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HomeMy WebLinkAboutTR-8721A John M.Bredemeyer III, President O�\\OF SO -®1 Town Hall Annex Michael J.Domino,Vice-President O 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Cn Southold,New York 11971 A.Nicholas Krupski �O� Telephone(631) 765-1892 Charles J. Sanders ��ificou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1255C Date: August 17, 2016 THIS CERTIFIES that the removal and rgplacement of existing deck with a new 286 sq. ft. deck attached to seaward side of dwelling; At 7390 Great Peconic B'ay Blvd.,Laurel Y Suffolk County Tax Map#1000-126-11-11 Conforms to the application for a Trustees Permit heretofore filed in this office Dated October 14,2015 pursuant to which Trustees Administrative Permit#8721A Dated January 20,2016,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 removal and replacement of existing deck with a new 286 sq ft deck attached to seaward side of dwelling. The certificate is issued to BRUCE ROTHSTEIN& SARAH ROTHSTEIN owners of the aforesaid property. Y_ *W� F E -M Authorized Signature John M. Bredemeyer III, President N3� Com Town Hall Annex Michael J. Domino, Vice-Presidentj� yl; 54375 Route 25 Glenn Goldsmith ; P.O. Box 1179 A. Nicholas Krupski y ® Southold, NY 11971 Charles J. Sanders Telephone (631) 765-1892 } Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: FS/1"?I1 b Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction r' '/ constructed v'/_ Project complete, compliance inspection. INSPECTED BY: G. cs' + COMMENTS: p� u;1� or% o�cco4dane-e. w,-0- Par CERTIFICATE OF COMPLIANCE: John M. Bredemeyer f if, President SpFFD(,f co Town Hall, 53095 Main Rd. Michael J. Domino, Vice-President G P.O. Box 1 179 o011 rry 11971 James F. King "' � Soi�t�� 1u, �. y �► �� Telephone(631)765-1892 Charles J Sanders p Dave Bergen �a 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 15t day of construction Y constructed 1� Project complete, compliance inspection John M.Bredemeyer III,President SoUlyol Town Hall Annex O 54375 Route 25 Michael J.Domino,Vice-President ,�, P.O.Box 1179 Glenn Goldsmith N' Southold,New York 11971 A.Nicholas Krupski ® �O@ Telephone(631) 765-1892 Charles J. Sanders oli�/Coum� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8721A Date of Receipt of Application: October 14, 2015 Applicant: BRUCE ROTHSTEIN S CTM#: 1000-126-11-11 Project Location: 7390 Peconic Bay Blvd., Laurel Date of Resolution/Issuance: January 20, 2016 Date of Expiration: January 20, 2018 Reviewed by: Trustee John M. Bredemeyer, III Project Description: Remove and replace existing deck with a new 286sq.ft. deck attached to seaward side of dwelling. 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 Robert I-. Brown Architect, P.C., dated on September 30, 2015, and stamped approved on January 20, 2016. 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 �O 00 000 Y rr^ L '!1 V CONC ° �° OCT 1 4 2015 ` c MON Z i N � r Q 7 } Sou!hel,Town - r END/ p � L FENCE U+ �. - R�ifrt�l?�P Ist rn0 70rn N411 APPROVED ,BY, JBOA D OF TSU St'E�S `4's TVI�Io! OF'SOUTI UTILITY POLE _ , (yam(� '9 J�:,n J1/, •r LIL 37A ,C 6V(� - 6 ` GRAVEL DRIVEWAY W/TIMBER CURBING ryFvo ' O (l (N� D GENERATOR �� '• j ENCLOSURE D n ; rn EXISTING z 2-STORY FENCE rn STRUCTURE r AO N o ° PROPOSED SECOND O nFLOOR ADDITION rn EXI5TING I-STORY O 5TRUCTURE rn - - rn SLATE ENTRY - - OUTD R !1 r- WOOD FENCE SHO rn C) EX15TING D 2-STORY z RESIDENCE r z rn z n rn —NI O 0 NEW WOOD DECK W/RAILING REMOVE TO REPLACE EXISTING DECK 6u ° BASED ON: I SURVEYED BY Es STANLEY J. ISAKSEN, JR. Z: rn SURVEYED 23 AUGUST 2005 J o� AREA = 29,G77 S.F. OR 0.68 I ACRES EXISTING AREA OF STRUCTURE, INCLUDING EXISTING DECK: 33 1 3.G SF = 1 1 .2% 'I°°° AREA INCLUDING EXPANDED F 35 1 1 .3 ,5f= 1 18%D= . IT%WOLATION OF THE , LAW FOR ANY PERSON, �PieS UNLESS ACTINGUNDER THE �°o ,ai�.,•r o �N DIRECTION OF A LICENSED �"�° ARCHITECT,TO AFTER ANY END FENCE s �0P5 ITEM ON THIS DRAWING IN 000�a`y` AL2 WAY ANY AUITHORIZED ALTERATION N MUST BE CONC MON NOTED,SEALED,AND - LEANING EAST �'� 0� '�. ,9��DESCRIBED IN ACCORDANCE WITH THE LAK �19P��'G °� ROT H STE I N IBES 1 D E N C E °�' ��++ 7390 PEC IC BAY BLVD, LAUREL NY -1 1948 sep 30, 2015 B,y�F au,a"oE° �EPED ARC SCALE: 1 " = 30' B,qo Robert I . , brown Architect, P.C. -9205 205 Bay Ave. Greenport NY ° �E`J'I admin@Yalrweather-brown.com G3 1 -477-9752 , EXISTING BEDROOM EXISTING BEDROOM 3 1-011 SHAFT FOR HVAC DUCTS VE AEE 0 i I.� � ?1_011 o J , SECOND FLOOD 41- 1, PART PLAN 1/4" = I' PROPOSED SECOND FLOOR WALL DIRECTLY OVER THE FIRST FLOOR EXISTING ACCEPT AS NOTED WALL PROPOSED SECOND FLOOR WALL O DIRECTLY OVER THE FIRST FLOOR i WALL - Ln 4'-01 d- IT 93 A VIOLATION OF THE EXISTING WALL AND WINDOW LAW FOR ANY PE SON, TO BE DEMOLISHED UNLESS ACTING UNDER THE DIRECTION OF A LICENSED ARCHITECT,TO ALTER ANY OTEM OM THISDRAXIVING IN .ANY WAY.ANY AUTHORIZED ALT ERATION MUST BE NOTED,SEALED,AND DESCRIBED IN ACCORDANCE WITH THE LAW. EXISTING BEDROOM BOTH ST I N RES 1 D E N C E 7390 PECK NIC Y BLVD, LAUREL NY 1 1948 sep 3 2015 E°e�hi�� 5CAL : 114" = 1 '-0" °� rt 1 . Brown Arch ect, P. C. 3vAIy�� 205 Ba Ave. Greenport NY admin@ alrweather-brown.com G3 1 -477-9752 NEW ROOF NEW 5ECOND FLOOR EXISTINC. FIRST LOOK WEST ELEVATION (PART) SECOND STORY ADDITION EXISTING ACCEPT A5 NOTED Zn NEW ROOF NEW SECOND FLOOR MA MOMmM > — — — — n���0� I�othstein f�esidence -I.-< mw�ma Ifl D�> �t��3®---G" EXIS N FI FL OR ® � ��, -0 Sep 30, 201 5 �'v SCALE: 1 /8" = 1 10" momo . -G)>ZnZ-i Robert I . Brown ®��ox m m Architect, P.C. EAST ELEVATION (PART) SECOND 5TORY ADDITION EXI5TING ACCEPT AS NOTED 205 Bay Ave. Greenport NY admin@talrweather-brown.com G3 1 -477-5752 John Bredemeyer, President �o0fF04te Town Hall Annex Michael J. Domino, Vice-President °° °ay 54375 Route 25 Glenn Goldsmith ti P.O. Box 1179 A. Nicholas Krupski • Southold, NY 11971 Charles J. Sanders y�o! ,� �a°' Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: / 1� / 6 Robert Brown Architects on behalf of BRUCE ROTHSTEIN requests an Administrative Permit to remove and replace existing deck with a new 286sq.ft. deck attached to seaward side of dwelling. Located: 7390 Peconic Bay Boulevard, Laurel. SCTM# .1000-126-11-11 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound », Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland, Coastal Erosion Amendment Administrative Emergency - Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable 'Info needed: Modifications: Conditions: aj- Present Were: /JBredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Bay Constable Other Form filled out in the field b Y Mailed/Faxed to: Date: SURVEY Or: pd DESCRIBED PROPERTY SITUATE LAUREL, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. ( Q � i SURVEYED FOR: BRUCE M. ROTHSTEIN &t SARAH E. ROTHSTEIN 4 O Z7 t GUARANTEED TC. i BRUCE !7 ROTHSTEW SARAH E, ROTHSTEIN COMMONWEALTH LAND TITLE INS, CO, UBS ;dORT(ftSE LLC � 4 unurr'PME UL 37A GRAVEL DRIVEWAY Wfn7A5F.R CURswo x, c NERA70R 9s 35.3' p mom-GARAGE t r L I OCT 1 4 2015 G SLATE Southold intro "T I 2--STORY `n RESIDENCE m I T 2' n 'D A WOOD_DECK srEr v WIRAILING m (r m G1 CA V GUARANTEESIAI=TEDNEREON'SHALLRUN ONLYT4277FPER"ONFORLV"7 UTVESURVEY O7 IS PREPARED,AND OVHIS SEHALF TO THE TYTLE C04P4NY,GOVERNMENTAL AGENCY, LFXOfNG(i'SRTUTION.IFLSTEDHEREON AND TO 7HEAMVNEES OF 7HfLENOAVG INS 7T MON GUARANTEES ARENDT7TWISFERAOLE TO ADORIONAL INS17TU77ONS OR SUSSECLAFNT CKWERS UNAUTHORRFDAL TERA MNCFSSCTM72090 OTN/S SYIRVET'LsA?KS?ATONOFSECTNL W DF •,��f � 7NE NEyYYOVXSTATEfOUCATIONUW C.O9'ESOF777ASSVRVEYAGVNOTSEARRJG ..,��,.*'�' ,s•- THEL.LVOSURVEYOPSENSOSSEDSEAL SHALL NOTEEOONSDEED TO EEA VALD TRUE COPY M FENCE C4 L&d+GUEAST SURVEYED: 23 AUGbST 2005 SCALE = 30• AREA = 29,677 S ' JR 0.681 ACRES SURVEYED BY STANLEY J ISAKSEN, JR. P,O. Bb .234•Ltd- NEW SUFE N.Y, 11956 631-734,,5835 " sEti' Q 05R?Lud f- myi/a aDaD � O' MATLN \/ SEE SEC NO 1 -- 22 R LINE v MATCH LINE --FOR PCL NO --.— S �16 F SEE SEL NO 6 1T 22070066 ,yb 5 28A(c)'S u ^`♦ °. 3° •a T Q QO MATTITULK / PARK DIST p �� �,..,P6 ;`�.' + a2 $ may\ �✓'` $.`.°`° ♦♦ #` MATTITU PARHC 214A(cl r b DIST 12B 13 5, '.0 w�, 6 �\. M1- y�m ° w 0 w � 115A(U a 4✓ / °o 7 %63• 6 b yi O yp T15p Forton Creek / 0P•l ''SI.J.o` y„ ,t G� ,♦ w e s` 201 201 3�°F�"° ,•P+_'ba'.', c� M'`, �l e� O e 4n. .r a^"fi �♦L :, 164` m ep Q6 Fl -``G p`,A'b 1' q♦ m 4er• 10 a, a ,4,.n>,`�` y > Oe SEE SEC NO 131 i ,!pip,e*`4,%ga 2° �� e,te• 5 3 °' .+, 'nro`43 �� s ,9 6 5 / Q Q I° � `°p,3 P� ♦�fi�V.^6 2 �3F y' /� `4j p' ,b�'9 //3 * 1. FOR PCL NO `,d K ♦ p 7 •O �y ' q / q SEE SEC NO q,�s p�`•+ ^. 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Main Rd. &Youngs Ave.) Southold, NY 11971 �� Telephone: 631765-1938 ®lyc®UNT`I LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD "j MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: January 14, 2016 Re: Local Waterfront Coastal Consistency Review BRUCE ROTHSTEIN SCTM# 1000-126-11-11 Robert Brown Architects on behalf of BRUCE ROTHSTEIN requests an Administrative Permit to remove and replace existing deck with a new 286sq.ft. deck attached to seaward side of dwelling. Located: 7390 Peconic Bay Boulevard, Laurel. SCTM# 1000-126-11-11 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. BOARD MEMBERS �F S (/j Southold Town Hall Leslie Kanes Weisman,Chairperson O�� yQl 53095 Main Road-P.O.Box 1179 ti O Southold,NY 11971-0959 Eric Dantest Office Location: Gerard P.Goehringer G Q Town Annex/First Floor,Capital One Bank George Homing Q io 54375 Main Road(at Youngs Avenue) Kenneth Schneider CQ��(,� Southold,NY 11971 http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel.(631) 765-1809-Fax (631)765-9064 FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF DECEMBER 17,2015 ZBA FILE: 6901 NAME OF APPLICANT: Bruce Rothstein SCTM#1000-126-11-11 PROPERTY LOCATION: 7390 Great Peconic Bay Boulevard(adj. to Great Peconic Bay)Laurel,NY SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated Nov. 23, 2015, stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated Nov. 30, 2015. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation that the proposed action is EXEMPT from Coastal Consistency Review. PROPERTY FACTS/DESCRIPTION: Subject property is non-conforming with 29,677 sq. ft. located in a R40 Zone. It is improved with a two story single family dwelling. It has 100.00 feet of frontage on Peconic Bay Boulevard, 337.66 feet along the eastern property line, 103.06 feet on Great Peconic Bay and 345.35 feet along the western property line as shown on the site plan prepared by Robert I. Brown,Arch.Dated Sept. 30,2015. BASIS OF APPLICATION: Request for Variance from Article XXIII Section 280-124 and the Building Inspector's October 21, 2015 Notice of Disapproval based on an application for building permit to construct a second story addition to existing single family dwelling, at; 1) less than the minimum code required side yard setback of 15 feet. RELIEF REQUESTED: The applicant requests a variance to construct a second story addition to a single family dwelling having a side yard setback of 11 feet where the code requires a minimum of 15 feet. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on December 3,2015, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property Page 2 of 3—December 17,2015 ZBAH6901—Rothstein SCTMH1000-126-11-11 and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law §267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. Two story residences are characteristic of this neighborhood and the proposed second story addition will be at the same side yard setback as the existing second stories. 2. Town Law 4267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The residence exists at a non-conforming 11 foot side yard setback;therefore any proposed additions will require a side yard setback variance. 3. Town Law 4267-b(3)(b)(3). The variance granted herein is mathematically substantial,representing 27%relief from the code. However, the substantiality is mitigated when considering that the two story dwelling exists at an 11 foot side yard setback and the proposed second story addition is only approximately 320 S.F. and will not be any closer than the existing structure. 4. Town Law &267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law 4267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a second story addition, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Schneider, seconded by Member Goehringer, and duly carried,to GRANT, the variance as applied for, and shown on the site plan dated Sept. 30, 2015, and the architectural plans labeled A-1,A-2,A-3, dated Sept.30,2015 prepared by Robert I. Brown,Architect. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s)granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3) years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one (1) year terms. Page 3 of 3—December 17,2015 ZBA#6901—Rothstein SCTM#1000-126-11-11 Vote of the Board.- Ayes:Members Weisman (Chairperson), Schneider, Dantes, Goehringer. Member Horning was absent. Resolution as duly adopted(4-1). Leslie Kanes Weisman, Chairp rson Approved for filing /Z//Y /2015 1. John M.Bredemeyer III,President ��®F S011lyo Town Hall Annex Michael J.Domino,Vice-President �0 l0 54375 Main Road P.O.Box 1179 James F. King,Trustee JW Southold,New York 11971-0959 Dave Bergen,Trustee G� ® �O Telephone(631)765-1892 Charles J. Sanders,Trustee �OIyCOU - Fax(631) 765-6641 BOARD OF TOWN TRUSTEES n TOWN OF SOUTHOLD To: Southold Town Building Department 15 2015 . OCT Re: Verification of Building Department Permit Requirements SCTM#: 12 A� Property Owner Name: ' k V6F RGri - �t N Date Sent to Bldg. Dept.: 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 Budding Permit? Will the proposed project require a variance determination fr from th6Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: C ^ Signature of ewer Date so John M.Bredemeyer III, President Town Hall Annex 54375 Main Road Michael J.Domino,Vice-PresidentL ,. P.O. Box 1179 mr "i"U«. James F.King,TrusteeSouthold,New York 11971-0959 Dave Bergen,Trustee Telephone (631) 765-1892 Charles J.Sanders,Trustee x. �° Fax(631) 765-6641 BOARD OF TOWN TRUSTEES F TOWN OF SOUTHOLD i; Office Use Only So F:4e _Coastal Erosion Permit Application 1 Tai:-n Wetland Permit Application Administrative Permit —Amendment/Transfer/Extension Received Application: 16,141S' $ Received Fee: $ 1 t7DI ---Completed Application: _Incomplete: _SEQRA Classification: Type I Type II Unlisted �Coordination:(date sent): y „LWRP Consistency Assessment Form: ! CAC Referral Sent: 1/ Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: ,l Public Hearing Held: 11491151, Resolution: Name of Applicant: 40 Q.�1 "�;&W L ANS 1 IVW4A1_-'Z-0 Ak/ I l0 Mailing Address: n Phone Number: 65t — 4- 27 — 9 752 Suffolk County Tax Map Number: 1000 - 116 Property Location: --7390 P ELR�b2 x_ - 6A Y 6�t jb L-A J��y`� 11946 (provide LILCO Pole#, distance to cross streets, and location) AGENT: ZOA1 P t TET (If applicable) Address: ? ✓+2� ~��T 11 q'1 Vy / Phone: 31-_V 77-q7S 2 "Lrd of Trustees Applicati,J!' GENERAL DATA Land Area(in square feet): 24 , 677 SOW A&& Pfr Area Zoning: 4 0 Previous use of property: Intended use of property: Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _1, Yes . No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes 4No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date _I J No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ?� No Yes If yes,provide explanation: Project Description(use attachments if necessary): 5 EcoAd0 S-F—ba-1 . P�pp�i lots -� - ir�►s'i-iN(� �r�l�-r g-�%�.y �6LvvrVtz.� � t� tL�u��i� �G�Ci. pa�C G f E-QJAILiNG - 54.1A&4-r F-do9Nuf - J(-' Z�G ,r r Mrd of Trustees ppplicati'-- WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: Aopas ,jt-,. --(1,z3vc.,et � una-00W\ Area of wetlands on lot: 4/ square feet Percent coverage of lot: — % Closest distance between nearest existing structure and upland edge of wetlands: '73 feet Closest distance between nearest proposed structure and upland edge of wetlands: 6 ` 1n`t feet Does the project involve excavation or filling? A No Yes If yes, how much material will be excavated?_ . [� cubic yards How much material will be filled? _cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed,or deposited: 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): 6g mac - 7t:;Coi-�/3azi<W D 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 Name of Action or Project: 01-11 S , P -SMIEVIX.4ck�J �Tto/J Project Location(describe,and attach a location map): 7310 Paz.or-tc. &Ln_mf LAiQ 04 119 8 Brief Description of Proposed Action! SEz.DwM S-T X,-v A0011-110N T- exis7 1 STviLy sLA.AJW P,(to F 13A c*— Q zK i=QiP L.,ti.r (- tia.,Aad: Name of Applicant or Sponsor: Telephone: 631 4b t5 �' -1- ��o wAl ,/ .Lm E-Mail: Address: 7-o5 6A-t -Ave-),j-c GnZevno2-r W City/PO: State: Zip Code: NJ I l 9 `i '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 [ D 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: 1 0 3.a.Total acreage of the site of the proposed action? 76 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? s7 b acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban []Rural(non-agriculture) ❑Industrial [:]Commercial (Residential(suburban) El Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 4 5. IS the proposed action, J,,'/ J / NO YES (N//AA a. A permitted use under the zoning regulations? GG%� �cJU` a Vav,% z1x 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? 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: 10_ 0 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO (Y�E` 1ZS 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? M 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:. I 11.Will the proposed action connect to existing wastewater utilities? NO. YES If No,describe method for providing wastewater treatment: __ ❑ ' 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 01 EJ I b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies re ul ted by a federal,state or local a ency1:1 Ta ? iT- ��l c b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? El If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: _ 14. dentiPy the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: IN Shoreline ❑Forest ❑Agricultural/grasslands []Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? C91 1:1 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 storm Water discharges flow to adjacent properties? ❑NO YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: F1 NO []YES Page 2 of 4 18 Does the proposed action include construction or other activities that result in (lie impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 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: . _ El 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 THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: A .Sioo Date, 28 5LWntmAas �iS Signature; _.� rt 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 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? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? ?.—..1 El 5. Will the proposed action result in an adverse change in the existing level of traffic or 1 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: i❑ a.public/private water supplies? b.public/private wastewater treatment utilities? El 8. Will the proposed action impair the character or quality of important historic,archaeological, (� architectural or aesthetic resources? t—! 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage —� problems? IL 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. Check this box if you have determined,based on the information and analysis above,and any supporting documentation,' that the proposed -action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town'of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 --_ )ard of Trustees Appliaati_w AUTHORIZATION (where;the applicant is not the owner) I c LG �-rh/ST _residing at (print name of owner of property) _ (mailing address) r- � .�/.�7. = /T�✓�� do-hereby authorize A&2`� '.. (Agent) G , ���t 'J2 to apply for permit(s)from the –�-- ,— . e Southold Board of Town Trustees-on;my behalf.- (Owner's signatureX -_!ard of Trustees Applicati&.: AFFIDAVIT, 3 R u C R o TN ST&d P✓, BEING DULY SWORN DEPOSES AND AFFIRMS THAT;'HEMIE 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 IOR 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'. Signature of Property Owner SWORN TO.BEFORE ME THIS o2�1 DAY OF n, 2015 Not Public— , kBURDICK Notary Public Stc!e of Connecticut " My Commission Expires Jan:.31,2016 APPLICANUAGENUREPRESENrATIVE TRANSACTIONAL DISCLOSURI$FORM T to w 'of aid' 'Ca Etli' inhibi't's' fl' " af'n# f i rt 'f rti iec ane to s of s f necessary to avoid same. YOUR NAME: (Last`name,first name,piddle 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 VarianceTrustee ,—_ Change of Zone Coastair 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)havea relationship"with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,,or business ihteri st'4)3ttsiness interest"means a business, including a partnership,in which the town officer or employee has even a partihl'dwnership of(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 applicant (when'the applicant is acorporation); I3)the legal orbeneficial 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 2e day of S� , 200 /S Signature 7q, — Print Name �l ytt v ,0 p.,- Form TS l Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answerniust,-be-.explaine''d in 'detail',-titingt both �Mpport'ing an`d:non- supportin.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 at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# I16 - 1( Oil PROTECT NAME12�S1 A c.E lh Q A�-r o N The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. S� Board of Trustees 1. Category of Town of Southold agency action(check appropriate'response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation,land transaction) ❑ (b) Financial assistance(e.g. grant, loan,subsidy) (c) Permit, approval, license, certification: Nature and extent of action: 5Et4b."D 5—JbQ-,Y. �J ie3 1.3 SiNbLE S'iU;L7 rh? 6AA;tu)AK0 Re -WAC,�r VAcTM civ c7� ,�EIUO t� 5-Moyi-uR E Ahln S�kJflgLts �',A L•� o�� Z.d6 ..��' Location of action: 7 3�i o~ (tri x- Ay 8-v4 11 T 4& Site-acre4p-. Present land use: AESJ u r1A(- Present zoning classification: (Z-Ha 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: f o;3!�ILT :T- Anaw" Aat"m--, ArJO A6 (b) Mailing address: loAvI-vC (, ,poz— N1 ng qL4 (c) Telephone number: Area Code( . --_ (631 - 4-77 - v"75.2 (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 federaLagency . 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. F]Yes No cRNot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria F] Yes 1:1 No'N] Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and- protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for'evaluation criteria ❑ Yes ❑ No 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 LWR'P Section III—Policies Pages 8 through 16 for evaluation criteria Yes NoN Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through-21 for evaluation criteria- ❑ Yes n No ENotApplicable 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 App ble 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. 0 Yes n.NoN Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LAW Section III—Policies; Pages 34 through 38 for evaluatiop criteria. C] 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. 0 YJD No n.Not Applicable Attach additional sheets if necessary WORDING COAST P®LICIE' Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. F] Yes [:1 No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. "Ek❑ Yes ❑ No Not Applicable Attach additional sheets if necessary' Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. 1:1 Yes El NolSkNot Applicable Attach-additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III--Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY g�-iAu S,p,2 TITLE A 6gvr DATE 9 12,6 zvi S