Loading...
HomeMy WebLinkAboutTR-8612AJohn M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King Charles J. Sanders Dave Bergen BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 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 %constructed _)(_ Project complete, compliance inspection Soil i John M.Bredemeyer III,President Town Hall Annex 54375 Main Road Michael J. Domino,Vice-President ', P.O.Box 1179 James F. King, Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Telephone (631) 765-1892 Charles J. Sanders, Trustee ` 00 NT`I,' � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8612A Date of Receipt of Application: May 29, 2015 Applicant: Steve Curry & Carol Groneman SCTM#: 52-5-21 Project Location: 645 Bayview Avenue, Southold Date of Resolution/Issuance: June 17, 2015 Date of Expiration: June 17, 2017 Reviewed by: Board of Trustees Project Description: To replace waterside windows on existing dwelling with a 12' wide sliding glass door; install a 3'x6' landing from door with steps leading down to a proposed 13'x16' paved patio on grade. 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 14, 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. W , = John M. Bredemeyer, III, President Board of Trustees Firs R. P%AF 0411111'", THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD; N.Y. 11971. TEL.: 765-1892 John Bredemeyer, PresidentgUFFD1 Michael J. Domino, Vice -President �cO°y� James F. King y s Charles J. Sanders • Dave Bergen Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field InspectionMork Session Report Date/time: P r , 20 i = �/a�► Frank Uellendahl on behalf of STEVE CURRY & CAROL GRONEMAN requests an Administrative Permit to replace waterside windows on existing dwelling with a 12' wide sliding glass door; install a +/-4'x13' wood landing from door with steps leading down to a proposed 13'x18' paved patio on grade. Located: 645 Bayview Avenue, Southold. SCTM# 52-5-21 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 Type of Application: Wetland Coastal Erosion Administrative Emergency Pre -Submission Notice of Hearing card posted on property: Yes - Storm Water Management Review: Yes No Info needed: Modifications: Conditions: 11"VIV4- Present Were: J. Bredemeyer_ Bay Constable Form filled out in the field by Mailed/Faxed to: Date: Chapt.111 other Amendment Violation No Not Applicable Not Applicable 2-,f. J-4 /F,- M. .T; M. Domino J. King C. Sanders D. Bergen Other Frank Uellendahl From: Frank Uellendahl <frank.uellendahl@gmail.com> 7FVl`AY,2" 'z Sent: Wednesday, May 27, 2015 12:35 PM To: Frank Uellendahl Attachments: 2015-05-2011.03.46.jpg 9 2015 S THE CURRY GRONEMAN RESIDENdE—. 645 BAYVIEW AVENUE SOUTHOLD, NY VIEW DIRECTION: EAST — MAY 20, 2015 - 11:30 AM 1 owl tal few, FOR S SEE SEE NO NOTicE COUNTYOFSUFFOLK © e 021 _ ; I{. ]iReal Properly Naz Sernce Ager,ey r $Z 99 �}R .tit cecnrr Oxnv R.vinwNrllWt M rn�. T ... NI s • r �_�� u. --r-- tx��--rw-- ,wnN r 1y1.✓}ruY� tnr F a r 5200 PROPER, ! T m -a ♦ r ° Fray A „( •t+r , (RE—D PARK A DOUNOI ,n • W 121µU \ \ \ .yX e M1 `M1♦ \_ e� �.L: A��tt 4N r � a (\ 2 I µc1 ISS) �\ � yjcl ,0µc1 T,McI AEBEPTEON 51 6 I w �'�� � I • tl 9 9.2 M I � { WU r . 1owr2 oFawlrlo�o .4}•- . ,..':I• 5910 >. sA :,r la 9e I � Nw I ewU � �\ as It '\ VV.. (O�� PEcoNlc uNornuET I s TeNU vo\\ '¢ eaVU •Z 6. o, Rq O m t. u \ f x J O 11 \ \ O a seE9e NO Tp x IS — aMEs[oewK1. ,K.2O —C.No . Fa No \ 'S0•E'C0 1 Sr= 0 , ruTCN—iM—xlo! w z --------------------------m_--_-- z- SEx _—__— \2----- —M__—_—__2� --_--- MATC x / -11- 11m / SEESEc Nom SEE EEC NO ow NOTicE COUNTYOFSUFFOLK © e 021 _ ; I{. ]iReal Properly Naz Sernce Ager,ey r $Z 99 �}R .tit cecnrr Oxnv R.vinwNrllWt M rn�. T ... NI s • r �_�� u. --r-- tx��--rw-- ,wnN r 1y1.✓}ruY� tnr F a r 5200 PROPER, Cantrell, Elizabeth From: Frank Uellendahl <frank.uellendahl@gmail.com> Sent: Monday, June 15, 2015 8:16 AM To: Cantrell, Elizabeth; Verity, Mike Cc: Frank Uellendahl Subject: RE: TRUSTEES: CURRY GRONEMAN Application revised CORRECTION: I meant to say: the maximum size of landing From: Frank Uellendahl[mailto:frank.uellendahlCa)gmail.com] Sent: Monday, June 15, 2015 7:54 AM To: elizabeth.cantrell@town.southold.ny.us; mike.verityCcbtown.southold.ny.us Subject: TRUSTEES: CURRY GRONEMAN Application revised Dear Elizabeth, The owners of the above referenced Administrative Wetland Permit Application —Warren 5 Curry and Carol Groneman — confirmed over the weekend that they are satisfied with the attached revised landing and steps leading down to the proposed paved patio. The landing is as wide as the slider opening (6ft) and has the as per code minimum required depth of 3ft. Mike Verity confirmed that this is the minimum size of landing for the proposed slider that would not require a variance. Kindly revise your agenda accordingly. Thank you for your help in this matter. Cheers, Frank OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUMIFF JUN 12 2015 To: John Bredemeyer, President - - Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 12, 2015 Warren/ Re: Local Waterfront Coastal Consistency Review for STEVE CURRY & CAROL GRONEMAN SCTM# 1000-52-5-21 Frank Uellendahl on behalf of STEVE CURRY & CAROL GRONEMAN requests an Administrative Permit to replace waterside windows on existing dwelling with a 12' wide sliding glass door; install a +/- 4'x13' wood landing from door with steps leading down to a proposed 13'x18' paved patio on grade. Located: 645 Bayview Avenue, Southold. SCTM# 52-5-21 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. 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 Ow`�QF s®�lyol Michael J. Domino, Vice -President '` 4 James F. King, Trustee Dave Bergen, Trustee G� ® O Charles J. Sanders, Trustee '* OWN% BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To: Southold Town Building Department Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Re: Verification of Building Department Permit Requirements SCTM#: Property Owner Name: Date Sent to Bldg. Dept.: Telephone (631) 765-1892 Fax (631) 765-6641 G' la J 1 2015 J -- 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 Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: Signature of Wviewer John M. Bredemeyer III, President Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J. Sanders, Trustee BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application Administrative Permit AmendmenbTransfe ./Exte sion Received Application: > G s _ eceived Fee:$ _A.,Vompleted Application L5 Incomplete _SEQRA Classification: Type I Type 11 Unlisted _ oordination:(date sent) _WRP Consistency Assessment Form 5 S CAC Referral Sent: ate of Inspection: � O _Receipt of CAC Report: _Lead Agency Determination: —/echnical Review: Public Hearing Held: (0 111 IlIs Resolution: Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 MAY 2 9 2015 A 9 4 Name of Applicant Mailing Address P-5ALNl E - LUAU e' Phone Number:( -7 60 ",3,v Suffolk County Tax Map Number: 1000- 5.2 — _5 — Property Location: "kf/ �'i ao bC t 7 -U 'jNy [19-7( C (provide LILCO Pole #, distance to cross streets, andlocation) AGENT: (If applicable) r' Address: Phone: (DLJ L _ ird of Trustees Applicati— GENERAL DATA Land Area (in square feet):' Area Zoning: (2--4-0 Previous use of property:���� Intended use of property: 0�?54D Covenants and Restrictions on property? Yes No If "Yes", please provide a copy. Will this project require a Building Permit as per Town Code? /Yes No If "Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this ro'ect require a variance from the Zoning Board of Appeals? Yes V No p J If "Yes", please provide copy of decision. Will this project require ny 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 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? V No Yes If yes, provide explanation: Project Description (use attachments if necessary): Ti i.s !� t t T �' �� C—R G� LCL.` Ao p Rt�(0(� � t'X�3 1CL3&) -T-b A Bi d of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: cw tlt it� p�ei) Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: CA 41& aG feet Closest distance between nearest proposed structure and upland edge of wetlands: e.'A, 2-6.5 feet Does the project involve excavation or filling? No Y Yes FOP—? C2, 60k?0-Tu lames If yes, how much material will be excavated? 64 I'a cubic yards How much material will be filled? ' A cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: 6Z��.?�1 t% -`� – �L� 4 �E Manner in which material will be removed or deposited: )Y 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 Appendix B Short Environmental Assessment Form Instructions for Completinp_ Part 1 - 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 Name of Action Project: /oar rr����',� �tL("V tL !u Project Location (describe, and attach a location map): on t Lif:1:1- Pd Brief Description of Proposed Action: `6— UA 00 _117C)U-2 � � �GL�J � 5LL U i Name of Applicant or Sponsor: Telephone: 1� �fiVe ��°"� 2 G���®(S� E -Mail: Address: 64-6 1 —_—LJ A -(JC City/PO: ����t LV State: UL(/L ZiplI Code: l 43- 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO YES _,L administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that�i ❑ 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: _ C2��5b(,1�� 3.a. Total acreage of the site of the proposed action? ©,' acres b. Total acreage to be physically disturbed? acres " c. Total acreage (project site and any contiguous properties) owned or controlled by the applicant or project sponsor?,�- acres CLcr(— IN Zen) 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, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ ® ❑ ❑VQ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES ❑ M 7. Is the site of the proposed action located in, or does it adjoin, a st listed Critical Environmental Area? If Yes, identify: r0k:5 NO YES ❑ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? 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? NO YES NO LSI ❑ ❑ K/1 ❑ 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features and technologies: , } NO YES 0 El 10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water: �% NO YES ❑ ❑ 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment: NO YES ❑ ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic 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 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? If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: NO YES 54❑ NO ❑ YES ❑ ❑ 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: ❑ Shoreline El Forest ❑ Agricultural/grasslands El Early mid -successional Wetland El Urban Suburban 15. Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES � ❑ 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? If Yes, Will storm water discharges flow to adjacent properties? �NO YES b. Will storm water discharges be directed to established conveyance systems (ru off and storm drains)? If Yes, briefly describe: INNO [_]YES NO YES Ela. Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: NO YES ❑ to large impact impact may 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? If Yes, describe: NO YES ( ❑ Elregulations? 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes, describe: NO YES ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? E?f ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the I AFFIRM THA T INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso n �1C_ Date:0 Signature: Part 2 - Impact Issessment. 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?" Page 3 of 4 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 Elregulations? 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? E?f ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area (CEA)? 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? 7. Will the proposed action impact existing: a. public / private water supplies? Ef El b. public / private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic, archaeological, �`j ❑ 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 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. F1Check 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 vironmental 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 environme)PI11i 1 impa s. _/�Town of Southold - Board of Trustees V Name of Lead A ency Date �D � � � President Print or Ty e Name onsibk Office in Lead Agency Title of Responsible Officer SX nature of Regpdrisible Officer in Lead Age cy Signature of Preparer (if different from Responsible Officer) PRINT Page 4 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 drainage �j u 1:1problems? 11. Will the proposed action create a hazard to environmental resources or human health?FN El 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. F1Check 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 vironmental 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 environme)PI11i 1 impa s. _/�Town of Southold - Board of Trustees V Name of Lead A ency Date �D � � � President Print or Ty e Name onsibk Office in Lead Agency Title of Responsible Officer SX nature of Regpdrisible Officer in Lead Age cy Signature of Preparer (if different from Responsible Officer) PRINT Page 4 of 4 B ---d of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, �I G pV L C_712DDeHR I _residing &Cb (print owner of property) (mailing address) do hereby authorize q2POL LAISULOUVOOC- (Agent) C A Z0,L_VI7eL'- to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) Board of Trustees Applicati— County of Suffolk State of New York S. CL,_ r r u an J (a rn L roripm o it BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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, INLUDING 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. . Owv�&_�a' ___ & 4'11� Signature of Properwner/ SWORN TO BEFORE ME THIS Mrd DAY OF—M Q 1_,20 15 &,_'& L4LL) Notary Public CAROL BEST (Kc 0 Ndary Public State of VW VA No.ON 71 Q1Mt. lS APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: (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 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% 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 applicantlagent/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 thi day of 200 _ Signature s-AG�1l�n� Print Name mai 2,IQ fi1A-AJ Qa S' P on r f Form TS 1 Town of Southold is LWRP CONSISTENCY ASSESSMENT FORM INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si fgiu icant 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, listiniz both supportinLy and non - supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online website (southoldtown.northfork.net), the Board of Trustees Off local libraries and the Town Clerk's office. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 1001) - J�- - d (5 — �L( oQ of Southold 1 s Planning Department, MAY 2 9 2015 a PROJECT NAME lRt� 6QP— ke EC -5C QGOCG�� The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board ❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ❑ construction, planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: NZ Nature and extent of action: Vt?-0F'V-5iF—=D�1'"�3U� ` ir4rt D �1,?)l ),-- Location of action: c`t---2 epy-ewell A -l/4:-- , S7oulAbLQ Lft Site acreage: CkC; Present land use: ���� t (L:R1 eR P -L Present zoning classification: V — 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: Rpt (b) Mailing address: �Q�j l� 6 &cLL)UPO�Z �❑� LI �� (c) Telephone number: Area Code ( ) �� �/ �� ' gz 2 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No Q 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 — Polic' s Pages 3 through 6 for evaluation criteria ❑ Yes 0 No 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 — Polici 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 — Policies Pages 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 IH — Policies Pages 16 throug 21 for evaluation criteria Yes 1:1 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 evaluatio criteria. ❑ ❑ Yes No Not Ap ible 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 a luation 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 wtApplicable ee LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. 1:1 Yes ❑ No 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. ❑ YesD No P /Not Applicable Attach additional sheets if necessary WORKING COAST POLICIF Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See WRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes F]No Not Applicable Attach additional sheets if necessary Policy 11. Promote sus ainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town wa rs. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. F-1Yes El No Not Applicable Attach additional sheets if necessary Policy 12. Protect agA tural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for eval ation criteria. ElYes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III — Policies; P es 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY � � UJJ� 1' 'AUL TITLE A(ZGDATE q 2Q 6 CA 48.51 CA 28.5' L .�w i ' •••tet.: 10 CA 223' PROPOSED PATIO ADDITION � W � o r CURRY ' JUN 1 5 2015 3 RESIDENCE SOUTHOLD NY BAMEW AVE 645 _ ARCHHECT FRANK MOM .� 123 OEM AVDKX P.010 316 OREMRF, NY 11944 TEL 631-477 8624 OWNERS R MARREII 5 CUARf 645 BAYWV AVM SOUINOID, NY 11971 TE631765-3415 STONE PATIO/ 'ON GRADE/// 1 1 3' :t16 • 21' DATE 05/28/2015 wyc. 3/18• = 1'-0 PATIO LANDING W. NAME CA 230' �. NONO A-3 W � o C.0 J � DATE 05/28/2015 wyc. 3/18• = 1'-0 PATIO LANDING W. NAME CA 230' �. NONO A-3 CD ¢ o 0 CA 48.5' APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE CA 223' o ,:,mum ONE-STORY DWELLING /jjjjjj�j�jjj�i CA 230' AREA CALCULATIONS LOT AREA = ca. 11,325 SF =100.00% EXIST'G BLDG. COVERAGE = ca. 1,150 SF = 10.15% I WETLAND AREA PER LOT = ca. 925 SF = 8.17% 1 SITE PLAN BASED ON SURVEY BY R. VAN TUYL, 09/18/74 ® PROPOSED PAVED PATIO WITH WOOD LANDING ® EXISTING RESIDENCE I¢ DRIVEWAY V A, PROPOSED SITE PLAN SCTM# = 1000-52-05-21 VILLAGE OF GREENPORT SUFFOLK COUNTY, NEW YORK EXISTING WATERFRONT FACING WINDOWS TO BE REPLACED WITH SLIDING DOOR REQUIRING A LANDING AND STEPS DOWN TO A 13' X 16' PAVED PATIO ADMINISTRATIVE WETLAND PERMIT APPLICATION PROPOSED PATIO ADDITION Z CURRY RESIDENCE SOUTHOLD, NY 645 BAYVIEW AVE ARCHITECT FRANK UELLENDAHL 123 CENTRAL AVENUE P.O.BOX 316 GREENPORT, NY 11944 TEL: 631-477 8624 OWNERS CAROL GRONEMAN & WARREN S CURRY 645 BAYVIEW AVENUE SOUTHOLD, NY 11971 TEL: 631-765-3415 w � o U z w 3 o ¢ O N o � I¢ DRIVEWAY V A, PROPOSED SITE PLAN SCTM# = 1000-52-05-21 VILLAGE OF GREENPORT SUFFOLK COUNTY, NEW YORK EXISTING WATERFRONT FACING WINDOWS TO BE REPLACED WITH SLIDING DOOR REQUIRING A LANDING AND STEPS DOWN TO A 13' X 16' PAVED PATIO ADMINISTRATIVE WETLAND PERMIT APPLICATION PROPOSED PATIO ADDITION Z CURRY RESIDENCE SOUTHOLD, NY 645 BAYVIEW AVE ARCHITECT FRANK UELLENDAHL 123 CENTRAL AVENUE P.O.BOX 316 GREENPORT, NY 11944 TEL: 631-477 8624 OWNERS CAROL GRONEMAN & WARREN S CURRY 645 BAYVIEW AVENUE SOUTHOLD, NY 11971 TEL: 631-765-3415 � o U 0 3 s N � 0 oz U o Its 1:1 Z a DATE: 05/28/2015 N SCALE: I" = 15, �o 3 e SITE PLAN N Z a DWG. NAME A-1 9g ® :� DWG. NO EXISTING ELEVATION SCALE: 1/4" = 1'-0 PROPOSED ELEVATION SCALE: 1/4" = 1'-0 KESIUENLE SOUTHOLD, NY 645 BAYVIEW AVE ARCHITECT FRANK UELLENDAHL 123 CENTRAL AVENUE P.O.BOX 316 GREENPORT, NY 11944 TEL: 631-477 8624 OWNERS CAROL GRONEMAN & WARREN S CURRY 645 BAYVIEW AVENUE SOUTHOLD, NY 11971 TEL: 631-765-3415 PROPOSED t X PATIO ADDITION Z D O D O W CURRY KESIUENLE SOUTHOLD, NY 645 BAYVIEW AVE ARCHITECT FRANK UELLENDAHL 123 CENTRAL AVENUE P.O.BOX 316 GREENPORT, NY 11944 TEL: 631-477 8624 OWNERS CAROL GRONEMAN & WARREN S CURRY 645 BAYVIEW AVENUE SOUTHOLD, NY 11971 TEL: 631-765-3415 �. t X W O D d D � W = 3 3 0 w � N N Z O W W Z O � o W � � w � N DATE: 05/28/2015 SCALE: 1/4" = V-0° =o 3 Y o u., a ELEVATIONS o� DWG. NAME A-2 g ® �:,j DWG. NO