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HomeMy WebLinkAboutTR-8770 r. v , r'SUFFUL `- John M. Bredemeyer Ill, President ,-V ,----,�co� Town Hall Annex � n yam, 54375 Route 25 Michael J. Domino, Vice-President ,,Y1^� �, F Glenn Goldsmith rc = z ., P.O. Box 1179 .- Southold, NY 11971 A. Nicholas Krupski • 4, �, , r owl'' Charles J. Sanders <-01 .11../ Telephone (631) 765-1892 ;t,,:, JR. Fax (631) 765-6641 �tc��...lr`t BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction //2 constructed Project complete, compliance inspection . i it • d• ��: � aR4� 1� `. 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Y.',�\M*NXt?$hl5•`uk t4`w.� ��°" x4+.':5..°T.7.u•:�..'i•iPtJt:-:�9.+S.Y.0 S.!'..e.^Lt...,.'`�".�r • ,I ye4 > �5,, BOARD OF SOUTHOLD TOWN TRUSTEES , � ;} I SOUTHOLD,NEW YORK l sill/ , a ` PERMIT NO. 8770 DATE: APRIL 20, 2016 ro,, . `“11 Py 1 g ISSUED TO: RICHARD & LISA ISRAEL I� �"' ` t r I PROPERTY ADDRESS: 685 OSPREY NEST ROAD, GREENPORT E „ 41f`t ' SCTM# 1000-35-6-27 4 a':° 'e"s' . °re c't AUTHORIZATION' r Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in Y"';'-'-` :.:Ir. • `' accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 20,2016,and in Y, ' ' consideration of application fee in the sum of$250.00 paid by Richard&Lisa Israel and subject to the4 t -' I'ep ° l :,,t, and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the 0•}k , ;00 following: ,�, ,: l` \ • t, Wetland Permit for the demolition of existing single family residence and carport; A • construct new 2,793sq.ft.two-story dwelling with new foundation, and 1,154sq.ft. abovet r '' grade patio on seaward side; abandon existing sanitary and install new sanitary system ,. ~'` *�� '. on landward side of dwelling; and install gutters to leaders to drywells to contain roof g' runoff; and as depicted on the site plan prepared by Robert I. Brown,Architect, P.C., ; mf >> fiaat • dated October 28Ill , 2015 and stamped approved on April 20, 2016. `` ` fir,'- IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, , , '`` and these presents to be subscribed by a majority of the said Bo as o is d if. K= lir- 1 4.0.14...4.7-,, . cfrt ,&-e14-1—:--- .▪... . - .!...*i'..''*:-.."‘;1 1 e /.4. ' . - 0, , , ." ,.5-4.----- • /jiy} o . \ ‘;:--• Iii 1I;-- '..:9. (,:„,:i 11 ' 111 4771 I I , X4da 1 f -41,4c iii 3 # d, 4 f , 1 � „�� (; iz 1fr vs��,.4,, v:,:.3". -' ,—v: 7,... f'm•3s.'Guz,,,- ,,,,, ,, . ,e-f u`rYdib.•s.."'U.D.r t"U'..- z.Ca2cG3 f"_'3$4+,,.. z,. air+: '....,.aY3�"u a.z.^.' "A pw:, . , � t,n=.'. -.Y,� tt. r, a:s. ,y ce - ap - dam' <r,k'-::-.--'} ..`fit 4 > 4.r,`1; 1.5� +.-;,:i--,4, %.0;."4„,:::.4. '. SSS � � u ,-----2' _ r� 1: � �e�t.\�� � g t .r /f*.��y �j,,•,� �„`� !!C=5 ; • � . T� r, a.- �,;%'' 1 n! 1. '°..,.--.: a t t tl., 71' -':-"if - r r.'vtn. ,,.sv 1'y P f 0. r�.'„' • „poi {yY •,t ods�} tSt 4 '+ �.-- <r` � ._..,.-> �;dsv�at tj�A .�,y s dY P iti v 30q;4 ....$440)1,,...tt", ,' ,. t.. ':**'" +"t;*.4"-s w .'e't i�t__,L .. ., dp' . i ei e ..Mipl..sd!} -7,A.,•-•:43..... .,4-1far 4ile -4s PV_._.-'r t. t�'�.is pt 'Ar ! � ,h,i. taSs t.4. _ $5.,,4}' d t f �'. / TERMS AND CONDITIONS The Permittee Richard&Lisa Israel, residing at 685 Osprey Nest Road, Greenport, New York,as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if,in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. I cE SO!ir John M.Bredemeyer III,President ••° 4* Town Hall Annex 4 O : 54375 Route 25 Michael J.Domino,Vice-President P.O.Box 1179 Glenn Goldsmith ; ; Southold,New York 11971 "-fA.Nicholas Krupski `` Telephone(631) 765-1892 Charles J.Sanders Fax(631) 765-6641 S-- 0"s BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 20, 2016 Robert Brown, Architect 205 Bay Avenue Greenport, NY 11944 RE: RICHARD & LISA ISRAEL 685 OSPREY NEST ROAD, GREENPORT SCTM# 1000-35-6-27 Dear Mr. Brown: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 20, 2016•regarding the above matter: WHEREAS, Robert Brown Architects on behalf of RICHARD & LISA ISRAEL applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 2, 2016, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 20, 2016, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, • 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of RICHARD & LISA ISRAEL for the demolition of existing single family residence and carport; construct new 2,793sq.ft. two-story dwelling with new foundation, and 1,154sq.ft. above grade patio on seaward side; abandon existing sanitary and install new sanitary system on landward side of dwelling; and install gutters to leaders to drywells to contain roof runoff; and as depicted on the site plan prepared by Robert I. Brown, Architect, P.C., dated October 28, 2015 and stamped approved on April 20, 2016. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, 6964— fettgle0979.X.- John M. Bredemeyer Ill President, Board of Trustees JMB/dd (1)UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A ROLATON OF SECTOR 7209 OF'THE NEW YORK STATE EDUCATOR LAW (2)DISTANCES SHOVM HEREON FROM PROPERTY LINES TO LEOSTING'STRUCTURES ARE FOR A SPECOTC PURPOSE AND ARC NOT TO BE USED TO ESTAEUSH PROPERTY LINES cR FOR ERECTION CF FENCES.(3)COPIES OF,THIS SURVEY MAP,NOT BEARING THE LAND DRRVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE CORY.(4)CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TILE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON.AND 10 THE ASSIGNEES OF THE LENDING-INSRTUTON CEFTSCATONS ARE NOT.TRANSFERABLE.TO'ADDITONAL INSTnUTIONS OR SUBSEQUENT OVANERT (5)THE LOCATION OF WELLS(W).SEPTIC TANKS(ST)A CESSPOOLS(CP)SHORN HEREON ARE FROM FIELD OBSERVATIONS'AND OR DATA OBTAINED FROM OTHERS I. t- 400 Ostrander Avenue,Riverhead,New York IIg01 tel.631.727.2503 fax.651.72'1.0144 admin®youngengineerfng.com N O - P 4ffl3 et 134Uflc3 ...: ..._... . o . - `f i Howard W.Youngii Land Surveyor ,:. � ilr", A4 moThWlpeProfessional hf� GTeat,Architect iii.--- .a -� neerV Douglas E.Adams,Professional Engineer 0. S - • SITE DATA 0 4€0o - " ;kOI /�/ tai 1 3 0�0 .10{'.� it + AREA I4,5=15 5Q. FT. o'01 \0C 0� O// / •SUBDIVISION- "MAP OF SECTION'ONE CLEAVES POINT FILED IN c �\ ®/' THE OFFICE OF THE CLERK'OF SUFFOLK COUNTY ON SEPT. 10,1451�U� Qb� ®/ $Q. AS FILE NO.2152. T 564: \� O•' ®/ O A • VERTICAL DATUM = N.6.V.DATUM(MSL.1424) o qT i , 0� Q. \� /®� 44, Aip� FR, 'k4 p ,_,ate • ELEVATIONS SHOWN THUS: +5.51 , a0 0 Q /® f yrc IVF T •SEE FLOOD INSURANCE RATE MAP PANEL NO.361OSGOI76 H ' av`` Q a rd.t, '��I R 4 yr U►YL0,.p LAST DATED SEPT.25,2004. 8 . . .4.• .,sem f o,° �"'``W 8 SURVEYOR'S CERTIFICATION N \0'� .00 4,•, R, \\-s. ' ' / ' 1 ur+ , • •PIE HEREBY CERTIFY TO RICHARD ISRAEL & LISA a\'1 �4° �. `�'o° ass: ISRAEL THAT THIS SURVEY WAS,PREPARED IN ACCORDANCE 1,. `� Q �� , �' sa A WITH THE CODE OF PRACTICE FOR LAND SURVEYS,ADOPTED;SY �J (J\� +7 m • n�� ryp S THE NEV(YORK STATE i SOGIATION OF PROFE5510NAL'- r O �4• - - SURVEYORS. .::Q, r►. ^_ t9 �c(� • 14 I I' U �'�Qj y�/ 9 rye. \�6�, /�J • . l +723 '�'' •C). U�• ^Q. `.`'�j y,.1 •- ,_✓� ® � `',� `J� 10.47 0 (�' ` • •,., , • Aa 4 6.73 8 08 nem, U' Tf • e + nh • �� Q� yy� ,ALJ{ '. +653 qj T I � .;H.:, Q� 4. 5.64 �2 ^ry0a e+7rx+ P �R,�,FFQ d` u\�I('vp r `O� �-[lf �//�j f�{/) �IM,ysRY`;'. »Y • 9�>,S 657 ® 8.03+ 0.47 h' (! iTf r r r" ` "i"i. - ; 'rI. lk 5•554 ` % Q '� �,`. •..r1:.. `�� � e 1 HOWARD W.YOUNG,N.Y. .L.S.NO.45883 *�.' .�� +721 0. \O ed. O. s.46 E b- 0%." ` 0%." ' `% +7.'11 ttdj �52 0 _ 7b9 O RQ -'• `♦ 7.12 gym•6.16 q.i) ,...4 + i„ . .... . -.4.„ SURVEY FOR N • ' 551 +735 4' I O r - +7b! ® ...... - +6.68 r ¢ RICHARD ISRAEL 4 LISA ISRAEL TIE LINE ALON6 APPROXIMATE WOOD S� Lot I I • • ,`0 I� LOT II "MAP OF SECTION ONE BULKHEAD 4 HIGH WATER MARK O 614 a 0� CLEAVES POINT" 7r,,., ., s, +733 731+ + 584 *S'% '' O at East Marlon, Town of Southold G 1„. .--- o,, 528 1- - Suffolk County, New York Ge6J®' I d. ... w CERTIFIED 5URVEY <C .v. ` y /' I County Tax Map District 1000 Section 55 Block 06 Lot 27 /�� �•� °\ FIRM ZONE BOUNDARY LINE _V-----------R 1 i� V Y� +6.91 Q) AS SCALED FROM FLOOD „ .:I� ' 0 ;.;ss tl; 1 FIELD SURVEY GOMPLtLtL SEPT.OS,2004 �\ +5.18 �ry INSURANCE RATE MAP', I I MAP PREPARED SEPT.04,2004 � ,= I o { ReGord of Revisions / �. 481 rl N .7';:i RECORD OF REVISIONS • DATE O / 6,�,, I = ;,,- ---I N '-� 1 UPDATE SURVEY AUG.Ob.2015 61 ' /.05 y , r_; o 4.45• f v, • 15 50 60 521°50'05"W N53°05'15" 50 0N55°05'15"11F it 4.22' 132' � ��� _1Seale: I" = 50' .105,NO.2015-0095 D116.2004_01832015_0045_cs I OF I El =MONUMENT SET •= MONUMENT FOUND A= STAKE SET A o STAKE FOUND DI = DRAINAGE INLET . TEST HOLE DATA 1/22/15 P-•PERTIESWIT ', 150' HAVE BY McDONALD GEOSCIENCE PUBLIC ►, :TER MIXED SAND AND LOAM 3' PALE BROWN FINE TO �� EL 9 26' STORM DRAIN COARSE SAND SW �F' P4 Q F0 0D WATER IN PALE BROWN FINE a�� V" ':• /T HOL (APP'OX) 40 TO COARSE SAND SW � �, ° \ �C�O`C �� �� EL 9 16' ;• EDGE OF PAVEMENT iSe WAT R'ENC0IJ,NT F ��(� �a,�Q ��co �a� ', nJ� . • ;1 , >'';x ft"� Y L ,? Q .`'?, G� ,. r4,\/\ ° UTILITY POLE 8 ,� OK' ���� Ap, Ove w/ GUY WIRES :WARD OF TRUSTEES-- -' ��°oe Ialwir ����� �, Allp, f - '` 0 40/ .41 ekt„ %.., ''' n •7® �O/ AQ F / F( :/,2/i.:if:!_ii.\ S;+ EL999' 0. ss, foo ,• :, Ai -,,, �`` 2 STORY 4 BEDROOMlc, - :,• off° RESIDENCE w/ BASEMENT4 934•, /\�o /ss, F.F.EL 11 .5' 8's/, ry� 2 � 2 a) S ° O OPO PO�� +6. S /8 08 O \ �� o DR . ELL: • Ps'SA2' P' •'' LLS: o '•• 4 �. :� < ONE I AND 2 j m .P O• p ,<c. , +7 69 O ty �k is # $/' .53 21 a 2 o +752 • CO `L /O 6 ') ' 0' �� +7 12 Lot I I D' ELL: M' 34, o , +7.35 A• �� ONE4 , !Er'Q C.)-", �� +5 51 0� +7 61 \ 0 TIE LINE ALONG ,,f, 9�<s \ ,p�� ' ��i rG O +6 19 J APPROXIMATE G� 0 e +7 31 O�� WOOD BULKHEAD $ < T +7.33 \\ tiF O+F HIGH WATER MARK `op ooZ��p +5 28 S \ \t'15'o •e p LOT COVERAGE <�F �GC):'.6' ��/ A s LOT AREA • 14,598.7 5F cyc DRAINAGE CALCULATIONS: 'I /0 O� °-,8, +6.91 \ ZONE I 823.8 SF x O. 17= 147.8 CF NEW BUILDING AND EXISTING 00`�� �� �° ZONE 2 1144.5 SF x O. I 7= 194.6 CF SHED: 2,878.2 SF 2, <:) � CL TOTAL: 342 4 CF 2,878.2 / I ,4598.7 = 19.7% 0 y7 +5 18 PROVIDE (2) 10' DIA x 3'D. DRYWELLS: 410.6 CF BASED ON SURVEY FOR �� ZONE 3 70 I .7 SF x O. 17= 119.3CF RICHARD AND LISA ISRAEL Sr PROVIDE ( I ) 8' DIA x 3'6"D. DRYWELL. 147.8 CF BY YOUNG AND YOUNG '0� • LOT I I 'MAP OF SECTION ONE `� ZONE 4 604.9 SF x O. 17= 102.8 CF • CLEAVES POINT AT EAST MARION' / •cp PROVIDE (I ) 8' DIA x 3'6"D. DRYWELL: 147 8CF TOWN OF SOUTHOLD / SCTM No. 1000-35-6-27 A5 REVISED 06 AUGUST, 20 15 • ��� �.e�I'es `9S • . �hFg06ti •• - ;; ;:,..',.m), 527°50'08"W ,�v ,r,;.- EiR, c' y� - SITE PL _ ; t -t µ?, tF .,:: ,°:---, ,r.,--,,,.,.--;,7, r'r37 SCALE: 1' = 20' Ir , ii: �' . O ', is M .. ,:. MAR - 2 p '.tr.. ,, . • . -, i ..,ITLIN,ANY 2016 ! N53°05' 15"W �t ,v,.,-.; ", :- s- ;',r1.';',11 i;4 e '-- 71—* —e—N—T-5-1 ' I .32' ' IA .6 ,\:_____:,\,:k./, - - . ,, -.- ,...---,31---a "n 3 FIN FL EL 115' LOCKING CASTING TO GRADE ~ wt 7ac ,�Y�L c� POR MAKEMAINTDROPENT ACANCE551BLE i i CE GRADE EL 10 5 .. GRADE EL 9 3 GRADE EL 9O' y ISRAEL RESIDENCE io©,,o7rr 2'MAX II II 8 53 TOP OF SLAB I E 8 55 E 8 2_2_ ,c L B ®uerr cm -- � 8 2 TOP OF RING rl E 7 95 OUTLET I E 7 87' NOTE PROVIDE CROSS-OVER PIPES G85 OSPREY NEST ROAD MIN MIN J 4'0 MIN OTHER GALLEYS Ftow m APPROVED PIPE • EAST MARION, NY BAFF ,0 OIC, EL 4 93' EL 5 2 28 OCTOBER, 20 15 EL 4 GO @ BOT OF TANK - 2 2 GROUND WATER 2 2 GROUND WATER Robert I . Brown AS PER SCDH5 oAS PER SCDHS p I EA. 1000 GAL-SEPTIC TANK (3EA)8 5'X 4 75'PRECAST LEACHING GALLEYS Architect, I . C. AS APPROVED BY SCDHS Fa i t vv e a t h e r PROPOSED SEPTIC SYSTEM DETAIL Design Associates, Inc. 205 Bay Ave. Greenport NY admin@falrweather-brown,com .., 63 I -477-5752 1 5'-6" 33'-0" / / / 71-101. 7'_81 3'-I I" t 3.-1 I" 3'-10" 3'-10" 6'•7" 9'•1 I" \ 9'•I 1" 6'-7" LING or ROOF / / / / ITYPICAL BATH �OVCRHANG ABOV I r I 1/7.757,./77-d WAIN5COOT 1 I 3 6•MGT Win PULL TILE 1 O I OAT TUB OR SHOWER Q - O I O 1 siMMEIMLlin CERAMIC TILE IN THIN Or O N I SCT PULL nGT TILE // BATH No I O I (:) A AROUND TUB TYPICAL �O —+--� \ 6 II% iJ'3600 OR I � JO15�5 @ 16.0 A ��I 0 w 11 1.TJI 360 FLOOR 1 IQ Q 1n I 11/•TJI 360 FLOOR .a. 1 6 • r---- �.V -I - JOISTS @ IS.O C '- Ib 1W ..,5,,@,,..c A' I iI _ •I 91 Qom/ IF101 I \ \ - ' r�r�7L mmeLe�i1 BEDROOM No I _ '-' BEDROOM No 2 I- L 'I..YQi1..lr� 71 8" 174 SP 'l—, 174 5P T1) RE DD LIGHT.13 92 SF //��"��" A RCOD LIGHT.13 92 SF o' MARRY TILE III, 1 MECTI p®I...11 O STONE PATIO - REOD VENT=6 9-SF © irj`,.CC REOD VENT 6 97 5F TnICT SET 1 Sn+ EINEM. 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N ISRAEL RESIDENCE WEST ELEVATION SIDE 685 OSPREY NEST ROAD EAST MARION, NY I I FEB. 20 I G ` `-;., 3/ 16" = I '-0" ftll��"% �11'7� -`\` 1 - ei dF .y7: ...^',TION OF I=.E Robert I . Brown ,,f f�-f `V ,. - _ ,c..G„rte. ',,,, LAW a--:i'7/-',NY C'{m,''t.`3"oil, '` f •.t: ✓: 1 1�` .a`_ 7:ACTING € NDE.'3 THE Arch itect P.C. \ v . .., = ' ,f .i:t w�.TION q C Fairweather ARCHITECT,x FO;A -(ER PHI / 7654A,,,„4:7/J; t\i'vV a:,V:1 ` PEZED Design Associates, Inc. `�'ti -� . i•,=$-Y�;D, 9FPU J,AND205 Bay Ave. Greenport NY �'` �”` �: ` {u �' ���= `� �''� admin@fairweather-brown.com tL''"gi a:-;I:W_.rw. 63 I -477-9752 • 777 fH. - 4'THICK BLUESTONE CAP t.:•_ I I C i`7 '; C C) ti - ' I 1, '7 I ft - i —. FIELSTONE FACING-TYPICAL ,_I �- '- J 1 N 1- - ..40.O 18"RW CEDAR PERFECTIONS w/5Y" VI o �, '�� EXPOSURE OVER. I'x2-SPRUCE SKIP .` ' I-X G"•AZEK'FASCIA BOARDS w/3V2 I - AZEK'SPRUNG CROWN-TYPICAL I SHEATHING-TYPICAL = r I'X 8° RAKE BOARDS w/ / 1CRO..•.__.._. R._;. SOLID CROWN-TYPICAL A / 1 \ I..X G"'AZEK'HEAD CASING w/ hi. _ _ I SOLID CROWN 1 r 1 1 ! I A !1 / \ / \ / \ / \ /-1 IN 11 r 1 5/"X 4"'AZEK'CASING- TYPICAL FOR DOORS AND WINDOWS 1_____ — I I i I NL-11 II {1 I I� 0 I I _ I I _ _ _ — —1 /\ �— OPERABLE WOOD SHUTTERS BY ,ll I / \ SHUTTER CRAFT INTGILFORDGREEN CONN _ _ / \ I PAINT BLACK FOREST GREEN BY 18'YELLOW CEDAR.SHINGLES ! I II, _ / 'BENJAMIN MOORE'-TYPICAL (CLEAR WITHY'BUTT)5° EXPOSURE OVER 30 lb I \�;; — BUILDING PAPER ON y2'CDX r I PLYWOOD SHEATHING- — — TYPICAL I — III — I — — — l _ I 1 I I I I ISRAEL RESIDENCE NORTHNEST ELEVATION (FRONT) 685SPREY I I FEB. 2016 /y/- ` - � 3/1 6" = I '-0'I f ---2-7-- t ,1",,.--:- ..,,,r-� .-j e l i -f V,(...CAT: !-F F'MERobert I . Brown r �(: �-,-,,-,. ,2-,L,,,� .� \, �5 "SS:F Cr :D:: i4_ �Ei �. �',-E Architect P.C. / - _- -\�. • 't=_-a k '-.r, ^^5"-_ t,..r°-. e1 ' Ea � rweather `^,�t�1 ..r 3 r !-(; `'?t?:��ei.�•c �^,;-e�:;�,twi�1 . , a Design Associates Inc. ',....,N.,„.,..( I,, \;Y f € :�. 1.i'.:_ �, �� 205 bay Ave. Greenport NY {- ._..�- ---y 0=`-- .r- ' ASC``-:'--IDA �`•-E admin@falrweather-brown.corn %�./ : -.,,,,:-.:: 1_:,-,....% 63 1 -477-9752 suFFotk�-� John M. Bredemeyer III, President or- Town ooG�, Hall Annex Michael J. Domino, Vice-President k � yl 54375 Route 25 James F. King i yV, ,? P.O. Box 1179 y Dave Bergen br'oSouthold, NY 11971 Charles J. SandersTelephone (631) 765-1892 -4-Pxzr. L . Fax (631) 765-6641 BOARD OF TOWN TRUSTEESa6rF(.4, TOWN OF SOUTHOLD TO: Rico-A1 Ii 6A- I b L e/, oW�I bowl Please be advised that your application dated 1 201& has been reviewed by this Board at the regular meeting of A#3 . L 241 20110 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1st Day of Construction ($50.00) 1/2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 5°' 1107 BY: John M. Bredemeyer III, President Board of Trustees John M. Bredemeyer Ill, PresidentoG g� Town Hall Annex Michael J. Domino, Vice-President 7 �� y 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski - Southold, NY 11971 Charles J Sanders 1 6'4% �p'r Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 12 ' J L (1 b L(, kVA Completed in field by: Cliot of Sq t4 0,0 Robert Brown Archtiect, PC on behalf of RICHARD & LISA ISRAEL request a Wetland Permit for the demolition of existing single family residence and carport; construct new 2,793sq.ft. two-story dwelling with new foundation, and 1,154sq.ft. above grade patio on seaward side; abandon existing sanitary and install new sanitary system on landward side of dwelling; and install gutters to leaders to drywells to contain roof runoff. Located: 685 Osprey Nest Road, Greenport. SCTM# 1000-35-6-27 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=1✓ Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of He ring Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment '- Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: -v ot.o,1 1, -J-o V h!AN.) Present were: ;\/Bredemeyer er �M. Domino 1/ G. Goldsmith 1 N. Krupski Y p l/ C. Sanders /Other CCS 41/C0 Page 1 of 2 John M. Bredemeyer Ill, President , goFOt70 / Town Hall Annex Michael J Domino, Vice-President �° Gam 54375 Route 25 Glenn Goldsmith o � P.O. Box 1179 A. Nicholas Krupski : . Southold, NY 11971 Charles J. Sanders ' '1,yj� x ao� Telephone (631) 765-1892 _ � Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Robert Brown Archtiect, PC on behalf of RICHARD & LISA ISRAEL request a Wetland Permit for the demolition of existing single family residence and carport; construct new 2,793sq.ft. two-story dwelling with new foundation, and 1,154sq.ft. above grade patio on seaward side; abandon existing sanitary and install new sanitary system on landward side of dwelling; and install gutters to leaders to drywells to contain roof runoff. Located: 685 Osprey Nest Road, Greenport. SCTM# 1000-35-6-27 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. 5525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be'discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 — '",---,, , :---:-...- -. .'"ii` N..iiimi.... -'-'. -1; - '!!'""-,,A A:.-'''.• . 4‘ )• 1.\,:14, • ,. , , 7 'k. ' ,'Sld, ''' •,,.„ \ , ,4i()et 1 • , -, -4, +4 • 4,,,- : -4.c4,tr .: ''''-4,..„ ' ',.•.-d.,,,„.t',c^114N'.4---•0'- ' '\.•, 4,'7,:i1i'„'':'"'.:`,•..-,,4--, s ,ti,t1.'•il,)iv.l•/'' Richard h-'ma'rtdt: & Lisa Israel \ A 685 Osprey Nest Road,Greenport ' ,...9,.7..-_t-2,4_07:),....-.. 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I - '..-....... .7.14r. .. - . .. .' : • — NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSE`' • ,;.• rte, ,) i. t'>� -� 11 n Division of Environmental Permits,Region 1 1 SUNY a Stony Brook,50 Circle Road,Stony Brook,NY 11790 1 I P:(631)444-0365 I F:(631)444-0360 { www dec ny gov MARv72016 SOuCIIUid Town 81.11 fTN) • Letter of Non-Jurisdiction — Tidal Wetlands Act Richard & Lisa Israel February 29, 2016 PO Box 2100 Greenport, NY 11944 Re: 1-4738-03775 /00002 Tidal Wetlands Jurisdictional Inquiry for Israel Property 685 Osprey Nest Loop Road Greenport SCTM# 1000-35-6-27 Dear Mr. Card: The Department of the Environmental Conservation has completed its review of your recent request for a jurisdictional determination pursuant to the Tidal Wetlands Act (Article 25 ECL) and the Tidal Wetlands Land Use Regulations (6 NYCRR Part 661) for your property at the referenced address and your proposal to remove an existing house and existing septic system and construct a new single family dwelling and septic system. We have determined that the proposed construction area is located landward of existing bulkheading which qualifies pursuant to Part 661 as a jurisdiction limiting structure. In order to limit Tidal Wetlands regulatory jurisdiction, a structure must be manmade, substantial, prevent normal tidal action, be at least 100 feet in length (or be part of a contiguous structure of at least 100 feet in length spanning one or more properties) and be constructed before the August 20, 1977 effective date of Part 661. The bulkheading along the Gull Pond shoreline of your lot is part of a contiguous length of at least 350 feet of bulkhead at the site and on the adjacent parcels to the north and south. This structure meets all of the above criteria as evidenced by the March 24, 1976 aerial photograph by Aeroimage (Exposure # 75-2101). The portion of your property located landward of the bulkheading is therefore outside DEC regulatory jurisdiction. No DEC Tidal Wetlands permit is required for any activities contained wholly behind the bulkheading. Please understand that it the property owner's responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or disturbance within Article 25 jurisdiction (seaward of the bulkhead) which may result from the project. Such precautions may include maintaining an adequate work area between the jurisdictional boundary and the project (i.e. a 15-foot wide undisturbed area) or erecting a temporary fence, barrier or hay bale berm. I S A(YOOFRK Department of TAIE OPPORTUNITY Environmental Conservation .r i Richard & Lisa Israel February 29, 2016 Page 2 Please also note that this letter does not relieve the project sponsor of the responsibility of obtaining any approvals which may be required for their project from other agencies. I can be reached at (631) 444-0371 or george.hammarth(a�dec.ny.gov if you have any questions or need to discuss this determination. 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I 30A1U 1 HYLET 4169 al vp, \, \ �� k 9 1 .WI t .*nwua a.a O 132 a i 1 11 8A(c) � .� 11sa() %, \ \ _ f TONM OF \ 6SNONESEEUElEAY I SOUTHOio ,� INSERTA N \ , i I/u �' 6EE;NEER, 4 SGL•1••100' * - 1 ea 1 �w I W 1 ' 9 a II 1.0412 0 fpm i 1 `_ US 54I W ` 1 !IN I0 \ I �_ L `- ^^ I- �^�•- --•"— �+� --N-- NOTICE Wu COUNTY OF SUFFOLK © K tovetiOF SOUTNOLD SI C-��_- .....7.4.17. _ r (21)"%`� � _ _ �_ _ewe, � 9� MVO xvMEN.w.ECrnCCCrx euE Nx E vrt4CE Nr _ _ 1 Real Property Tax Service Agency N' I H� - - ..,. -- �� * '� Caunry Center RNeiMnG,NY11901 wawa €:,,:r.i'''.,-.'...,.'Ar.;',-,:',.", . •°v.m>:.'}-FAL. &ct«,v«,,,�`z' _^ y, _ �r.'P=-.i�r�..—.— � '�,a,, dl FEE, A® . VII 'Tr wvA.�• 'i :.d:�\ 'y'i~'§� M}.Y'°SB y, ^yt!'J•:�:.�'•r-� '9Y. ,�• � —_ �•� An�� `.i'� , tto ® IZ_y DEMO NO 1000 L . ri S:«•T ''',,,•.0,5t, ).x.r,..�L. ,}r. ,:,,': 2,4`77;:-,,,,':;Z::',',',!=:.: .--, -:Pi—rrr,...2•24-7,7-7;-.."`",7,71,,-- -"--2-77.7-="''''''". -1•" i P om:�® ' PR ^, ,T,1"..7 x ., rv+ w.. !!,?;:.:1-.. 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Main Rd. &Youngs Ave.) Southold,NY 11971 • ":.:Ft i Telephone: 631 765-1938 i/ 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: April 13, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for Wetland Permit for RICHARD & LISA ISRAEL SCTM# 1000-35-6-27 The Zoning Board of Appeals issued a variance for the action on February 16, 2016 Robert Brown Archtiect, PC on behalf of RICHARD & LISA ISRAEL request a Wetland Permit for the demolition of existing single family residence and carport; construct new 2,793sq.ft. two-story dwelling with new foundation, and 1,154sq.ft. above grade patio on seaward side; abandon existing sanitary and install new sanitary system on landward side of dwelling; and install gutters to leaders to drywells to contain roof runoff. Located: 685 Osprey Nest Road, Greenport. SCTM# 1000-35-6- 27 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 LWRP policies and therefore 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. Peter Young,Chairman ; Q i Town Hall,53095 Main Rd. Lauren Standish,Secretary ; ,�. ; P.O.Box 1179 `'3 ft Southold,NY 11971 `-, �0 `Z►fl��r� Telephone(631)765-1889 1` Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 13, 2016 the following recommendation was made: Moved by Peter Young, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of RICHARD & LISA ISRAEL to demolish a single-family dwelling, carport, porch and sanitary system and replace with a new two- story dwelling with basement, new foundation, new septic system and drywells for roof run-off. The existing setback is 61' from the bulkhead to dwelling and the proposed dwelling setback is 66' with the patio at grade. Located: 685 Osprey Nest Rd., East Marion. SCTM#35-6-27 Inspected by: Peter Young The CAC Supports the application using best management practices. Vote of Council: Ayes: All Motion Carried r + �� ,,.,,.�.__O BOARD MEMBERS ,, ',�E $l�[/�, = _ Southold Town Hall Leslie Kanes Weisman,Chairperson : ./, y 53095 Main Road• P.O.Box,1179 44.0 !O Southold,NY 11971-0959 Eric Dantes Office Location: Gerard P.Goehringer � G $ Town Annex/First Floor,Capital One Bank George Horning is -4�� 54375 Main Road(at Youngs Avenue) Kenneth Schneider ;oeA,COUNVa Southold,NY 11971 O http://southoldtown.northfork.net � 4 _ - .^�� 'r, ZONING BOARD OF APPEALS l';; _ iE 1! TOWN OF SOUTHOLD MAR - 2 2016 Tel.(631) 765-1809•Fax(631)765-9064 J ; _ _j FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF FEBRUARY 18,2016 ZBA FILE: 6917 NAME OF APPLICANT: Richard and Lisa Israel SCTM# 1000-35-06-27 PROPERTY LOCATION: 685 Osprey Nest Loop Road(adj.to Gull Pond Inlet),Greenport,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 January 11, 2016 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 February 12, 2016.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 CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. PROPERTY FACTS/DESCRIPTION: The subject property is a non-conforming 14,595 sq. ft. lot in the R40 zone district with 112.50 ft. along Osprey Nest Road, 116.79 ft. along Gull Pond Inlet, 183.79 along the easterly property line, and 149.63 ft. along the westerly property line.'It is improved with a one story frame house,roof over concrete car port, wood decks and a frame shed, as shown on the survey by Young and Young last dated Aug. 06, 2015 BASIS OF APPLICATION: Request for Variance from Article XXIII Section 280-124 and the Building Inspector's October 21, 2015, amended November 2, 2015 Notice of Disapproval based on an application for building permit to demolish existing dwelling and construct a new single family dwelling with elevated patio,at; 1) less than the code required bulkhead set back of 75 ft., 2). less than the minimum code required front yard setback of 35 feet, 2) accessory shed in location other than granted in prior ZBA#4815. RELIEF REQUESTED: The applicant requests variances to demolish an existing non-conforming dwelling and construct a new non-conforming single-family dwelling with elevated patio having a bulkhead set back of 66 +/- feet where the code requires a minimum of 75 feet and a 29+/- foot front yard setback where the code requires a minimum of 35 feet,all as shown on the Site Plan prepared by Robert I. Brown,R.A., dated October 28, 2015. Page 2 of 3—February 18,2016 ZBA#6917—Israel SCTM#1000-35-6-27 ADDITIONAL INFORMATION: The existing non-conforming dwelling, to be demolished, has a 61.6 foot bulkhead setback and a 31.5 foot front yard setback, as shown on the survey prepared by Young&Young Sept. 04, 2009, last revised Aug. 06, 2015 to update survey. Due to recent changes in the town zoning and wetland codes, the proposed non-conforming bulkhead setback is no longer within the jurisdiction of the Board of Appeals and the applicant must obtain relief from the Board of Town Trustees FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on February 4, 2016,at which time written and oral evidence were presented. Based upon all testimony,documentation,personal inspection of the property 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. The size and style of the proposed new single-family dwelling is characteristic of what exists in this neighbor. The applicant's agent submitted prior variances for other non-conforming setbacks along Osprey Nest Road. 2. Town Law $267-b(3)(b)(2). The benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue, other than an area variance. The applicant could construct a much smaller new single- family dwelling having conforming setbacks. 3. Town Law$267-b(3)(b)(3). The variance granted herein for a front yard setback is mathematically substantial, representing 17%relief from the code. However,the applicant is proposing to locate the new dwelling farther from the water/bulkhead and replace an old septic system from the seaward side of the existing dwelling with a new septic system on the landward side of the proposed new dwelling. Also, when compared to other existing non- conforming front yard setbacks of neighboring dwellings,the request is not substantial. 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 $267-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 §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of constructing a new single-family dwelling, 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 Weisman (Chairperson), and duly carried,to GRANT, the variance as applied for, and shown on the Site Plan prepared by Robert I. Brown, R.A., dated October 28, 2015 and the architectural drawings, Project Title: Renovations and Additions, Sheets Al, A2. A3, A4 and A5, all dated November 6,2015. Subject to the following conditions; CONDITIONS: 4 Page 3 of 3—February 18,2016 ZBA#6917—Israel SCTM#1000-35-6-27 1. The existing frame shed on the subject property shall either be demolished or be made to conform to the size and location requirement stipulated in ZBA decision #4815 before a certificate of occupancy is issued. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. 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. Vote of the Board: Ayes:Members Weisman (Chairperson), Schneider, Dantes, Horning. Member Goehringer was ab e . is Resolution was duly adopted(4-0). AihalTh/V-e4 i f i Leslie Kanes Weisman, Chairperson Approved for filing 1 /2016 o FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL DATE: October 21, 2015 TO: Amy Martin (Israel) AMENDED:November 2, 2015 205 Bay Avenue Greenport,NY 11944 Please take notice that your application dated October 7, 2015: For permit to demolish an existing dwelling and construct a new single-family dwelling with elevated patio Location of property: 685 Osprey Nest Road, Greenport,NY County Tax Map No. 1000—Section 35 Block 6 Lot 27 Is returned herewith and disapproved on the following grounds: The proposed single-family dwelling on this non-conforming 14,595 square foot lot in the Residential R-40 District is not permitted pursuant to Article XXIII Section 280-116B,which states; "All buildings located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists and which are adjacent to tidal water bodies other than sounds shall be set back not less than seventy- five(75) feet from the bulkhead." The construction has a setback of 63±feet to the existing bulkhead. In addition,the proposed construction is not permitted pursuant to Article XXIII Section 280-124, lots measuring less than 20,000 square feet in total size, require a front setback of 35 feet. Site plan indicates a front yard setback of 29± feet. NOTE: As per ZBA decision #4815, an existing±7'x8' shed to be located in the north/west side yard 2' from property line. Site plan indicates a 7.1'xI 1.9' shed located±1.5 feet from property line. Amended to reflect site plan received on 10/30/15. Authorize ature Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC file, Z.B.A John M.Bredemeyer III,President y • Town Hall Annex Michael J.Domino,Vice President 54375 Main Road t P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee ' { Telephone(631) 765-1892 Charles J.Sanders,Trustee 4e Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application V Wetland Permit Application Administrative Permit Amendment/Transfer/Extension -s " Received Application: 3i21/t EFI .. __ ' ` Received Fee:$2&-0,0-0 V,Completed Application: 3i 5��� it E i; Incoomplete: MAR — 2 2016 SE RA Classification: Type I Type II Unlisted t Coordination:(date sent): So:t'+%iJ T^:?' jK+ LWRP Consistency Assse�We Form: �g`/�0 �.._ r{ 1 V7CAC Referral Sent: t/Date of Inspection: J.13/gip Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: 4,201/0 _ Resolution: Name of Applicant: i10144 11 - k/ , Mailing Address: f j ))( 2./e-74f /? EA/7 ,�� /A/ //910 Phone Number: 5/-- %'D2—s-Z ) Suffolk County Tax Map Number: 1000- 3.5-- Gj - 2 7- Property Location: ; ./ 0'3 A, 4P (provide LILCO Pole#,distance to cross streets, and location) AGENT: 7 7�/ AJ f //rT? had .5 (If applicable) I Address: Phone:43/-*_7V-1-2.6)- \14 C . Board of Trustees Application GENERAL DATA Land Area(in square feet): /I/6T ', 7- Area Zoning: £- v Previous use of property: .5 - _ sd Intended use of property: Sl %' (Ly XeS/DOGE Covenants and Restrictions on property? Yes / No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? )( Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? X 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.? 3c-• Yes No Does the structure(s)on property have a valid Certificate of Occupancy? A Yes No Prior permits/approvals for site improvements: Agency Date ii'"AP4 ,APAP-evAb 48-4, 6646S— AppR-oVED 4.72 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 jlial,4"i om a 1323-s P 6(nfiie._ J l � ,y g3 s e :. - ,,4 Forth avd 60-16 r !� 01aGe[it� .144 I ' 1 / AIt 1 ; k I W L keftilt q load is G0P-1/--Feet- / aJ '/ re td t&t "The popoSed Houk dx�al� l ceet w t - 1 , polio b a.Z--Ora,/' I ►5�IS �ve�rac 2 r .0 ` I Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA r ' Purpose of the proposed operations: L":I/1i1,�AV Az! 1d Area of wetlands on lot: square feet Percent coverage of lot: 19 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest,distance between nearest proposed structure and upland edge of wetlands: — feet Does the project involve excavation or filling? No X. Yes If yes, how much material will be excavated? l 4(9° cubic yards How much material will be filled? I 14-6217 cubic yards Depth of which material will be removed or deposited:_ .. b feet • Proposed slope throughout the area of operations: 14, Manner in which material will be removed or deposited: i 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): ` � t 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -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 I 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: Project Location(describe,and attach a location map): 8.S OSP SST )9 , 6-4377'14,-10A4 AIK Brief Description of Proposed Acti n. nol14-5-on 106c f 10.4 t Nc� 3g3-4 s.c CA-g- poel, AN3>. I 43 3 - Fb 1 €rtes c eE- l)c-r4A ii 2,161 3 G--1 F'I.lzy -ml 1)0 l-r--i emey ►)-1 - - -fbiN 1 kOisca-s r1 G �--xtr1rbc , 6 &I'4/ -r 1:314/44X-A,DT-0 km)D ,T+lE Pe6ET, use Ser cpd+lr oil firiom--6emE Name of Applicant or Sponsor: Telephone: oi. 7 SpA � FES 1 ab y lter� f'C, f�6Mii5 E-Mail:I o (! by0AnaArazikzec m Address: 265 -1 f 71414/6- City/PO: State: Zip Code. Q2W\fP�r N> I RAN I.Does the proposed action only involve the legislative adoption of aplan,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 (I nmay be affected in the municipality and proceed to Part 2. If no,continue to question 2. J'� 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: zeDA.-AttpagnrEDY , - �iNCy1/906,0,4-770/./ L 77 -Or—,/D/1i GegiDrca?-ieW u JO .s-ED . 3.a.Total acreage of the site of the proposed action? rr 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? I 35 acres 4. Check all land us s that occur on,adjoining and near the proposed action. ❑UrbanRural(non-agriculture) ❑Industrial ❑Commercial Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify); ['Parkland Page 1 of 4 5 Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? [1 I� l b.Consistent with the adopted comprehensive plan? l �'" El 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 11 R 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: �I, U 8 a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? wig c.Are any pedestrian accommodations or bicycle routes available on of near site of the proposed action? ill 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 t. .n existing pub private water supply? NO YES If No,describe method for providing potable water: _ I j 11.Will the proposed action connect to existing wastewater utilities? p-1c.... NO YES If No,describe method for providing wastewater treattm nt:pep_ �STof�j D 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NOYES Places? ►�1 n 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? • `J If Yes,'identify the wetland or waterbody and extent of alterations in square feet or acres: -i�1.1 F El' 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest 0 Agricultural/grasslands DEarly mid-successional ❑ Wetland 0 Urban .J 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? Zl ( l 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? 3 NO RYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO :(]YES ASVZI ;—. • -d, Ai Page 2 of 4 A18.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,darn)? 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: _ _ J< 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 INFORMAT ON P t 0 1DED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY . NOW LEDGE / Applicant/spo sor nal - Date: "G l t� 1 at e. I -AO 11-;A'„�,E .40'4110.7 i 'Q./.1(.4/ %�/�_'.L.cr Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of thefollowing 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? dr f 4. Will the proposed action have an impact on the environmental characteristics that caused theri establishment of a Critical Environmental Area(CEA)? ri/ 5. Will the proposed action result in an adverse change in the existing level of traffic or X ('�affect existing infrastructure for mass transit,biking or walkway? 4 I 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? [Zr1 7. Will the proposed action impact existing: 7.4' a.public/private water supplies? b.public/private wastewater treatment utilities? FT 8. Will the proposed action impair the character or quality of important historic,archaeological, ,Er 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 \N / 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 if problems? 11. Will the proposed action create a hazard to environmental resources or human health? n W 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, it reversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. s f i .$ s z ' LICheck this box if you have determined,based on the information and analysis above,and any supporting documentation,Lthat the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. EdCheck 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 enviro m nttal ' ppcts. Town of Southold-Board of Trustees Name of LeadAAg�iaincy Date b (3(`"v` ,( President Print or Type e of espo s,ble OfficiN Lead Agency Title of Responsible Officer dl' s te A . r . ._. `� Signal j/of•esponsib =O leer in Lead A'�ency Signature of Preparer(if different from Responsible Officer) __ _ PRINT Page 4 of 4 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK -al residing at -- i 1/ wit , being duly sworn, deposes and says that on the _j day of-- J 20/‘", deponent mailed a true copy of the Notice set `orth in the Boar. of Trustees Application,directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at MhZ(i,/ ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETU� RECEIPT. i op Sworn to before me this I Day ofd; J , 20 K"–i\ ,L 64 1\Afr blot u — – – – --- , ary---P–b-lic CONNIE D. BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14, 2 91 4 John M. Bredemeyer III, Presiaent �4��5 LcoG��.` Town Hall Annex Michael J. Domino, Vice-President ,'� x � s 54375 Route 25 Glenn Goldsmith` ;1 y €k 4 '� �` a P.O. Box 1179 t�, A. Nicholas Krupski .� �� c Southold, NY 11971 Charles J. SandersTelephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of RICHARD & LISA ISRAEL COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS I, ,Z, .1& , residing at/dba 75ell 474 'Kel r 777/ // // being du y sworn, depose and say'. That on the%)y of cji , 2016_, I perso ally posted the property known as by placing the Board of Trustees offs ial poster where i' can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,April 20, 2016. Dated: ,I ii le) / Sworn to before me this 13-11, day oA°ri 120/ (0 Notary Public CONNIE D.BUNCH Notary Public,State of New York No.01 BU6185050 Qualified in Suffolk County Commission Expires April 14,2 -0 -I. I I l� ' Postal ''1u!.44401 -?..,A = ' 4 ` ' U.SP,osfal Ser.,ce� • 17 4t,` - ' , - CEROFM , -- - ,,, '€EMI okt FIEDMAIL° RECEIPT N ` tv , 4 ,: � . re0 ri ' 1'Uomestic,Mail k . ,„li,,,, e m a DomesticMaOnl/ N,i ' r rv ' '' 03 "''`F"or deliver`information website at www us s:com ,�ED alb delivery,tnfortnatl n''visit}our website at www us s.com1 x EAST HAt1f'T0 c NY 11937 n n ( i-.� RIVERHE@0; " 11 "!i,1 •, ., 11 h ( r' -0 L)., Li- t if ! 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Extra Services&Fees(cheek box,odd fee p te) 9 I r 0 Return Receipt(hardcopy) $ •r-r ) ,c ..a 0 Return Receipt(hardcopy) $ ' '� - � D 0 Return Receipt(electronic) $ $0 a 00 j� Postmark CP\i D ❑Return Receipt(electronic) $ $1-1.111) I /(® Postmark D ❑Certified Mad Restricted Delivery $ ( M� �ieCt0 t D ❑Certified Marl Restricted Delivery $ '9i l 1-On Fire'-t9r8Y916 ❑Adult Signature Required $ $(� 0 r��tatrtJ t D 0 Adult Signature Required $ $0.00— rL6�@ 0 Adult Signature Restricted Delivery$ , D ['Adult Signature Restricted Delivery$ o Postage $0.49 \ ,' Postage �� -� 7 �'�� $ $0.49 'O4(/C�9'/9O11,6 D Total Postage and Fre. 0711J097,201, 6 D Total Postage and Fees $6.74 es.74 - $ 74 $ Ln t' ,I Sent TL�, JrJ 1-1 714hC. /e46Sent To /6L ,iles Streetyleg 182* 1 r- 2ate A�p�,Nov� o. £1 5,ZlP+474.0 ”y / e2 Cit .- Zl.- mailer.) / ' l�3 Ps or ' G E116;117-530.02-0o-9047 ," ,W2?� { 3800,, • M7530-02-000.9047' t nft'' at - 1j S'Postal Set ieeTM„ , ' ''' CERiTIiFI'ED MAIi�° RAE 4- Tri ,* Djomesttc,Matl OnIY:'' f}''''; ��s' 'a ''7�"`'t " R 'I ,,.17 For deliver tnformatlon vis t our website at www u"y"s'�s corn ,r a „.) it ! j4 4 g u it- = Certified Mail Fee 45 U ';''''Or 8 e m $ J• t?.q� 1"~ Extra Services&Fees(check box,add fee ey orq,Qrngte) �(' 1 ,—.01.,-, ,-,3 0 Return Receipt(hardcopy) $ 5lt•.."•' 7,-..V's, IO 0 Return Receipt(electronic) $ $U.01 J Iz / Postmark D 1:1 Certified Mall Restricted Delivery $ In-no rlu q- Her �t D 0 Adult Signature Required $ $0 a 00— r p�ig— 0 Adult Signature Restricted Delivery$in i F� i' Postage $i 4.49 `. O Total Postage and14,46/ Fges.74 ''. ___ r-R Sent7,, ,e50'',,,, „ s Ir Stree�y51A L/of or i-ibB e: ai y J,q41,7 -City Sttaaatte,ZIP+4° • v' I �/� �' ,7i✓effii.a1! / 11-•1 l r( i cat 11` ':SN 7530o2 b0e90i _ )31 -e Reverse for'lliaagt60 - I- PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: - pro, s STATE OF NEW YORK 3`;'. COUNTY OF SUFFOLK oerng duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 ------�totary Pubic--------------- NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: RICHARD & LISA ISRAEL SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the demolition of existing single family residence and carport; construct new 2,793sq.ft. two-story dwelling with new foundation, and 1,154sq.ft. above grade patio on seaward side; abandon existing sanitary and install new sanitary system on landward side of dwelling; and install gutters to leaders to drywells to contain roof runoff. Located: 685 Osprey Nest Road, Greenport. SCTM# 1000-35-6-27 TIME & DATE OF PUBLIC HEARING : Wednesday, April 20, 2016 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 -board- of Trustees Application AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE.PREEMISES 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. j / rinf P operty Owner SWORN TO BEFORE ME THIS / 1--1* DAY OF Fe V(Aa Y •,20 I (p, Jessica Leu Notary Public,State of New York sc!fle46A/0, No.02LE6306669 Cualified in Suffolk Court Notary Public Commission ExPifes° tp_Ia 3 I ? 9 Board of Trustees Application AFFIDAVIT ! )1BEING 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. V-teL,p9 Signature of Property Owner • SWORN TO BEFORE ME THIS DAY OF A (LAQY ,20 < <P Jessica Laud Notary Public,State of NewYodt I OCU,LekNo.021E630f3t;89 Qualified in Suffolk County Commission Erriires ofe L l a 3 ' I Notary Public Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) /e ms residing at T2 (print name of owner of property) mailpr5x address) p p ( g 413J9% T ity 894,/ do hereby authorizRbt r / 4e,ic / (Agent) 7e `er_ ° 1) .�.,• qi l� to apply for permit(s)from the Southold Board of Town Trustees on my behalf. i Owners stgna ,. • • ,2,04 board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, &1-Li _ ! 4 - residing at m (print name of owner of property) (mailing address) ag..03\feafr'i . 116M do hereby authorize •f ,lo (Agent) ) pe, D 11e. 4,6',00-1-5-- to apply for permit(s)from the Southold Board of Town Trustees on my behalf.' 7111111114 (Owner's signature) i 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. '---RYOUR NAME: a II) ���die-4141— (Last name,first name,middle i itial,unless you are ap)lying in the name of someone else or other entity,such as a company.If so,indicate the oth r person's or company's name.) TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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 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 that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)'the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP (4 Submitted this )41' *y of 0 ,20 /67 r� Signature j1w� y Print Name faV 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. YOUR NAME : ./ e A� (Last name,first name,middle initial,unless you are applying irfthe name f someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone _ Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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 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 that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP l0// — Submitted thisof 20 y/ /lam Signature Print Name • APPLICANT/AGENTAREPRESENTAITVE TRANSACTIONAL DISCLOSE FORM '1`1ie T9 7t,iif•SontholdtSCod'a of Ethiesls iltibl)cconflfctl•of irtterispen t(ie part•of town officers,andiemployeos:The purpose,of 1.� ' 1.111 , t►� ie f!1l1 itl..l, i. s. .. -�1 u- 'a'ii:'' 0.:* ..1i ..",i..l w.,.of;.�. .; ��� _. + r"t.�':i - ii Lractai�i.' necessary to avoid same. t A� _ YOUR NAME: L-4440 vl V (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance .. .„- Trustee Change of Zone , Coastal Erosion Approval of plat Mooring Exemption from plat or official map - Planning Other " (If"Other",name the activity.) Do you' eretinally(oilluetlgii yr<ur ompaity,,spouse,.si ,iing,parent,-or child)have a relationship with-any officer or employee of the TOM of Southold? "Relationship"includes by blood,iilarriage,or,business interest."Business interest"means a business, including;a porinership+•in which^the town oftieer or employee has even a partial ownership of(or employment by)a corporation in which•titetown officer or emp)a co owns more titan 5%ofthe shares. YES 1v 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 ,\ I A —' - - - 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): J)the owner,otgrca(er,than 5%a ofth'e''sashes'af therciiirporate'stocit>f the applieent (When theapOIiia(tt''la,ii:coipoi'ation); - - " the-legal or;l ertefcial'owner,ofany interest in a non-corporate entity tlie• `applicant.is;nat•a corporation); , C)an-officSer director,partner,coreitmployee of tlae applicant-or U)the actual applicant. DESCRIPTION OF RELATIONSHIP ., • fes' V Submitted this day of 4.414./41F,...„,200 • Signatu =►, ' �lCu/.� - Print Name Form TS 1 • APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM ' .IL rd I I , , .75 �A� „:!:. '.;..C, '• riU !t -tee rmt. !:. (his form is-to provide Information which can atertthe town of DOSsihle conflicts of Interest and allow it to'take whatever action 1$ necessary to avoid same. YOUR NAME: (Last name,first name,fiddle 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 (lf"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 orempioyce 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 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 A)1 • 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%ofthe,sharlcs'of the corporate stock of the applicant (when the applicant is a eorporadon); • 1\1t"` 13)the legal or'beriefreial owner of any interest in a non-corporate entity(when the 'applicant is not a corporation); ' tJ)iui officer,director,partnei or•employec of the applicant;or D)the actual applicant. • DESCRIPTION OF RELATIONSHIP t> I`pry 'J• t— Submitt,•' hi. •L ' of , 20-rte Signatu .1 \ .. 1_— Print Name W.! _trhW 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 benefcial=and adverse effects upon the coastal area(which includes all of Southold Tow* 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# 35- C, - 21- PROJECT NAME ( 7/CT The Application has been submitted to(check appropriate response): Town Board IT Planning Board fl Building Dept. ❑ Board of Trustees N' ZA4 a p a) 1. Category of Town of Southold agency action(check appropriate'response): ( ps,�c) (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) Perm ,approv , icense,certification: Nature and extent of a tion: T12,t9 321' i / 6 t ' ' '440i ' Cf 3; 6r ( Ol*) 0,n0/143 . 3 5F foych 5 16 -(46< :.-Peplap_e_. Lol (1/2,0 g.743 e -640-9 ( -chi-W ti bzWint Gv �( 1P0 1 f ) d c9& dJ 13 -6( roof II -�. �h��� -�r� hci �l ad . df, —Pr ess' ue w/p ►o races Location of action: 69S 71e5sprcy Site acreage: 3� Present land use: Y j 4„,„,r-i.G(JV Present zoning classification: e` l ' 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: -kt a,fd 71 1)1 c,ct 16raet (b) Mailing address: T Q, y))( 21 ex) 6ree(10-, 1944 (c) Telephone number:Area Code,( _) I — ''i 02 - 52.6 (d) Application number,if any; - &9' I Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes . No PIC If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how theprojectwill 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 El No a 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 El Yes E No J1 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 H Yes NoR Not Applicable _ f 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 11 Yes FT No E 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 El 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 Not Applicable • 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 J NoJ 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. Li 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. El Yes-- No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES 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. r Yes n No gl 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. Li.Yes Nog 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. N, Lt` YesNot 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 ✓ �_� TITLE L� d� 75 J �.�L._. �- DATE 10 / / /_�G / /7