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HomeMy WebLinkAboutTR-8720A Glenn Goldsmith, President ®F S®U/'� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 e0UN11,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 2076C Date: September 8, 2023 THIS CERTIFIES that the existing 615sq-ft second-floor balcony• and installation of three new columns to help support the structure; At 360 Bayview Drive,East Marion Suffolk County Tax Map#1000-37-4-1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 31, 2015 pursuant to which Trustees Administrative Permit#8720A Dated January 20, 2016,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for existing 615sq ft second-floor balcony; and installation of three new columns to help support the structure. The certificate is issued to Paul&Diane Goleb owner of the aforesaid property. Authorized Signature 8,zz.z3 Glenn Goldsmith, President � S® Town Hall Annex A.Nicholas Krupski,Vice President +`® ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly CO- MA Telephone(631) 765-1892 Elizabeth Peeples ;;' ® a® Fax(631) 765-6641 00 Wn BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: v 4�-ZzrZ4 INSPECTED BY: �'�` Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection COMMENTS: 7 20A CERTIFICATE OF COMPLIANCE: L�� ✓ = ' (rt ,,,,,,,, John M. Bredemeyer 111, President ,0' skIFFOL,I, Town Hall, 53095 Main Rd. � �G Michael J. Domino, Vice-President P.O Box 1179• ���� ' �1 o t James F. King Ir v 11971 W ; Southold, Charles J. Sanders ss.y 0��1 Telephone(63E)765-1892 Dave Bergen - Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO.CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. • • INSPECTION SCHEDULE Pre-construction, silt fence 1st day of construction '/ constructed t/_ Project complete, compliance inspection John M.Bredemeyer III,President oo� ��®� With Town Hall Annex Michael J.Domino Vice-PresidentO # R l® 54375 Route 25 J 3 P.O.Box 1179 Glenn Goldsmith u, ptt Southold,New York 11971 A.Nicholas Krupski `` X �Q ��, Telephone(631) 765-1892 Charles J.Sanders -4y`,®U .�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8720A Date of Receipt of Application: December 31, 2015 Applicant: PAUL & DIANE GOLEB SCTM#: 1000-37-4-1 Project Location: 360 Bayview Drive, East Marion - Date of Resolution/Issuance: January 20, 2016 Date of Expiration: January 20, 2018 Reviewed by: Trustee John M. Bredemeyer, III Project Description: For the existing 615sq.ft. second-floor balcony; and to install three new columns to help support the structure. 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 December 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. r John M. Bredemeyer, Ill President Board of Trustees :� , BASED ON: SURVEYED BY ' RODERICK VAN TUYL, PC. ' AREA = 14,378 SQUARE FEET , / I/ t o c�a sip„ A '' . 'Pm //// ATF 'Pp16 "\k-.A.., I . , , - , , w ,� rmilcD �2 co .APPROVED BY o _ , , j T W — =_,- _ BOARD OF T RUSTEES.-r. : , .--.---\ -:---4,,:': TOWN OF SOUTHOLD` '` 1 I .°. E�-5 /:'_=e ING U�aDE= THE - +I F ;. 5 �a9, d ?/ ' 4 SL" :q F"PiuFA IN i,ear-` p;-- t -:osp-�izED .�� Iiii \ c0 "j' l`uy.r` : , "`;�*_y ;,A'Iff fRD{�p CE PROPOSED '( �' S� COLUMNS UNDER ivj",M • p EXISTING DECK GOLEB IBESiDENCE N O \ j��� �S 30DCMB2015 97\ �� �o, SCALE: I " = 20' _ �/ �° Robert I . Brown ,,• ��A _ N PROPOSED ,'�� , -._�_� :: ry•--.-� 0� N COLUMNS UNDER _ _._, _ 1) Architect, P.C. cm EXISTING DECK Fairweather `��% z n P��Q I DEC 31 2015 , '�P i Design Associates, Inc. 20' ± J�°��`��° L�._ _ _ _ -,,,,,,„,, y , ,.Q _ 205 Bay Ave. Greenport NY TO sllo-ELINE co� info@ribrownarchitect.com 6o' ± 63 I —477-9752 NEW WINDOWS NEW WINDOWS REFRAME AND REFRAME AND PATCH PATCH AS SIDING AND TRIM AS ta SHOWER NECESSARY g B NECESSARY HEAD res e . wnCON,5C1-1E.LE .ores . tass c Lwow ` /FAUCET o '.55". ;'.r... ... Pam. , NEW WINDOW • © REFRAME AND PATCH 43, SIDING AND TRIM AS •ru, KIM a> 0 NECESSARY \ x .,.aawa.a=,,,,..,.a.o W.crasc.. 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S'M'3"x`6lnR E.••�k'�9 y,'gg O r , IXISTINGGSGCOLUMNS -. .,======z_7=:::-...:-_-==:,--_==���^^^- REMOVE CEILING --x° P'^�_S; rr iq""7 UNDER gH 1 // // CAD w/PAINTED WOOD REMOVE EXISTING — \ O NEW PROPOSED ] = Fz `C ` T NEW WINDOW FILL IN 1 LINE OP CEILING ;- 1YC S r>; s:9 ill p D [.,� 36°TALL ISLAND QT ` OPENING PATCH @ DROP ' G 1�'� &+e 4•3n5 9� 1 NEW 3°X 8°EXPOSED DRE555ED COLLAR TIES 48.0 C _ r: _....... - /PAINTED WOOD aP ` ' :r L[gym+3CLOSET TO MATCH EXISTING eA -, TO k1.Try,s�'a Y> N' $COUNTERTOP2668 y >o I TINDICATES NEW FRAMEOO • ,r _ �'2�Tf°~'SR ._17\ _111 Q REMOVE CARPET PROVIDE STRIP 1--_1..." C° ti.,i-•;-"SI':F.-_ 310F�.EZED CONSTRUCTIONr"''. - U i///� IA _, WHITE OAK FLOORING WITH 3e '^<a^-S i I a j `t'F`€Cr:: T w F COAT POLY FINISH THROUGHOUT --. 12'-IC Irl° 5-3 1/2" I i-5' THIS FLOOR LEVEL 6' me-.° .6 ey. a - b —1 I I 1� J Q __..._......._�..—_......_.____.__......__.w © E'%T. .r-' P = r.b`i:.P�.T.-s�+AND!'��F�'y (-e_' F9,' ti nt -.!ACVORDAN.E EXISTING WINDOWS EXISTING OFFICE 1 NEW SLIDING DOOR REMOVE EXISTING EXPOSED TRUSSES,PATCH CEILING, REPLACEMENT WINDOWS �Y,j_ - "'T-T r"C rH 3r.T REMOVE EXISTING PANELLING REMOVE EXISTING PANELLING I ,f?: ®E.�-_1.1. W. REPLACE WITH DRYWALL 'T REPLACE WITH DRYWALL TO REMAIN REPLACE WITH COLLAR TIES AS SHOWN © REFRAME AS NEC / W; Ti-: WINDOWS No EXISTING WINDOWS TO REMAIN — TO REMAIN rl 15 I4 1 - 1 GOLEB RESIDENCE �fORT ❑ I EXISTING CANTILEVERED DECK FOR € © © © "© • © . ©`, II I EXISTING WINDOAiO' NEW DOORS IN EXISTING OPENINGS TO BE EXISTING WINDOWS NEW COLUMNS TO MATCH EXISTIN9 ONS SO CAN'BLOCK EXISTING WINDOWS REPLACEMENT WINDOWS 3 0 DECEMBER 2015 TO REMAIN ENLARGED BY CUTTING WALL TO FLOOR LEVEL TO REMAIN PIERS ON 2'z2k I'D POURED CONCI FOOTINGS TO REMAIN REFRAME AS NEG REPLACEMENT WINDOWS @ MIN 30 BELOW GRADE 1 REFRAME AS NEC II' SCALE: 1/811 = l '0" EXISTING DECK - EXISTING DECK Robert I . Brown Architect, P. C. -----� - LINE OF DECK ABOVE LINE OF DECK ABOVE 1 Fairweather 1 2,2.I2PT - Design Associates, Inc. \, GIRDER f NEW STRUCTURAL SUPPORT FOR \ / \ EXISTING CANTILEVERED DECK /�4\ NEW COLUMN5 TO MATCH EXISTING [.. ON N°GONG BLOCK 205 Bay Ave. Greenport NY PIERS ON 2'z2k I'D POURED CONC FOOTINGS @MIN 36'BELOW GRADE -/' Info@nbrownarchitect.com LOWER LEVEL �� UPPER LEVEL @ EXISTING EXCEPT AS NOTED EXISTING ACCEPT AS NOTED 63 I -477-9752 s . \ NEW WINDOW REFRAME AND PATCH SIDING AND TRIM AS SIDING AND TRIM AS SIDING NECESSARY [ I NEW WINDOW TO REPLACE EXISTING NEW WINDOW REFRAME AND PATCH REFRAME AND PATCH AND TRIM AS NECESSARY NECESSARY NEW WINDOW REFRAME AND PATCH NEW"'DOW SIDING AND TRIM AS REFRAME AND PATCH REFRAME AND PATCH NECESSARY SIDING AND TRIM AS SIDING NPCPSSARY NEW WINDOW AND TRIM AS KIFfFSSA,RY , - .±-. ... . i I EXISTING DECK PATCH EXISTING SIDING AS NEC PATCH EXISTING SIDING AS NEC I ,- f I - . \ / ,. . EXISTING SLIDING \ -- - NEW COLUMNS NEW COLUMN WINDOW TO REMAIN ,,,- . \ / N -- N / \ NEW 3068 EXISTING DOOR TO ENTRY DOOR REMAIN PROPOSED EAST ELe :: EVATION .._ ..C"\--' c..EkT L EXISTING ACCEPT AS NOTED 1 4 ,,_-..:^ , ' )1 \ 4- \ ET IS A ViC LATION OF THE LAW FOR ANY PERSON', UNLESS ACTING UNDER THE - DIRECTION OF A LICENSED ARCHITECT TO ALTER ANY . • '<.-‘4-;'''.-: r-.'' ITEM ON THIS DRAWING IN , AN!WAY.ANY A,.TH 0 R IZED :ersieursesiarra- isreranerWI'- ALTERATION MUST BE aammarrailas. iarararrearzesew- NOTED,SEALED,AND 1.1.1'1'1'11'11' 1.1 I I I P- a DESCRIDED IN ACCORDANCE I,- 111`;.Tii THE LAW. - thit4i 1.- EXISTING HALF MOON .- WINDOW TO REMAIN GOLEB RESIDENCE u - 30 DECEMBER 2015 - _ :INEN,,,I(IRSETP,IggriTNIG.MSINDOWS ii ill NEW REPLACEMENT WINDOWS I SCALE: I/8" = l '0" IN IXISTING OPENINGS EXISTING WINDOWS TO REMAIN REFRAME AND REPAIR REFRAME AND REPAIR SIDING AS NECESSARY SIDING A5 NECESSARY .... .. • J 1 _I II Robert I . Brown Architects 1=1.C. i EXISTING SLIDING EXISTING SLIDING - - WINDOWS TO REMAIN WINDOWS TO REMAIN fairweatlier , NEW DOORS IN ENLARGED OPENINGS ANEW COLUMNS Design Associates, I n c. PROPOSED SOUTH ELEVATION , EXISTING ACCEPT AS NOTEDLE205 Bay Ave. Greenport NY info@nbrownarchitect.com G31 -477-9752 r John Bredemeyer, President �,ofFott Town Hall Annex Michael J. Domino, Vice-President ,,.4e 54375 Route 25 Glenn Goldsmith y ? P. O. Box 1179 A. Nicholas Krupski •1y ' • ,+ Southold, NY 11971 Charles J. Sanders Ol * Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: /I :� : �� �� Robert Brown Architect, P.C. on behalf of PAUL & DIANE GOLEB request an Administrative Permit for the existing 615sq.ft. second-floor balcony; and to install three new columns to help support the structure. Located: 360 Bayview Drive, East Marion. SCTM# 1000-37-4-1 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: �)� (� peAM/ (Ail /2 ZModifications: � ✓ , Conditions: Present Were: Bredemeyer M. Domino y o o G. Goldsmith N. Krupski _ C. Sanders Bay Constable Other Form filled out in the field by d—TM B,- dgp 2 eY Mailed/Faxed to: Date: 1^ { I ‘. f ,7 ,O „ i • ". . piot] � 0 S . .� , I I t"K4, 'iT AI to 4)k 4.1 l• 1104‘!' ' ' 1: . 11, ,cr...41,..1` ,---R / \ ) D.' .5144, V .....-- . /, LOCATION MAP • ZONE• g.-42 j ; -...- DAV VI S o oeiyE 1n r1- T • — - • .4o D' 3476• ---I \ I on.r;• - ---- - oA,p�,^ y I Sear tovn--iii-- I /9. ' or' '71 ¢ItWAgO biB6A51• MO f5A/vl Cif Dfc Y rrrROVED All PER TEjs it : b0 ) • i1 Diii 712E/0y KSA, , i_ _ . ro• BUR.ONB SUPPLIES TO BE DELIVERED TO REAR OF PROPERTY O - ' !r �- _-._.- -._ PROPOSED ROOM TO BE iitA.T ON DECK,NO DISTURBANCE OF SOIL. - ••�y - ,. �^ eoNo�KL. Yc�•/ -•-•K. '5•4;0, �� P I ! ms, ,/ •_,C1-411relJ VI LLQ 3' g(yn t3/W•/VIEW Or.,va 5peiuE roHU PLOT PLAN -- ILAICE-J A- A P.:.0=, -IL. p. • COM 5U LTIFIF =,1 '.1.JFEk.- SCALE:1'=40' pogo,- lon 7e•7. :r,'. LANE DATE' MA/I2 ZOO4 JDw 1.1.2. 1 5203 -�l� �� ' \ lir `� i _� (-- •.1.-.. -. • ---t •,.- ....,,, • ,A,„,,i;",,aman 4'.A %it: ,'''..: i'..4- 7� 104.,,,,‘t, •• i r ;Ni "�11t, � lCNtid�i� V UC (, ..,v,-. ' . T • - ,,.:. t„- . _ :: J1.- Board Of Southold Town Trustees , w SOUTHOLD-h..,," , NEW YORK D 7' PERMIT NO. / ® DATE: Feb. 25, 2004 :-...., Y d♦ .141- ` ISSUED TO RICIIARD DIBLASI ..k: • ..i's;.:7 f7 ; 1 ,uitiurizatir i 4;.:....,*, M.: ` Pursuant to the provisions of Chapter 615 of the Laws of �` 1; the State of New York, 1893; and Chapter 404 of the Laws of the '".-- ,„ "-1 State of New York 1952; and the Southold Town Ordinance en- • titled "REGULATING AND THE PLACING OF OBSTRUCTIONS -; ' I _„ IN AND ON TOWN WATERS AND PUBLIC LANDS and the kT.:' a : '=° f: REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM ;= ' ` 1 N LANDS UNDER TOWN WATERS;" and in accordance with the AP'`? '` is ' Resolution of The Board adopted at a meeting held on Feb. 25, k r 2004 , and in consideration of the sum of $ .209.00 paid by r.: ,a • Richard DiBlasi Y:' �• East Marion j ^ .� ;/; of ... .. . . . . N. Y. and subject to the 14 .-. . Terms and Conditions listed on the reverse side hereof, •.< :; ;4.` of Southold Town Trustees authorizes and permits the following: $ t„ ',_ �' t Wetland Permit to add a one-story room on the existing deck, a': � •' f . M b'X 12', with the condition drywells and gutters are installed ,, to contain the roof run-off, and as depicted on the plan 3.:. ' : '' prepared by Warren A. Sambach Sr. `' r. last dated March 10, 2004. 1,. 1I! " all in accordance with the detailed specifications as presented in " the originating application. , -• ,,—,..4...... { f ', IN WITNESS WHEREOF, The said Board of Trustees here- ' k\'?': � by causes its Corporate Seal to be affixed, and these presents to ►�- be subscribed bya majorityof the said Board as of • . this data. _ ' 7 tl k •.� { • '� St.. lArtie Foster (absent) �`: ! l }• 0..�o '401' Trustees yy " . ,1 t e ► r -7... .:12...,::‘,::_ ,: i., re' t . 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) ca �r Southold,NY 11971 � A®7 �� Telephone: 631 765-1938 lec®UNri xt '� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD 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 PAUL & DIANE GOLEB SCTM# 1000-37-4-1 Robert Brown Architect, P.C. on behalf of PAUL & DIANE GOLEB request an Administrative Permit for the existing 615sq.ft. second-floor balcony, and to install three new columns to help support the structure. Located: 360 Bayview Drive, East Marion. SCTM# 1000-37-4-1 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, the action is recommended as CONSISTENT with the Policy Standards and therefore is recommended as 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. -- 1. /ow, //i ice,- ' John M. Bredemeyer III, President ���o��®� SOUT�o Town Hall Annex O ..1:-,;-•' l 54375 Main Road Michael J. Domino,Vice-President '` •��.it?'r ;,' ';r?» •...''': :.til . ,mss • P.O.Box 1179 James F. King,Trustee t ?- >,': :`• l'78" % Southold,New York 11971-0959 N ray :N,-,.:•,:!.:'r Dave Bergen,Trustee � Gf, ' :� r` �• Charles J.Sanders,Trustee `. 'Q -• ... •... �O�I� Telephone(631) 765-1892 IyCDU �io Fax(631) 765-6641 ..---••., .. 01. BOARD OF TOWN TRUSTEES - ' TOWN OF SOUTHOLD 1 iII To: Southold Town Building Department 1 I !L1 JAN - 1 2016 L.' Re: Verification of Building Department Permit Requirements SCTM#: -4-i Property Owner Name: ' Date Sent to Bldg. Dept.: 1, L'/to 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 tr2lae—Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: • 0////6 Signature of R vi wer Date { //,,/, iii i..__-, • John M.Bredemeyer III,President 1Ols.c �o.. SO ��"0, - Town Hall Annex Michael J.Domino,Vice-President ~ O ` 54375 Main Road P.O.Box 1179 James F.King,Trustee ����, . . Southold,New York 11971 0959 Dave Bergen,Trustee *:411:‘'.--;e' `vn'LL* � �� Telephone (631) 765-1892 Charles J.Sanders,Trustee ;��CQU � / Fax(631) 765-6641 ot BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application _ Wetland Permit Application Administrative Permit _.,_/Received Amendment/Transfer/Extension l/ Received Application: I 2.3l./.5. �-, Received Fee: $ ',0?J A-s-P tHL-T '! ., . • - ___._..._....____.....___.. .7—Completed Application: 12-3J,Is- II Ill Incomplete: L - DEC 3 1 2015 ' o SEQRA Classification: Type I Type II Unlisted 1 Coordination:(date sent): /'gj/� , --_.__..- _- — - _.-.... _ __ Vic...:::,,: ;� •� -�LWRP Consistency Assessment Form: 1 CAC Referral Sent: L�"' "" - I Date of Inspection: /6 111.11t2 ' Receipt of CAC'Report: _Lead Agency Determination: Technical Review: -Public Hearing Held: !i ZO /( , Resolution: Name of Applicant: --)34)/L- S GDLEI ( Mailing Address: 203 --)--- 1 LLJ ( /Y-_-__ ed . , Ms} Phone Number: WI —FOj --2.1-(� � `-) 20g- Suffolk County Tax Map Number: 1000 - 3-q- " ti-- I Property Location: 7 V-1,01,07)- 4Z )4440X) , ' (provide LILCO Pole#, distance to cross streets, and location) AGENT: 1 OttN 04-1-i-' r -P 7-',. 45r71 Ioe- 11 (If applicable) Address: 2e6- --ag- aez Dor )JJ' Phone: (D 3/ - 'i-- T 97I2— , quid of Trustees Applicati GENERAL DATA Land Area(in square feet): ) 1-1-13-q- . .. . Area Zoning: k— (, Previous use of property: SI - /, A i.C1,0',!1L. Intended use of property: 4 g L6 ./14:(1.,(1 7\e,SiGeaei--, Covenants and Restrictions on property? Yes A 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 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 X No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency D 74 SF-I-ID-00)0 W --Af-F6-2) P-' (6c9. 0 , . vt (ZAK() TAti-apti•- --Deplt--tEkrr ,,i(rvith/P I nta9:7- .— II Mi /qv (8,plaitadt-a- u.,UJ(P 1(- t b 1-03 n - 1 3170 15-- (p 'tl a C No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? /r' No Yes If yes,provide explanation: _ Project Description (use attachments if necessary): )46,t) nem) l (urn --& 4--T)zr� -e4-1 .chieLA ,k1 eenAcer_attoe i 1 e A &t:e ,ip 4e. a 41,, itt-PW-S7 s zL -3 iti,n .s-1 hi ( vorted zin X6 "tie) - ,ard of Trustees Applicati WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: ,, // fQciL( (IL/ Area of wetlands on lot: square feet Percent coverage of lot: (!) Closest distance between nearest existing structure and upland edge of wetlands: 60 feet Closest distance between nearest proposed structure and upland edge of wetlands: 6 a 1 feet Does the project involve excavation or filling? No ;\/. Yes If yes,how much material will be excavated? I i6c 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: l l Manner in which material will be removed or deposited: (r 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): �, ts Q'j -hdal 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing 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 l 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 I. 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 7-�-6pad, ehbet Pc as4164 a ads -Fe- 014, Name of Action or Project: Project Location(describe,and attach a location map): — e0Z31 6g4 )1(1004,Y1 ,Lytq Brief Description of ProposedAction: 6-i-atL 114,10 86-6,c/rt./LS,/,S 4 ' G b‘164-c- 6/s- -Pf ,3 P alae &lad�t 4 &A ur� - Name of Applicant or Sponsor: Telephone: LA_ gip E-Mail: l boo o ou (i1/l.(1fTi corn Address: f f? City/PO: State: Zip Code: GP [Pa Cr /19 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 F may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 3.a.Total acreage of the site of the proposed action? .3y acres s. b.Total acreage to be physically disturbed? NA acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? ,31-1 acres • 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban El Rural(non-agriculture) ❑Industrial El Commercial ,Residential(suburban) ❑Forest DAgriculture CI Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? 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: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES �1'�I ❑ 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? \] n 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: -Rt ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 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 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: �J 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 0 Wetland 0 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? a ❑ 16.1s the project site located in the 100 year flood plain? NO YES f'V 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? n NO nYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: 0 N nYES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)9 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: 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 n..= e: _4 A)� , A / / Date: /21)--Ibb - Signature: f 440 Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning 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)? 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? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 • ( i . No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. • n 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 e vironmental impact statement is required. i heck 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 environmentald7�impacts.` ` Town of Southold-Board of Trustees -- '/ /, Name of Lead Agency Date fV/f yJ e(QAM e A Cr President Print or Ty se Name of Responsible Officer inn Lead Agency Title of Responsible Officer dr _.77 .gnature of R sp nsi le fficer in ea gency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application AFFIDAVIT I M & 101. 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. • Or ignature of Pro Owner SWORN TO BEFORE ME THIS 2-q1+1 DAY OF —De.--C • ,20 ib f KRISTIANNA SAROGLOU Notary Public-State of New York 11"'A I A NO.01SA6160360 Notary Public Qualified in Suffolk County My Commission Expires Jun 22,2019 Board of Trustees Applicacion AFFIDAVIT Tctul C . C. ol-e.1) 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. Signature of Prope y Owner SWORN TO BEFORE ME THIS 2-91lin DAY OF . , 20 IS KRISTIANNA SAROGLOU I „, Notary Public-State of New York / NO.01SA6160360 '1 11 Qualified in Suffolk County Notary Public My Commission Expires Jun 22,2019 . .. .. . , „..,. _..,. ..__, Board of Trustees ApplicatLc,Ja AUTHORIZATION (where the applicant is not the owner) I, t e.., -4---2, 1 ' / 4 0 i " residing at_2( r14'..P1'1"CIY" (print name of owner of property) (mailing address) # i , A t c 4, .i LA,' 7 bly 0 Io hereby authorize ---Th -T" :I: ffID bx:1 (Agent) -M4.01 —. .(.2 ' _filiwI-_-11<, iir,e4F":--;NJ-14 to apply for permit(s) from the Southold Board of Town Trustees on my behalf. )c-car. (Owner's signature) . . APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold'=Code of Fillies prohibits conflicts of interest on th pa rt of tnwn officers and employees.The purpose of this form i3 to provide information which can alert the town of possible conflicts of interest 9 ncl rrfo w it to take whatever action is necessary to avow!same. YOUR NAME: • L(ot-� (Last name.first name,.�oiddle initial,Mess you are applying in the name of sor:one else or other entity,such as acompany.If.so,indicate the other per ='s or company'.ra:me) NAME Of APPLICATION: (Crock 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 (l#'°`Ot er`,rime the activity_) Do you perstuethy(or trough your cemimpany,spouses sihl:ng.parent or cl hl)have a Manor ip with any officer or employee of the Town of Southold? -Relationship"includes by blood,marriage,or business interest"Business iirteres-r"means a business, including a partnership.in which the town officer or-employee has even;a p rtra1 nert ip of(or employment by)a corp Lien in which the town officer or employee owns more than 5%of the cares. , YES NO If you answered-YES;complete the balance otthis form and date and sign where indicated, Name of person employed by the Town of Southold 0 Title or position of that person •- Describe the relationship between yourselfgthcapplicantfagentfref.+:esentative)and the town officer or employee.Eitherelteek the appropriate line A)though D)and/or descohe in the space provided. The town officer or cmp,o ez or his or her spouse,sibling,parent,or child is(check all that apply): A)tie outer of greater than 5%of the sl- of the corporate stock of the applicant (Ashen the applicant is a corporation); B)the teal orbeneficial owner of any interest in a non-corporate entity(wherr the applicant is not coroo a't3naat: C)an officer,director,partner,or employee of the applicant;;or Ii)t e ambit applicant_ DESCRIPTION OF RELATIONSHIP - — — _ Submitted this day of 200 ip Print Name Form TS I 7::7A ✓L C. G„, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.Thepurpose 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. YOUR NAME: (J� .( I11 (Last name,first name,.rp d le 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%of the shares. YES NO V 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 Il Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the Napplicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitte• thi 2 day of 2-1 2061 Signatur- Print Name ' 15A.49,0"/ Form TS 1 - APPLICANT/AGENT/REPRESENTATIVE 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.445\1 ,�,�, _ ,/� YOUR NAME: ��� V 7.2(1--7-4-7- 0A— (Last �i 7-4 10A (Last name,first name,.rpiddle 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 V 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 t an 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 10 k........„; Title or position of that person V 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 isi a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the Iv applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitte this /?ted of 2 20@ L5 Signatur L-. Print Name , . �0 z tA. — Form TS 1 • 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 answer must be explained in detail, listing both supporting 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 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# 51- - - - • PROJECT NAME—Paa 1 i aEs /'0�� i The Application has been submitted to (check appropriate response): Town Board Planning Board Bui ding Dept. Board of Trustees RI f40 ix oceut. . Category of Town of Southold agency cy 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 extentf action: iiykU / 'a) çuYL 5 JUS t'"'esei-ftavuks , ,J,, ,t le 2 Wu/�V �'�l �Q farl'asafe (d � � x ' 4,e L(' (�f Q'1 I &-4-ed / def - rte Location of action: Site acreage: , 34 Present land use: ci -- ,f ../ t(546/1-�`-(� Present zoning classification: - 4 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:'t�r".� .�OLAII �l.:.�'� � , /.�Al� � ti Jt:/ 5 �� 6066 (b) Mailing address:6rea - / , /044- (c) Telephone number: Area Code(. 1 - 437 -1i6d (d) Application number,if any: âUiIdMJf Z)C 4/4 ,c77:22 47-40-207---fraleafiri‘ 12s) Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes Noo If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria Yes No X, 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 N? Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes No 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 AI Not Apia__. able -_ Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes n No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See 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. Ye No ,i Not Applicable Attach additional sheets if necessary WORKING COAST POLICIL__ 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. Yes ❑ No MI Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes Nol4 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. Yes No ei Not Applicable PREPARED B,10111rA `� TITLE DATE1/4/4___ 40-r-ote," TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE , s� SOUTHOLD, NY �St 1 it rarrr * BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 40322 Date: 12/3/2015 Permission is hereby granted to: Goleb Paul C Revoc Trust 203 Tschiffely Square Rd Gaithersburg, MD 20878 To: construct interior alterations to an existing single family dwelling as applied for. At premises located at: 360 Bayview Dr., East Marion SCTM # 473889 -- - Sec/Block/Lot# 37.-4-1 Pursuant to application dated 11/30/2015 and approved by the Building Inspector. To expire on 6/3/2017. Fees: SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $620.00 CO -ALTERATION TO DWELLING $50.00 • Total: $670.00 Building Inspector . , , ,.1 _ . _ . , . . . L. - A. L.,Th - ' ' '- ' : L. . „ a ' T#11-:.:'. - , 0 0 , . pp.-, , . ,.... . „. . s,_. . . , , , . „ ., . . . . . . • _ . , , ., .. , , .... . , ,. , , s , . . , . . ,. . .. , . „ .. . . . .. . . .. ., . .„ s . . , , . . . , . ,, . , „ , . .. . ..., ,, , . . . ,... , . „ , . _ . .. . ., „ ,. . , . . .., . . . ...... ,,e . . . .. . . ,. . .. , , . .. „, .. . , . ... . . ., .. . . . , . , ........„ .. s , .. . . . „ „ , : . . s , 4, s . . " .. . . , . , . . ,.. ,. . , ,, , _ .. . . . , . . , .. . . s ... . ,. „ , .. ..,... . . . , . , , „ . . . , ,, . . .. , . „. , .. , , . . . . _ ,_ . , . 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I i ‘,..... .... , \...: „,,,,, \ , N., 0,., , , deao D V ','"'" , \ .. .'" , ' \ F..)4y vi e zu em-q-t1,42eioN, Ay ‘0. • - .....- \ .,-. 000-3-7.......2/_ 1 a \ / cr4A , . , ; --, 00 A \I \ \ \ \ 1 \\ \ \ \ k, •.5 -r\_,/, \ •,-,,,z,.. 3 z , in 'W:0* ..,• ,, Z \ '% ..."'''''''''' \,-, S.irf l -,' '',,,!...,..11•„\ t .... .k \ .--•••."''. "'" -':), e• '''s . 'r- / _ . $..! QA1 ..C., I i i -.• '''''''' ::'," SITE PLAN '"7,'2•:0;-;- ZE I"=20 ISTING CQNDMON5 EASED ON: 5U-RVEYED bY RODERICK VAN TUYL, PC. .... } ` t FORM NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. 's BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 18762 Z Date /14..! , 19l..2 Permission is hereby Igra�nted to: ea‘orov9letee .t aX ,k0-"ezg."0,;(eiti-e% -4(54 `g-3 4 to ked ...... doevigio,- aie .1441,4-1, atelf er0-44S-4-49actise "Acti,*(A1Z.,.' ‘57-e 0-71.71;436.8472:17tAteei ,R4.47....49 :11.c.erWe- eX(.04el4/e) County Tax Map No. 1000 Section $3.7 Block Lot No. pursuant to application dated . / 9 19 , and approved by the Building Inspector. /90 Fee $.. v /4"/-0 .48111I. .� uilding I .. tor • Rev. 6/30/80 ' FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20336 Date NOVEMBER 12, 1991 THIS CERTIFIES that the building ADDITION Location of Property 360 BAYVIEW ROAD EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 37 Block 4 Lot 1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 26, 1990 pursuant to which Building Permit No. 18762-Z dated JANUARY 29, 1990 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS. APPLIED FOR AND TO CONDITIONS OF THE ZBPi #3852. The certificate is issued to RICHARD DIBLASI (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A P47,1 - /6"2"/-‘z- uilding Inspector Rev. 1/81 ,,,, ''', N, „, qfair Southold Town Board ofAppeals � MAIN ROAD - STATE ROAD 25 P.O. BOX 1179 SOUTHOLD, L.I., N.Y. 11971 'i,It� TELEPHONE(516)765-1809 FAX No. (516)765-1823 APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS,JR. SERGE DOYEN,JR. JOSEPH H.SAWICKI ACTION OF THE BOARD OF APPEALS JAMES DINIZIO,JR. Appl. No. 3852 Matter of RICHARD DiBLASI . Variance to the Zoning Ordinance, Article III, Section 100-30A 3, as disapproved, for permission to construct open deck in front yard, nonconforming with bulk area and parking regulations in this R-40 Zone District. Property Location: 360 Bayview Drive, East Marion, County Tax Map No. 1000, Section 037, Block 04, Lot 01. WHEREAS, a public hearing was held and concluded on September 21, 1989 in the matter of the application of RICHARD DiBLASI, under Appeal 3852; and WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following findings of fact: 1. The premises in question is located along the south side of Bayview Drive, Town of East Marion, and is identified on the Suffolk County Tax Maps as District 1000, Section 037, Block 04, Lot 01. 2. this is an application for Variances from the Zoning Code Article 100-30A.3, for permission to construct open deck in front yard, nonconforming with bulk area and parking regulations. 1 page 2 - Appl. No. 3852 Matter of RICHARD DiBLASI Decision rendered October 4, 1989 3. Article III A, Section 100-30A.3, no building or premises shall be used and no building or part thereof shall be erected or altered in the Low-Density Residential R-40 Zone District unless the same conforms to the requirements of the Bulk Schedule and of the Parking Schedule, with the same force and effect as if such regulations were set forth herein in full. 4. The subject premises consists of a proposed open deck to be 4 feet by 28+- feet and will be located in front yard area, 20+- feet from the property line at its closest point. 5. In considering this application, the Board finds and determines: (a) that the circumstances of this application are uniquely related to the premises and its established nonconformities; , (b) that there is no other method for appellants to pursue; and placing the proposed open deck in any other location on the premises will require other variance relief; (c) the area chosen for the open deck is not unreasonably located; (d) that the variance will not in turn cause a substantial effect on the safety, health, welfare, comfort, convenience and or order of the Town; le) that in carefully considering the record and all the above factors, the interests of justice will be served by granting the variance. Accordingly, on motion by Mr. Dinizio, Seconded by Mr. Sawicki, it was RESOLVED, to GRANT a Variance in the matter of the application of RICHARD DiBLASI as applied under Appeal No. 3852. Vote of the Board: Ayes: Messrs. Goehringer, Grigonis, Doyen, Sawicki and Dinzio. This resolution was duly adopted. RFEIVED ANS? FILED BY � �� hoo THE SOUTHOLD TOWN CLERK �.Q- O DATE ////4/ s9 HOUR /../s PGERARD P. GOEHRINGER, CHAIRMAN Town Clerk, Town of Southold Page 6 - Notice of Hearings Southold Town Board of Appeals Regular Meeting of September 21, 1989 8:15 p.m. Appl. No. 3852 - RICHARD DiBLASI. Variance to the Zoning Ordinance, Article III, Section l00-30A3, as disapproved, for permission to construct open deck in front yard, nonconforming with bulk area and parking regulations in this R-40 Zone District. Property Location: 360 Bayview Drive, East Marion, County Tax Map No. 1000, Section 037 , Block 04, Lot 01. 8:20 p.m. Appl. No. 3852 - ELLIOT PASKOFF. Variance to the Zoning Ordinance, Article III A, Section 100-30A.3, (Article XXIII, Section 100-231 (A) , as disapproved) for permission to construct an attached deck with insufficient side yard and accessory fence (trellis) in front yard at the height of more than required 4 feet. Lot area is nonconforming in this R-40 I Zone District. Property Location 205 North Sea Drive, Southold{ NY, County Tax Map No. 1000, Section 54, Block 4, Lot 4. )\ 411• 1 _ I'I.,co.CON C eaT r0 SEER?, NOTE. 5140 11"TN11E� 1 1 T NTEACTOES TO VISIT JOS SITE,MCA ESIBTI«v CONDITIONS 4I�N` —�—II— CONSTRUCTION AND MINI NON NEN DACE MENEM IS 90 VERIFIED AND CONTRACTOR EAI BIRO DEORESPOR'IBL INEDSIONS TO 20/A126.Y•b ET 1450 POI.NDECK LIMBER 1=00 PSI. E SCCTON' ^,T B V I v ANv C AACTOO 1 ALL 9 Vol,TERROR I 4 NANO STRUCTURAL eRp EDSIRON DO MIME CI SUPPORTS 11 4 2+TIC .C. - ALL LOADER D R ON DECK A EOPLOOE01 0110 AT ,y I P WITH PROPER DUMPSISVSO BE ltNOvev IRONSITED OIN Oe1v At 4 L\Of _' _ _ .._ /�—_—_ _.__.--__.____—._ - I+.4"YANG 0 - $00010 P0?7 SITE DT CONSTRUCTED Nx«I o Ac '0 \ A LATESSY INP Who."GCT'i RAILINGS TOP E00IVAL[«i OP1A NUN LINEAR P fOT {A� 4. POUNDS i „_\\.,...!1..../ I e x+.a Ib flOL 4^ St D 1E POD — - • ' 6aflt NEN LNL I > E%/STING RESIDENCE — ' III/ g =_• _—_-,-- • a �+ — ��� I I E r--{I ~ _ da '-nI I —_ka ._--_ ii '4.... NVYMIa�tm To WcnNC� I ? X �I I - II �D•• 6 1.1wa S. 0.00 ' _—_ I Sm.. IOAtlRN6 I E:xtliNS _ I I' II !_ _i 1 - . 1 —- - wine, ?,.•DI Ivt, CCA I ��� I It OCCUPANCY OR ' j I� ; ` i USE IS UNLAWFUL ,�r —lrnsnwa_ m• .—9n•'— �P� I III WITHOUT CERTIFICATE PP e ` — I �I T I I a� j III OF OCCUPANCY P ` L 1 ,"5 - 11lAJc LNTINa I -- --- -- -- - -- — -- + PLOT PLAN' -- _- _ -_ = opal aPDaOYEE W MO ... I L Par_ Pt _ -- _ --. — L _ _En.- SCALE NOD,WED.DRANITMESI WIT 1 TWO=SYR TO•PRIMA DO I FOLLOWING INSPECTIONS _ -- -_= i 1 a ROUGH4POO PLINIENID 1 1 - - J AMY.•m1B�1E1�C1CNIANT _'S' ..-4. •o 4• 240 Y 0.” i ='L• , 1„ •tt L• I V__ 'i•L• I !',• =1=• 6'aC • * i WM INN mm I1n CONSIIILICIER CA T O lee - q� MIR CONIAINKINXI COWL .ISOM 1 Dlmllal .aNa. UPPER DECK PLAN _ r i,:i _ __ 3_ rr I I�� M I_ t, ; - I 111=;LT T --- --- -- - Liv - _ ' A1,. W. 791' New 0411144 To ION!ORM rt, , I AM BLOC cone QNLL3 A RC 4JLPTICW a{ __ IoPeUHRA Fsrr 'EN OP[:10NP5 NOT To ^---- I *14t1\ \ EI COC,,4+5 i. __ _ . \ . . ___ I • I ,_ I I' , _ , ." 4L. FRONT ELEVATION SIDE ELEVATION SCAM 3n•-1w ' DECK EATEN SION M(M PJCNAZD DI BLASI 100 BAYVIEW 0200E RA5T MAOJON, NY I19'At SAMBACH ASSOCIATES ' '501010RS.PLANNERS.ARCHITECT PO 0001039,CAE LANE TI GTTCNOOUO.NT 550E5 5. DI Sin .ITr+ WY gp,vd 011 IYRaQ ow IYp .D".Na ETI.A ..M 1NRI,l Owe W I+1 I I 1 1 , a , i • GENERAL NOTES \8 \ ' - I. ALL C C0N7[AC YUEi TO YISIT )OR SIYE, GN FGI6 \\..r_p N. E115lIUCONSTEUCTION ARO c-ONSTCLILT1C)N M4E2E 7.?.,(:' • � OELIL 1570 m.IN 57ALI-En 70, 2 FDUEED CON GAs r 3000 P51 zo c' ' /)�` -w 3 LUMOGZ FOE Oft4 TO e, F FSSJSP TNEATO2 \\ CCA(CNROMAT'O cop A(4 J 7a)TOA O / In (•Fm Jr:DY OF 0.60 LBS pe L+(JB1C FOOT IW Q J}(U7C OANf.F W(TN Ahl FI.IC.AN WOOD P¢e: y,3 E�y( --- -I C - / ._-.----------••�-- fII-II T ,. ASX.CiATIOAI s,62374 ` I = - - A . 1% / 1-Q_3"Y10^IJ kA['VP. I 1 ; ^\ • 2"v bt- Ib^o/a--- I fI .. . �, I I I 2"V 4" oe "r 6" ON FLAT ' . 15.. I • , •i 1 II /s"' spa(E wr4Jy'8N 0 G' / 5 ` Dere usI c•" u 'J / ,� 1 ICI), I_ 3 \ ,y /' L. / 11=---- � _ — v / CJ I X11-._- _. -___ I CI /..o+ ` / a`� / I I19.g•rla•usAnoP .I �I 11-:--7..- —_-==- - - ' 'Pc. J t1I I I – N PQOP pyo " a/") / / I I - ' _=:...7._-_---. 11 _ .. LL LL. 11=-7-:----17=-._.r2____"____--- , - -bo-"D- y I E x151'11,16, LANDSCAPJNF-1- STo JE COV5JC• l ` C U J .:' • `- -EY STI u(, LANvSCAPIUC WALL - N PF _ PLOT PLAN r1 -- r2._L SCALE:1'=40' DECK PLAN i I I -�- -----r--i-/- •--r-•------ -i I --- 2-3"SID" - - : I"Y 6" OmmVA,I. T --I g'zi SY IN TREAD4-215F 4"r-1, fc,.7 --- —2'.r o¢ v.v. :....N FLAT CLING Wkc OILY i'1 p fn., 1•'1,1 V'• LL -__� •' 2•.,b"-16v ,- - 'Ir,r.R,1-Q�--ter+-b-ci-m• ... _I. N O ^_, FF 2.3•.In'-N.IW..-_ A _ ---fir ,?),•r,_ _le- .T r-- -2.3•v I[Y (-E2.STila, SCOFF 11� pUnpc52D SI.D PF --1-- ki 36w �_-==•-1---_----�_1•_-- -J --==- 1 ' - 1 k. —�=-- —_ - I -__17:713‘ m EJIS,u4, lnuo•.'1?in,i to"r -� 11 peOP05qU WOOD DEr'IC I Wr.c y YI.ES _IL/ .v-r:- I I y`E.. !I{'j, kVA LICNIftr D!PL1151 * 2EY-o• -} 360 dAYVIEW DEIve_ i EAST MAIZIt)'J, NY Ill39 SECTION DECK FOUNDATION PLAN .,...f...„,, SAMBACH ASSOCIATES0j1.711* ENGINEERS,PLANNERS,ARCHITECTS ' P.O BOX 1033,COX UNE pATC•3.369 tw CUTCHOGUE,N,Y.110b { P SCALE: 114"=1'0' 1 I°`MrstRI t 914/7.1 BY ar.IN JOB N°5786A S.AIY,A5 ;urn,IN INN I"c 1 1 3. Nature of work (check which a1, 1icablc). rvcw Building • Addition i . . .. 'All, ,,.:in • •. 1 Repair Removal Demolition Ot deck... . 1 � cscription) 4. Estimated Cost . , . 3200 i 00.f Fee • - , - ' (to be paid on filingthiis�a plication) u If dwelling,number of dwelling ilnits Number of dwelling units on each floor If garage,number of cars 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use 7. Dimensions of existing structures,if any: Front r 29' Rear 29' " Depth .57' Height 26 Number of Stories 21 Dimensions of same structure with alterations or additions: Front 29' Rear .2.9' Depth 57' i Height 26' Number of Stories 21/2' 8. Dimensions of entire new constriction: Front ., 20' Rear ..28' Depth .12' Height on/nkove .ga Nifinber of Stories 9. Size of lot: Front231' Regi' 205,06' Depth 10. Date of Purchase 1.980 � Name of Former Owner ,. ,.Cully.Brown 11. Zone or use district in which pre ises are situated.1;-40 12. Does proposed construction viole any zoning law,ordinance or regulation: Yt=s- 13. Will lot be regraded ,no Will eicess fill be0ia ovedd from premises: Yes x No 14. Name of Owner of premises Righard BiBlasi Addres nollwoodr Road Phone No.516-921-3885_ �ILl'Ct ltbWri'NY '' '' 516-743-7492 Name of Architect Warren A.I Sambach r Sr AddresPO..Box•.1.033 Phone No. Name of Contractor I AddressCu.tcbog3.1..NY..1.193Bhone No. 15. Is this property located within 300 feet of a tidal wetland? *Yes ....X No *If yes, Southold Town Tru' tees Permit ma be required. • PLOT DIAGRAM e.vN i AI ii� 12-40 Locate clearly and distinctly all buildings, whether xi ing tlr, aropos , a13 �$�i id'911 sei'-iack dimensions from property lines.Give street and block huinber or descriptio ace. ding t.9deed, d s 6iSt nam4and indicate whethe interior or corner lot. S 1- L07I l r'et, / sr+', In �. 3/)?oy w �/yl\ 41 b .., . e/ I.NN j c g Pa -I n uo' t.'1'3 4 tih% I g;e. \ • lb Chi 0 ls• N Njoir kw, n., 4 x $ I STATE OF NEW YORK I COUNTY OF SUFFOLK �S.S • Of Warren A, . Sanll?1p1,,. .•P.,),. .eing 1u y sworn,deposes and says that he is the applicant (Name of individual signing contract) e, a above named. I 't/g, _— He is the Consulting Engineer • .(Contractor,agent,co,Lporate o ' r,etc.) of said owner or owners, and is duty authorized to perform or ham performe the said work and tb make and file this application; that all statements contained in this application are trueif9yk the best o ' knowledge and belief;and that the work will be performed in the manner set forth in the application filed tKerewith. 4.-- ' Sworn to before me this '',_ Ztiaxil /(i daay/of Apr il , 19.89 � /�`� Notary Public, �v �S- 113-R- County `` I ' : '' I %i 446// ;' I HELEN K.DEVOE1 (Signature of applicant) NOTARY PUBLIC,State of New York No.4707878,Suffolk CDuntyQv I 1 Term Expires Merck 30.19___._