF FACT/ REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on July 11,2013, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence, the Zoning Board finds the following facts to be true and relevant and makes the following findings: I. Town Law &267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The building footprint will by expanded by 5.8 sq. ft. from the existing 634 sq. ft. to 639.8 sq. ft. for a total increase in non-conformity of 0.92%. The new stepped landings are the minimum size allowed in order to comply with building code, and are not to be included in the consideration of any overall increase in non-conforming habitable space. The building will remain a single story, seasonally occupied dwelling, in a neighborhood characterized by many similar, seasonally occupied dwellings. 2. Town Law $267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. Code defines that this seasonal cottage is a part of a larger non-conforming use of multiple dwellings, all co-located on a single residentially zone parcel. Therefore, any structural enlargements or alterations require the grant of a variance. 3. Town Law 4267-b(3)(b)(3). The variance granted herein is not mathematically substantial, representing 0.92% relief from the code, which the Board determines to be de minimus in nature. 4. Town Law &267-b(3)(b (� 4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The existing building will be temporarily raised in place to facilitate the foundation renovations, and then lowered back onto the foundation. There will be a small increase Of 0.92% to the existing footprint. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code and all other applicable building Code. 5, Town Law 4267-b(3)(b)(5)- The difficulty has been self-created since the applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. However,to the extent that a seasonal structure such as this one periodically requires some degree of reconstruction and/or alterations to continue the safe use of the structure, the need for variance relief is not self-created, but is created by zoning Code that now prohibits an existing use and activities that at one time were not prohibited. Page 3 of 3—July 25,2013 7.BA#6660—Breezy Shores Community,Inc.QVI zrahy) SCTM#1000-53.5-12.6 6. Town Law &267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of renovations to a seasonal cottage, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Horning , seconded by Member Dantes, and duly carried,to GRANT, the variance/variances as applied for, and shown on the survey drawn by Howard W. Young, sheets 1-3, dated March 04, 2013, and building plans drawn by Frank W. Uellendahl, Registered Architect, sheets A-1, A- 2, A-4 dated April 30, 2013,and sheet A-3 with latest revision dated July 11, 2013 to shown all proposed additions, and the proposed increase in size from the building existing footprint. Subject to the following conditions; CONDITIONS: I.The cottage use will continue in its current status as an unheated seasonally occupied dwelling. 2. No other alterations or additions may be undertaken without review by the ZBA, except for necessary minor repairs as determined by the Town Building Department. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s)granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board: Ayes: Members Weisman (Chairperson), Goehringer, Schneider, Dantes, Horning This Resolution was duly adopted(5-0)), Leslie Kanes Weisman, Chairperson Approved for filing7 6 /2013 James F. King, President• QF sours • Town Hall Annex 0� - 54375 Main Road Bob Ghosio,Jr.,Vice-President ti 'o P.O.Box 1179 Dave Bergen 4 Southold, New York 11971-0959 John Bredemeyer G Q .� �O Telephone(631)765-1592 Michael J. Domino O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application Administrative Permit _Amendment/Transf /E tension Received Application: .3 L/Received Fee:$ 2 MDn Completed ApplicationIncomplete SEQRA Classification: Type IType Il_UnlistedCoordination:(date sent)VILWRP Consistency As sme t Form 315 3✓CAC Referral Sent: ate of Inspection: 3 _Receipt of CAC Report: _Lead Agency Determination: Technical Review:� Public Hearing Held: Resolution: Name of Applicant DO L'L 2e--k I,-( 1� Mailing Address 2,116( 5! Apr kleEIO yZ7e!�__ ,C) K /00G9 Phone Number:( )� �� 712 Suffolk County Tax Map Number: 1000 - 15J /2• l0 Property Location: ¢�� �G(>Z� 2C�7 �2ECLY SfF42ES (provide LILCO Pole#, distance to cross streets, and location) AGENT: T�A.t,/c (If applicable) Address: 123 4!�—:;rur22Ac f I06 S/lo \/ Phone:) �ard of Trustees Applicati� GENERAL DATA Land Area(in square feet): Area Zoning: Q 8 Previous use of property: fJlp��Li(1!yC FCj�r—�tJACA� S Intended use of property: /105 S!U6AU77AL 6645dx>Ae Gf�rl'A� �✓' Covenants and Restrictions on property? Yes No If"Yes", please provide a copy. / Will this project require a Building Permit as per Town Code? V/ 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 No If"Yes", please provide copy of decision. Will t s 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 governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): R pL1?G� R17tJ to,iu�irFi�ev1( s �rrti 3 2 Tp 4pp� 4!:7,4-fpGiA.U7- ivAU 415 BF#d of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: tZEPl�aG� �.�F Pl�LD (�,U9171J1�C Axr1 21q/15V5 G9 2 F7.' 7D 1"PIPOVE Area of wetlands on lot: square feet Percent coverage of lot:-% Closest distance between nearest existing structure and upland edge of wetlands: 71 feet TO J'`/fPAlil�l�ESJ /g(o,rj Fr 717 OV44L-1NEA�j Closest distance between nearest proposed structure and upland edge of wetlands: feet Tp �lf/L� 7!?�5l /�3.5 22750L-k1ATt9D Does the project involve excavation or filling? No V Yes If yes,how much material will be excavated? 17,222 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: �`xl�,Vb- SLpPE !�j kezk7/NRC. Manner in which material will be removed or deposited: f 18 70 Pe �-tRVD DO,,- Statement ukStatement 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): � �?' 04) -We 54o5utL=� (�5LPk_)D SUL.uT> 61T20 PROJECT ID NUMBER • APPENDIX C • SEQR STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only PART 1 -PROJECT INFORMATION (To be completed by Applicant or Project Sponsor) 1.APPLICANT/SPONSOR 2.PROJECT NAME j �TJo .�/iiafFY co2� 2�S cC�.�s�r, �ivG. 3.PROJECT LOCATION: �rz, n pDe .c�Y 6var Municipality r.�10Gf� County 4.PRECISE LOCATION: Street Addess and Road Intersections, Prominent landmarks etc -or provide map 6!64100 . VOr1 2 lo/L �beT 7047.tr; &7F �cc7U7' bLd ! SG7�7 /2, 5.IS PROPOSED ACTION: New ❑Expansion ICS Modification/alteration �I 6.DESCRIBE PROJECT BRIEFLY: � s ,vD l2Ais� � � 717 1�6Ti,U Gdy.� GdltiPu.�,v"T- C�lGi.LJb ft�/bft7�i 7.AMOUNT OF LAND AFFECTED: �/' Initially 916.. acres Ultimately C7(p.� acres 8.WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? ❑Yes x No If no,describe briefly: ckr'G .vc.� --Got-lr�G�a�,r�T ��.��R-� Gd�G� i2E1SZv1 9.WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) Residential ❑Industrial ❑Commercial RJAgricutture 9park/Forest/Open Space ❑Other (describe) I 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (Federal, State or Local) 9Yes No If yes, list agency name and permit / approval: 7-Z1'vr7Cr 670VTHOL-V . Z0,4L,4rP261V65p 11.DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? {.71 JAIYes ❑No If yes, list agency name and permit / approval: j 12. AS ARE UL OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? es N I CE T Y THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant / Spd s r a ,(J/� Gl�l.-1 ��1�A �A Date: o-4- 1-3 Signature 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 Agency) A.DOES ACIIO11. N�EXCEED ANY TYPE t TWRESHOLD IN 6 NYCRR,PART BtTm .a7 if yes, aNfltate lite rei process and use bre FULL EAR 13 Yes L. No B• VNU-ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNUSTED ACTIONS IN-6 NYCRP,PART 617.67 If No,a negative declaration may be superseded by another"ved agency. 13 Yes ©No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING:(Answers may be handwriltea,if lel le) C1. Edsi air Quality.surface or gtoatdwa�r Vtoflly a quantify,noise levels.e"V baftic patient,safld waste production a disposal, eMitd far eroskn,drainage or 600dhg Prdtleao7 E)platn bllefly C2 AWhetio,agrkWWml:wdmedogleal, orodwns(UrweradkaatresM— or alocticharalE C3. Vegetation a fauna,fish, 'a apecin.sigmia"haw ,Nor fw"tenedarendangemd spedes?Explain bdafly C4. A community's existing plans or goals as alfvdapy adopted,w achartge in use m in ensfly of Use of land or other naWral resources?Explain fwieay C5. Growth,subsequent devebpmem;or related activities likely to be induced by( proposed action?Explain briefly: 06. Long term,short term,cumulative,a other eneds nor Identified in C7-057 Explain briefly: :. C7.Othet• ands ndud chat in use of eipt!''-j'',rarta.ort of ? air briafl :_... D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CI'61RACTERISTICS THA CAUSED THE F�TA6USHfJFM OF A CRITICAL ENVIRONIii AREA 7 Q Yes Q No [rYesMe QNo PARTM-DEi1+RNtldAIMOF OMM(TubeCloo fed by Age ) mill I k18i1RUCilONS: FaroadtadtroreetNPeotkialNWedalpove do6twmiltewAlegtrxxke�bstaa6ad lalpe,gylp(>ul(oft>atetvAaesignYitalN E lath ellsd altolAd be aaate6aed kt odallaL6da rllUl its(aj ttalNllg(i.e,ulball ar IUIBQ;(I>)probaYlgbr dooallfiil�(W dupa6olC(�imarrelabily;(e) aft o rtdemib>AI adve Mill add vllentsarektarloeaupPor6rtglrlalllrk& EramO ltc4ltrtootacolttain yea,lbed Wshoof,�nlRo�lo Hilda ev Ism b'oonWlodaWWGqud*sd*"NC. I(ques$mdofpaltkwindmoed Pd�l knpladcf the pra�aed aotlon an Yle�dretadarfa&s of the CEA. Chock#6batifyouflaVaWaAWMonooraarepowro*tingeorsigr adwwaehOadswtachMAYoocur:Tlonpmoaeddkactlybtlo W and/or prepare a Positive dedawWn. Check tltis box N71)(114sawx determkod.based on In ktfonnation and analysts atpove atd qtly a"OrI ng doe tion,hof the proposed VWLL nresult(n any sigrrifxaM adverse in deterermlrneads AND provide, on adadwnads as necessary, the reasons wi ppdnting IN Board of Trustees Name of LeaJFF)d // Z a / d Agency Dale JA k, r s F. 14/A)lr President Prart or TNy�ge ame of Responsible Officer in Lead patency /Yry/�_ r(le of Responsible ORcer IL ,5'L3 -5�-�a. � on� PROOF OF MAILING OF NOS ATTACH CERTIFIED MAIL REI Name: Address: - i2e6 Pa trrx g2& CM4t4 -�-1-rL( 1 Sc7il: 0V - 53- S - l2.Co rio7ldown STATE OF NEW YORK Board of Trustees COUNTY OF SUFFOLK 11Lil�lk U�II,e�lQ(aG� , residing at IQ3 �[illl/fQ� � 8 being duly sworn, deposes and says that on the — p" 1 _day of S 20 3 deponent mailed a true copy of the Notice set forth in the Board of 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 No were mailed at the United States Post Office at ° lit that said Noti mailed to each of said persons by CERTIFIED MAELIRETURN ItECEIPT. 1 Sworn to before me 4 � �e this Day of_5j'20� Notary Public CONNIE C], BUNCH Notary Public, State of New York No. 0 BU6185050 itualiiied in Suffolk County �emmisslan Expires April 14, 2 I Se • gry S�g fF01�coG • � d lanes 1-. King. President O - l o,�r I all,53095 %Arlin Rd. N Boh Ghosio, Ir. .Vice-Prc,idcnt �y� � P.O. Ros 1179 Dace Bergen �' Southold.M 11971 John Bredemerer �'�� �0� lclephone(631)765-1892 Michael ).Domino '� * �' Pas(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of IDO MIZRAHY COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO RE C0d9P1-E1 T.D AFTER POST/NG REMAINS LN PLACE FOR F, 12i�OORR,EIGHS T DAY I, �A114L/ (,(�lle�nl ( , residing at /dba 123 CkAr L pl1 U-1-- being duly sworn, depose and say: 22 14 That on the ay of 41(t r2A I personally posted the propert known as 4� by placing the Board of Trustees official poster where it can easily be seen, and thw 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. September 18 2013. Dated: ( ' nature) Sworn to before me this Mkday o'IT, 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: ado Mi 'LrakX SUBJECT OF PUBLIC HEARING: Replace rotten locust footings with 3' deep concrete footings under the existing cottage and to raise the cottage +/-2' to code complaint ceiling height; and replace all windows. TIME & DATE OF PUBLIC HEARING: wWnewy, bear I Xr X13 v, odr-or obcw&S . o% PP# If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection rior to the day of the hearing during normal business days between the hours ofp8 a.m and ,4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892 Board of Trustees AppliQmLiou County ofSuffolk' WS Ar�cS State of ork C+4 I Fo< 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 APPLIC ION. ignature of Property Owner SWORN TO BEFORE ME THIS 7iZ DAY OF 5 V I— ( 20 1 ~—deli IL PSN Casrw a No. 2010N worwn rwu.4moosrn wtronneoum Notary Public I wo■.ab�+uesan.in� ' j I l � Sod of Trustees Applicatio"o AUTHORIZATION (where the applicant is not the owner) 1, I p residing at 2- 2- 6 2 Y 2j (print owner of property) (mailing address) do hereby authorize 12.3 Ct5Unz/G /-)VE�— (Agent) i�lj� ?✓!6 1Z� I to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) BREEZY SHORES COMMUNITY, INC. P.O. BOX 925 MATTITUCK, NY 11952 PeconicpaintingCbel Isouth.net April 26, 2013 I, Donald E. Wilson, President of Breezy Shores Community Inc. Coop Board, hereby affirm that the Board has reviewed the site plan and cottage for renovation of cottage number 25 for Ido Mizrahy, which was prepared by: Frank Uellendahl PO Box 316 Greenport, NY 11944 and have no objections thereto. Both the Board and the Architectual Committee at Breezy Shores certify that we have seen and approve of your plans. Donald E. Wilson i The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the(own of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME : 1-71,-2 /� ({Y, I oc (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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 NO V 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 that 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 r Submitted thisN�dayof U�� 2 � . Signature L Print Name —1- D C2 12 A /./ APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the nag of town officers and emplovces.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is i necessary to avoid same. YOUR NAME: U&LC�X-J 2914 Air, . (Last name,first name,iriddle initial,unless you are applying in the name 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 Tutee 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 NO V 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%of the shares of the corporate stock of the applicant I (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 Submitted this4pA jt zoo 2&13 Signature Print Name Form TS I Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: s.c.T.M.t: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Ol /OQQ 53 5 /2,& STORM-WATER.GRADING.DRAINAGE AND EROSION CONTROL PLAN Sea on "� CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCITON ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? Will this Project Retain All Storm-Water Run-OR (include Total Area of all Parcels located within the Scope of Work for Proposed Wishuctio, �' Generated by a Two(2')Inch Rainfall on Site? ❑ (S.F.f Anes) (This item will include all run-off created by site b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed :L�,.s r Site Improvements and the permanent creation of tivilyT r construction ac (s F)Aces) impervious surfaces.) DFSCRD PROVIDE BRIEF PROT2 Does the Site Plan andlor Survey Show All Proposed F.CI' xi'fON (Retitle AddewY Pere ae N,wdtl) Drainage Structures Indicating Size&Location?ThisIteV ❑ Stomp ss all Controlling Surfaude all ce Proposed ter cGrade hanges and V X0&0 T n_ 3 Does the Site Plan and/or Survey describe the erosion ❑ �7 �'�{ and sediment control practices that will be used to f-- control site erosion and storm Water discharges. This — GfJ��� item must be maintained throughout the Entire Construction Period. Q Will this Project Require any Land Filling,Grading or ACJ�3��i� Cb Excavation where there is a charge to the Natural El — Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? Ky 5 Will this Application Require Land Disturbing Activities ❑ f 7; Encompassing an Area in Excess of Five Thousand ✓ (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the ❑ Site? is this Project within the Trustees jurisdiction General DEC SWPPP Rewhements: or within One Hundred(100')feel of a Welland car Submission or a SWPPP is required for all Construction activities involving sol Beach? disturbances of one(1)or more acres; indudkV disturbances of less than one acre that Will Mere be She preparation on Existing Grade Slopes are pad of a larger contriver,plan that wil Wtimetely disturb one or rare acres of land; which Exceed Fifteen(15)feet of Existing Rise t0 includkg Construction activities involving soft disturbances of less than ane(1)acre where One Hundred(100')of Horizontal of Distance? — the DEC has determined that a SPDES pemut h required for storm water discharges. (SWPPP's Shag meet the Wnimum Requirements of the SPOES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges time Coostrustrm wuvity.Permit No.Gp-0-10-001.) Surfaces be Sloped to Direct Slone-Water Run-Off 1.The SWPPP shell he prepared prior to the subrnilial of the NOT.The NDI share be into and/or in the direction of a Town htvf-way? F submitted to ae Department Prior to to camherxxarent of ccnsbuctlen ac". z.The SWPPP shell describe the erosion and sediment rxrtml practices and where 9 Will this Project Require the Placement of Material, required,Post-WSIMIC ion storm water menaganimt practices that Will be used and/or Removal of Vegetation andbr the Construction of any constructed to reduce the polutenls in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and caMithms of this parting.In addition.the SWPPP shag identity potential sources of potation which may reasonably be expected m m affect am Area?mss IteMN Nor twlute me Ine,e wtm a odvemey Aaaae) ❑ quality of slam water dhUarges. NOTE: NAny Answer W Ouesdq Ors trough Nine b Answered wtM•Check Mak 3.AN SWPPPs that require the post-caiabuce n slam water management practice in a Box and the combueton site dlstaidanx e N between 5,000 S.F.a 1 Am in are, component share be prepared by a qualified Design Professional Licensed in New York a Stomn-Water,(trading,Drainage a Erosion control Plan Is Required by the Tam of that is knowledgeable in ae principles and practices of Storm Water Management Southold and hist be Submitted for Review Prim W Issuance of Any Buildhg ParmL (NOTE: ACheck Merk(J)snww Arnea Tar each duartidh is Required for a complete Appleton) STATE OF NEW YORK, COUNTY OF.....J`...4 F .SS duly swum,deposes and says that he/she is the applicant for Permit, (Name ol ndmiduai siprwmg Documenq And that he/she is the ... (Omer,Correc or,Wit.coM:ate a.o�.Wi................................................................ Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this apphcat on are true t best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith Swore to before me this; ...............ire./ '...............I day of...,f..+:II GU��T............. ,20.1 Notary Public ...........CINQA'1'C00PER.............. .................... ....................................... (Signature of Appkant) FORM - 06/10 NO 01 C048225133, Suffolk Cnun)u Term Expires December 31, 20 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. ECE9 A copy of the LWRP is available in the following places: o ie o website (southoldtown.northfork.net), the Board of Trustee e, the Planning Dep t, all local libraries and the Town Clerk's office. AUG — 6 2013 B. DESCRIPTION OF SITE AND PROPOSED ACTION u,n,,,)?msn RmrdAf SCTM# PROJECT NAME G�i?�A6E 2✓ f�T �j.E?EZc/c`�ft�{sS Gf�/%.�f. ��VG, The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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: Nature and extent of action: RSP �s 8--��G 4660s7- ,P2267- LUIIUTJdLt Location of action: 6ti 4!!�) D 12457-&r7j?F7 2 5 eAP�iZ gra -7- vY Site acreage: <52. C U"B g `J' Present land use: ,24576/ ,C?TJ L V 50R�AL �C�TT3�� Present zoning classification: 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: /moo (b) Mailing address: 2 4�v E 2kiD! ST_ �4 (c) Telephone number: Area Code -7p glp (d) Application number, if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No Rf If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ONO 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 9 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�g 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 Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 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 HI—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ Yes No Not Apr4ble 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. FlYes E] Nox 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/E Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yej—] 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 g 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 evaluation criteria. ❑ Yes ❑ NoRr Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No rL<r Not Applicable PREPARED BY r4-2,194>L L/ELLC470496TITLE 4eG/-//T�e7- DATE 5-4"!3 (I)VNAOTIORIEEO ALTERATION CQ ADN[M I M THIS 4ML£Y IS A N0.APCN CE SECTOR 7208 OF TIE NEW Y K STATE EDUCATION LAW.(2)D'STANCES SHOWN HEREON f1,W PRCPEAIY LINES TO 1.SMG ST2NCNRES ARE MR A..Ex P...AND RRE NOT 10 BE USED LO ESTABLISY PRCPERN IME'OR FOR ERECTION OF PERCES.(J)COPIES OF THIS SURREY NAV NOT BEARING ME LAND SUAREYORS INKED SEAL ON ELBOSYD SEAL STALL NOT BE CCNSCERED TO BE A VALID TRUE CWY.(A)0DREFICATM INDICATED HEREON SHALL RUN ONLY TO ME PERSON FOR WHOM ME SMKY IS PREPARED AND M HIS BEHALF TO THE TT£CgIPANY,WNRNMEN7AL A@,CY AND L£NOINC INSTNTM NSTFD HEREON,AND TO ME A59MEE5 OR ME WRONG INSTNTM.CERTPTCATO,S ARE NOT TRANSFERABLE TO ADDITMRL M'TMEONS M SUBSEQUENT OWNERS. (5)ME LOCATM DF WELLS(W),BREED TANKS('T)k DESSPOOLS(CP)SHOWN HEREON ARE FROM PEW OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. 400 Ostrander Avenue,Riverhead,New York 11901 tel.651.921.2503 fax.631.121.0144 admTmgoungenglneering.LOm Howard W. Young,Land Surveyor OL Thomas G. Wolpert,Professional Engineer Douglas E.Adorns,Professional Engineer r Robert G.Taet,Archi otect 1 n 0 N A• O 5 O O O (� EcEivE D 3 AUG — 6 2013 asouoid rnun oRwrd of Trustees p ` SURVEYORS CERTIFICATION CJ J f ` f DD Q !�w'rt''�'''t�• t• ' o BOW.:eAeT' EDO MIZRAHY —, TTA&E 25 R � fla o oa o:0Q#%0 9Q4p SURVEY FOR r 1 °a0000ao _ - WO MIZRAHY R COTTAGE 25, "BREEZY SHORES" of Greenport, Town of Southold 5 Suffolk County, New York BUILDINb PERMIT SURVEY County Tax Map Di.tn.t 1000 sTOD 55 Blau 05 LO< P/O 12.6 MAP PREPARED JAN.O9,2015 Record of Revislons RECORD of REVISIONS DATE w m51 �MAP 400 O 200 400 600 SCALE: I"=400' Scale: 1" 400' d JOB NO.2012-0210 17WG.2010_0203�Id88\2010_0203-2012_02T0Jbp I OF 3 O = MONUMENT SET = MONUMENT FOUND 0' = STAKE SET A z STAKE FOUND (LIUNAUMMIM ALIEAAPCN OR AENTM TO MIS MAMMY IS A NCCATW OF BECTON 7209 OR ME NEW YgtN STATE ELUCAPW LAW.(3)DISTANCES SNOW NE12M FROM PROPI UNES TO E.RTNG SMUSM11 ARE FOR A BPEGHTI PURPOSE AND ARE NOT TD BE USED TO ESTABLISH PRKERiY UNES M FOR ERECTION CG MUSES.(5)COPIES OF MIS SURVEY MAP NOT BEARING 111E LAND SURVEYORS INKED MAL OR ENSOSYO REAL STALL NOT BE CONSIDERED TO BE A VALID MILE COPY.(t)CERPTCATION INDICATED HEREON MALL RUN ONLY TO ME PERSON FOR WHOM ME SURVEY IS PREPARED AND W HIS BEHALF TO ME T -E COMPANY.GOVERNMENTAL AGENCY AND LENDING INSPTITCN UST:D HEREM,AND TO TLE AS9GNEES OF ME LENDING INSTNTCN.GERTROATMS ARE NOT TRANSFERABLE TO AODITONAL INSTLUTCNS M SUBSEQUENT OWNERS. (5)ME LOCATW OF WELLS(W).SEPPC TANKS(ST)R CESSPOOLS(CP)STOW HEREON ARE FROM REM QUMFVATO"S ANO p DATA OBTAINED FEOR CIPHERS. ` 400 Ostrander Avenue,Riverhead,New York 11901 LEGEND N tel. 631."121.2303 fox.631.171.0144 admineyoungengineering.com SSE A � __ $ O�tri� k�41�1Z� C e CA WATER METER ` - E Howard W. Young,Land Surveyor ITT OO 'rF' ` '1`', Thomas G. Wolpert,Professional Engineer NiO �� W _f Douglas E. Adams,Professional Engineer CD RYDRANT FIX . FIND DOCK ¢ vq TSO \ E Robert C.Tost,Architect h EDIT N N FLO = FLOATING DOCK by © IDMS. \ WS WOOD 5TORASE a GE • CELLAR ENTRY RIO :ROOF OVER A ` S a OOR SHOrER 01 05 26 = FRAME GO�AOEE 4 NUMBER NOTES TH 6 5.09 • (SURVEY)ELEVATION X 65 • (RECORD)ELEVATION s17� 'CyNA h FLOOD IN5URANGE RATE MAP PANEL NO,3610300159 H LAST = WETLANDS FLAG s NUMBER eb `. �`� }� OQ O^ DATED SEPT.25,200q. / TOn AT s; a 4e S m i ZDV SURVEYORS CERTIFICATION a APPROVED BY .-"' 29 BOARD OF TRUSTEES TOWN OF SOUTHOLD +-U 3� ORATE 3 )1 y_- cga ♦ IS,, HOWARD W.YOUNG,N.Y. S.NO. \`1 t R!l L'; Ae S 8 eo ♦ ♦ ) WRYLY FOR R A CIS IVO MIZRAHY ' is +,m GOTTA6E 25, "BREEZY SHORES" HEHE o s.m ++� ♦ at 6reanport, Town of Southold a � Suffolk County, Naw York • - © SUILDIII PERMIT SURVEY BI .' •.• • County Tax Moll D Nva 1000 SADDEN 53 BIII 05 Lot P/0 12.6 �.. . • E7Y MAP PREPARED JAN.Oq 2013 U +� Sric'A,tNRecord of Revision n �wQp F^7'05 BpI.� RECORD OF REVISIONS DATE oF -""p,,, q)py I,5 6ENERAL AMENDMENTS MAR 04,201 IN T'.DgNI , TO ED s m �D K"�AD PLAN 3o O IS 50 60 SI I' . 30' Scale: I" = 50' VERTICAL DATUM = NAVD 1988 JOB NO.22-02-10 pY�.2010 10205_navd66\2010_0203_2012_0210_bp :20F 3 MONUMENT SET = MONUMENT FOUND = STAKE 5ET = STAKE FOUND EXISTNS COVERAGE ❑ YCP'T 1, CT "Y PROPOSED 6DIA X 2' DEEP DRYWELL - 45 CU.Ft. RUN-OFF CALCULATION FOR 2" OF RAW TO BE CONTAINED ON SITE EXT'G FOOTPRINT OF COTTAGE WITH GUTTER LEADERS FOR ROOF RUN-OFF (TYPO COTTAGE 614 SF : 100% -un-oft coefficiert = 102 cu ft INCL OUTDOOR SHOWER 634.0 SF -- - — 30'-6 1/12 2'-10" J 1'-8° PROPOSED COVERAGE N ' �' 11 1,/1 HWH ADDITION 5.8 SF 639.8 Sl- 10' - lF� - _1 _ _ _. _ 15 —_ _- _ LANDING A ADDITION - 9 SF EXEMPT LANDING B ADDITION - 9 OF EXEMPT TTAG 5.8 SF ADDITION 2 LANDING C ADDITION - 15 SF EXEMPT CO i i i4GL TOTAL ADDITIONS - 5.8 SF = 0.92 % GREENPORT, NY LEADER 4 -6„ 25 BREEZY SHORES HWH ACCORDING TO THE CHIEF BUILDING ARCHITECT — INSPECTOR MICHAEL VERITY ALL THREE RANK uELLENDADL 0 + 00 - -- W D LANDINGS PROPOSED IN THIS PLAN o 123 CENTRAL AVENUE DW O O �20 SFR RONo« 318 DOCUMENT ARE REQUIRED BY CODE AND a GREENRORT, NY 11944 ARE EXEMPT FROM COUNTING IN THE TEL 631-4n 8624 FOOTPRINT COVERAGE. KITCHEN BATH RM 7 OWNER THE MINIMUM SIZE OF LANDINGS IN FRONT 0' MIZRANY OF SINGLE DOORS IS 3'X3.' _ C-,;ACE q 25 - — THE MINIMUM SIZE OF A LANDING IN FRONT eREE2v se�REs BEDROOM REF 48x24 IS AND CLOSET _3 _�_ OF A 5' WIDE DOUBLE DOOR IS 5'X3'. = 22 NEw YORX��NY 113 >F 3 TEL 646-498 776E ANY INCREASE IN SIZE ABOVE THE MINIMUM o, REQUIREMENT IS NOT EXEMPT AND WILL BE LANDING B � ADDED TO THE FOOTPRINT COVERAGE M - o N PROPOSED ALTERATIONS - - NEW WINDOWS, SIDING, AND ROOFING - SITTING ROOM DINING SUN ROOM - RAISE EXT'G ROOF BY Co 1'-4" TO N IMPROVE CEILING HEIGHT AS PER CODE s o - RAISE EXT'G FLOOR ELEVATION BY -10" F FRAMING sem _ TO INSTALL NEW FLOOR - REPLACE ROTTEN WOOD FOOTINGS 3 WITH 36° DEEP 8° DIA CONCRETE of FOOTINGS m - COTTAGE TO BE LIFTED UP TO ALLOW o ANDING A 5068 THE NEW FOOTINGS TO BE IINSTALLED wl o o �REpgR wl LANDING C W.UE(��Sym o LATE 08/06/2013 3 -0' SCALE: 1l4" - I' C" mol LEADER LEADER * j� =wj PROPOSED FLOOR PLAN 1 6'-9 1/2° 021�6� DOG NAME FIROPOIEI 6'DIA. X 3' DEEP DRYWELL - 67 Cu.Ft. PROP SED EL0 PLAN DOG NO A-3 TH GUTTER LEADERS FOR ROOF RUN-OFF (TYPE) SCALE: 1/4" = 1'-0" PROPOSED EXISTING COVERAGE "' ADDITION PROPOSED 6'DIA. X 2' DEEP DRYWELL - 45 CU.FI. RUN-OFF CALCULATION FOR 1°OF RAIN TO BE CONTAINED ON SNE ID(TG FOOTPRINT OF COTTAGE e WITH GUTTER LEADER$ FOR ROOF RUN-OFF (IYPn COTTAGE 614 SF : T00% run ccelfrcienl = 101 cu it INCL OUTDOOR SHOWER 634.0 SF 30'-6 1/2' 2'-10° 1'-8 PROPOSED COVERAGE N 3'-1 U 1/2" —�� HWH ADDITION - 5.8 SF 639.8 SF =, 15-2° , LANDING A ADDITION - 9 SF EXEMPT LANDING cssF EXEMPT F5—8 sFwITroN 2'-6" ADDITION - 1 T COTTAGE TOTAL ADDITIONS - 5.8 SF = 0.92 x GREENPORT NY LEADER 4'-6" 25 SITT SHORES NADH ACCORDING TO THE CHIEF BUILDING R4CHRECi O O INSPECTOR MICHAEL VERITY ALL THREE rRu mmm _ _ 123 cow Hm O UW O O W/o R 'I; DOCUMENT ARE REQUIRED BY CODE AND 316 a ARE FTPRINT ROM ROMMCCOUNTNG IN THE ML 01-m 024 b . OWNER KITCHEN &T" R" ' 1E MINIMUM 511E OF LANDINGS IN FROM oo WPM OF SINGLE DOORS IS 3'X3.' BEDROOM REF. THE MINIMUM SIZE OD A LANDING RN 48x24 ISWNO CLOSET 3'-0" 111 1' WIDE DOUBLE DOOR IS 5 ' § ANY INCREASE IN SIZE ABWE o REQUIREMENT S NOT EXEM LAM B ' ADDED TO THE FODTPRMT 5 PROPOSED ALTE TI - NEW WINDOWS, SIDING, � SITTING ROOM DINING SUN ROOM Ruse EX'c ROOF Bi r>g .TB,� 0 RASE ECG FLOOR HEIGHT AS PER G'-10 _ _ d - RASE TALL FLOOR ELEVATION Ri-10 - TO LACER NEW FLOOR FRAMING - REPLACE ROTTEN WOOD FOOTINGS WITH 36" DEEP 8'N CONCRETE FOOTINGSim - COTTAGE TO BE LIFTED UP TO ALLOW LANDING A 5068 THE NEW FOOTINGS TO BE IINSTALLED c EC � 11i � 7 as D LANDING C o qR 06/0 13 AUG - 6 2013 LEADER LEADER ° FLOORRED PSLN 5'-0" a € 6'-9 1/2' A --- ac wx Sou:hnid TaGaO � A-3 Ougot TrusteesPROPosED s'DA. X 3' DEEP DRrwELL - sT Cu.R. PROPOSED FLOOR PLAN ®� 9K ro WIfH GUTTER LEADERS FUR ROOF RUN-Off (lYP/) ti SCALE: 1/4' = 1'-0° ■n Tlilllllllllllll - G Imo,'■I■I r :�.II■I■I I■!ILII � ' ���J�I ISI I■il i��ll'■I■!I 11 1 I I son I_ ��11111111111IIII IIII , .-��. 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