HomeMy WebLinkAboutTR-8536A . i
John M_ Bredemeyer 1I1, President Town Hall,53095 Main Rd.
O�� eco
Michael J. Domino, Vice-President �� Gym P.O_ Box 1179
James F. King N x Southold,NY l 1971
Charles J. Sanders �� Telephone(63 1)765-1892
Dave Bergen 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 lire
1 st day of construction
% constructed
Project complete, compliance inspection
� �r
John M.Bredemeyer III, President pF SO
�� yQl Town Hall Annex
Michael J. Domino,Vice-PresidentO 54375 Main Road
P.O. Box 1179
James F.King,Trustee T �c Southold,New York 11971-0959
Dave Bergen,Trustee OQ
� Telephone(631) 765-1892
Charles J.Sanders,TrusteeQIiYCOUN Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN-OF SOUTHOLD
Permit No.: 8536A
Date of Receipt of Application: November 14, 2014
Applicant: Anthony Daniele
SCTM#: 87-5-9
Project Location: 990 Koke Drive, Southold
Date of Resolution/Issuance: December 17, 2014
Date of Expiration: December 17, 2016
Reviewed by: Board of Trustees
Project Description: For the existing irregularly shaped (326sq.ft., 19.25'x30.25')
overhead deck structure attached to rear of existing residence; and to add to it by
constructing an additional 381 sq.ft., 16.7'x24.3' overhead deck structure with
new swim spa (114sq.ft., 8'x14.5'); remove existing overhead deck stairs and
construct new stairs (53sq.ft., 3.6'x14.4') from north end of existing deck
structure to grade; and for the installation of swim spa equipment.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Samuels & Steelman Architects, last dated November 13,
2014, and stamped approved on December 17, 2014.
Special Conditions: None
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
John M. Bredemeyer III
President, Board of Trustees
Anthony Daniele
990 Koke Drive,Southold `
SCTM#97-5-9
12/10/14IR
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John Bredemeyer, President �gOFF014 Town Hall Annex
Michael J. Domino, Vice-President °°� cO°y 54375 Route 25
James F. King ti P.O. Box 1179
Charles J. Sanders • Southold, NY 11971
Dave Bergen y�ol ,� �a Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time: LL-.c, ' 2,,0 Ji�D
Samuels & Steelman Architects on behalf of ANTHONY DANIELE requests an
Administrative Permit for the existing irregularly shaped (326sq.ft., 19.25'x30.25')
overhead deck structure attached to rear of existing residence; and to add to it by
constructing an additional 381sq.ft., 16.7'x24.3' overhead deck structure with new swim
spa (114sq.ft., 8'x14.5'); remove existing overhead deck stairs and construct new stairs
(53sq.ft., 3.6'x14.4') from north end of existing deck structure to grade; and for the
installation of swim spa equipment. Located: 990 Koke Drive, Southold. SCTM# 87-5-9
Type of area to be impacted: /
Saltwater Wetland Freshwater Wetland Sound rV/ 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
Notice of Hearing card posted on property: Yes No Not Applicable
Storm Water Management Review: Yes No Not Applicable
Info needed:
Modifications:
Conditions:
Present Were: _I/J. Bredemeyer u;P01. Domino�ingSanders D. Bergen
Bay Constable OtfPer
Form filled out in the field by
Mailed/Faxed to:
Date:
DANIELE RESIDENCE, 990 KOKE DRIVE r!.
11/13/14, 11 :33 am, View West
NOV 1 4 2014
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DANIELE RESIDENCE, 990 KOKE DRIVE
11/13/14, 11 -33 am, View East
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DANIELE RESIDENCE, 990 KOKE DRIVE
11/13/14, 11 :33 am, View North
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DANIELE RESIDENCE, 990 KOKE DRIVE
11/13/14, 11 :33 am, View South
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OFFICE LOCATION: ��0f SU(/r�0 MAILING ADDRESS:'
Town Hall Annex �� l0 P.O. Box.1179
54375 State Route 25 Southold, NY 11971
(cor.Main Rd. &Youngs Ave.) y 41CG Q Telephone: 631765-1938
Southold, NY 11971 a
c0UN�1,�
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: John Bredemeyer, President �` EC - 5 2014
Town of Southold Board of Trustees ? C
From: Mark Terry, Principal Planner S�itt,u; �csrit
LWRP Coordinator -- ---
Date: December 5, 2014
Re: Proposed Wetland Permit for ANTHONY DANIELE
SCTM# 1000-87-5-9
Samuels & Steelman Architects on behalf of ANTHONY DANIELE requests an Administrative
Permit for the existing irregularly shaped (326sq.ft., 19.25'x30.25') overhead deck structure
attached to rear of existing residence; and to add to it by constructing an additional 381 sq.ft.,
16.7'x24:3' overhead deck structure with new swim spa (114sq.ft., 8'x14.5'); remove existing
overhead deck stairs and construct new stairs (53sq.ft., 3.6'x14.4') from north end of existing deck
structure to grade; and for the installation of swim spa equipment. Located: 990 Koke Drive,
Southold. SCTM# 87-5-9
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the
Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the LWRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation that
the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with
the LWRP.
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
John M. Bredemeyer III,President �*zf ® Town Hall Annex
Michael J. Domino,Vice-President �� l® 54 Main Road
P.O..Box 1179
irk
James F. King,Trustee in Southold,New York 11971-0959
Dave Bergen,Trustee G Q
Telephone(631)765-1892
Charles J.Sanders,Trustee OI�,C�UNTY N Fax(631) 765-6641
BOARD OF TOWN TRUSTEES ® E C E V rE
TOWN OF SOUTHOLD
To: Southold.Town Building Department NOV 2 1 2014
Re: Verification of Building Department Permit Requirements
BLDG.DEPT.
G� TOWN OF SOUTHOLD
SCTM#:
Property Owner Name: AnA
Date Sent to Bldg. Dept.: I Ig l
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
he proposed project require a Building Permit?
Will the proposed project require a variance determination from
t Zoning Board of Appeals?
Will any part of this application be considered as Demolition as
described under Town Code?
COMMENTS:
P
1112-1 /
Signature of e ' wer Date
John M.Bredemeyer III,President r Town Hall Annex
Michael J.Domino,Vice-President � "`4 54375 Main Road
P.O.Box 1179
James F.King,Trustee Southold,New York 11971-0959
Dave Bergen,Trustee
Telephone(631)765-1892
Charles J.Sanders,Trustee ( • Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
_Coastal Erosion Permit Applicatic
Wetland Permit Application Administrative Permit
Amendment/Trans er/E en ion
ceived Application's
is lL�
eceived Fee:$
—Completed Application
_Incomplete ( I
—SEQRA Classification: 4 i NOV 1 4 2014
Type lType Il Unlisted
Coordination:(date sent)
WRP Consistency Assessment Form
CL
Referral Sent: L-4-1 ate of Inspection:
Receipt of CAC Repo
!Lead Agency Determination:
._.,/technical Review:
Public Hearing Held: . ?
Resolution:
Name of Applicant ANTHONY DANIELE
Mailing Address PO BOX 150,Southold NY 11971>
-----Phone Number:( ) 631-734-6346
Suffolk County Tax Map Number: 1000-_ 87-05-09
Property Location:_ 990 KOKE DRIVE, Southold NY 1.1971, 580 feet North to
Main Bayview Road
(provide LILCO Pole#,distance to cross streets,and location)
AGENT: Tom Samuels, Samuels and Steelman Architects
(If applicable)
Address: 25235 Main Road, Cutchogue NY 11935
Phone: 1 631 734 6405
r)ard of Trustees Applicatio
GENERAL DATA
Land Area(in square feet): 31,680 S.F.
Area Zoning: R.-40
ftevious use of property: Residence -Single Family
Intended use of property.- Residence-Single Family.,
Covenants and Restrictions on property? es X No
If"Ye",please provide a copy.
Will this prolect r luire a Building Permit as per Town Code? �X 'des No
If`Yes',be advised this application will be reviewed by the Building Dept,prior to a Board of Trustee review
and Elevation plana will be required.
Does this project require a variance from alae Zoning Board of appeals? Yes X No
If"Yes'*,;please provide copy of decision.
Will this project requite any demolition as per Town Code or as determined by the Building,Dept.?
-Yes X Na
Does the structure(s)on property have a valid Certificate of Occupancy X Yes_ No
Prior permits/approvals,for site improvements:
Agency Date
No prior pertnitslapprovals for site improvements.
Has any permit/approval ever leen revoked or suspended by a governmental agency'?-A- No,-Yes
If yes,provide explanation: n m ,
pro"ect f`�eri�tiora tree attacl°nttaents if ncrssa ,. ,... .,
Existing,exterior,irregular shaped,overhead deck structure(326 sf, 19.25'x 30.25') attached to the rear of the
existing resi ence,to e ad e to with a new overhead deck structure(381 sf,16.7'x 24.3')with new swim spa
(114 sf,8'x 145).Existing exterior stairs (36 sf, 3.1'x 24.1') from existing deck structure to grade to be removed.
New exterior stairs (53 sf,3.6'x 14.4') to be constructed from North end of the existing deck structure to grade.
E ,,,d of Trustees Application-- .
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
New outdoor overhead deck addition with new swim spa
Area of wetlands on lot: 1,742 square feet
Percent coverage of lot: 5.5 %
Closest distance between nearest existing structure and upland
edge of wetlands 78.6' feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 75.6' feet
Does the project involve excavation or filling?
No X Yes
If yes,how much material will be excavated? 5 cubic yards
How much material will be filled? 0 cubic yards
Depth of which material will be removed or deposited: 3 ft feet
Proposed slope throughout the area of operations: 12%
Manner in which material will be removed or deposited:
Digging by shovel
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):
None
a
617.20
Appendix B
Short Environmental Assessment Form
Instructions.for Completing.
Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,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 1-Project and Sponsor Information
ANTHONY DANIELE
Name of Action or Project-,
DANIELE RESIDENCE
........ ....
Project Location(describe,and attach a location map):
990 KOKE DRIVE, Southold NY 11971
Brief Description of Proposed Action:
New outdoor overhead deck addition with new swim spa
Name of Applicant or Sponsor: Telephone:
ANTHONY DANIELE E-Mail
Address:
PO BOX 150, Southold NY 11971
City/PO: State:. Zip Coder
Southold NY 11971
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that o; F]
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:
Southold Town Building Permit,New York State DEC ❑ a
3.a.Total acreage of the site of the proposed action? _0,127 acres
b.Total acreage to be physically disturbed? Q Q,_,_acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 8.527 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑Rural(non-agriculture) ❑Industrial []Commercial ®Residential(suburban)
❑Forest ❑Agriculture ❑Aquatic ❑Other(specify):_
❑Parkland
Page 1 of 4
5. is the proposed action, - NO YES N/A
a. A permitted use under the zoning regulations? ❑ [1:___1flJ 1
b.Consistent with the adopted comprehensive plan? o
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape?. (Zt 1
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
U ,
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? ff] El
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;
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: ON SITE SEPTIC SYSTEM O (�
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? r:;7_1
b.Is the proposed action located in an archeological sensitive area? X I❑__I
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? o
b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? F71 ❑
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres; Lii
14. Identify the typical habitat types that occur on,or are I ikely to be found on the project site. Check all that apply;
MShoreline El Forest ❑Agricultural/grasslands ❑Early mid-successional
® Wetland ❑Urban MSuburban
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?
16.Is the project site located in the 100 year flood plain? NO YES
TTTXT'
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 YES D
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: [—]NO QYES
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;;��__
._� X.
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: (
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:..-
s
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name; Tom Samuels Date: 10/17/2104
Signature
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
1. Will the proposed action create a material conflict with an adopted land use plan or zoning Ma
regulations?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community? _ ' ✓' o
4. Will the proposed action have an impact on the environmental characteristics that caused the (`� f-1
establishment of a Critical Environmental Area(CEA)? L
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
reasonably available energy conservation or renewable energy Opportunities? 2 Li
7. Will the proposed action impact existing: (—/f
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological,
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
A i
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 drainage
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.
D. Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
t t the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
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. n
Town of Southold-Board of Trustees
Name Leaad gency _ Date
V&02V1 �� President M ..
PdtoTypeNameo es onsi aOfficerin Lead Agency Title of Responsible Officer
gnature of R nsible Officer in d_A ency � (if different from from Respatsi ble Officer)
PRINT Page 4 of
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NOTICE TO ADJACENT PROPERTY OWNER
i -
BOARD OF TRUSTEES, TOWN OF SOUTHOLD
In the-matter of applicant:
ANTHONY DANIELE SCTM# ..,,10,00-87-05-09
3
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a Permit from the Board of
Trustees to:
New outdoor overhead deck addition with new swim spa t
3�
2. That the property which is the subject of Environmental Review is located
adjacent to your property and is described as follows:
990 KOKE DRIVE,Southold NY 11971
3. That the project which is subjects to Environmental Review under Chapters
96,111 and/or 275 of the Town Code is open to public comment on:
f
DATE:
i
4=
You may contact the Trustees Office at 765-1892 or in writing.
The above-referenced proposal is under review of the Board of Trustees of the Town of
Southold and does not reference any other agency that might have to review same
proposal.
PROPERTY OWNERS NAME: ANTHONY DANIELE
MAILING ADDRESS: PO BOX 150,Southold NY 11971
PHONE #:
i
AGENT: Tom Samuels- Samuels and Steelman Architects
1 ,
MAILING ADDRESS: 25235 Main Rd. .Cutchogue,NY 11935.
PHONE #: 631-734-6405
I
Enc: Copy of sketch or plan showing proposal for your convenience.,
E
f
osuk Town of Southold
a
z Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
000 87 05 09 STORM-WATER,GRADING,DRAINAGE AND EROSIONCONTROL PLAN
str ct eco –6 o6T cT —Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW.YORK
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No
B. What is the Total Area of the Project Parcels? 31,680 S.F. 1 Will this Project Retain All Storm-Water Run-Off
(Include Total Area of all Parcels located within 0.727 AC. Generated by a Two(2")Inch Rainfall on Site?
the Scope of Work for Proposed Construction) (This item will include all run-off created by site
440 S.F.
b. What is the Total Area of Land Clearing
(S.F.iacres> clearing and/or construction activities as well as all X
and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of
0.01AC.
construction activity? 40,l Acres) impervious surfaces.)
2 Does the Site Plan and/or Survey Show All Proposed
PROVIDE BRIEF PROJECT DESCRIPTION (Provide AddlllonalPages asNeeded) Drainage Structures Indicating Size&Location?This X
Item shall include all Proposed Grade Changes and El
New.outdoor overhead deck addition with Slopes Controlling Surface Water Flow.
3 Does the Site Plan and/or Survey describe the erosion
new.swim spa and sediment control practices that will be used to X El
control site erosion and storm water discharges. This
item must be maintained throughout the Entire
Construction Period.
4 Will this Project Require any Land Filling,Grading or
Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards El X
of Material within any Parcel?
5 Will this Application Require Land Disturbing Activities
Encompassing an Area in Excess of Five Thousand X
(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
X
General DEC SWOOP 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 will ultimately disturb one or more acres of lend; which Exceed Fifteen(15)feet of Vertical Rise to El
X
Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance?
the DEC has determined that a SPDES permit Is required for storm water discharges.
(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious
for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off El
X
1.The SWPPP shall be prepared prior to the submittal of the Not.The NOI shall be into and/or in the direction of a Town right-of-way? --
submitted to the Department prior to the commencement 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 storm water management practices that will 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 .X
compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Itom will NOT Include the Installation of Driveway Aprona.) El
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 Chock Mark
In a Box and the construction site disturbance Is between 5,000 S.F.&t Acre In area,
3.All SWPPPs that require the post-construction storm water management practiceea Storm-Water,Grading,Drainage&Erosion Control Plan Is Required by the Town of '
component shall be prepared by a queliflad Design Professional Licensed In New York Southold and Must be submitted for Review Prior to Issuance of Any Budding Permit.
that Is knowledgeable in the principles and practices Of Storm Water Management. (NOTE: A Chedc Mark(,r)andfor Answer for each question is Required for a Complete Appitce0on)
r
STATE OF NEW YORK,
COUNTY OF..{� �...............SS
That I ANTHONY DANIELE
being duly sworn,deposes and says hat he/she is the applicant for Permt,
(Name of ind(vidstgNop DGcumigi)-
And that he/she is the ...... . ...,.OWNER,-...-. ... ....- .... ... ....... .............................................................. is
(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 it)die application filed herewidi.
Sworn to before me this;
:... day of.,.... 20.4
Notary Public: ,1lVr ..............
(Signature of A i licant)
PATRICIA RICHARDS
FORM - 06/10 NOTARY PUBLIC!ATE® NEW YM
QUALiFIED IN SUFFOLKN7y
COMMISSION EXPIRES MAY 3%20�(%
Bogard of Trustees Application
County of Suffolk
State of New York
ANTHONY DANIELE BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR
REPRESENTATIVES(S),TO ENTER ONTO MY PRO RTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OFFTH A P ATION.
Signature of Prope Owner
SWORN TO BEFORE ME THIS_. ��DAY OF. 20
s
otary Pullic
PATRICIA RICHARDS
NOTARY PUBLIC,STATE OF NEW YORK
NO.01816042467
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES MAY 30..20
Board of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
t
I, ANTHONY DANIELE residing:at 990 KOKE DRIVE,
(print owner of property) (mailing address)
Southold NY 11971 do hereby authorize
(Agent)
Tom Samuels to apply for permit(s) from the
Southold Boar n Trustees on my behalf.
(Owner's signatur
APPLICANUAGENURE PRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM t
!F
71_Le Tit�vn of SctulhoTd's Code of Ethics ,fir It2tiits corbfliets�bf tntcre'st on the Bart of town officers and em lovees l7te nornose:of
eni fotm is ib pmvid�mfnrmatioit which can alert the town of po5sibie confhcls oI'mtereiyand allow it io blie whatever 4zets n Is '
necessary to avoid same.
YOUR NAME: .
ANTHONY DANIELE l
(Last name,firstname,4iiddle initial,unless you are applying in ilio name of
someone else or other entity,such as a company.If so,indicatetheother
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building A
Trustee X
Variance 1
Change of Zone __.. Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other',name the activity.)
Do you persrnally(fir tltrough;yqur company,spouse,stbltitg,parent or child)have a relationship with any officer or employee
of the Town ofSouthold? "I2claisonship"ntcluzl s by bloo 3,marriage,or business interest."Business interest"means a business,
includmg<tii partnership, h W iich the[o vn officer or employee has:cvbn a partlal ownership of(or employment by)a corporation
in whech the'tovvn Qfce rctr employee;awn"s rtorc.than shares.
YES
YES NO X
If you answered"YES",complete the balance of this form and date and sign where indicated. E
i
a
Name of person employed by the Town of Southold
Title br position of that person
E
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. €f
The town officer or employee or his or her spouse,sibling,parent,or child is(check all,that apply):
A)the ounicr';of greater.than'-5%l,bf the s#iares of the.corporate stock of the applicant I
(when ihc;applttant'is a corpomtton�; ' � . = ,
13),the lcgxil or bene ficial owneC:of any'interest in a ribn-corporate entity(when the
apphcant.is nota corporation),
C)an offieeF dtrector;..pirwez,or gglplqypc ofthc:,Ipplirant;or
b)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this d of 200_
" S►gnature;
Print Name ANT Y
Form TS T
Town of Southold
IffilECid NSISTE CY ASSESSMENT FORM
A, lNmucriONS
1> All applicants for permits* including Town of Southold agencies, shall complete M CCAF for
proposed actions that are subject to the To of Southold Waterfrott Consistency Review Law. This
assessment is intended tD supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal&osion Hazard.4rea.
2. Before answering the questions in Section C, the preparer of this form,should review the exempt
minor action list,policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A Mpoggd, ction wilL ated- as !A _AUMpa—
a nt
all-off'8
3., If any question.in Section C on this form is answered"yes"or"no", thethe proposed action will
of the adidevement of the LWRP policy standards and conditions contained in the consistency
review law. Thus eack aijAver,IoWt t&MMWg"defflfl,li9fing arty 10-0--
&M9-11WLL*_ts. N an action cannot be certified as.consistent with the LW RP policy standards and
conditions,it shall ao—t b—e and keit.
A COPY of the LWRP is available in the following places. online at the Town of Southold's
website(southoldtown.northfork.net), the Board of Trustees Office,the Planning Department,all
local libraries and the Town Clerks office. 17
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 87
05 9 NOV 1 4 2014 ...... I
PROJECT NAME DANIELE RESIDENCE
The Application has been submitted to(check appropriate response):
Town Board 0 Planning Board El Building Dept. 1:1 Board of Trustees
I> Category of Town of Southold agency action(check appropriate response):
(a) Action undertaken directly by Town agency(e.g,capital
construction,planning activity,agency reguladon,land transaction)
(b)- Financial assistance(e.g.Want,loan,subsidy)
(o) Permit approval,license,certification-
Existing,exterior,irregular shaped overhead deck structure(326 sf, 19.25'x 30.25) attached to the rear of
the existing residence,to be added to with,a new:..overheaddeck.structure 081,sf,J6.7-x-241)with new
swim spa(114 sf,8'x 14.5).txfsting exterior--stair-s' (36'sf, 3Xx 24.1')from'existing deck structure to grade
to be removed.New exterior stairs (53 sf,3.6'x 144)to be constructed from North end-Qf-the existing deck
structure to grade.
Location of action: 990 KOKE DRIVE,Southold NY 11971
Site acreage:: 31,680 SF/0.727 AC
Present land use: RESIDENTIAL
Present zoning classification: R-40
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: ANTHONY DANIELE `
(b) Mailing address: PO BOX 150, Southold NY 11971
i
(c) Telephone number: Area Code( }
(d) Application number,ifany:;
Will the action be directly undertaken,require funding,or approval by a state or federal agency?
Yes U No.KI If yes,which state or federal ageiiGy
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.
E]Yes Q. No ❑X Not Applicable
r
.... ... ... ... -
Attach additional sheets if necessary
n 4
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
E
l Yes E No PXI Not Applicable
There are no historic or archeological structures on property. _.
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
FRI.
Yes ❑, No ❑ Not Applicable
Deck structure is in keeping in style and scale of neighboring
structures. The existing deck,structure is in keepingin n style and
scale of neighboring structures.
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
ol
1---�1 Yes :R No X❑Not Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages,22
through 32 for evaluation criteria.
Yes No Not Applicable
No development will take place in the"protected"or"natural indiginous environment".
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.
11'! Yes E] No LJNot Applicable
The development will not add pollutants into the air.
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
0.Yes . ; No 0 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.
h! Yeo. No 0 Not Applicable
No public land involved. Littoral access unimpeded.
1
Attach additional sheets if necessary
WORIUNG COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in
suitable locations. See LWRP Section IH--Policies; Pages 47 through 56 for evaluation criteria.
YesF11 No X❑ Not Applicable
There'are no public or commercial activities or uses on site.Historically this property and
neighboring properties are residential in use and will remain residential.
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.
1Not Applicable
M.Yes .❑. No❑
This project will.protect and preserve the living marine resources by
maintaining all rainwater discharge on site.
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 F- I Not Applicable
There are no agricultural lands onsite.
,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.
M Yes ❑ No ❑ Not Applicable
The construction will be using equipment approved by the Federal government
for energy usage.The pro'ec� t will meet Federal standards for conserving energy
"energy Star Program
PREPARED $y Tom Samuels.. TITLE Architect DATE 10/17/2014
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COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS INKED SEAL OR Land Surveyor
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY
CERTIFICATIONS INDICATED HEREON SHALL RUN
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TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND Successor To Stanley J I , Jr L$
Joseph A Ingegn
LENDING INSTITUTION LISTED HEREON AND gegno L S
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Title Surveys — Subdivisions — Site Plans — Construction Layout
TUTION CERTIFICATIONS ARE NOT TRANSFERABLE
/ PHONE (631)727-2090 Fax (631)727-1727
THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS I
AND/OR EASEMENTS OF RECORD, IF 1586 MGIn Road P 0 Box 16
ANY, NOT SHOWN ARE NOT GUARANTEED Jamesport, New York 11947 Jamesport, New York 11947
4-1 3
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AND STAIR - OWNER ANTHONY DANIELE
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SOUTHOLD, NY 11971
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