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TR-8339
®F ®(Oj' Town Hall Annex John M.Bredemeyer III, President o�'#01.0 � �® ,`Q � l® . 54375 Main Road Michael J.Domino,Vice-President t ' sks P.O.Box 1179 f # l Southold James F.King,Trustee � ., ,New York 11971-0959 Dave Bergen,Trustee G ,1,,. �� g , Telephone(631) 765-1892 Charles J.Sanders,Trustee -: .� , o' Fax(631) 765-6641 �IC®UNrt,* see •i/ ts BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1192C Date: December 18, 2015 THIS CERTIFIES that the construction of a 20'x40' with 12'x16' "L"extension in- ground pool; construction of a 1,700 sq. ft. pool patio; install 4' high pool fencing; construct a 700 sq. ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas:, with the conditions of establishing a 50' wide Non-Disturbance Buffer landward of the edge of wetlands; that the pool fence to be located on the border of the Non-Disturbance Buffer; the Non-Disturbance Buffer is to be re-vegetated using native vegetation; and a pool drywell to be installed; At 4553 Wickham Avenue, Mattituck Suffolk County Tax Map#107-4-13 Conforms to the application for a Trustees Permit heretofore filed in this office Dated October 17,2013 pursuant to which Trustees Wetland Permit#8339 Dated November 13, 2013 and revised on January 22, 2014,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 construction of a 20'x40' with 12'x16' "L" extension in-ground pool; construction of a 1,700 sq. ft.pool patio; install 4' high pool fencing; construct a 700 sq. ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas; with the conditions of establishing a 50' wide Non-Disturbance Buffer landward of the edge of wetlands; that the pool fence to be located on the border of the Non-Disturbance Buffer; the Non-Disturbance Buffer is to be re-vegetated using native vegetation; and a pool drywell to be installed. The certificate is issued to THOMAS &LINDA KELLY owners of the aforesaid property. gel"— gnu 61410,741.2 Authorized Signature John M. Bredemeyer 111,President ,'OgUFFp1 C'` Town Hall,53095 Main Rd. ,� Michael J. Domino,Vice-President ,1J OGy P.O.Box 1179 James F.King ; ti ; Southold,NY 11971 Dave Bergen `.Wo 4��/ Telephone(631)765-1892 g =rit �p'`t• 1 Fax(631)765 6641 Charles J. Sanders . 1 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 124(45- DATE/0F INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE - Pre-construction, silt fence - 1st day of construction / '/ constructed Project complete, compliance inspection. INSPECTED BY: " COMMENTS: ov 16totar !®/02. a e.? 3 CERTIFICATE OF COMPLIANCE: t ' >6.61,14).( l(e, � 1S e ?e ,r-vn -1— 333q LO‘C-t(11 3-to v/va \-Nrk Ncy \y—tz_ t „..) 4-.1/1 A v cAy,S {mac 4 toy I,2 0L v. er_e_ke sA0 oby-4- (s+ kA5240,+ c _i _o ex_ bel ekt)ey c_N v\_Q 7r( -ex_va(_ AotA r �i��s CC# : C15-50327 T.et COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 12/17/2015 under Liber D00012845 and Page 190 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 12/17/2015 . R E. SUFFOLK COUNTY CLERK DEC 1 7 2015 1i 41;24.� JUDITH A.PASCALE Southold Town SEAL / /r / / / iivi1111111u11111111111111111111111111111111111111 1111111111111111111111111 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 12/17/2015 Number of Pages : 6 At: 10 :31 :30 AM Receipt Number : 15-0175806 LIBER: D00012845 PAGE: 190 District: Section: Block: Lot: 1000 107 .00 04 . 00 013 .000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $30 . 00 NO Handling $20 .00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $0 . 00 NO Notation $0 .00 NO Cert.Copies $7 .50 NO RPT $60 .00 NO Fees Paid $137 .50 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County D E C t �� E 7\ ,1 DEC 1 7 2015 i i'� Southold Town Board of Trustees © e - / ,� RECORDED ,a"r of pages (U 2015 Dec 17 10:31 30 PM ° ,JUDITH A. PASCALE • CLEFT: OF SUFFOLK. COUNTY This document will be public L C.00012845 record. Please,remove-all P 190 Social Security Numbers - prior to recording. Deed/Mortgage Instrument • Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 I FEES Page/Filing Fee 30 -- Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 . Sub Total Notation Spec./Assit. , or EA-52 17 (County) Sub Total Spec./Add. EA-5217 (State) TOT.MTG.TAX R.P.T.S.A. C.o0 a) Dual Town Dual County � , Held for Appointment Comm.of Ed. 5. 00 " F "' 1 ,_ Transfer Tax • - �u, • .1 AI =.: iT • ' Mansion Tax Affidavit t �' rJ SD == The property covered by,this mortgage is Certified Copy ( or will be improved by a one or two NYS Surcharge 15. 00 g ( family dwelling only. Sub Total YES or NO Other I 3-7 ,5o If NO,see appropriate tax clause on Grand Total 490 'page# of this instrument. ifA -Ili-ts" 1 I 1 J Dist. 1000 10700 0400 oi3000 5 Community Preservation Fund 3066237 Real Propert} , P T Consideration Amount $ Tax Service R LPA } Hllll IIII SII VIII ILII I�VIII I� Agency 17-DEC-1 CPF Tax Due $ Verification — aved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Add•ers i E ( r PI 1. i RECORD & RETURN TO: s 7 Vp.c IA t Land ..,o t.,,v.4_ 41AKA---.. 1P--114rid? DEC 1 7 2015 ?' iD w ', I , k"}-r-t' 1 NI i. i.95-2__ Sat,filiold lown Board of Trustees TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# 8 Suffolk County Recording & Endorsement Page This page forms part of the attached \>e_cts2.4 --4"t6V) made by: 1J. WUt'S1J (SPECIFY TYPE OF INSTRUMENT)-Q. The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of 56'441'61-1" In the VILLAGE , or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104..10/O8kk (over) / DECLARATION OF COVENANTS // r �� THIS DECLARATION made this 16th day of December, 2015, by Thomas Kelly and r Linda Kelly, residing at 4553 Wickham Ave, Mattituck, NY 11952, hereinafter referred to as "DECLARANT (S) " : WITNESSETH : WHEREAS, DECLARANT (S) is/are the owner(s) of certain real property located on 4553 Wickham Ave, Mattituck, Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section 107 .00, Block 04. 00, Lot 013.00 which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a 50' Wide "non-disturbance buffer" adjacent to and landward of the edge of wetlands; iiin-��C 1 7 2015 --------- -7i'D 1 Southold Town . .: aIIfTrsee „r �y. t`/ NOW, THEREFORE, the DECLARANT (S) do/does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained a 50' wide "non-disturbance buffer” as defined by Chapter 275 of the Town Code; and as depicted on the project and site plan, see Exhibit A attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANT (S) , his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) has/have duly executed this instrument this On 1(-) n.—day of Q.' be , 20 I . . \OWNER'S SIGNATURE-51 ph4S 1 4 4 66c, OWNER'S SI ATURE Linda.. <Z.A\i t. STATE OF ss: COUNTY OF On the day of , in the year 20 , before me the undersigned, a Notary Public in an for said State, personally appeared 2 DECE DEC 1 7 2015 $F; L________ _______i Sout o;d awn B+ar •f Tu ees J LOT AREA = 7e.823 SQ FT )CV l rJ• l f I 181 acres -------------- 2Y A Ob ' APPROVED BY • \CD BOARD OF TRUSTEES -. TOWN OF SOUTHOLD C51. a99.9 CS 7:5 .�Ni"a� a A�iD 8°4 na99�9 �N DATE 12/13�13 Fier •6'. DLA B S' �/ • on.8 1, o,Qta; •p y0 0_ .. X9vng 0 MCGWG LABELED A N I1 `A•••'t"Y'.:�..-� ,. BDA.REMANDS AS BY ,50990^9 1HOIA5 W CRAMER. ON OCT 4 2013 .-4/' yam` \/ �� IIog9�n9 . F cfr 7 {� nogq�ry P L a' J f f 4.9z noq{nn9 nate Donne and IrtM.ater / `t / Donne/TO (3)....., )3A z l� �J ,V bra LFA na 03210 y�_/ ` to z no99m9 7'n9 F4O 0 1*05O 115 8 N Yr 151 1 H B FRESHWA WETAMOS AS FOCI 4 HY f J�P f D THOMAS W CR1141ER.ARA ON OCT 4 2017 /9DDt. Pr''') r'' j 06 S. C.1 n0991n9 I N. Po -fti" 1 A /7 z A 0)) \ O 0I \ na9Q e n9 / N 72 25'20'rE 1 15 001 I ro �\ A o oN \\ O nag9rng F—� cone ream 1911 N U' \ p5 mead rd pbtlorm N OJ5 al UJ Fel nN M war V ?cJi �i 4•x20•.2 2 S r- —ftaehce_ rn 0 \ ___c -c 0.0v9 I- 716' FD Pi \ �'•Y 50' i PIPE Z BUFFER I 32 0. 7 1 rn (I) T N In \ N 13 0 ON too. q 1 N Ik/ny 1 9 0 1 a J covered 0_ \e V m N 2 STY FR ^: perc0 01 nO M DWELL 0 \ 2 • UI Irlo99�nq ma" 210 V.S. \1e it ,—� n / 171 157 GAR + 1 U 293 N 1 o / —I— J I one,5 °a \\ N. l'", 1 1 �SH" 1N / Q!o �,\w ca cc. �\0, 001 0 N ua 0 cEFIT % \ S 72'25'20'•W 342 64' \-...11°- NOW OR FORMERLYNOW OR FORMERLYCONLON STEVENSON 73 JG) S.co • E �` T pry ,IL./, WICK-HAM AVENUE \1II i DEC 1 7 2015 WICK-HAM TUTHILL ROAD) Southold Town .la 1, 0 T . .. . -- 11-7-2013 ADDED 50' BUFFER ALONG WETLANDS THE 01101,5(OR DIMENSIONS)SHOWN HEREON FR01.1 THE STRUCTURES TO THE PROPERTY UNES ARE FOR A SPECIFIC PURPOSE AND USE IND 0ERE70RE ARE NOT INTENDED TO PUDE THE ERECTOR OF FENCES RETNNIN0 WALLS.POOLS PATIOS JOB No 13-255 FILE No 952 F PLANTING AREAS A000BON TO BUILDINGS OR ANY OTHER CONSTRUCTION SURVEYED FOR THOMAS KELLY as UNAUTHORIZED ALTERATION OR MOT10N TO 1105 SURVEY IS A VIOLA00N OF SECTION ' DGam- I��y`V�. r`—jl rag OF THE NEW YORK STATE EDUCATION LAW ' GUARANTEES INDICATED HERON 511611 RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED ALIO ON HIS BEHALF TO 111E TIRE COYPINY,COVE 110090IL AGENCYSITUATED AT MATTITUCK IN0 LENDING INSTTIUAN TON USTFD HEREON O TO THE OSSA NESS OF THE • NOT/ ) ! 2013 L CANG OR OVLm UENT OWNERS. ARE NOT 1PrN5FETFaWE To ADOfOw1 INSTITUTIONS TOWN OF SOUTHOLD, SUFFOLK COUNTY, N Y V I COPIES OF THIS SURVEY MIP NOT BEARING D10 LAND SURVEYORS INKED SEAL OR SCALE 1" = 50' DATE 10-7-2013 I EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY SaDtllami.1171 FILED MAP No DATE Tr e CERTIFIED ONLY TO TAX MAP No (REF ONLY) 1000-107-4-13 DISK 2013 HAROLD F TRANCHON JR P C LAND SURVEYOR P.O.BOX 616 ��__ j/� 1566 WADING RIVER—MANOR RD WADING RIVER, NEW YORK, 11792 631-929-4695 I` N LIC No 048992 HAROLD F TRANCHON JR PENN LIC No 2115—E r` • . • Uniform Form Certificate of Acknowledgment State of New York . . • County of 11,43C-tjt K- • / On the fl day of 1 ek1'Ain the yearID before e, the undersigned, personally appeared. • Nra LA.Y1 )(1XLQIi personalty known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name"(s)is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their • capacity(ies), and that by his/her/their signature (s) on the instrument,the individual (s),or the person upon behalf of which the individual (s) acted, execute+ the instrum• ent t fir 11 • �otary Public . 1' •• STACY MARIE SUNDERMAN Notary Public,State of New York No.04SU6287725 • Qualified in Suffolk County Commission Expires Aug. 19,2017 • • DEC • • • • • • • • iiij • 1 2015 ao 3 Y Southold Town Board of Trustees • • • • Title No.: NST-13-0105 SCHEDULE A,CONTINUED..... THENCE along the westerly side of said 30 foot Right of Way the following three courses and distances: 1) South 23 degrees 59 minutes 50 seconds East,26.46 feet 2) South 35 degrees 00 minutes 00 seconds East, 126.12 feet; 3) South 30 degrees 17 minutes 20 seconds East,29.08 feet to land now or formerly of Stevenson,the point or place of BEGINNING. TOGETHER with an easement for ingress and egress between the above described premises and Wickham Avenue over the 30 foot Right of Way,the westerly side of said Right of Way being described as follows: • BEGINNING at the northeasterly corner of the premises herein described running thence the following three courses and distances: 1) South 23 degrees 59 minutes 50 seconds East,26.46 feet; 2) South 35 degrees 00 minutes 00 seconds East, 126.12 feet; 3) South 30 degrees 17 minutes 20 seconds East,246.36 feet to the northerly side of Wickham Avenue. ' RECEVE - „u DEC 1 7 2015 (' Southold Town - Board of Trustees • • The policy to be issued under this report will insure the title to such buildings and improvements erected on the premises which by law constitute real property. • • r Title No.: NST-13-0105 SCHEDULE A f ALL that certain plot, piece or parcel of land, situate,lying and being at Mattituck, in the Town.of Southold, County of Suffolk and State of New York, being more particularly bounded and described as follows: BEGINNING at a point on the westerly side of a 30 foot Right of Way distant 217.28 feet, northerly as measured along the westerly side of said 30 foot Right of Way from the corner formed by the intersection of the westerly side of said 30 foot Right of Way with the northerly side of Wickham Avenue, said point also being where the division line between land now or formerly of Stevenson and the premises herein described intersects the westerly side of the 30 foot Right of Way; RUNNING THENCE South 72 degrees 25 minutes 20 seconds West along the northerly line of land now or formerly of Stevenson and land now or formerly of Conlon,342.54 feet to land now or formerly of Amelia P. Kneski; THENCE North 17 degrees 34 minutes 40 seconds West along said land now or formerly of Amelia P. Kneski, 324.99 feet to the ordinary high water mark of Long Creek; THENCE along the ordinary high water mark of Long Creek the following three courses and distances: 1) North 27 degrees 13 minutes 20 seconds East,29.46 feet; 2) North 57 degrees 26 minutes 47 seconds East,28.29 feet; 3) North 46 degrees 45 minutes 48 seconds East,48.52 feet to land now or formerly of Shirley Bean; THENCE along said land now or formerly of Shirley Bean the following two courses and distances: 1) South 41 degrees 34 minutes 40 seconds East,218.07 feet; 2) North 72 degrees 25 minutes 20 seconds East, 115.00 feet to the westerly side of the 30 foot Right of Way; CONTINUED..... The policy to be,issued under this report will insure the title to such buildings and improvements erected on the premises which by law constitute real property. ' • • 7.5 TOGETHER with all the right,title and interest of the party of the first part,of,in �epv c 04 and to the land lying in the street in front of and adjoining said premises. EEE l IIDEC 1 7 }� 1 2015 L Southold Town B of Tratees 1;, --til ,•,i --\--1--- \ /_ ( ?\%--\- 1 _'- - 1C A ‘\ VK 1 1 , �,�/ �� r BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK / �` E m ?. / / , i 1 PERMIT NO. 8339 (Revised) 2014 � '�� ISSUED TO: THOMAS & LINDA KELLY i�PROPERTY ADDRESS: 4553 WICKHAM AVENUE, MATTITUCK \'/7 `' SCTM# 107-4-13 i' ' AUTHORIZATION , J / 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 January 22.2014,and in consideration of application fee in the sum of$250.00 paid by Thomas& Linda Kelly 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 for construction of a 20'x40' with 12'x16' "L" extension in- ' \�7 '' ground pool; construct a 1,700sq.ft. pool patio; install 4' high pool fencing; construct a � \I 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas; with the conditions of establishing a 50' wide Non- Disturbance Buffer landward of the edge of wetlands; that the pool fence to be located :-/ - on the border of the Non-Disturbance Buffer; the Non-Disturbance Buffer is to be re- /: vegetated using native vegetation; and a pool drywell to be installed; and as depicted on ' . �/ ' the project plan prepared by Thomas Kelly, received on November 12,2013, and I\ stamped approved on December 13,2013; and as also depicted on the site plan prepared by Kelly Brothers Landscaping, last dated November 8,2013 and stamp j \\„h, approved on December 13,2013. ,/ IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, y' and these presents to be subscribed by a majority of the said Board as of this date. %\ i as. Ellagist UFFO J ,' off co c' � � " � -sir- 0 A . _,-: ))' O it/ \ ',( 7 IP L_ ------ /, `�% �_ u • • TERMS AND CONDITIONS The Permittee Thomas& Linda Kelly, residing at 4553 Wickham Avenue, Mattituck,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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 1 I. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title,or interest in real or personal property held or vested in a person not a party to the permit • James F.King,President ;• gfFFO(r Town Hall,53095 Main Rd. Bob Ghosio,Jr.,Vice-President 4 '; P.O.Box 1179 Dave Bergen d ' Southold,NY 11971 fi John Bredemeyer oy Telephone(631)765-1892 Michael J.Domino f 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 1I4 day of construction IA constructed Project complete, compliance inspection 1 I V BOARD OF SOUTHOLD TOWN TRUSTEES . ' SOUTHOLD, NEW YORK / l// PERMIT NO. 8339 DATE: NOVEMBER 13,2013 ij b ISSUED TO: THOMAS & LINDA KELLY 1 � I // ' , PROPERTY ADDRESS: 4553 WICKHAM AVENUE,MATTITUCK SCTM#"107-443 I , ; ,rr ' fY ' -I— — . ,: • - I I- AUTHORIZATION \\ s , - I Pursuant to the provisions of Chapter 275 of the Town code of thg Town gf Southold and in 1 r ,Meeting f.r accordance with the Resolution of the Board of Trustees adoptt ed at thenieeting helif'on 1Sovember t3,2013, „' (- I and in consideration of application fee in the sum of$250.00 paid by Thomas&Linda Kelly and subject to the f Terms aq'dtoncitfbns asittated i'o'the`Resoldtioh,the'So Southold Town Board of Trustees a.ithontes and permits ; 1 the'tbildt4ifig.' ` ', Wetla d Permit for construction of a 20'x40' with 12'x16' "L" extension in- , >; ground'PAc onstruct'a t,*boosq:ff: pool pa't o 'instal 4' high`pool fencmg;fe&istruct a ' '` I' 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and I ) 'i,' � �_ i re;ye0�iate Rfeviopaly;,clrared areas;areas; with the condition,t4efence be located on the \ I border of the Non-Disturbance buffer; re-vegetation of.ithetdi sturbed buffer:$fea with native vegetation; and installation of a drywell for pool backwash; and as depicted on •. =. I the project planprepared br Thomas'Kelly, received on'November 12,2013,Bind i. I stampedfapproved on December 13i 2013; and as also'depioted on site plan/prepared by .i ; I44 'B14119teS�§IflstndSca in last datedNovcmberS,2013 and'stan► a p g� p approved on Decembe# 13 2013. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, '/ `/. and thde'¢reseht§=to be?aubscribed by a majorityl'of the said Board as of this date. x i,� � S. - ; ei ( L i eft 16 ..___ /4 jo .0.i 0 1 1. e41. 1 ., 1 i i V V - • TERMS AND CONDITIONS The Permittee Thomas& Linda Kelly, residing at 4553 Wickham Avenue, Mattituck,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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 toibe 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. y, :f 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 ,St for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference wrth,navigatign as a result of the work herein authorized. 6. That there shall be no interference with'the right of the public tq pass and repast tilting the sr. - beach`between high andrlow water marks. ,i ,: ''++ M 7. That if future operationsiof the Town of Southold require the removal and/or alterations in 74 the location of the work,hereinauthorized,or if, in the opinion of the Retard of Trustees,::. `. ., the work shall copse unreasonable obstruction to free navigation,the said Pe naitteq will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit hns,been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the cotrlpletio t..f the work authorized. } ' . 10. That the Permittee will obtain all other permits and consents that w} aired } 4. supplemental to this permit, which may be subject to revoke upon'"': lore'tootbtain same. James F. King, President • se'�aOF S�U�yO=` • Town Hall Annex Bob Ghosio,Jr.,Vice-President / � 54375 Main Road P.O. Box 1179 Dave Bergen t•* * ) Southold,New York 11971-0959 cfl John Bredemeyer . enQ ,• • Michael J. Domino � e.1� Telephone(631) 765-1892 W. J'1 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 13, 2013 Thomas & Linda Kelly 4553 Wickham Avenue Mattituck, NY 11952 RE: THOMAS &.LINDA KELLY 4553 WICKHAM AVENUE, MATTITUCK SCTM# 107-4-13 Dear Mr. & Mrs. Kelly: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, November 13, 2013 regarding the above matter: WHEREAS, THOMAS & LINDA KELLY 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 October 17, 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 Policies 5 & 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: re-vegetation of the disturbed buffer area with native vegetation; fence to be located on the border of the Non-Disturbance buffer; and installation of a drywell for pool backwash; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on November 13, 2013, at which time all interested persons were given an opportunity to be heard, and, 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that 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 THOMAS & LINDA KELLY for construction of a 20'x40' with 12'x16' "L" extension in-ground pool; construct a 1,700sq.ft. pool patio; install 4' high pool fencing; construct a 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas; with the condition the fence be located on the border of the Non-Disturbance buffer; re-vegetation of the disturbed buffer area with native vegetation; and installation of a drywell for pool backwash; and as depicted on the project plan prepared by Thomas Kelly, received on November 12, 2013, and stamped approved on December 13, 2013; and as also depicted on site plan prepared by Kelly Brothers Landscaping, last dated November 8, 2013 and stamp approved on December 13, 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, JJ James F. King President, Board of Trustees JFK/amn • • ier e James F.King,President Town Hall Annex Bob Ghosio,Jr.,Vice-President 54375 Route 25,P.O.Box 1179 • Dave Bergen@s 1' Southold,NY 11971 John Bredemeyer - _ 1 4 .0'0 Telephone(631)765-1892 d Michael J.Domino , Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: I h omaS + LI'n-a k J[y Please be advised that your application dated 10/i l)3has been reviewed by this Board at the regular meeting of (1')3,1)3 . and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Flay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) '/z 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: $ SQ ,Dh BY: James F. King, President Board of Trustees :1 1 / rc '4 ' . f fr , . eti 4. Thomas&Linda Kelly ..c• ,i*, e 4553 Wickham Ave.,Mattituck ', "el ' • ' \ /4.; . '41 4‘ 4 '" ' ,... . • ,..CTM#107-4-13 ' ,744 . ii:J ,, l 1 , k_ i i V. , i f 4 • 12/4/13 , . 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At - , -*Ai" 4 0 4 0 • 4 0 -• • •A b-,e 41P iy. *40,4 et •14: IAL44. _ Airs* , • 4•-•4 74 0-4•-•47.-4 pAP,i 40,_•.44# .tii.ki!el v.,.=, Akt- 44.!k''-'11' 4 -. '--..-.. • - . - •..* - " ,,,. -•.: - ...-....‘ :*e.-410 413,. • 4 0 . 4*.ri I, 4 6.1 I 04 p .,. 4 0,4 I. ,.4 p,v4 s,4 6,4 r4 0 74#.- t i. • P'14 . .•a I, ..^. .2,....15 li. , *-! :/..!,;#',itt, 47.S.. - '.. -.,., 'X.,'Paelli...ir"-*X•it.-4.411-11, 4,A. 4p, .,40,w, A 40,v,k al* v _41p.w„h_40,411114,47,4414,-, •%-•.;), ,.,- ,,-.Pe: , '4. ;!-:•, N :..-iii; Vi!45164-.•:14r- -4t.. 40,' 44.1; -',40,..frly 3"--vgir--4* * 'CA 411P 4p_3._40':V- tr40.44"1"41$7". V.W110404014V-4r. r 41744rrP g‘411' 411. 41‘`.--4 %.17 <te4t".1° 441 4ir St" • v.* ' - • • SUFFOL James F. King,President r�pp� C�: P.O.Box 1179 Bob Ghosio„Jr.,Vice-President ti Z Southold,NY 11971 Dave Bergen t ? Telephone(631 765-1892 ea John Bredemeyeru, T Fax(631)765-6641 Michael J. Domino y �'1� dol * +aa. Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 121y/3 Site Inspection at THOMAS & LINDA KELLY property to inspect commencement of in-ground pool without any Town issued permits; and discuss where the dirt from the pool will be graded out on the property due to run-off concerns into the wetlands and adjacent properties. (Trustee Permit has not been issued) Located: 4553 Wickham Avenue, Mattituck. SCTM# 107-4-13 Type of area to be impacted: _Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland f 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: w6n/C cF 1ed s n Gyred 4`-e7L Present.Were: 71. Kin B Ghosio D Bergen, C. Bredemeyer z Michael Domino D. Dzenkowski other Form filled out in the field b Mailed/Faxed to: Date: , Town of Southold ' K 2565 Suffolk County, NY 7/billet office The People of the State of New York vs. LASTN.INUAE(DEFENDANIkat y 71/0 iv, FEMME MIDOLE INMAL 1 STREET 1 cr,,, 7-4,..3wiemmi AvThe—gewicKapitAr4) 1 1 cg 119502-• LICENSE OR REGISTRATION BER 116 i 63 91421/[5 I I STA IDOf LIC EAM DATE EXPIRES SEX I DATE OF BIRTH OPERATOR ; N 0936-2° '8711 n I gAt OWNS VENOM OYES ONO TNE OPERATOR OR REGISTERED OWNER OF VEHICLE DESCRIBED BELOW PLATE NO. DATE EXPIRES , STATE PLATE TYPE ; 0 N.Y. ON. •N.Y. 0 NA. 0 0 PASS 0 CCNIA 0 VEHICLE MAKE 0 DODGE O BUICK 0 CHEV 0 CADILLAC 0 PONTIAC , ' • O FOOD 0 ••• 0 PLYM O TOYOTA 0 vcxxs 0 rm ::: 91- -:. :: 111;1 BODY 0 2 DR 0 4 DR 0 BUS 0 MCY 0 S.W. TYPE 0 TRUCK 0 TRAILER • 0 Iii SIN NUMBER DEC - 2 2013 THE PERSON DESCRIBED ABOVE IS CHARGED AS •h•• • PCT ggrAIRRICIAlefi AVer in inrIN DATE OF Cal 0 il Ott CD GE.CR HAMLET SUFFIZAK couvrv NY t,i,.r I T •• II-2iFF-aii -117-40-LD IN VIOLATION Cf SECTION SUBD. OF THE 0 VEHICLE AND TRAFFIC LAW OF THE STATE OF NEW YORK , odnwe mean, " X75, C 0 0.5. 000u 0m15 0 HAZ CEF YEN MAT 0 SPEEDING 4TH Am ne,-,-Nse MPH IN A MPH ZONE p/0 friamiT MISDEMEANOR 0 FACTUAL PART(NOT FOR MN THE ABOVE NAMED DEFENDANT DID ON THE STATED DATE,nmE AND PtACE g"t3J Ecr . po, eh Noiscracvieine3 bvimour . 1 067itinfit/G• A Pezmir IIIII Ts*FoANciro Is based on(Femoral krovaKINS and/or Onlarmatbn&NSW).Ms source beim the emeNKI mom tispoOkanis)Co Ancios-erk oteci-Ry &doll #-.z6- /5 PARIONG SCHEDULED RIPE$ CONTACT COURT 0 , THE PERSON DESCRIBED ABOVE IS SUMMONED TO APPEAR AT SOUTHOLD TOWN JUSTICE COURT,53005 ROUTE 25,SOUTHOLD,NY 11011 , OM OF APPENANCE NOT FOR TA ; ON /2- 36 - 13AT . I/, (IP, am FALSE STATEMENTS HEREIN APE PUNISHABLE AS A CLASS A MISDBAEANOR PURSUANT TO SECTION210AS OF THE P.LNY.S.CON ' tli i #.41! DATE //".'it•-•/3 BADGE # m A° --7 rtITTAT onpv 110 James F.King,President /att SOC441 Town Hall Annex Bob Ghosio,Jr.,Vice-President li �� �/-: 54375 Main Road P h 'oP.O.Box 1179 Dave Bergen ; iii *; Southold,New York 11971-0959 John Bredemeyere/+ ac C 1%� Telephone(631) 765-1892 Michael J.Domino O�yC ��.�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES D C I Ill/ 15 2 TOWN OF SOUTHOLD ll To: Southold Town Building Department OCT 2 3 2013 ii-1 Re: Verification of Building Department Permit Requirements BLDG. DEPT. TOWN OF SOUTHOLD SCTM#: I 0 —1' I /- 13 Property Owner Name: Mil d rYl a S f L in da ice 1 I y Date Sent to Bldg. Dept.: 16123113 I The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES - NO j// Will the proposed project require a Building Permit? Will the proposed project require a variance determination from / he Zoning Board of Appeals? I/ Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: /L°''e.-2.`z12 ` en-t. . 2-0 elr ,iiie , t. /°/3/ Signature of Previewer Date sufFO;�: James F.King,President '4) C P.O.Box 1179 Bob Ghosio,Jr.,Vice-President V `rid Southold,NY 11971 Dave Bergen { e . Telephone(631 765-1892 John Bredemeyer Fax(631)765-6641 Michael J.Domino ‘ Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 4//6-4l THOMAS & LINDA KELLY requests a Wetland Permit for construction of a 20'x40' with 12'x16' "L" extension in-ground pool; construct a 1,700sq.ft. pool patio; install 4' high pool fencing; construct a 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas. Located: 4553 Wickham Avenue, Mattituck. SCTM# 107-4-13 Type of area to be impacted: fSalfwater 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: IV i l /it) ed - i - Sr <� T- 71:4311.---- 4-4/14742a v- J- /;ea/P Prent Were: J. $44 B. Ghosio D. Bergen, J. Bredemeyer Michael Domino D. Dzenkowski other Form fills out i17,the field by Mailed/Faxed to: Date: , , , '' , A `� , I- BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT Nth 2 DATE:JULY 22.2009 ISSUED TO: RICHARD BOSWORTH PROPERTY ADDRESS: 4553 WICKHAM AVENUE.MATTITUCK SCTM# 107-4-13 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter I 1 I 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 /alv 22.2009,and in consideration of application fee in the sum of W0.00 paid by Richard Bosworth 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 install a new spa,in-ground swimming pool and patio,4' high fence and gates,clear existing trees and shrubbery to 50'of freshwater wetlands i and re-vegetate,and install an impervious driveway,with the conditions that a 50' Non- -\ !I Disturbance Buffer will be maintained from the pool fence seaward to the freshwater wetlands,there be no clearing from the proposed limits of clearing line seaward to the tidal wetlands without further review from the Board of Trustees,the pool patio is made pervious,and as depicted on the survey prepared by Metes and Bounds Surveying,last dated July 8,2009,and received on August 4,2009. 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. '\ Iln3 � - - - ..., k_ba t g, , .---7-.4."-1--# / /. I 4110 a TERMS AND CONDITIONS The Permittee Richard Bosworth.residing at 4553 Wickham Avenue.Mattituck.New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. 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 requited 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. al...1. r 0. • t� i !$ .... . ' '' f�����.\ I�11111 lay ■al'! I A� ii „e ,Y `!%1111111! ♦' ,: fit, © "� e a rh ..1`'`��' - EMA—r It - �' � ��N 1� w C n �, a y�6 4 ✓, ✓r ?� -!. 'Ne'aralet.ASL �-. � Sr ��J ' t , ,� 1 . , qts�Tr ,'��� \ \00 I•��i+..\rei 1�. h %i 1Sj . , «K Ira ..... >'+ Ge I\ Atlile4air le sem•,.'�. ^r "� 1elEf' * it fe, /cy,.:,. 1:11,(44-1411.4igit ..� e- r. ..., avarAcr ��•�s�aT/v n�l I L if 0Jo IL;awl� CS ----Jr—sc.:w. l'�>� �. �'4 wP - 'ev- j �i�IrPB I� ';. 4� `�1nt'7 .m, .-d. >... �•1 �� }�,��..% .P. ,4 CP S .......i..,:...":,:....:::::::, �. w,.e .�.... - v 3'.XJ341532' til Op•L`I /i�i �1 ���'QI"`t�,,�:{ `: qp- 1 - 49 I(Mini ....ales_ I ISI is©��yiwtiil.©, -iid'.s ei .mom....... . '.'.` �_�+•�.•i.174 �? ,w,...._—___,—. �r�vll�`�ii iC ��, G Ti`s is _ �'"J ,.., ail �.w iO •i —.......� � :� • �7.�.t i, ;�'I•Plitt L. y0. ...�..s ccoi ( ] .....' i II1° _,. 1 „ick '® , i �"=,__ �-.- ........,A.w.+..w —...-- i I r O O O ,�.�'I »J m.... it ‘‘.1r1; W ,:J. _/ .. .�r. 5 >n rm0 AO Sll Lir ban NeW / LasrrysaS ,,,dCll M,a,..mJ _ I anSiS]6 36VT+a1'Wr ,0 NW TPCS I I f / m. I . AIY'XJfWLLVW \ _ 3/rtl NYIIYJIM F554 �_�-�- I I 9 id 1121 HINOMGOCd -7-7:17:-=:-.7____-__ —� . \ N4 Aclvosarn� -�dn+d��NQ� pECEIVED - / TOTAL LOT COVERAGE _4 OVER ADJACENT LOT AREA ()4.121 p. ft.) oowrpN BMA if LOT cfo,a ilmivISURVEY OF PROPERTY Ras ESO}.NOM W H SITUATE LAN0111105 BOSOM »"S SRH 71% • MATTITUCK Y PROP.HOUSE PMO ir TOWN OF SOUTHOLD �.�` pO2.POOL.HOT TUB >w p.n. .OM PROP.POOL N IO 15 p.H. % SUFFOLK COUNTY, NEW YORK O¢�� 'r PROP.DRIVEWAY , J=p.N. °r S.C. TAX No. 1000-107-04-13 ' ' TOTAL MVO A PROP' 10'70'•0'"' ""' — SCALE 1"=40' y0�. 0S ,79',,,A'4t U• FEBRUARY 25, 2009 `I% $ MAY 12. 2009 ADDED PROPOSED POOL n1 �`�'14 JUN: 9, 2009 FOUNDATION LOCATION ht16ti'j.' o°yam'•'i4 �'f JUNE 15. 2009 Rc 1SED LTE PAN i /„gy p I JULY 6. 2009 REVISE SHE PLAN O STi 02 \ y AREA = 80.618 c. ft. -:' ! (5,,,, • ).BS °c. h , -I`.".,, zi k • "ti\y 3i . i Ss CERTIFIED TO: : T � y� RICHARD BOSWORTH '•�/' Pk 'e 1 ” ' �`�� r \gyp CHICAGO TITLE INSURANCE COMPANY ` \ P y _ � 1�'� � O„q �•, \��:. �4� ')` :S.0 a u I T.A. 4 I.OWATIOM MC WIMP=A 4c YL.Ma GTY NO= IL ur' •^, 'P' �� MOW m�,l•OR'p"i Na• 910MSal"M®1Ms ,-____ A• i 'Y y/ �••, �' L un Wine nu,EN awN ME sw[cr TO V 1cA' ••I • r '8 y \ ST KW 19a Sia Ypro OHP RaANTM•RRIOU. , _- Y' 3.NORM SOKMOWED UM UM wWRS NS 0ONS MC MIMI nun 4tKSI HYISC 91130 Owns. .T`µ`nA``_J u ' E i`•• S1 I TNN:r°I.''MMI APPROVED BY \N ""� 9 ±.•1° s 4. 4.Nwww U•owe m»Y FM 4 aapa1 SOUK IT 300 MI H MEWL•a.. `\'.T y . F pas:r aa.r r. BOARD OF TRUSTEES \w � "` •'COMO EN.oN Na- •FMK=KAMpa TOWN OF SOUTHOLD (gyp\ rN ®PM^'M an MH DATE /T•'U 7 O 9 s M. \ \ i�\ rul=NyN�y. W 5. 1,0011 'Si ML IOGTON a*WS AK aD00 S Sall KKK•p MOW SOO ///III \ l\ mpNATIOM 414M KM MIMIC I Man. to /� e. v.TWO rrOlEn ea ROM ZOO WS(FL ) - I 'W M001300 MK N M Mamma - J yt=a4 STY yO Le IKE 6.4 011rna C �,},.,,y1 \ 7.Ina=WMA°01•M1 MT INNrI T 011:1 )4.p1 q.". [`ry L PIppMO NOr[ I.SM gH.MTINa M)•74.1 YrA co: too NI lit SEPTIC MRN MO x S� MMY 1ONI MO IVY MM MILL C MOVED MO Apl� 410 a.TM a KLAN MM TMppD IN BION M KUNO WOKE MILL SI 1®TO La RLL ML MRN. METES AND HOUNDS SURVEYING t }aWb'• /��, yygire arsrrJt r.lrmmnxe ✓` ISO' ]2 AMERICAN PVFN.E . p.._1 ' J. I' �_ COPY.NY. 1')2) ��'TC it . KNOW 4.452,).It. r M1 MOE(6l,)2JS-.TM I� t,R MT x N.L 0..51 M 1».N r r.I®N.S pM iquY.N Ap FAX(OJ1)i]R-9Y-0 r/ _j PSa'Ia(Y)r K S r MSN SIOY MAN VOOS yn P• !.• UJT:IJ BLOCN: Y SE'Clp\:101 ttSIRKT:IaO 1 \'AI �% novo NBA 0.M W.». ,p ,y1•`• J,M p.».N O.,T.Mwh Err OF: E=r`vet-, ^' \ 7;.!: /_Y�' '• 9...H./m.22 venni R.A r .POOLS PwI,°Mu.a Pv•- v:=, ¢OP9� '.�.::. .. r"'S ,11.. .• •.J Maa(II)r r N r no SIKH OKM pas �/ w CS- TLL SITUA'ED Al: TOWN OF 44.44.44/.,.�. 'a 1 i L TOWN a 9wYxaA MHFax>a.N.Y. ,,...ve �,: PROPOSED RL.r OPv Rmas tH9 Ima NM-aF NL lMGA ELSE RICHARD 905.9MTH �..a, l.n„•�` pa0m s'al N a'av OITEM.3 IE MEW MMAf ML slaw INNS OR 010430•c0 nnE INSURANCEINSURANCEcaPNIY 1os to s.^ (€3157D TO: JOB HO.: 0.-1N0 rca.O,i.K PNn a.,Sv �. 1 DAR JAY=MM • r James F.King,President ' 0*SOU7 Town Hall Annex Jill M.Doherty,Vice-President '�O� 54375 Main Road Peggy A. Dickerson P.O.Box 1179 Southold,New York 11971-0959 Dave Bergen `, Bob Ghosio,Jr. i Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 16, 2009 Mr. Rich Bosworth 5035 Peconic Bay Boulevard Laurel, NY 11948 RE: 4553 WICKHAM AVENUE, MATTITUCK SCTM# 107-4-13 Dear Mr. Williamson: The Southold Town Board of Trustees reviewed the site plan prepared by Metes and Bounds Surveying, last dated February 25, 2009, and received on April 8, 2009, and determined that the construction of a single family dwelling, attached garage, driveway, and sanitary system is out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275)and the Coastal Erosion Hazard Area (Chapter 111)no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff,without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. This determination is not a determination from any other agency. • 2 If you have any further questions, please do not hesitate to call. Sincerely, fra James F. King, President Board of Trustees JFK:eac PROPOSED SEPTIC SYSTEM DETAIL M..K WT TErsasTEST HOLE DATA ' In- _ (TEST a DUG 2Y saOtIl W omen.M DODO ' .OZ1.5.10 -------7 la---- , trr.r.,r—r--•••••••------ ,larsra�.wat n"""s.o Y V - ,f .T1ei9 r,rY Sf9j , �b. � __C SURVEY OF PROPERTY Cyd„,-,,,e_.-iii, 1 SITUATE 4 T.°% 04,4,, --- , H . tiLsy MATTITUCK 'R` ` ' // /✓ M1 9 y I, p/ • TOWN OF SOUTHOLD *" :?,- , ,y 11 SI IP it, I SUFFOLK COUNTY, NEW YORK A. / / W S.C. TAX No. 1000-107-04-13 ' %'-f I E sr SCALE 1"=601 S i f`/ 110 •'` "� FEBRUARY 25, 2009 f =" W;1' '3. ", Ty5 ao c a \ � � AREA = 80.313 eq. H. _ � e�p� _ ft J+` Q i'i�i �. ::.4'� 1.855 Ac. a '` .. i—Li �$ , _\A b` �`•� ,," t ya,� I 1 ON r Q �Y p i LI 4 CERTIFIED T0: 1.11 .\� II L s° '$ 3 ,'_ , _ _ ° RICHARD ZtTT ` + 16. ANY -m WnW I. ..o I m R1� a - -® a11.6 se 2. Dana EUVANONS xn VTUAC muuw aaw AIR SMELT ro'a ATnI .VOW War n 411. I 1I y 1 \ y . MOOSW DIYAmu At 5110•11111115:M '.M`` %•_. yA y,.W.A 2.106416 m10 Tr C PA T[S FO.0 4.mw0l MOUS 0 OLIN Wart a 6 TAW: 2 IDS TWIN FOR 4 0[0X)0 I•ut 3 3m a n MM.Ma , \`y ` \� 3A2' 6 e[n ��� ' y �d y p• • TAM=•EMO.aE APR B 309 0 IA u\` \1 y 11 ' KN ®Isam..a.N. L� .�.�I�� � 6 rR IRAlM R•Oli MO COMAS SnOr IIXM ME Id FIELD LEOY0.1 A • �00 (IMEM M AO/nl DATA MAIM FROM 61103. 2"459.1.1 O.TO mom Y W nOD 10134 ILLI I) ` II53 C n MR 2"r Ib.311090.0/0.I l [+'a• W .Ian Awns t13T1t 1T 2°. 7. 04X0001 lC p• Nu wT 060'IX 115.r61 1 0.". 1 a 5 M1S rWpYe Itl14.I.EEE y n.t,T.1.0 0 0 4 004 31 S 'p/lcoOR n. 4 sync SWIM 100..N.x RAC 0.0 ADM an W0 a1.S EE MOW A0 1 }6v^�1�E�•. I ISO y..or CLOP WO 1N®n EIIW An 2".i 9.M6 9IALL t LUC 10 YR MI TIE TTb. 1 p� !ETES AND HOUNDS SURVEYING .� j%tg.� i. . SII 22 AMMAN 4,77.MOILI117278 . �" rr.: II. , T RHONE(631)716-6310 • .i..... - 000, FAX(611))Y-8110w�•••wi.w ( MIEAIME .,r,ri190.w' LOT:I3 BLOCK: 04 SECR011:IW DISTRICT:ICOR :Cr. �' Fjl OAP CE: twist r. w=_ ` �nr.1 ; spm Mak..5.272.17: IIP Albert.L Krupaki,President ,,ist sof 80UjyO \� Town Rall James King,Vice-President 1' 6 63095 Route 25 * P.O.Box 1179 Art'Poloster : Southold,New York 11971-0959 Ken Peggy A.Dickerson Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 7, 2005 Mr. John Prudenti 45 Inwood Rd. Center Moriches, NY 11934 RE: ESTATE OF RALPH W.TUTHILL 4553 WICKHAM AVE., MATT(TUCK SCTM#107-443 Dear Mr. Prudenti: The Southold Town Board of Trustees reviewed the survey prepared by Joseph A. Ingegno last dated April 6, 2005 and determined the proposed single-family dwelling, attached garage,driveway, and sanitary system to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97)and the Coastal Erosion Hazard Area(Chapter 37)no permit is required. Please be advised, however, that no construction, sedimentation,or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 25' landward from the top of the bluff,without further authorization from the Southold Town Board of Trustees pursuant to Chapter 97 and/or Chapter 37 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area,which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. !ak 41112 This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely,' ea n 907' Albert J. Krupski, Jr.,_Pres Board of Trustees AJK:lms • ..„ . ,.., - A ,• i % ..4 Ir .:',* ,.'' 4 - • Y .. - . .. . • .•.T". .. ,. • o- • '—' • ., .,E C F, !! V IS.= • ,, - , . , • it"' '..-- •. ''::.4. 111/ -.I.!' .-, - •::tt.,it"; .tf. -- ,i . I' .s1V`Z.; .'".,"'t. . ' %.• ‘. , ..1''.* .. '",.4 4----: - • "1: 11 ..... . 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OFFICE LOCATION: rrrr$ SOUj�o MAILING ADDRESS: Town Hall Annex e 'er 4 : P.O. Box 1179 54375 State Route 25 * * Southold, NY 11971 (cor. Main Rd. & Youngs Ave.) y a Southold, NY 11971 :` @ 1 Telephone: 631 765-1938 t /l Fax: 631765-3136 te COMM r� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM E C [ IV T NOV - 7 2013 To: Jim King, President Town of Southold Board of Trustees sue c.0Thrall :,,n , ' f From: Mark Terry, Principal Planner LWRP Coordinator Date: November 6, 2013 Re: LWRP Coastal Consistency Review for THOMAS & LINDA KELLY SCTM#1000-107-4-13 THOMAS & LINDA KELLY requests a Wetland Permit for construction of a 20'x40' with 12'x16' "L" extension in-ground pool; construct a 1,700sq.ft. pool patio; install 4' high pool fencing; construct a 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas. Located: 4553 Wickham Avenue, Mattituck. SCTM# 107-4-13 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 proposed 50' non-disturbance buffer is not the correct classification for the buffer since the area will be planted. It is recommended that the Board require that a landscaped buffer be applied. An example definition of the landscape buffer follows. LANDSCAPED BUFFER A land area of a certain length and width which is planted with indigenous, drought-tolerant vegetation similar to that found within the immediate proximity of the parcel. Vegetation shall be installed in sufficient densities to achieve 95% ground cover within two years of installation. Survival of planted vegetation shall be 90% for a period of three years. Maintenance activities within the buffer are limited to removing vegetation which is hazardous to life and property, trimming tree limbs up to a height of 15 feet to maintain viewsheds, replanting of vegetation and establishing a four-foot-wide access path constructed of pervious material for access to the water body. [Added 12-15-2009 by L.L. No. 15-2009] To further Policy 5, it is recommended that the Board require that a pool dewatering well be installed. Further it is recommended that the "tool shed" be located outside of the 100' minimum wetland setback distance. 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 /iiwww %gpFF044.- ;sr° Peter Young,Chairman tl 'Town Hall, 53095 Main Rd. Lauren Standish, Secretaryert P.O. Box 1179 irtt` Southold,NY 11971 *lt y ,DOit Telephone(631)765-1892 1 JiltT �' �'� Fax(631)765-6641 w.•r Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., November 6, 2013 the following recommendation was made: Moved by John Stein, seconded by William McDermott, it was RESOLVED to SUPPORT the application of THOMAS AND LINDA KELLY to install new in-ground pool and 1700 sf. patio with fence and gates, 10'X 12' tool shed and re- vegetation of previously cleared areas. Located: 4554 Wickham Ave., Mattituck. SCTM#107-4-13 Inspected by: John Stein, William McDermott The CAC Supports the application with the Condition of a drainage plan to include the pool. Vote of Council: Ayes: All Motion Carried • r��� S ''QF l7(/ Town Hall Annex James F. King,President t� 74 '� 54375 Main Road Bob Ghosio,Jr.,Vice-President �',��/�, ,�{, P.O.Box 1179 Dave Bergen T T ; Southold,New York 11971-0959 John Bredemeyer ` !a l�tQ� Telephone(631) 765-1892 Michael J. Domino tt Fax(631) 765-6641 O it ..,,.• BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _atCoastal Erosion Permit Application Wetland Permit Application Administrative Permit AmendmentiTransfe t: •ion ✓Received Application: y ‘713,eceived Fee:$ _ b t Vtompleted Application ♦ In 3 p E C =Incomplete SEQRA Classification: Type I Type II Unlisted OCT 17 2013 Coordination:(date sent) VLWRP Consistency Asses meetForm 1415/i3 ✓CAC Referral Sent: (O Z� ),� Date of Inspection: "" • -`T''" Receipt of CAC Report: Lead Agency Determination: /Pechnical Review: ublic Hearing Held: VIM 3 Resolution: I I Name of Property Owners) Is .4 et.A L t✓1 d� e l ` Address 11553 ‘-.�\t`�� A ^-, y- . VA.a% c� Ny ( visnap- Phone Number:(k$d ''L4 - q 3 ZZ Cc) 51 1,2— O8 5-59/6 /b Suffolk County Tax Map Number: 1000 - ( 01 - D y 13 Property Location: q c5 5 LJ'.JLar' ?w-t• tA& —H-t-1v.c kt ,Jy 11152- (provide l95L(provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: \, r, CYI/ 1D11/' • GENERAL DATA • Land Area(in square feet): gQd 3_1 1 Area Zoning: •�� Previous use ofproperty: ` �t Intended use of property: Ze 5 Ion .^-0 Covenant and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? K 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 If"Yes",please provide copy of decision. X No Will thisYroject require any demolition as per Town Code or as determined by the Building Dept.? _SNo Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: 6%.4.‘ e�y hr.N7l-r� / / Date �t, bfrlo5 ?y- Y 0 TrKS.y-e eS D 1 di �� _ ylelea No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X. No Yes If yes,provide explanation: Project Description(usep.achments if necessary ` (1 �er3 �IZoO �. t n )-t1nS�-xt�� �f-�tl� 1- rll'1 .. � %And a sirgs. '}e.5 t O x 12-- F-r, ?v'ol s IRs- e _ d+l+;o' erC . eV,ots CI-ear-ea ,avewLS a5 A r 0.40-C\\LA S . -Yoo 4 w i , \ta- ?.o)04 O (edam+-j4 w 1 l2 Yl to L- ex {e.1-5cen , seen. t ,tOa+to "4c•rrac.a" taitk 1 6-E- 1 o -e100 s(tci, Slid of Trustees Application. WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: 704 /12414 i o La.4 Scott Hatsim Area of wetlands on lot: Ili 0 1 square feet Percent coverage of lot: 1 _ 1 Closest distance between nearest existing structure and upland edge of wetlands: 1 Z 0 feet Closest distance between nearest proposed structure and upland edge of wetlands: 5 0 feet Does the project involve excavation or filling? No I Yes If yes,how much material will be excavated? I SD cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: (o •S feet Proposed slope throughout the area of operations: Manner in which nmaterial will be removed or deposited: MI y G XeSva-k� - w aAk e X to 10-4- 5.e.reskaA wA LA sr-f-ci. 'tT� Gfto+ burw% -fw e ° ' - -' sQ we1-taAd$ 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): N 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part I. Responses become part of the application for approval or finding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I -Project and Sponsor Information Name of Action or Pro jef`t7/ ?Co) Project Locationn((descrribe,and attach a location map): tit4 g%4.4 6 � 4 t 4553 k.JtG��ww, Icu-e , Wka j-j-t}t.ck ,Ny l tis-2._ IJ o wtLFvv¢r Brief Descriptiop\n of Proposed Actikon: v L a.y's `` 1As*.\,\a- .ovn INA 1rt•grct.to.J ocA pot,* ft 4' .C4.'1 CO amp IQ tt2{-t. teal 5U-a. l�e%e gktt.•Ft.sti -.A n e./' Cvlolt5tf C.1.11 o•�t� c ✓ e6� t. I-{� tn-a''Stt -J v s Act .t1 1 . Name of Applicant or Sponsor: `\ I Telephone: 6;I "24 l 3 ZZ• t 1 wtrS Zl Llv.c]a �!`�� E-Mail::I Ktlly ��5a v...il lin at.Cat— Address: 'tcs3 wA City/PO: State: Zip Code: vAA'0.k-4i- NY t I9 SZ I.Does the proposed action only involve the legislative adoption of a plan,local law,ordinan e, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 11 3.a.Total acreage of the site of the proposed action? /• ?SS acres b.Total acreage to be physically disturbed? 2-0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? /, gSsacres 4. Check all land uses that occur on,adjoining and near the proposed action. ., 0 Urban ❑ ,p� Rural(non-agriculture) 0Industrial ❑Commercial 1QAesidential (suburban) El Forest ❑Agriculture ID Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 Project Description(use etta if°o s4�. � necessary): tKS�Cc��w^I-cwt ov%s..1 WI -Yes „ ,met�('!- 41:7 t • r�pa Ku? A -kS 'exit-P+. tuck St-�c�. cUetrea aysa5 0.5 r cv}}o c a S ldP irsolgaitat/n . i . -PotA w 4.O 4"e c-4a t34 ;#-In l2 M to L- ex }4Pt9cen , seen° -c {oa+to ”-krrac.e" w:1 I 6-¢. 100 sb-'f, 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ yI ❑ b.Consistent with the adopted comprehensive plan? ❑ El 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES x ❑ b.Are public transportation service(s)available at or near the site of the proposed action? © ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? IN ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: it I ❑ ❑ • 10. Will the proposed action connect to an existing public/private water supply? //p, NO YES If No,describe method for providing potable water: it//t ❑ IN II.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: / r ❑ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ('� ❑ b. Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? - ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? n ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: CI Shoreline 0 Forest 0 Agricultural/grasslands ❑Earlymid-successional ❑ Wetland 0 Urban l Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑X ❑ 16.1s the project site located in the 100 year flood plain? NO YES i 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO OYES © ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ONO OYES Page 2 of 4 • • 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: xn 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 0 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: Ed' I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE-- Applicant/spons.[ e: 1�• A " \ Date: to( 11 113 Signature: uu Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? r9 0 3. Will the proposed action impair the character or quality of the existing community? n 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? �J 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate I1' ❑ reasonably available energy conservation or renewable energy opportunities? I r 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? }1 CI 8. Will the proposed action impair the character or quality of important historic,archaeological, I ./1 ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 • • No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainagePI ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. [1 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. 0 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees N o a 1 / 3 GName of Lead Agency �- Date thd ;IA 6-5 f. /C/ A1(y President Print or T e Name of Responsible Offi in Lead Agency Title of Responsible Officer stildil ea. Si ture of Responsible Officer iAgency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 • Town of Sou!hold •` Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM Q�,; PROPERTY LOCATION: s.C.T.M.p: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 4( •' STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN TECO- as3ion Block Torp— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT YesNo a. What is the Total Area of the Project Parcels? (Include Total Area of al Parcels located within D 7�i Will this Project Retain All Storm-Water Run-Off the Scope of Work for Proposed Construction) 0 Or 73 Ill I , .SS Generated by a Two(2')Inch Rainfall on Site? Elk the Total Area of Land Clearing (S.F Acres) b. What (This Item will include all,Urn-o f created by site Nit clearing and/or construction activities as well as all — and/or Ground Disturbance for the proposed 3 D A C Site Improvements and the permanent creation of construction activity? (s.F./Agee> impervious surfaces.) osed PROVIDE BRIEF PROJECT DESCRIPTION (PnrvMeAddtlw,Paan Massa,) 2 Does the Site eandorSurvSiey ShowAll on?ProThis Drainage Structures Indicating Size&Location?This X Item shall Include all Proposed Grade Changes and — Slopes Controlling Surface Water Flow. 'T1 ) la- 1'tan (`� v�a,J i1 V1•�Y01A vd� gaol) 3 Does the Site Plan and/or Survey describe the erosion �+1 o 1 H - e. c.e o,.3 10 X 1) -foal and sediment control practices that will be used to El ` `` 1 control site erosion and storm water discharges. This ghout ntire s)r..Qp , VCc,t (AQi tq('.•) 1 ,TSI f� 1/LOt"S�"[� 4 item CCoolnnstruProject Require anyLand Filling,gEGradinga CAaare� Laois. ?hav'I6An O 2XtStr CV... Excavation where there is a change to the Natural S Existing Grade Involving more than 200 Cubic Yards — of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities 5 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 Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil 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 part of a larger common plan that wet ultimately disturb one or mare acres of land; which Exceed Fifteen(15)feet of Vertical Rise to IN including Construction activities involving we disturbances of less than one(1)acre where the DEC has determined that a SPDES permit Is required for storm water discharges. One Hundred(100')of Horizontal Distance? (SWPPV.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-Penult Na GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off Ell �( 1.The SWPPP shall be prepared prior to the submittal of the NOI.The NOI shall be into and/or In the direction of a Town right-of-way? ' submitted to the Department prior to the rarmencemeM of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction stonn water management practices that wit be used and/or 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 terms and conditions of this nem*.In addition,the SWPPP shall Areal plop Item will NOT Include IM lata tion of Ddveway Apnea.) Identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: if Any Answer to Questions One through Nine is Answered with a Check Mark 3.MI SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance h between 5,000.S.F.a 1 Acre in ares, component steel be prepared by a qualified Design Professional Licensed in New York a glom-Wear,Grading.Drainage&Erosion control Plan b Required by the Town of that is knowledgeable h the phdples and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance ofAnyPerak. (NOTE ACheck Mark( dierAnswer for each Question u Requiredfor a Complete Applkeeon) STATE OF NEW YORK, QQ c�f COUNTY OF..... 1 K-$'!.!,,., SS That I, 1/10N' ? k Y being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of incMMal sled Document) And that he/she is the Du.)r-t r (Owner,Contractor,Agent,Corporate Officer,etc.) 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 application are true to the 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 bef re e this; n ilri ;;yr /6 20.f.,Notary Public . /0(b. i �;1 'IF (S store of Applicant) FORM - 06/10 Project Description(use tac ` (100 �t. if ltn�-l-cc�lw,l-�tl� n�vie�J tin -��z„nd e. • `' i' ntoo ' he¢ . - S to X ty¢-r, ?tnil • 11t- G Dc BVtou51 G r areui-5 a5 r a,41,-Ck .t S t44) l2 x 1 to L- ex 4enscon , Sera iOa+to "-krretor to• I 6-e 100 sb4i. • • PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: — w�,s A bin As Ke 1 �y Address: Liss �� CF �^a vh A ‘/-e vho.-A-10 ki-^e1c ,ty 1 19S2 STATE OF NEW YORK COUNTY OF SUFFOLK S -- l V , residing at LI c5 ?j L3 tckLa p A,s. /tilt-IA k 1 J1y'2 I , being duly sworn, deposes and says that on the 31 day of n oto be r , 20 3 deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessmenMroll of the wn of South Id; that said Notices w- - ailed at the United States Post Office at `t'offt r\t 1513n ff N�, that said No; were ed to each of said persons by CERTIFIED MAII./RETURN RECEIPT. rte. Sworn • •efore me this 31 S+ Day of/Arc, ., 20 l3 1, III _ Askei, / otary Public JUMIFER E CASTROVA Nary Pula Ws of Non Yak Na OtCA82005111 &omiWon ExpiresOalxSOWE III • " r tr; U.S. Postal Service,,, U.S. Postal Service CERTIFIED MAIL,, RECEIPT CERTIFIED MAIL„ RECEIPT . (Domestic'Mail Only;No Insurance Coverage Provided) m (••t e ti .it •.1 • . I C. •ra Provun , p. 0cr.0 For delivery information visit our website at wwg®w.uusps.com , FO For delivery information visit our website at www.usc- •1 �_ 1.• rr m- OFFICIAL USE r TIAL USE m m Postage $ Postage $ Certified Fee ;v3 H Certified Fee A��i Return Receipt Fee t.PDslmark \H v\k ,• p (Endorsement Required) yHerLa, c Return Require) G w ' O (Endorsement �c.. < Restricted Delivery Fee "' O (Endorsement Required) iJ Restricted Delivery Fee • OO c 7 O O (Endorsement Required) cQ�, u•I Total Postage 8 Fees $ O � O Ln Total Postage 8 Fees $ r9e t 4 I -.. O .r..•-. 1 , a1y W_M l j� m � �C(Z creel Api - -- ►A ,441 N ■u■ fy-.. s,r„r ,unn n-i,a ert� . J - Sec Hnvcrse tru Inskucbr„i; PS Forn,3801.Avg/:t 2006 , U.S. Postal Service r:, CERTIFIED MAIL„ RECEIPT U.S. Postal Service m (Domestic Mail Only;No Insurance Coverage Provided) CERTIFIED MAIL, RECEIPT in •� For delivery information visit our website at www.usps.comET- fOL (Domestic Mail Only;No Insurance Coverage Provided) `_ r I t I co For delivery information visit our website at www.usps.com. _u Postage $ OFFICIAL U E Certified Fee 1-4 rq Postage $ Postmark Certified Fee O Return Receipt Fee O (Endorsement Required) Here )l , O O ReturnsemReceipt Fee `f•Cbtletj . Restricted Delivery Fee `i O (Endorsement Required) Q t,.,,/ (Endorsement Required i� O -' ricted Dlivery Fee A O l O (Endorsement Required) 3 iO Total Postage&Fees O c •�_ - ,1 • O Total Postage&Fees $ • O Eieta_” 7 $ a ie :A flG&• �� (( ••- - + , 1 �7� . N IT nil° arPoBorNa » 0 3`ireel,ilptN: ...•,r - + .... Y(vl;.`. I M1 or PO Box No. �• �� Cr.u .Al� .• •- -. • I: a. '. �., _ec Pevcrze for iosvuaunn; met& l. Ps rot 3800.August 2006 U.S. Postal Service CERTIFIED MAIL„ RECEIPT U.S. Postal Service,, a ,Domestic Mail Only;No Insurance Coverage Provided) o CERTIFIED MAIL ,, RECEIPT O ..D (Domestic Mail Only;No Insurance Coverage Provided) T O F F I C I A ® E Dr.• For delivery information visit our website at www.usps.corn O �/ '-USE OFFICIAL USE .mL Postage $ ”. IT A Certified FN ' :`i `1- r i Postage $ O Realm RtwNpt Fee ��sL��IA `Y:jv' fib Postmarkrq Certified Fee G (Endorsement Required) Q(l + ✓i, Here O Return Receipt Fee 0 O (EntlorsementRequired) V� Posbrlerk Restricted Delivery Fee �, O there 0 (Endorsement Required) Restricted Delivery Fee O O (Endorsement Required) O to Total Postage 8 Fees $ O Ln Total Postage 8 Fees $ '.74 . ? -} Ct l O W - i 1\AA o BreefApt. •:i I. Lira._ N or PO Bax 7 & ["r. i $.1 .c . PIS n.' -l AT �t --_ +lum d800.A Ju.12006 Sc, Pe vc.c lot lnstt uebon �' PS Fern,3800.August 2006 Suv lirvc,ee Moi hr. m • Y,,...,,,�_- 31.h,1/4% FFO{tcO • • GZ James F. King,President o A\ Town Hall,53095 Main Rd. t co Bob Ghosio,Jr.,Vice-President a. ,t ; P.O.Box 1179 Dave Bergen y �,�c Southold,NY 11971 John Bredemeyer 4_* 0,..• Michael Telephone(631)765-1892 Michael J.Domino -- 1 Fax Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of THOMAS & LINDA KELLY COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, vv.".$ , residing at/dba �c 53 Li`L� wn Au-e, vti\o, rho cic t 11 z being duly sworn, depose and ay: „{� That on the d day of & ove nn6er2013, I personally posted the property known as ter A L( 553 ,.)1e_ ,. -, .3—e 1 t Ae A. v-k.,ck , lJy 11133 by placing the Board of Trustees official poster where it can easily 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 Wednesda November 13 2013. Dated: 1(OVdvi i-yo I" III Zo t 3 I (Si: ature) Sworn to before me this day : 1\1) .201 /I JAl L a LS11/a 1 otary liffr r w . PaMasNswwVVaBJ No.O1CA62119548 *mad In teak County e rnlMlon—oslobrn 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:nompsetftinck Kelty SUBJECT OF PUBLIC HEARING: Construction of a 20'x40' with 12'x16' "L" extension in-ground pool; construct a 1,700sq.ft. pool patio; install 4' high pool fencing; construct a 10'x12' tool shed; construct a 700sq.ft. terrace seaward of existing covered porch; and re-vegetate previously cleared areas. TIME & DATE OF PUBLIC HEARING: • av - S30" G� , Av�er►►b�-r 13, 13 a�'o�o��-i' If you have an interest in this project, you are invited to view the Town file(s) which are available for inspectionrior 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 Bed of Trustees Application. County of Suffolk State of New York i '- --- \ I BEING DULY SWORN DEP SES AND AFFIRMS TH E/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND AT 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 R' IEW OF F i IS APPLICATION. b 'ignature o Property Owner SWORN TO BEFORE ME THIS ft, . DAY OF OCTd13&,20 ) / 4/ / iL'a ot�'t ublic /JENNIFER E.CASMOVA • Pubic,State at New Yak No.01CA8288518 Ovslised In SAM County Commission islon Epires Smeller all • • APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the Dart of town officers and emolovees.The outpost 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 necessary to avoid same.e. 1/ YOUR NAME: -C I 'Y, IV% n/ (Last name(firit name,middle 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 Trusts Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other Of"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 X 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 • (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 thy ' day of 001 b*/ 2003 Signature Pint Name twt ‘C-t.lty 'r-l\J Form TS I CNS TENCy ASSESSnm,,N�,, RM 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 assessment is intended to supplement other information used SoutholdReold Law.geThis making a determination of cons *Exceptby a Towa of agPery is and other ministerial r to intCoasinortal al Erosionempt acHazionsard including Building Permits Permits not located within the CoastalHazard 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 WaterfrontRevitalization Programle uat as to its siantfic 1 r: . . . . 3: If any question in Section C on this fonn 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. Th ea a Ins he a , •, , ., , . stwnortlna facts. If an action ��._. �' '�,"� ,� � ;1„ , , ,�_, , _ , cannot be certified as consistent with the LWRP policyn,n- conditins ro ,it shall not b________sa_sndertak standards and A copy of e LW'RP is in website(�utholdtown.northforkenet), the Board ollowing f at the Town of Southold z e local Ilbraries and the Town Clerk's office.' Planning Department, all B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM#__t2 PROJECT NAMEpas The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board 0 Building Dept. 0 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 .f: tion: ❑ 1 - s_ n .. •arca a a 10,0 100 sb ) t • x,Zf • L . •A • et.)toKst , c- • - red c. eas. moo. - rr�( 2-6 a c4ty 1 c 1 -A t2 Xt6 L Gw4erLit ion , & r.A.}cu?tD -Arra cP .ht i �` Qaritc , �-e. '1 Go stct. • • • • Location of action: 1(55) LJ lCV-VA on Ah v-12. OAa {-}-t'j-kLEt PJy l9S2. Site acreage: l .155- nn Present land use: S i n 4 ko ) Present zoning classification: g 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: 'rh.-o no. S & L t to af=t 1\y (b) Mailing address: ki S S 3 Li A%s-..n A -t . 1N\a+}'W c. . t N Y 119 c7 (c) Telephone number: Area Code(bi) 412.14 q 3 2-2- (d) Application number,if any: Will the action be directly undertaken,require finding,or approval by a state or federal agency? Yes ❑ No 11 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 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes No n 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 Gil 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 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 N]Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ � �l Yes No Not Apable I Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes.` lSee LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. 111I Yes ❑ No LJ 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. ❑ Yes0 No[K Not Applicable Attach additional sheets if necessary • ' WORKING COAST POLICIE• • 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. n Yes n No R] 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 ❑ No q 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 IA Not Applicable PREPARED BY TITLE DATE LOT AREA = 78,823 SQ. FT. 1.81 acres Dc APPROVED BY N.' BOARD OF TRUSTEES `1 TOWN OF SOUTHOLD A Ragging 9175 .o+5 G� aT 20$° eggxg FD DATE 12/13 /►3 Q•O11 tdgw # B P 0 0 Za'z 0v99'n9 FLAGGING LABELED A th I Cn 0Oi , ' .. - , ' ....._ MLLL WETLANDS AS BY gagging THOMAS W. CRAMER, ON ba. 4 2013 Aiir o flogging " / C 3" g�G n9 in note. con TO LI, WNM ala trecllwabr tp ` YY frit' flogging rrlx 1 gg/oo � O, Z If:: .r)„JR to°o I- z '109 9 W�m9 THOMASERW MN 4D 1017 i �QD �p.1'D IQ' �T6� vI ,8 Y ) {a 7 zz 0 01) \ 1 \ A flog N 72'25'20"E 115.00' I to\\ �6 I FD J FD MON -1 IN.) \ O R099Ing cone retaining wall N U1.\ /3 raised wd platform N 0.3'S 0 LO M wiN AC units V ? (P A eaahce- +'xzG. 2.25 .-lo Gn o `` Olagging 50' I 71.6' a rn 1 / z BUFFER I 32.0' 1 rnN co x r 13.0' N \ Bagging C....„.1 4.0• I Ut \ N 4 covered (] \p v 1 .`i 2 Stt FR ^! po"cN p 1 0 Bogging /I m O N It1n9 ,2 DWELL f R. Gil \o �1 21.0• \t to U / 1 .1• 12.7' GAR a \\ 29.3' i ^ .—_ cut T-3 \ wd landing 1 / I \tor 4.3' 4.5•x5.4" aOubad/40 N-\ \ y e4 h \ LID 1`.3 Q 4 tD \ CO J N 1qN \ 00FD 031 FD Mn MON ii S 72'25'20V 342.64' O.. NOW OR FORMERLY NOW OR FORMERLY o_ CONLON STEVENSON A CO O T t WICKHAM AVENUE • (ELLSWORTH TUTHILL ROAD) 11-7-2013 ADDED 50' BUFFER ALONG WETLANDS THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY UNES ARE FOR A SPECIFIC PURPOSE MO USE MD THEREFORE ARE NOT JOB No. 1 3-255 FILE No. 952 F INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS. POOLS, PATIOS, PLANTING AREAS. ADDITION TO BUILDINGS OR ANY OGLER CONSfRUCDON. SURVEYED FOR THOMAS KELLY 1� .:n L f• 4 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION D t {{ n �1 .V ]$Og OF THE NEW YORK STALE EDUCATION LAW. L�JII'E\/''ll 1. GUARANTEES INDICATED HERON SHILL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED; AND ON HIS BEHALF TO THE TIME COMPANY, GOVERNMENTAL SITUATED AT MATTITUCK AGENCY AND LENDING INsoNNON USTED HEREON, MO TO THE ASSIGNEES OF THE NOV 2 12013 LD G IS RRION. GWAANTEES ARE Nor TR,wsE.RABLE TO ADamNn INSTITUTIONS OR SUBSEQUENT OWNERS. TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. V COPIES OF nn SURVEY IUP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR SCALE 1" = 50' DATE 10-7-2013 SouEMBOSSED SEAL SNOT BE CONSIDERTO BE A VAITRUE COPE. tliu,.d 0111' SHAM- ER VAIN TRUE FILED MAP No. DATE L,, t CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-107-4-13 DISK 2013 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR P.O. BOX 616 r � �,(� 1866 WADING RIVER-MANOR RD. WADING RIVER, ° T I ?� ` `.. NEW YORK, 11792 N. . LIC. No. 048992 631-929-4695 HAROLD F. TRANCHON JR. PENN. LIC. No. 2115-E LOT AREA = 78,823 SQ. FT. 1.81 acres to - - 1 A,Ou!`'� G 009049 Gi 2g2�6 vet N 4T 40$� , aggVp MON as 1 ,„,.0N. . ,a x ` csigrs P. I I- .. ,„„ nagging RAGGING LABELED A th 1 C" �i r�` TIDAL * �ERANDS AS BY O 1911a9 n9 moues W. coma, AS 4 2013 tiir nagging ` IL n F PrAPyitf f`( Nagging Fa9gag nate. cgnN 0. tidal anfrwtllratr / .l� e13 8, ,nut rt,N ) /i P z flogging 'aggro IABEIED 1 Rlra B 1-3-4 bZ • �a lr T,,ry�A/�ppt H /BB FR CI wEMN05 As OCT.F4 01 f i-. P a THOMAS W. ASU ON OCT. 4 2013 > �Opt. pt. Na )p 16 ck fang N- $Q'°• .o • '� \ za 00 \ o o na, g N 72'25'20"E 115.00' \ (n\ FD MO 1 -11 YON (Nils \ O nagging cent retaining wall N 01 \ C /5 raised rd platform N 0.3'S (O 1 m with Ac units V ? 0:, .e 2frC _ 4'x2°', ars • a m o -< na99m9 1 X /4 50' --71.6' %m m \ ZBUFFER t 32.0' 0 1 19 Li) 13.0'N__ NI ri- (NO fkVWn9 e' ° . y2Fltn!17)CP I/ ea1 .T 12.7' Gm ' l a CA / / CAR 2111( i g.3' N\\ rd landing T I .....••• - 4.3' \a4,6'xe55..4• o+". %M4 a N 1\ „oy 1 b, SNa D A °"�. \N CO w VD\ _ MON V J o PIPE2.4 o 1rn �l S 72'25'20"W 342.64'. 1 w NOW OR FORMERLY NOW OR FORMERLY o- CONLON J -c5 STEVENSON A N 0 T WICKHAM AVENUE (ELLSWORTH TUTHILL ROAD) 11-7-2013 ADDED 50' BUFFER ALONG WETLANDS THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AHO THEREFORE ME NOT JOB No. 13-255 FILE No. 952 F INTENDED TO °VIDE THE ERECTION OF FENCES, RETAINING WAILS, OLS, PATIOS, PLANRNG AREAS, ADOITON TO BUILDINGS OR ANY OTHER CONSTRUCTION. SURVEYED FOR THOMAS KELLY (� T it! . UNAUTHORI ED ALTERATION OR AOORION TO THIS SURVEY IS A VIOLATION OF SECTION DJ [--s -. _ )1'.C N:-a '�\ 7309 of THE NEN YORK STATE EDUCATION uw. �,'\U/III 0s 0. 1 J1 GUARANTEES INDICATED HERON RUN OILY TO THE REASON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BOWS TO THE MIX OTHE AS GOVERNMENTAL SITUATED AT MATTITUCK J AGENCY AND LENDING INSTTRgN USIED HEREON, NO TO TIE AS:OWES OF Ti[ NOV 1 2 2013 �NpNO gRAN"0N' ° NOT ,RANSFERABIE ITT: AODROHAL NSIIR ONs TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. DR s ,FNT . COPIES OF THIS SURVEY MAP NOT BURNS THE (MD SURLRYOR'S INKED SEN. OR SCALE 1" = 50' DATE 10-7-2013 EMBOSSED SEAL SHALL Nor BE CONSIDERED 10 BE A WOO TRUE COPY. Southom icwn FILED MAP No. DATE ' ' CERTIFIED ONLY TO: TAX MAP No. (REF ONLY) 1000-107-4-13 DISK 2013 HAROLD F. TRANCHON JR. P.C. LAND SURVEYOR P.O. BOX 616 T 1866 WADING RIVER-MANOR RD. WADING RIVER, I � �` -' NEW YORK, 11792 N. . LIC. No. 992 631-929-4695 HAROLD F. TRANCHON JR. PENN. LIC.. No. 2115-E LOT AREA = 78,823 SQ. FT. 1.81 acres \/ •o, OCT 1 7 2013 J • YL tv1 C0 SouthD,a(Dwr. I' bwd re Tostigi d 29 23 R09A 0IN Art BO •01 T oc „poiB v orrt op. A Z O. 0,t� I 90 p RA TABBED IA Vim I t� O TIDAL CMOs AS FUMED BY p nor TONS W. CRATER. ASIA ON OCT. 4 2013 -^ 13 dr INGOT V.- TrT r-.4. STOW 0 SNOT rob. ©anneal I ED a, GAM and heohwabr I Arland, ""' TSTen 2 Z \ibrg FLAMING LABELED 1 R_.. B tJ H 4 FRE5111M11FA WETLANWETLANWETLANDS ! AS FLAGGED BY Ta-•S W. CRMER, ASIA ON OCT. 4 2013 J N a a f /1 N ng \ Q A \ InaPP..P \ 0 M N 7725'20"E 115.00' FD ul\ 11 11/o magi NON t.0 \\ A /5 Ininjcan rota wall Cr \ /3 mimed .A platform N 0.J' • Ip 11 with AC units N) A \ 4120', 2.1'S Y` O l A µ L______-7 1.6L-- a rT \ FT) I 32.0' v \ U) N J.0' P 1 NJ Aap/p,,q covered14.0' 1 W 1 to OaM� covered O \E V \ IE m 1 Stt FR ^. Paeh (7 e cn 4 J o• LL B' O l norg r 1' I 21.0' 1 tar GAR 1 . 25.3' \ GAR7amw`.o." 4b, . \ L �4.J' 4.5':0.4' 4.414 44 tJ.l 11D to N\ w Kp\0 . � J \ m p O F`SPE E o I 1 ri / S 7725'20"W 342.64' 1 / NOW OR FORMERLY NOW OR FORMERLY o_ CONLON STEVENSON N a co O TT WICKHAM AVENUE (ELLSWORTH TUTHILL ROAD) THE OFFSETS (OFT Gllotsnra) saw/ HEREON MN THE STRUMMER TO THE PROPERTY LIES ME FOR A "'ECAC PURPOSE MID USE NO MERIZTBE ARE NOT NM JOB No. 13-255 FILE Na. 952 F MOOED T) ajaE THE ERECTION OF FENCES. RETAIMO WILLS. POOLS. PATIOS. MANTIC;WAS. AOOION TO BUILDINGS OR NWY OTO CONSTRUCTOR. SURVEYED FOR THOMAS KELLY U4MJTH D ALTERATION OR MOTION TO THIS SURVEY IS A MORTON OF SECMIN 7209 OF TE NEW YORK STATE EDUCATOR W. QIARNaas:a INDICATED HEROIN %ILL RUN ONLY TO THE PERSON FOR BION THE SURVEY Is PREPARED. NO ON HIS BEHALF m THE TIRE CORNU'. oo.ERNENTM SITUATED AT MATTITUCK MERCY NLD LENDING INSTITUTION LISTED NEIEaN, ANO TO THE ASSIGNEES OF THE IDIOM INSTITUTION. OUNOINTEES ME NOT mweERMIE TO ADmTOINM ISTIVTaa TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y. OR SUBSEQUENT OWNERS. COPES OF THIS RUMMY IMP NOT : arsE ..gp ' .''s POSEM OR SOR SCALE 1" = 50' DATE 10-7-2013 EIBU59ED SEAL SHALL NOT BE •' w• •YO . G I COPY. 5k` TRA .4" FILED MAP No. DATE CERTIFIED ON TO i' NCy0, _ _ TAX MAP No. (REF ONLY) 1000-107-4-13 DISK 2013 SII= .x ts HAROLD F. TRANCHON JR. P.C. �• e, ,/ I, LAND SURVEYOR t % �9a A:0 P.O. BOX 616 'To SW?.SW?. ' 1866 WADING RIVER-MANOR RD. WADING RIVER, NEW YORK, 11792 N.Y. LIC. No. 048992 631-929-4695 HAROLD F. TRANCHON JR. PENN. LIC. 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