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HomeMy WebLinkAboutTR-8613A John M.Bredemeyer III,President *0f SUUTy� Town Hall Annex Michael J.Domino,Vice-President h0 l0 54375 Route 25 P.O.Box 1179 South Glenn Goldsmith old,New York 11971 A.Nicholas Krupski G ® Q Telephone(631) 765-1892 Charles J.Sanders O a Fax(631) 765-6641 l.7�®UMf`1,� ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1296C Date: December 14,2016 THIS CERTIFIES that replacement of waterfront facing windows on existing dwelling with a 10' wide and a 5' wide sliding glass doors-, install a 3'x5' landing and a 2'6"x3' landing with steps from sliding glass doors leading down to a proposed 16'x16' bluestonelpatio on grade; J stone pavers to be set on gravel and sand bed with a+/-2"wide joints for drainage; At 320 Lakeview Terrace, East Marion Suffolk County Tax Map#1000-31-9-13 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 29, 2015 pursuant to which Trustees Ac�nunistrative Permit#8613A Dated June 17, 2015, was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the replacement of waterfront facing windows on existing dwelling with a 10' wide and a 5' wide sliding glass doors; install a 3'x5' landing and a 2'6"x3' landing with steps from sliding glass doors leading down to a proposed 16'x16' bluestone patio on grade; stone pavers to be set on gravel and sand bed with a+/-2"wide joints for drainage. The certificate is issued to BASIL BOZIOTIS & SOFIA LIOREISIS owners of the aforesaid property. Authorized Signature t� John M.Bredemeyer III,President �o�� jy�lo Town Hall Annex Michael J.Domino,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Jw Southold,New York 11971 A.Nicholas Krupski ® �O Telephone(631) 765-1892 Charles J.Sanders ®I�C�U(1� Fax(631)765-6641 i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed ►° Project complete, compliance;inspection. INSPECTED BY: ��Y 1,LS U SG''14,C�,V�� COMMENTS: 1 S t� vi J_b otC O SO opt u CERTIFICATE OF COMPLIANCE: John M. Bredemeyer 111, President g�}FFO(,pc Town Hall,53095 Main Rd. �G P.O. Box 1179 Michael J. Domino, Vice-President -V- y� James F. King Southold,NY 11971 oTele hone 631 765-1892 Charles J. Sanders 41- !� p ( ) Dave Bergen �l ilk �O 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, silt fence 1St day of construction '/2 constructed _X Project complete, compliance inspection rjf S10 John M. Bredemeyer III, President ®V� y®�® Town Hall Annex Michael J. Domino,Vice-President 54375 Main Road P.O. Box 1179 James F. King, Trustee N Southold, New York 11971-0959 Dave Bergen,Trustee ® �� Old' Telephone(631) 765-1892 Charles J.Sanders,Trustee �'o(I( ,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8613A Date of Receipt of Application: May 29, 2015 Applicant: Basil Boziotis & Sofia Lioreisis SCTM#: 31-9-13 Project Location: 320 Lakeview Terrace, East Marion Date of Resolution/Issuance: June 17, 2015 Date of Expiration: June 17, 2017 Reviewed by: Board of Trustees Project Description: To replace waterfront facing windows on existing dwelling with a 10' wide and a 5' wide sliding glass doors; install a 3'x5' landing and a 2'6"x3' landing with steps from sliding glass doors leading down to a proposed 16'x16' bluestone patio on grade; stone pavers to be set on gravel and sand bed with +/-2" wide joints for drainage. 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 Frank Uellendahl, Architect, last revised on June 12, 2015, and stamped approved on June 24, 2015. 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 SOU.. THO*LD TRUSTEES Pio. Q Zgxal 130T.10+;& 0 Issued To Date "01"cow . Address.�O Lolcev�ewTe�race . F s� /rlar:a, THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION .TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 John Bredemeyer, President guFF014. Town Hall Annex Michael J. Domino, Vice-President °�O °O°s� 54375 Route 25 James F. King y P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen y�0r ,� �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: ��� IJ'?0 Frank Uellendahl on behalf of BASIL BOZIOTIS & SOFIA LIOREISIS requests an Administrative Permit to replace waterfront facing windows on existing dwelling with a 10' wide and a 5' wide sliding glass doors; install a 16' wide by 3' deep wood landing from doors with steps leading down to a proposed 16'x16' bluestone patio on grade; stone pavers to be set on gravel and sand bed with +/-2" wide joints for drainage. Located: 320 Lakeview Terrace, East Marion. SCTM# 31-9-13 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Ty pe 9f 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: J. Bredemeyer M. Domino /J. King C. Sanders D. Bergen Bay Constable Other Form filled out in the field by �� -u//f Mailed/Faxed to: Date: Frank Uellendahl To: Frank Uellendahl Subject: BOZIOTIS-ADMINISTRATIVE WETLAND PERMIT ADMINISTRATIVE WETLAND PERMIT APPLICATION THE BOZIOTIS RESIDENCE 320 LAKEWIEW TERRACE MAY 2 9 2015 EAST MARION, NY POPI VIEW DIRECTION: SOUTH — MAY 27, 2015 — 1:35 PM ADMINISTKIVE WETLAND • PERMIT � • PLICATION THE BOZIOTIS RESIDENCE 320 LAKEWIEW TERRACE EAST • • _. aw::. 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Real«Im opeN•m Tx ServioAgancy19 r a.Qa 31 'WONO o axr p M ,Rcrw 1000 P y Ne•Wl PROPERiV MAP Cantrell, Elizabeth From: Frank Uellendahl <frank.uellendahl@gmail.com> Sent: Friday,June 12, 2015 11:43 AM To: Cantrell, Elizabeth;Verity, Mike Cc: Frank Uellendahl Subject: BOZIOTIS APPLICATION Attachments: FLOOR PLAN W REVISED LANDINGS.pdf Dear Elizabeth, Attached please find the revised patio design with landings in front of the sliders. As I was leaving your office this morning I bumped into Mike Verity(who is copied w this email). He explained to me that no ZBA variance is needed if I reduced the landing—whether concrete or wood—to 3ft wide and the length of the actual door openings. The attached plan shows the floor plan with 2 separate landings: 3'x5' and 3'x2'-6". By bringing the steps down along the fagade of the building we 'save'two feet, and the actual distance to the top of the bank increases from—10ft to —12ft. Please review and kindly let me know if you need more information from me. Thanks—and enjoy your weekend. Frank 1 OFFICE LOCATION: 0® ® ® MAILING ADDRESS: Town Hall Annex ', P.O. Box 1179 Southold, NY 11971 54375 State Route 25 -� "'. (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM JUN 12 2015 To: John Bredemeyer, President n.. Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 12, 2015 Re: Local Waterfront Coastal Consistency Review for BASIL BOZIOTIS & SOFIA LIOREISIS SCTM# 1000-31-9-13 Frank Uellendahl on behalf of BASIL BOZIOTIS & SOFIA LIOREISIS requests an Administrative Permit to replace waterfront facing windows on existing dwelling with a 10' wide and a 5' wide sliding glass doors; install a 16' wide by 3' deep wood landing from doors with steps leading down to a proposed 16'x16' bluestone patio on grade; stone pavers to be set on gravel and sand bed with +/-2" wide joints for drainage. Located: 320 Lakeview Terrace, East Marion. SCTM# 31-9-13 The proposed actions have 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. 1. It is recommended that the Board require the establishment of a vegetated, non-turf buffer incorporating existing vegetation. 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, President0Of SO(/ryO Town Hall Annex Michael J. Domino,Vice-President �� l® 54 Main Road P.O.. Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Telephone(631) 765-1892 Charles J.Sanders,TrusteeOIyCOU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To: Southold.Town Building Department MAY 2 9 2015 Re: Verification of Building Department Permit Requirements BLDG.DEPT. SCTM#: 1� I ` TOWN OF SOUTHOLD Property Owner Name: ' Date Sent to Bldg. Dept.: .5 //_5 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 Will the proposed project require a Building Permit? Will the proposed project require a variance determination from t e Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: 2 ��9 0 Signature of a %ewer Date 06 John M. Bredemeyer ITI, President �; `, - "' �.s�. Town Hall Annex f;. Michael J. Domino, Vice-President 54:375 Main Road f 7 s' )' t .; P.O. ox 1179 James F. King, TPUSLee _~ f. Southold, New York 11971-09.59 Dave Bergen, Trustee Telephone (631) 765-1892 Charles J. Sanders,Trustee Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOI;THOLD Office Use Only _Coastal Erosion Permit Application aetland Permit Application dministrative Permit Amendment/Transfer Exte sion I - y t• -'�'�x; c,eived Application: VR ceivcd Fee: $ rDD mplc,ted Application: Incomplete: MAY 2 g 2015 SE•QRA Classification: B Type I Type II Unlisted �ordination:(date sent): ' }' VRPConsistency Assessment Form: IS _. .._ .� ':-: •'tip=:`� —.-•.._. J D;AC Referral Sent: ate of Inspection: Receipt of CAC Report: / Lead Agency Determination:— ' echnical Review: _ ��^^ y r Public Hearing Held:_—l(2 Resolution: p � t• Name of Applicant: JJ(L- alp'('(, Mailing Address: Phone Number: Suffolk County Tax Map Number: 1000 - �j C -b- CEZI - 13 Property Location: 2j�© (!� ���Z(! e -Z (provide LILCO Pole fl, distance to cross streets, and location) AGENT: F—Q-4l (vim L(�LL>✓(J'� _� (if applicable) Address: --- - -- --Phone: . rd of Trustees Applicatic GENERAL DATA Land Area (in square feet): ` t 6V_1L1 + Area Zoning: (2" -4-0 Previous use of property: (l=i5S VQ IE�K)4-1 Intended use of property: Covenants and Restrictions on property? Yes ',/N 0 If"Yes", please provide a copy. / Building Pen-nit as per Town Code? _V_ Yes No Will this project require a i g If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes /No If"Yes", please provide copy of decision. Will this project require iy demolition as per Town Code or as determined by the Building Dept.? _ Yes No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date V NoP rior permits/approvals for site improvements.^ Has an pen-nit/approval roval ever been revoked or suspended b a governmental agency? '�/ No Yes Y p pp p y If yes, provide explanation: Project Description (use attachments if necessary): (S�I,IJ(� lAf�Y(�L ?��� W[wbutt)5 tD til= V_EeLgAceL 1dt W(V� AUV 51 Wl1E SL(P8eS L_�k Jp IAJ �!�(!,J/27E x r p P� H ri v�L �) GA- 2/�1Jl9:)F 01)4ti1S .rd of Trustees Applicati4 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: �2 ,�77 _ -_-- ��U'�1� p,llf: eo Area of wetlands on lot: 4:!-,4 square feet ROk 10 ?7O!Lf LOCI E Percent coverage of lot: _ /�.4 % Closest distance between nearest existing structure and upland edge of wetlands: N_2.� feet Closest distance between nearest proposed structure and upland edge of wetlands: /0 _ feet '70 WO 13'A4J#A;L- -4! l~7' 77b 904,kW6,9D Does the project involve excavation or filling? No V/ Yes �Jc2 �3) J`T/,/©708ES If yes, how much material will be excavated? N i:�).2-2 cubic yards How much material will be filled? X A cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: _____G'� T�_� Manner in which material will be removed or deposited: 13f' 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): 617.20 Shoo-f LiTVirottiit[eiital Assessiiieitt Foi-m Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsihlc 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 furtlter verification. Complete Part 1 based on information currently available. Ifadditional 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 Project: 52-0 LAkeViGW Project Location(describe,and attach a location map): N <2 iao CTF bttlY AVE Brief l)escription of Proposed Action: 45t'T2E L6AVI1J,& cUMLL —TD 74 max} V >,, (61 PAILWE4 Name of Applicant or Sponsor: - Irl 'clephone:-Mail:i b,, 1 d�l-is i�.L[aCGC Address:- 167,61 - 2.IL,44L -5T- City/PO: i State: Zip Code: 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 ❑ maybe 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: t--�v tum l Ui, VEL"('C FV ❑ Ay P 5[.(.V 1>lN4, V bL)2S -! 3.a. Total acreage of the site of the proposed action? 3136 sr-am-1- 1).Total acreage to be physically disturbed? acres c. Total acreage(project site and any contiguous properties)owned -16 or controlled by the applicant or project sponsor? __2E acres 4 L&c IZjeC- -?) 4. Check all land uses that occur on, adjoining and near the proposed action. ❑Urban `Rural (non-agricul(ure) E]Industrial ❑Commercial Residential(suburban) El Forest ❑Agriculture VfAqualic ❑Other(speci(y): ❑Parkland Page I MA 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ VC_I ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ — 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? -E1 K 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: ^ �C —�✓( _�� --- -- --- ❑ S. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b. Are public transportation service(s)available at or near the site of the proposed action? 0- Elc. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? lel ❑_ 9. Docs the proposed action meet or exceed the state energy code requirements? _ NO YES if the :ogi ch ri e requirements,proposed action will exceed nts,dscbe design fcatures and technologies: --_- _ _ -- _- _ til_ A - ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply'? _ NO YES If' No,describe method for providing potable water: _ �1 ❑ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If' No,describe method for providing wastewater treatment, _— f t-1 ❑ 12_ a.Does the site contain a structure that is listed on zither the State or National Register of Historic NO YES Places? ❑ b. Is the proposed action located in an archeological sensitive area? -EN ❑ 13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other%vaterbodies regulated by a federal,state or local agency? ❑ b. Would the proposed action physically alter,or encroach into,any existing wetland or watcrbody? 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 ❑Shoreline ❑Forest ❑Agricultural/grassland s ❑Early mid-successional e)R—T Wetland ❑Urban r uburban 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 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a. Will slotTn water discharges flow to adjacent properties? ,NO - YES b. Will storm water discharges be directed to established conveyance systems(Lunoff and storm drains)? If Yes,briefly describe: No ❑YE.S Parc 2 of 4 IS. Does the proposed action include construction or other activilieb thin rCStllt Ill the rIII Pound Ill clll of NO YI?S water or other liquids(c.o. retention pond. waste lagoon. dam)'? If'Yes,explain purpose and size. - --__ - - --- - IKA ❑ 19. 1 las 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: _ _ _ ______- ._ _ __ _ ❑ i AFFIRM THAft' E INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDG� Appl icant/spo I s ��C,(���1���tC� Date: 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 I 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• A9oderate 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 ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of laud? U ❑ 3. Will the proposed action impair the character or quality of the existing community? u ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the P(- ❑� establishment ofa Critical )environmental Arca(CEA)? 5. Will the proposed action result in an adverse change in the existing level of Iraflic Or ❑ T 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? 7. Will the proposed action impact existing: _ ❑ a. public/private water supplies? u 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, (lora and fauna)? u Page 3 of 4 -- -- — T ---� - No,or Moderate small to Iarge impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 1:1prohlems? _ 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 fart 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 occutTing, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. LJ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, u that 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 ifyou 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/3 Town of Southold-Board of Trustees `—— G _ — Nan e f Lea Agency Date fPresident Print or Tyl Na ie of Re n ible Officer in Lead Agency 'title of'itesponsible Officer Sial M spot c A icer in Lead r,ency Signature of Preparer(if different from Responsible Officer) PRiNT Page 4 of 4 rd of Trustees Applicatii AUTHORIZATION (where the applicant is not the owner) P �®x f 9 I, A`S+L ��a�� residing at ® (print name of owner of property) (mailing address) EIV- i M4&oma, �� 3 / do hereby authorize —+O-,Pfuv- (Agent) Ayc.wto apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) �L rd of Trustees Applieati< AFFIDAVIT �4 S�l'L ���-! ®7'i"S 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 BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT"I'HE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. __ Signature of Property Owner SWORN TO BEFORE ME THIS a� DAY OF _ _ ., 20 t�g' OTiNotar ublic CYNTHIA M.CUSATI motor;Poo l'v,stite of !ev York Ouall:ivu in SA'01:t County L� Commission Wires Oct 201 rd of Trustees Applicati< AFFIDAVIT 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 BOARD OF 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, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. S' afore o roperty Owner SWORN TO BEFORE ME THIS +L- DAY OF , 20_�— Ntary Public CYNTHIA M.CUSATI Notar;'ubl;c,Mate of flee York NO.OCU6!GU`07 Qualified in Suf'olk County Commission Expires Oct 20�� r APPLICANU/AGENU/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of,)ojjthuld's Codc or Ethics prohibits conflicts of interest on the natt of town officers and emplovices.'rhe purpose of this tbrnt is to nmvidc inf�+rnrdinn«hieh c m:+ler(the town of nrrssible conflicts of interest and allow it to take whatever action is necessary to avoid same. ' YOUR NAME: _ 43_ _ - --- - - (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance __ _ __ _ Building Variance — _ Trustee ✓____ Change of Zone _ Coastal Erosion Approval of plat _� ___ Mooring Exemption from plat or official map —_ Planning Other (If"Other",name the activity.). Do you personally(or through your company,spouse,sibling,parent,or child)have a n:latinn>hip with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business intereo-.t."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial myncrship ol'(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO — 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 applic;tnt (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 this day of 200_ Signature Print Name n 2�— Form TS l J�'�'-: •"`''�—;.viii �I�//-t% NA-1�1 L v`•'�--1C�. l_t©Y=�j,5 t_5 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town 01' Southold agencies, shall complete this CCAF for proposed actions that arc subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Evicept minor exeinpt actions including Building PerWts and other ininisterial perinits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its siiZnificant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supportitt"', and non- supporting facts. If an action catmot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: onlin -of-Southold-'-T---, website (southoldto,,Nm.northfork.net), the Board of Trustees OfGI!tlte,Planning Department, all local libraries and the Town Clerk's office. ` B. DESCRIPTION OF SITE AND PROPOSED ACTION MAY 2 9 2015 SCTM# PROJECT NAME S 13 02lL--f_j Z.6 L 10 � C� l S CJ l`Q 0j CIE The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Towm agency (e.g. capital ❑ construction, planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action; (cam 161�< l /C, , - - ---- Location of action: � ��VI�(,[) � C � }�✓'T �1��� 1 ' Site acreage: e Present land use: ;j'C— Present zoning classification: —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 (b) Mailing address: vof:�-) -S31�, (c) 'Telephone nuinber: Area Code (d) Application number, if any: Will the action be directly undertaken,require.funding, or approval by a state or federal agency? Yes ❑ No if yes,which state or 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 F] No �1ot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III — Poli es Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional shects il'neccssasy Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Polic' .s Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No 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— Policie2,1400t 8 through 16 for evaluation criteria F-1Yes 1:1 No Applicable Attach additional shects if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 throw 21 for evaluation criteria ElYcs ❑ No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III— Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ [ Yes No Not ApI ble Attach additional sheets if necessary Policy 7. Protect and improve air duality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for aluation criteria. F] YesU No Nut Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. ee LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III —Policies; Pages 38 through 46 for evaluation criteria. ❑ YcO No M/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. Se WRP Section III—Policies; Pages 47 through 56 for evaluation criteria. F-1Yes F-1NoNot Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town wat s. 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 forevil tion criteria. ❑ Yes 1:1 No Not Applicable Attach additional sheets if necessary Policy 13. Promoteap ropriate use and development of energy and mineral resources. See LWRP Section III—Policies; P• ges 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY � � L-�EL����.1�,��{C_ TITLE 2CJ41TL� DATE 0)20/1 1 1 - c H PROPOSED ADDITION 3 ■ 60MOTI H if if fill!! 111111 11111 RESIDENCE EAST MARION III IIIIIIIIIIII IIIIII fill If 111 11 111111 IIH 11 111111 111111 111111 111111 lilt 320(PREVIEW TIME 11 111111 111111 111111 111111 1111 If I I I I ARCHITECT fill FRANK 1.11100411 123 CENIRAI.AVENUE 111 111111 111111 111111 fill 11 111111 Nil It IIII If IIIIII I YR 318 111]11 fill If 111]11 111XII Ilj� 11111 11 11 If 11 111111 � IO�EIiF9RT,NY 11944 TEL 631-477 8824 OWNERS 11 11111111111111111111111[,'1 111111111 HT11-111TH PSI BOZIDTIS &SOF14110REISIS 320 UA10:M TERRACE EAST NAm,NY 11939 s TEL•917-992-5189 1s 7r7 IIIIIIIHIIIIII iL it 1111 it IIII it IIIII 1111 11 it I 1 11 11 Hill IIIIII IIH 1.1 Li FYICTIAI(` CBCT ['1 n��T'^" c._ 3 ■ ■ o 113 If 11 11111 TMTi DATE, 05/28/2016 SCALE: 1/4'-1'-0' —°' EAST ELEVATIONS LLLULU DWG.NAME o PROPOSED EAT ELEVATION "° n-z M LJ LJ LJ LJ Ul PROPOSED y ADDITION a m J mc 0 U W 10'-1 1/4' 26'-6 1/2' s U z BOZIOTI REMENCE SUNROOM � EAST MARION 320 LAKEVIEW TERRACE ARCHITECT 16' 3' o FRANK UELLENDAHL 123 CENTRAL AVENUE m P.O.BOX 316 GREENPORT, NY 11944 tE TEL: 631-477 8624 a Up OWNERS F — r — BASIL BOZIOTIS & SOFIA LIOREISIS II I Z 320 LAKEVIEW TERRACE _ L J L — J EAST MARION, NY 11939 o LIVING RM DINING RM M TEL: 911-992-5189 L JL — J ,3x5, TJ WOOD ,OR CONC. ^ G cn A L _ J LANDING, 22 HIGH 3, o I " �( 1 7 04 N Lfl � +/- 16'X16' PAVED PATIO _ _ ° AT GRADE - - - - - W 3'x3' WOOD ,OR CONC. HALL LANDING 22 HIGH T� BEDROOM I KITCHEN c 00 00 3 1 n � s cn I— L w 0 w z APPROVED BY .I. L' DN ,BOARD OF TRUSTEES - - - TOWN OF SOUTHOLD Z w DATE: 06/12/2015 �� SCALE: N.T.S. �Z 14'-7" 3'-0" 5'-2" 13'-7" DATE 29'-9 I'f/2 _ - ' IST FLOOR PLAN Z�� DWG. NAME '17 JUN5 2015 0 A-1 ©:d DWG. NO CER TIFIED TO. j� SURVEY OF PROPERTY BASIL BOZIOTIS MAY 2 9 2015 SOFIA LIOREIS/S c A T EAST MARION SUSSEX BANK ,,. TOWN OF SO UTHOLD UTOPIA ABSTRACT CORP. � ,::•:�''_'�``'� __. _,J SUFFOLK COUNTY, N. Y. 1000-31-09-13 SCALE: 1"20' N/0/F LINELL D. & WALTER E. GAIPA NOVEMBER 17, 2010OCT 7, 2014 OCT. 16, 2014 (REVISIONS) I I I OCT. 22, 2014 (REVISIONS) D FR. GAR. x " y 2.8' ZMON 1.9' 30' N55047'20"E WIRE FENCE " 190.88' FE r 0.8'W 0.4'S I 17.8' I 9.8' 0 5 N 175' (DEED) 0 s DEER FENCE m z N 161.9' l c!1 FRAME I n CCO VER ONCRETE to blknd. nl II'a o GARAGE I o \ N y O 2'6' ~ CONCREIE o O J a, 29.8' v f m CONCRE I N ,Z mWA 7ER z 8.4 0 ?im v I OMEM? ASPHALT p ONE & TWO STORY o Z ASPHALT I ,,, FRAME HOUSE x o / a F.F. EL 24.1' k o \ ?c 2 ARES O NEPA 38.3 \ CA o pJE� COVERED 171.7' a ENTRANCE io m to blkhd. \ lZi] I INCLOSED 26'7 PORCH 1.87112" (DEED) N55*4 O E S55'47'20"W 210.04' FR, GAR 21.00' U77UTY N/0/F EDNA BROWN 710P or Bax a o POLE �� p7 a N/0/F CLEO GOGA TES OF , • ' AREA=11,627 SO. FT. n , ."A �. TO TIE LINE ,- ' C. NO. 49618 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION PECONIC &-y. C. OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. 631 765-5 631 765-1797 EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR ELEVATIONS REFERENCED TO N.A. V.D. '88 ■=MONUMENT 1230 TRAVELER STREET 10-233 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, MY 11971