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HomeMy WebLinkAboutTR-8829 Michael J.Domino, President � Ol0 Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders cis Southold,New York 11971 Glenn Goldsmith ® �O Telephone(631) 765-1892 A.Nicholas Krupski �Cot WN Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: r ® e-L t :7 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: Michael J.Domino,President ®f Solok, Town Hall Annex *70 John M.Bredemeyer III,Vice-President ti0 lO 54375 Route 25 P.O.Box 1179 Charles J. Sanders Southold,New York 11971 CA Glenn Goldsmith ® Telephone(631) 765-1892 A.Nicholas KrupskiO Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1403C Date: October 23, 2017 THIS CERTIFIES that the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1 418sq.ft. second-floor; construct 468sq.ft. addition to dwelling and first-floor renovations, enlarge the existing seaward side 412sq.ft. bluestone patio an additional 212sq.ft. with a stoop, for a combined total of a 624sq.ft. bluestone patio with a new bbqrig llin area; At 1875 Calves Neck Road, Southold Suffolk County Tax Map#1000-70-4-48 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 20,2016, pursuant to which Trustees Wetland Permit#8829 Dated June 22,2016,was issued and Amended on February 15, 2017 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1 418sq ft second-floor; construct 468sq ft. addition to dwelling and first-floor renovations, enlarge the existing seaward side 412sq.ft. bluestone patio an additional 212sq.ft. with a stoop, for a combined total of a 624sq.ft. bluestone patio with a new bbqirg lling area. The certificate is issued to JOSEPH&MAUREEN COOGAN owners of the aforesaid property. Authorized Signature �oF 80�r Michael J.Domino,President ®� yp�o Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O. Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski l/f'COU �`C,'' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES - February 15, 2017 TOWN OF SOUTHOLD Frederick R. Weber, Architect 52 Noyack Path Water Mill, NY 11976 RE: JOSEPH & MAUREEN COOGAN 1875 CALVES NECK ROAD, SOUTHOLD SCTM#: 1000-70-4-48 Dear Mr. Weber: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, February 15, 2017: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8829 to enlarge the existing seaward side 412sq.ft. bluestone patio an additional 212sq.ft. with a stoop for a combined total of a 624sq.ft. bluestone patio with a new bbq grilling area; and as depicted on the site plan prepared by Frederick R. Weber, last dated January 20, 2017, and stamped approved on February 15, 2017. Any other activity within 100' of the wetland boundary requires,a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, O Michael J. Domino, President, Board of Trustees MJD/dd SITE DRAINAGE: TEST HOLE DATA DR AREA VOLUME (Required) DRAINAGE STRUCTURES VOLUME (Provided) P E R TY McDONALD GEOSCIENCE Partial House, _ (1) 8' Dia. x 5' Deep w/ 211 cf C O O G A N PRO A 1043 sf x .166 Rain - 113 cF SITUATE APRIL 1. 2016 Attached Garage Traffic Bearing Top Elev. +16' (+/-) Partial House, (1) 8' Dia. x 5' Deep w/ 211 cf S O UTHO LD DARK BROWN LOAM (OL) B 1252 sf x .I6G Ram = 206 cf O 5, Front t Side Porch Traffic Bearing Top BROWN SILTY SAND (SM) C Driveway- Existing 920 sf x .166' Rain = 153 cf (1) 8' Dia. x 4' Deep w/ 169 cf TOWN OF SOUTH 0 LD 3' (if Re-Surfaced) Traffic Bearing Top I u u SUFFOLK COUNTY, NEW YORK D New Bluestone Patio 212 sf x .146' Rain = 35 cf (1) 4' Dia. x 4'-4" Deep w/ 39 CF no Traffic Bearing Top S.C. TAX No. 1000-70-04-48 A,� House and Porch Roofs to have Gutters ! Leaders SCALE 1��=2�' PALE BROWN FINE SAND (SP) Connected to Underground Drainage Structures (Typ.) 8'0 Ring: 42.25 cf/Ft of Height NATHAN CORWIN, LAND SURVEYOR SURVEYED: DECEMBER 20, 2015 ADD TOPOGRAPHY: FEBRUARY 23, 2016 WATER IN IC PALE BROWN FINE SAND (SP) AREA = 15,843 sq. ft. (TO TIE LINE) 0,364 ac. Q RESIDENTIALeAe CONT N ESNALONG J F + Ir O wO JOCKEY CREEK �� s `'o S , h +2' x. 0 , off• r r `�����:, JO +z.* 15) AOJT� �� r: r`�\,,k;` +5. X+4.8 d ` + CRAWING TITLE: P i , 60 r' d \X Py - 5 , p� P� � +2. SITE PLAN `fi:� 1j2� �`'�� Pq +4. 17-- +17.37N! � Ab t16.9� G �� h 1 'GipY 4p /`ti \� `Q 0�`�O �,`;.�`� X+3.6 �! t 17.3 1 C ���G�o 0 / ``'K h -� �d _'••.. t6\3 19 `ry ES i 516.9 �8t:'0 ' s `; `� `\ `.\�` .�`\`` %\qS +2.8 �0� NEAD MR i\ ` e�_:('��� \+1 '� ` � (• AR n R 16/i! \ .t:.•:?c::. C �Jo i yy..,..: �\\ �\` ♦X .`` `�`````` `. `SO 1� /o/s % ' `\ / :/r.RY.'. '::::•::: 4:•i:�Oxl� 7 } •S• O! DI2�'D' B ••..'.�:: �\ �` `` ``�`,` ,\ ` \ JOB. �{,, -" ....�.,.>'. �� \ `. �` `• `. Q� 1� T JO N IDR'A'�I=" •:`:: :.. Jc y / l \ ` \ ` `` W 1�; of 1 TEST _o ::$ ..:::X:. `. O i A/gFto/1i`F ��� IN �� 'R ,?qR 2.2 RENOY,4TION/ HOLE ,; F `, ` ` ? ? ADDITION <` \ Py ,�' �8\ 0 tri(\!, Sox � Py ��� ���\\. �``�\�+,N�O` `�� ��O�s +1� `�C'i`Qfti 2 ,� �j �i y Y/9 0� +15. �, `� \ ` �•��`� +22 +16.0 '�� �:'•::atT:::::::. � �0 '7' � .� \\ �``�` `x \P� -"'}DR•C I -ROUT .e' '1sJs��lo� X+,s.o �A `\\ 4� a 1813 CALVES NECK ROAD `-- AS REQUIRED \ ': �� A/' `\ ` e s SOIJTHOLD. NEW YORK TO MAINTAIN \ �" Q • P \ ct A;:. �{',:;:�::::. 5� +16.7T DR'e'I �, :: `\ +1* A2� / +15. 10' CLEARANCE T C ret X A F� \ "� 'i?i:: ? li":::. d\d�t� \ -/ _ :::' "- `. / TO SANITARY �`, \_, TOWN OF SOUTHOLD X TRENCH DRAIN ! \ W ah-O : 0 °S'/ °Oq \ y...:.: y�O'.:::............... (••Q 0 ``•` ```�`` i r �n SCTM# 1000-10-04-'48 O "! A ! IF DRIVEWAY /� ` ����.� tr:::;•;., W4D ` • 0 RE-SURFACED i / LP#I / e!." " FO ON• /'X lL.� I '.:X+15.9. \ / •::::•:4.. i t;ONC.M ., NOTE: !/X+ .5 �k; \\ \�-ir`� `.�`k\ +16. +16.5° ' +15.4 7S 66 �^ J< 1 �r 77 EXISTING / TOPS L `\ / NEW , " %< \ "" it'o ��° -0 S I O`C. ARCHITECT: (� DRIVEWAY TO B / T o ,Q CONSTRUCTION +. O ST, KPI E \ / SANITARY I SEPTIC�� ;rc ,N o� 1144.0d v 'STAGMG AREA' +15.3 ' , 1� X SYSTEMIZE O\ I °moo pgNCE Fj \ -� ` �_� `�`�> �°_ 9i`T11 FREDERICK R. WEBER /AOS�A >( i `; i " :,° Ate° 41 EAST MAPLE ROAD / r \ U / / i _ _ RESIDENTIAL GREENLAWN. NY 11140 N 0 F T i WATERFRONT JOHN & ROSEMARIA WALSH ! S ��,;``� x+15i°�° ° - Reno EU EXISTING >, F CONTINUES ALONG SINGLE FAMILY DWELLING Q x F ro �L� F�"+E ' SANITARY SYSTEM 1.1�0� �c�TERER JOCKEY CREEK 52 NOYAC PATH / ) it CO Ec 5 A IN THIS AREA R�+- 1 (PUBLIC WATER) �O� ' ,, S 3 S W� �E`'�RER WATER MILL. NY 119'14 x , \ C�ERaL 1414_ R pWE�UNG) ` (5114GVE UBMC Wp,7(ER) TEL 431 Z54-5555 P fweberarchitect9gahoo.com NORTH �1 9 % SITE PLAN JAN 2 s 3 2G17 JAN 20, 2011 I" = 20'-0" .� REV.: MAY 9. 201L _ o,.s,,,,d 1awn ar f T 1 ne DATE: APRIL 11. 2014 SCALE : 10 - 20' LOT COVERAGE (20% MAX.): JOB NO: w201510 LOT AREA: 15,8-I3 SF4,Ca e\GK R, �. LOT AREA TO BULKHEAD = 15,365 SF APPROVE® BY zo ^"r 4F DRAWING NO. EXISTING BUILDING AREA = 1,191 SF (11.1%) BOARD OF 1 RUSTEES � y PROPOSED ADDITION OF x{68 SF 65+ 1191 SF = 22SF (14.'1 %) OWN OF HOLD r `� _ SOUT LOT AREA TO TOP OF BANK = 11,310 SF Q EXISTING BUILDING AREA = 1,191 SF (15.8%) � �7 , ILS SF + I,-191 SF = 2265 SF (19.9%) DATE FQd /s20 PROPOSED ADDITION OF o OF A3 Coogan Existing Patio httf-,•"-~ail.aol.com/webmail-std/en-us/PrintMessage From: Frederick Weber<fweberarchitect@yahoo com> To: Burger Construction<burgerconstruct@aol.com> Subject: Coogan Existing Patio Date: Thu, Feb 2, 2017 10:28 am Eugene-Attached is existing patio sf plan=412 sf(New patio w/stoop=212 sD Total=624 sf Frederick R. Weber, Architect (631) 754-5555 D \, EI Illy, FEB - 2 2017 Southold Town a fT 1 of 1 2/2/2017 10:46 AM 41 EAST MAPLE ROAD, GREENLAWN, NY 11-140 ROBERT 52 NOYACK PATH, WATER MILL, NY 11916 WESER (631) X54-5555 Q�C�N1�4C�6�1' pE EIVE January 20,2017 JAN 2 3 2017 Southold Trustees ouiholdtown Tr PO Box 1179 Southold,NY 11971 Re: Joseph&Maureen Coogan 1875 Calves Neck Road, Southold,NY SCTM# 1000-70-04-48 Trustee Permit No. 8829, 6/22/2016 Southold Trustees: We have an existing Southold Trustee Permit for renovations/additions at the Coogan Residence and construction work is proceeding. On the water side of the house there is an existing bluestone patio that was shown on the site plan,but was not referenced in the permit as there were no proposed changes to it. We would like to increase the size of that existing patio to allow for an outdoor dining area. We are proposing an additional drywell to contain the runoff from this increased patio area(212 sf) as shown on the site plan. Also a grill space is proposed on top of part of the existing patio. We would like to amend the permit to reflect these changes which are shown on the attached site plan. Please let us know if you have any questions or if any additional information is needed. Thank you. V truly your Fr derick Weber,Architect i Michael J.Domino,Presid' o�QS�fFQj�co p Town Hall Annex John M.Bredemeyer III,Vice-Presia�,nt may` Gym, '� 54375 Route 25 Charles J. Sanders c P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:-�-3 1'-1S?K Completed in field by: C, OOVLP,j - Ecot(ItV Frederick Weber on behalf of JOSEPH & MAUREEN COOGAN request an Administrative Amendment to Wetland Permit#8829 to enlarge the existing seaward side 412sq.ft. bluestone patio an additional 212sq.ft. with a stoop for a combined total of a 624sq.ft. bluestone patio with a new bbq grilling area. Located: 1875 Calves Neck Lane, Southold. SCTM# 1000-70-4-48 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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 Hearing Card Posted: Y / N Ch. 275 " Ch. 111 SEQRA Type: 1 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: l Present were: J. Br demeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 uMo ono � LIOZ Z83� 03 16 • j \ 6 16 rR. 00 '� w G% loll ,. A, 41 ot On ae oe Off' 16 70 00, � a Xs � Boa � 41 - ,� C, , Michael J. Domino, Presid, 1r O1QcoG Town Hall Annex John M. Bredemeyer III,Vice-President ,� y� 54375 Route 25 Charles J. Sanders P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Frederick Weber on behalf of JOSEPH & MAUREEN COOGAN request an Administrative Amendment to Wetland Permit #8829 to enlarge the existing seaward side 412sq.ft. bluestone patio an additional 212sq.ft. with a stoop for a combined total of a 624sq.ft. bluestone patio with a new bbq grilling area. Located: 1875 Calves Neck Lane, Southold. SCTM# 1000-70-4-48 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. :525% 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 t' R r d � � I rd _ -AOO I IL "1R•_ k': 1 F r"7SVF John M Bredemeyer III, President Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 Glenn Goldsmith r,� �:; 2 `-' P.O. Box 1179 A. Nicholas Krupski "�� �► Southold, NY 11971 Charles J Sanders '' ol , y��- r Telephone (631) 765-1892 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, hay bale line 1St day of construction '/ constructed Project complete, p p compliance inspection " 71!.­ Paa�i BOARD OF SOUTHOLD SOUTHOLD, NEW YORK T 0 PERMIT NO. 8829 DATE: JUNE 22, 2016 ISSUED TO: JOSEPH & MAUREEN COOGAN PROPERTY ADDRESS: 1875 CALVES NECK ROAD, SOUTHOLD SCTM# 1000-70-4-48 AUTHORIZATION' Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on June 22, 2016, and in consideration of application fee in the sum of$250.00 paid by Joseph& Maureen Coogan and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit for the existing two-story'dwelling with attached-enclosed porch and attached garage; remove the existing second-floor; raise existing first-f[66i"walls; construct new 1,418sq.ft. second-floor; construct 468sq.ft. addition to dwelling and , first-floor renovations; and as depicted on the s plan prepared by Frederick R. Weber,Architect, last dated May 9, 2016, and stamped approved on June 22, 2016. M: A 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 of this do,— sxlfw C0013 >�•�'�� j'f,��i:�dvu'X:::is"��Zrfi"u::i/.x:k`i/Tl6Yu.'�•. ('¢t��? „1 % TERMS AND CONDITI®NS The Perr!ittee Joseph&Maureen Coogan,residing at 1875 Calves Neck Road, Southold, 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 Pen-nit 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 i-aterfere with the riparian rights of others in order to perform the permitted work nor does is 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 i I I John M.Bredemeyer III, President S0uT/y®l® Town Hall Annex Michael J.Domino,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G ® ap Telephone(631) 765-1892 Charles J. Sanders Fax(631) 765-6641 �eou V BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 22, 2016 Frederick Weber, Architect 41 East Maple Road Greenlawn, NY 11740 RE: JOSEPH & MAUREEN COOGAN 1875 CALVES NECK ROAD, SOUTHOLD SCTM# 1000-70-4-48 Dear Mr. Weber: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 22, 2016 regarding the above matter: WHEREAS, Frederick Weber, Architect on behalf of JOSEPH & MAUREEN COOGAN 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 May 20, 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 June 22, 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 JOSEPH & MAUREEN COOOAN for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1,418sq.ft. second-floor; construct 468sq.ft. addition to dwelling and first- floor renovations; and as depicted on the site plan prepared by Frederick R. Weber, Architect, last dated May 9, 2016, and stamped approved on June 22, 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, dVA_ qw-� _W_ John M. Bredemeyer III President, Board of Trustees JMB/dd SITE DRAINAGE: COOGAN PROPERTY TEST HOLE DATA AREA VOLUME (Required) DRAINAGE STRUCTURES VOLUME (Provided) SITUATE McDONALD GEOSCIENCE APRIL 1, 2016 p,/g House/Porches � (2) 8' Dia. x 5 High w/ cr S 0 UTHO LD 2295 sf x .166 Rain = 381 cf Traffic Bearing ToQ 422 DARK BROWN LOAM (OL) 0.51Driveway (Existing) TOWN OF SOUTH OLDBROWN SILTY SAND (SM)3' House and Porch Roofs to have Gutters t Leaders SUFFOLK COUNTY, NEW YORK Connected to Underground Drainage Structures (Tgp.) (� S.C. TAX No. 1000-70-04-48 8'� Dome: 62 cf L=J 8'� Ring: 42.25 cf/Ft of Height SCALE 1 " nc)PALE BROWN �, o FINE SAND (SP) A2F NATHAN CORWIN, LAND SURVEYOR SURVEYED: DECEMBER 20, 2015 ADD TOPOGRAPHY: FEBRUARY 23, 2016 WATER IN OV AREA = 15,843 sq. ft. 16, FINEESANDu(SP) (TO TIE UNE) 0.364 CIC. o° c� gyp, •'�i ?�4 S Com` 6 ��h �'9 Off• 0 O 6� o 335 6�6 •�O r5'' ` + w `C� o0 00 DRAWING TITLE: Ln Tlk o PJB° J�SO�G SITE PLA N 3• Cl 41 rn O VARES / S � ? f h G- � f ir'...�:::::::1'::.?O } •S. 'rye, �"::. �y S SqG tv /l� iS DR'�%�_ — :z:: jT':' ':: :?::.'O• �,p 'O. @4 F9 S9 <cp JOB:r .... REN OVATION/: " r??aHT ° UlADDITION ,y Y .. • . •� . 1815 CALVES NECK ROAD r s ;DR"B) c'°°�,Py SOUTHOLD. NEW YORK SZS ti 1 LPuI �° TOWN OF SOUTHOLD Q Aja s 5CTM#- 1000-10-04-48 iNEW / ?S 6 v (SANITARY 13 t =PTIC - - �' , (� SYSTEM STANK v �� `'-'_ - p N 144• 7 p'P �� ARCHITECT: •;,. FREDERICK R. WEBER Y M 41 EAST MAPLE ROAD '' GREENLAWN. NY 11140 _ 600 FOUND `�l R I 0 CONC MON. �� O A 7J4" �1, N °/QIES RE MAY 2 0 2016 ;,_, ' S 'i GHARLE p`NE RIES�RER 1 52 NOYAC PATH & GERA f. WATER MILL. NY 11914 TEL 431 154-5555 ....'s.W'..y..s 11. .... O �yF9 °cF fweberarchitectsyahoo.com ° o XI NORTH LOT COVERAGE (20go MAX.): SITE P L A N_ LOT AREA: 15,843 SF LOT AREA TO BULKHEAD = 15,3:;5 SF I" = 20'-0" REV.: MAY 9. 2014 EXISTING BUILDING AREA = 1,191 SF (11.1%) DATE: APRIL Ill. 2014 PROPOSED ADDITION OF 468 SF + 1191 SF = 2265 SF (14.1 %) LOT AREA TO TOP OF BANK = 11,310 SF SCALE : i" 20' EXISTING BUILDING AREA = 1,191 SF (15.8%) PROPOSED ADDITION OF 468 SF + 1,191 SF = 2265 SF (19.9%) �, \ JOB NO: w201510 % `%: DRAWING NO. APPROVED 6y • 490 ARD OF TRUSTEES j T WN OF SOUTHOLD QATELl TVA16 z2 ��� / OF A3 ov'I To Ro"" ME::] naric �11 Lj 3,g't �'&'T FfzIm-v' tt�-' i7 oa-A—i' 17- T-4, ZA -51 L F r-yz� mff:cr K p ' ��•% ���, � of � f '� . r, � , iL �'DE� 7,-V x,nlp TV UsA 7-1 7 t L7 'Ile=1 or ----—-------- f I IT-IT -V - kO 441 A 1 wy ------ John M Bredemeyer'III, President :?'o��s6' ��z KoG`=. Town Hall Annex Michael J. Domino, Vice-President '� < 54375 Route 25 Glenn Goldsmith ` o P.O_ Box 1179 A. Nicholas Krupski ror ' Southold, NY 11971 Charles J. Sanders 4oj �� ;' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD olf 10.2-VA TO: Please be advised that your application dated M 20( 2_01(0 has been reviewed by this Board at the regular meeting of 3VA11 22, a0l& 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) '/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: $ BY: John M. Bredemeyer III, President Board of Trustees John M. Bredemeyer III, President ted, k,. �pSUot� FF ,`4 , Town Hall Annex Michael J. Domino, Vice-President U - �jo Gy� 54375 Route 25 Glenn Goldsmith o ` P.O. Box 1179 A. Nicholas Krupski o ,' Southold, NY 11971 Charles J. Sanders Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD ti Date/Time: ( ` Completed in field by: ` Frederick Weber, Architect on behalf of JOSEPH & MAUREEN COOGAN requests a Wetland Permit for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1,418sq.ft. second-floor; construct 468sq.ft. additions to dwelling and first-floor renovations. Located: 1-875 Calves Neck Road, Southold. SCTM# 1000-70-4-8 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage oyOK=q 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 Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 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: t Present were: e/J. Bredemeyer M. Domino _eO Goldsmith (/ N. Krupski C. Sanders Other Page 1 of 2 John M Bredemeyer III, PresidentR f, cofF0(x4 Town Hall Annex Michael J. Domino, Vice-President ,�� yq 54375 Route 25 Glenn Goldsmith o $ P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J Sandersy o� Telephone (631) 765-1892 Fax (631) 765-6641 zri:rd�" BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Frederick Weber, Architect on behalf of JOSEPH & MAUREEN COOGAN requests a Wetland Permit for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1,418sq.ft. second-floor; construct 468sq.ft. additions to dwelling and first-floor renovations. Located: 1875 Calves Neck Road,, Southold. SCTM# 1000-70-4-8 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. :525% 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 I SURVEY OF PROPERTY SI T UA TE SOUTIHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-70-04-48 SCALE 1 "=20' DECEMBER 20, 2015 FEBRUARY 23, 2016 ADD TOPOGRAPHICAL SURVEY AREA = 15,843 sq. ft. (TO TIE LINE) 0.364 ac. CERTIFIED T0: FIRST AMERICAN TITLE INSURANCE COMPANY JOSEPH COOGAN MAUREEN COOGAN NOTES: O'(F 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM 00o EXISTING ELEVATIONS ARE SHOWN THUS:15.0 o EXISTING CONTOUR LINES ARE SHOWN THUS: — — — —15— — — — y>� F.FL.— FIRST FLOOR �O G.FL.— GARAGE FLOOR 10� �� Fes} TB — TOP OF BULKHEAD STOP BB — BOTTOM OF BULKHEAD r TW — TOP OF WALL 10 red J ��]�� s BW — BOTTOM OF WALL ell, r 2. FLOOD ZONE INFORMATION TAKEN FROM: �`. FLOOD INSURANCE RATE MAP No. 36103CO166H 6 ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); �o 4. pD .) J,�' BASE FLOOD ELEVATIONS DETERMINED 30 06-, ,y��0' �' ZONE X: AREAS DETERMINED TO BE OUTSIDE THE 0.2% ANNUAL CHANCE FLOODPLAIN. '08' 4- 3. LOT AREA TO THE BULKHEAD = 15,365 sq. ft. �oX o`' TA\\\\ \\� oOOe 22X BUILDING AREA = 1,797 sq. ft. OR 11.7% OF LOT AREA. (INCLUDING HOUSE AND PORCH) XA�Q 41 \�t ��`�o , 4. LOT AREA TO THE TOP OF BANK = 11,370 sq. ft. o s ��E sr�A \ °/ a.a o� �1 �'� BUILDING AREA = 1,797 sq. ft. OR 15.8% OF LOT AREA. I G� \�*ry/ \ A (INCLUDING HOUSE AND PORCH) CJtjn ` 2.5 �• ,� 17\ 17.3 �P�4 TFO'r FTa�o� rrya Pv�O�o \,\ \ x 3. , N 2F.-9/ 6 1 un � \ \ f-0 Lr' Ss O `sly \ \ \ \ \ ` 'c?: 5 of X 16.8 16 23 ONERHF-o S 16.7 760 \\ \TREE\\`\� y F�\ `S9 2 J, AR46 z O ° ppz)o\ 2 , o 16.0 // 15.8 �� 9�9 j yo \ �� \ \\� \ fpQ� O w e\. s/ o MAY Zo)6 1rz�7 \ to s�\�ti' o. ti ; ;Y v\ `spPicf hh / 9 rypm \ FpVND c ti:',b•.7_S:.zsf it e Sa > \ °o /. MON. \ W y x15 \ 24" TRE OONC. \32SC �� v �� `� v oO s x1�•-� �24" TREE 76.5 15,.4 /S � O % �< _LU,,,(((\(A®l�`r •�Q'5 �\ 15.3 � 44'0 ' � -0-1 PREPARED MINIMUM S NDARDSI FOR TITLE SURVEYS ASNCE WITHH AESESTABLISHED11 s oV* / p1 �O BY THE L.I.A.L.S. AND APPROVED AND ADOPTED TIOLESA OCIAE BY HE---NEW-YQRK STATE LAND \ X 1 T� OF C \o b0 R { AU MON 4'�O» W NWC�RIE$TTERER � SPT C >% e \w•00 �s a \ S 79 0 CHARL LDINE RIE S �l 7 x• . \ & GES �Pf. 0.1 o y�� N.Y.S. Lic. No. 50467 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE 09 EDUCATION LAW. Nathan T of t Corwin COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL Land Surveyor EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE Successor To: Stanley J. Isaksen, Jr. L.S. TITLE COMPANY, GOVERNMENTAL AGENCY AND Joseph A. Ingegno L.S. LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI— Title Surveys — Subdivisions — Site Plans — Construction Layout TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 35-270A � . ;��' t r • -� •�•_. 111 1 .. � ��_ I ���- � _ _. ._.yam � -_y.:, `'�.'. r n- - i �� ", . "�" ��i � .f � ��� 'r _ i_� '? � �• 4 � � � P � I _. f -. rr . e �� .4f' � '' �/ �; i . , a.. 1,► ---� t � � to "i, � ,.►!r .. � � , . i e � w it ','0.. •'f� �� /�.•. + F'►� �.i r.y r y i - 1> S' I� �;i New York State Department of Environmental Conservation Division of Environmental Permits Building 40-SUNY,Stony Brook. New York 11790-2356 Telephone (516)4440365 AM Facsimile (516)444-0360 John P.Cahill LETTER OF NONJ RISDIGTION TIDAL WET[ ANDS Commissloner August 25, 1997 Mr. & Mrs. Russell Mann RE: 1-4738-01166/00004 1775 Calves Neck Rd. Mann Property Southold, NY 11971 SCTM #1000-70-04-48 Dear Mr. Mann: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that the property landward of an imaginary line drawn between the seaward edges of two existing substantial man-made structures greater than 100 ft. in length, constructed prior to August 20, 1977 as shown on the survey prepared by Van Tuyl & Son, dated October 18, 1965 is beyond the jurisdiction of Article 25 Tidal Wetlands. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Ve trul yours, SR Per itlt Administrator MMR cc: G. 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J] '!° - 53 ♦ •,• _41 a w 3 n a w _ 2 2] 66 0 SOHOD — —_--— 1—035 —1— "54sm MATCH UNE E_-_-v...a,a,.. NOTICE � § ,•'ai s/ Z .�o.,.�,... --.-- .,o,,..... --x-- s n C s9 wN nr SOUTHOLD SECTION NO —�— (21) ,� cotr COUNTYOFSUFFOLK K 063E sdy rReal Property TaxServlceAgency r ,v070IG N • °niOei " sem' --- oma,.. --,-- axs..--•-- �* C1.1tYCenterfLXeraed,NY11901Oe9D �� n rMalu,z,A — — J ar M mo ucc ar 12 1 AI<I -- -- - FacF 1Ax sFmic6ACFncsy:� A 518rn xo p o 7000 PROPERTY MAP John M_ Bredemeyer III, President ��oF SoTyO Town Hall Annex O l 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 G Charles J.Sanders, Trustee '" ® �� Telephone(631)765:1892 < coU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES , TOWN OF SOUTHOLD To: Southold Town Building Department Re: Verification of Building Department Permit Requirements SCTM#: ' -7LI--4—� Property Owner Name: ` Date Sent to Bldg. Dept.: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO V Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will anypart of thisapplication be considered as Demolition as described under Town Code? COMMENTS: 9nats of Reviewer Date Fuentes, Kim From: fred <fweberarchitect@yahoo.com> Sent: Monday,June 20, 2016 4:17 PM To: Fuentes, Kim Subject: Coogan ZBA Attachments: cooganZBA0001.pdf - Kim, Please withdraw our application per the attached letter.Thank you - Frederick Weber, Architect E C E kyg Sent from Mail for Windows 10 D JUN 2 1 2016 Southold Town i --- Board ofTri e 1 i { f f G3( DoC�30C�C3 41 EAST MAPLE ROAD, GREENLAWN, NY 11140 52 NOYACK PATH, WATER MILL, NY 119-16 GiOoC�CGi� (631) 754-5555 WISER Q36f;��4C�6T C-37Eu E June 20,2016 JUN 21 2016 Southold Town Zoning Board of Appeals PO Box 1179 Southold,NY 11971 Scuii7uid icwn fT e Re: Joseph&Maureen Coogan 1875 Calves Neck Road,Southold,NY SCTM# 1000-70-04-48 Southold Town Zoning Board of Appeals: I would like to withdraw our zoning variance application#6963 for Joseph&Maureen Coogan scheduled to be heard on Thursday,July 7,2016. We have revised our plans to reduce the lot coverage to 19.9%(by reducing the size of a proposed front porch)and are on the agenda with the Southold Town Trustee for this plan.In the future we may re- apply for a zoning variance. Thank you. Very truly yours, Frederick Weber,Architect OFFICE LOCATION: �®v S®���® MAILING ADDRESS: Town Hall Annex �® �® P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) CIO Southold, NY 11971 ® �O� Telephone: 631 765-1938 ®`yCow,� 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: June 16, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for JOSEPH & MAUREEN COOGAN SCTM# 1000-70-4-48 Frederick Weber, Architect on behalf of JOSEPH & MAUREEN COOGAN requests a Wetland Permit for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1,418sq.ft. second- floor; construct 468sq.ft. additions to dwelling and first-floor renovations. Located: 1875 Calves Neck Road, Southold. SCTM# 1000-70-4-48 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 provided the following is required for further Policies 5 and 6. 1. Require that a vegetated,'non-turf buffer that incorporates existing vegetation is established landward of the top of bank. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. ogyFFO�,���� , Peter Young,Chairmanti Town Hall,53095 Main Rd. Lauren Standish,Secretary d P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 15, 2016 the following recommendation was made: Moved by John Stein, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of JOSEPH & MAUREEN COOGAN,to,remove existing second-floor, raise 1,418 sf. first floor walls, construct new second-floor, new additions and first-floor renovations. Located: 1875 Calves Neck Rd., Southold. SCTM#70-4-48 Inspected by: John Stein Vote of Council: Ayes: All Motion Carried S®UTA John M.Bredemeyer III,President '®`� ��.� Town Hall Annex Michael J.Domino,Vice-President ~ ® 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Telephone(631) 765-1892 Charles J.Sanders,Trustee cQU Fax(631)765-6641 ��,- BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD - - Office Use Only - -_-- - - oastal Erosion Permit Application Wetland Permit Application _Administrative Permit - .Amendment/Transfer/Extension Received Application:_ 2®�//D_ (-' Received Fee:$Z�5_0.M Completed Application:, ►1 Incomplete: �� { ''? _SEQRA Classification: - LL ? MAY 2 0 2016 ! Type I Type II Unlisted s oordination:(date sent): WRP Consistency Assessment Form: ` Sou'E c!d Tr,'n t CAC Referral Sent: np;FPe� Date of Inspection: 6.15-4to- -Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: .7-2./ Resolution: Name of Applicant: QS �1-�•} i�, -_. ( � _ Mailing Address: '3 YID t � �/ ip1rT� ��"( W-\�Ak 'lam Phone Number:051 Ga) Suffolk County Tax Map Number: 1000- Property Location:- (provide LILCO Pole#, distance to cross streets, and location) AGENT: Rt f. �Ih� —'+�; / 17 a (If applicable) Address: + th - &/n,I , LtmIA) \ f 5� Cori - - - _ - - Phone: 'ward of Trustees Application GENERAL DATA Land Area(in square feet): ,,0-v�J_. 51 r Area Zoning: ii o c0 N C-?A t yt�c? Wo-z !L4ao 10,_190 s F) Previous use of property: __ btJ(1& 11,`i-t 1WgA age _yl✓�X QP GARA�e,- Intended use of property: _CE_ Covenants and Restrictions on property? Yes _No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? X 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 -No Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: Agency Date 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):_ k 5g— F1,4P-2 r ward of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of-the proposed operations: x '13 a u Area of wetlands on lot: ���o - square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: 2,,J feet Closest distance between nearest proposed structure and upland edge of wetlands: ?�2=�'. feet Does the project involve cavatio or filling? No _Yes If yes,how much material will be excavated? __ o�r _ ,qubic yards . How much material will be filled? - ._Q_ cubic yards Chi GVZ�L S�rSC�� Depth of which material will be emov or deposited: D' °� et la-ac t't7zsfz„—� , Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): L ADDVR'I�15 K1 2,�d1� Hca�v��' y,�SCL r L ®ifs ( D11�1�(Zdp f b / o I s`I11�t upt�4C , AU, o C9N5NWCk10 N \►�11J(Zi�-- UUw� c�t.4� z�JfG l �ti r, rS 5 -- .l 5 L - � 617.20 Appendix B .Short Environmental Assessment Form Instructions for ComL)Ielling 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): Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: ` ,.. 5b—S5 E-Mail: 9webSr ay CMM- Address: City/PO: State: Zip Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. if no,continue to question 2. 2. Does the proposed action require er�55 funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or -j Is pEC "Now �lndei�SD1G�►Of�" f S tl.�,9LY� Co�.t,� Siaa�i l'�'`1 �'1��'^r, �v+�.o dap e 1Rt3�'jZ�� � ❑ 3.a.Total acreage of the site of the proposed action? m -6 acres b.Total acreage to be physically disturbed? "052 C2 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? r�J� acres 4. Check all Iand uses that occur on,adjoining and near the proposed action. [:]Urban ElRural(non-agriculture) ❑Industrial ❑Commercial residential(suburban) ❑Forest ❑Agriculture OkQuatic ❑Other(specify): ❑Parkland Page I of 4 5. is the proposed action, -- - NO YES N/A ` a. A permitted use under the zoning regulations? _❑ TKO-, b.Consistent with the adopted comprehensive plan? E:I M "U , 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 FTI 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? 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 existin public/ rivate water supply? NO YES If No,describe method for providing potable water:_ 11.Will the proposed action connect to existing wastewater utilities?� S NO _YES , If No,describe method for providing wastewater treatment: 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? � 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? moi' 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., u 14. Jidrntify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ",Wetland- ❑Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 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? XNO DYES EJ t5�1I b.Will storm water discharges be directed to established conveyance systems(runoff and tortn drains)? If Yes,briefly describe: _ ONO .NYES Page 2 of 4 u 8.Does the proposed action include construction or other activities that result in thim e poundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: _ n 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: _–_--- - -- -- _-- ,-- — _-- --_ Off I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons r mOR Date: Signature:__ F Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the..following ; questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" ; -- – --- Nb,or' Moderate small to large impact impact may may occur occur - F I., 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? a El 4. Will the proposed action have an impact on the environmental characteristics that caused the f71 establishment of a Critical Environmental Area(CEA)? LUJ_ El S. 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? u El 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? E_ 8. Will the proposed action impair the character or quality of important historic,archaeological, a architectural or aesthetic resources? LJ 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 - — - No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? a H. 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. t 3 � Check this box if you have determined,based on the information and analysis above,and any supporting documentation, '• that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. IL7J1 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees d Name of Lead Agency _ ' Date— - -J�h 11 _r3� � President Print or Type me of Responsible 0 er in Lead Agency Title of Responsible Officer Signa re of Res pon " fficer i 61o6d Agency Signature of Preparer(if different from Responsible Officer) i PRINT Page 4 of 4 r , PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: a STATE OF NEW YORK COUNTY OF SUFFOLK Ubup , residing at, W1 , being duly sworn,deposes and says that on the t day of �'ca�t�, , 2Q(h,h, 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 ��{;Y�.l�Af1.6'� ��, , that said "ces were mailed to each of said persons by CERTIFIED MAIL +TURN RECEIPT. i Sworn to before me this ( --644\ Day of�u�sL , 20 1 �4 _ Notary Public CONNIE D. BUNCH Notary Public,State of New York No.01 BU6185050 Qualified In Suffolk County Commission Expires April 14,2Q17 (� �% �1� �. Win. � �� �� mac`--i� ��. L���� rzrx��z John M. Bredemeyer I I I,''r-,esident 1r19 -; Town Hall Annex Michael J. Domino, Vice-President r'a� �. y<A� 54375 Route 25 Glenn Goldsmith ' ,? P.O. Box 1179 A. Nicholas Krupski �y� o� Southold, NY 11971 Charles J. Sanders o� ��j;.' Telephone (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 JOSEPH & MAUREEN COOGAN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, 61UX- W , residing at/dba 4kap, being duly sworn, depose and say: That on thel�day of Z"mQM , 2016, I personally posted the property known as 1615 C,Wt� om N , C--ow.-mot-0 4. by placing the Board of Trustees official poster where it 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, June 22, 2016. Dated: (si nature) Sworn to before me this � - day of J, - 20 t 6 JOSEPH B ABBATE Notary Public-State of New York NO. OIAB6269204 Qualified in Suffolk County Noty Pu c My Commission Expires -C`(- aI;Servfce7 USS. Po" V 'EC IPT �- C EATIP'[ED MAIVRECEIPT ZD MA E Domestic Mail Oniy0 Domestic Mail Only t-=1 .D Izi CP Certified Mad Fee co $3.30 / �I�7� {_I Certified Mad Fee $3.30 t t 74•I_I Extra Services&Fees(checkbox,add fee Opp a,�ate) C"y �7_,j°(7 1 � 7 Cf• FJctra Services&Fees(check box,add feeµs8p/��eto) '• Ill ❑Return Receipt(hardcopy) $ C/j i"' ❑ Return Receipt(electronic) $ I I,I i i I (� Pi7 mark ` ❑Return Receipt(hardcopy) $ I r+') a p0 tmark 0 U) ❑Return Receipt(electronic) $ _ j�� 1:3 ❑Certified Mail Restricted Delivery $ u_!,1 U `tire %7-. 1- ❑Cettflied Mail Restricted Delivery $ 11[]Adult _ 9 � Adult Signature Required $ v^_:� � `�� I M Adult Signature Required $ $171.0 _ ®� J.- 1 Adult Signature Restricted Delivery$ \ O g ` ❑ O Posta a \\ \1 Adult Signature Restricted Delivery$ =I- g $'i_.6v (��?(� p Postage $1:1.68 ti� �// Total Postage and Fees ),1�1'f l 11 $ °' I ibf 1 ',i 116 0 res68 .a Total Postage and ees g - L) Sent To y� Sent To 1 rn �l.{�y 76 4-G1Je-1--- -— ` � - rl Q -------Fi `----------------------------------- Stre t andApt.N.,or PC7 Box No. Street rid t No.,or PO Box No. --��� 'k ---------------------------- �r {��/ ,_ ------------------- Cr�Y�S�tate,ZIP+4� Ci Sta ZIP++4® W�s �m 9Y ` 55 2 ry �o,�r b 19 :11 1 :II 1 II 111•I I I - 1 Postal Servicle"m CERTIFIED �MAILO RECEIPT M1, I, Only Ln O SEEM= GARDEN VA-. 3 .0 Certified Mail Fee 3.30 I 114 ff Extra Services&Fees(checkbox,add fee p We) ❑ Return Receipt(hardcopy) $ tq; /� ��� tr) [I !1,�:I I O Post alk C3 Return Receipt(electronic) $ � f�t E3 ❑Certified Mail Restricted Delivery $ CC) 'Her 0 []Adult Signature Required $ - �( []Adult Signature Restricted Delivery$ O Postage $0..bEy ,� $ !16 } Total Postage and VSs;a 1:3O Ov $ ' Lr) Sent To ��69�1 ------------------�- ,L�'�---�kd_ __�----------------- C3 Street-a d Apt.No. PBox N. k, [�- ------.V ---�------------------------------------------ Clry,Sta ,z/ ;49 p +�� PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: '76 76 - STATE OF NEW YORK COUNTY OF SUFFOLK residing at being 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 MAEURE TURN RECEIPT. Sworn to before me this Day of , 20 i i i Notary Public ,NUTILI: U :I - H 't- ARING 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: JOSEPH & MAUREEN COOGAN SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing two-story dwelling with attached enclosed porch and attached garage; remove the existing second-floor; raise existing first-floor walls; construct new 1,418sq.ft. second-floor; construct 468sq.ft. additions to dwelling and first-floor renovations. Located: 1875 Calves Neck Road, Southold. SCTM# 1000-70-4-8 TIME & DATE OF PUBLIC HEARING : Wednesday, June 22, 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 � AUTHORIZATION (where the applicant is not the owner) I, ✓�' ��t- �'�� 1� residing at zy (print name of owner of property) (mailing addres ) dss 0 _ do hereby authorize (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. ner' gnature) - t. Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) -residingat STN (print name of owner of property) (mailing address) CAT- Y I Vii'->�o hereby authorize (Agent) 1/t''RCTM1 yto apply for permit(s)from the Southold Board of Town Trustees on my behalf. (O er's signature) i 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 SOUTHOLID 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 a 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 7BOjO;FTRUSTEES DURING THE TERM OF THE PERMIT. e lst� ature o roperty Owner SWORN TO BEFORE ME THIS DAY OF ALANNA RUSSO NOTARY PUBLIC-STATE OF NEW YORK No. O1 RU6300963 Qualified in Kings County My.Commission Expires April 07, 2018 Notary Public c 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 PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property O 7 SWORN TO BEFORE ME THIS 1 ( DAY OF ln'1 ,20 Notary Public MPRT.H P. PJRiLrr,t',1 Ch.�Gtiic�(i ,rt i!ct° a APPLICANT/AGENT/RE-PRESENTATM TRANSACTIONAL flDISCL®SIRE FORM ; The Town o(Sonthold's C—ade OfMics i ohibils conflicts of interest o the cart o to £ c s and e i !o ee The a os n t this form is torovida intprination which can alert the toEvn of possible oan#licts of interest and allow it to talce whatever action is riecessary to avoid same. Y YOURNAME! i (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.) j C 'i NAME OF APPLICATION: (Check all that apply.) i 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 tile town officer lir employee has even a partial ownership of(or employment by.)a corporation in which Ute town officer or employee owns more than 5%of the shares. YES NO , If you answered"YES",complete the balance of this form and bate and sign where indicated. C 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)andlor 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(tic shares of the corporate stock of die applicpn.t C (when Ute applicant is a corporation); 13)the legal or beneficial owner of any interest in a non-corponite 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 - C Submitted this d of 200 �l0 Signature. A ' Print Name to Form TS I C Y' t AP A.J1Y..L'8-LVVtSYIIE1V H/8'�-+�5911'.fSE AT V d.' TRANSACTIONAL DISCLOSURF,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the Dart of town officers and employees.The purposo of this form is to provide information which can alert thetown of imssible conflicts of interest and allow it to tale whatever action is i necessary to avoid YOUR NAME: (Last name,first name,apiddle initial,unless you are applying in the name of someone else or other entity,such as acompany.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 ofplat Mooring Exemption from plat or official map Planning Other ¢f"Other=,name the activity.) Do you personal ly(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,ntarriagc,orbusiness interest"Business interest7-means a business, including a partnership,in which tlac town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns moae 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 br position of that person___ Describe the relationship between yourself(the applicantlagent/representative)and the town officer or employee.Either check the appropriate line A)through D)andfor 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 tie applicant is a corporation); ti)the legal or bene6eial owner of any interest in a non-corporate entity(when the applicant is not a corporation); _C)an opicer.director,partner,oreinployce of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thisday of 20(�(P SignatureL . m Print Nae Q 1 Form TS I - F ' K � . t 1 APPLICANT/AGENUREPRESENTATIVE ; TRANSACTIONAL DISCLOSURE FORM The Town of Southold's c6de o(Ethics prohibits conflict's of interest on the Dart of town offieecs and`emplovecs Tlie mtrnose of this fonnis to it ovide'itiforination which Dan alert the tdti of possible conflicts of thterest and allow ttto take_whatever actiotias necessary to avoid same. /h �Q `p� YOUR NAME: F 'wa— 'z• "" (Last name,first name,middle initial,unless you are applying to 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.) (i Tax grievance Building Variance Trustee Change of Zone _ Coastal Erosion 4 Approval of-plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or,tllroukh ypttr company,spouse,,sibling,parent;or.child)have a relationship with any officer or employee of the Town of Southold?."Relationship",itichidi s by blood,-njarriage,or business interest."Business interest means a business, including a parineeship,ht-vhicWthe town,dffiedr or employee has oven a partial ownership of(or employment by)a corporation in which the town cifficer ar employce 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 t 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): ' i the owner,of greater,than-5%ofthe.share-s'of the corporate-stock of the applieont (wheii th'e applicant is ic0i00r'afi0bX B)the legal or beneficial owner of any interestin anon=corporate entity(when'the applicant is nom corporation); an ofticer,'directar,partner;oreniployec of.the applicant,ur- D)the actual applicant. DESCRIPTION OF RELATIONSHIP t ' Subtnitted th�r a of Signature Print Name r vt1 — A Form TS l Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt -minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si -if icant beneficial-and adverse,efCects upon the coastaLdrea'(which-includes d1of�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.'answ-er must be.explainM in.detail, listing both•s+ pnorting 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# 4 — PROJECT NAME-� The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate"response): (a) Action undertaken directly by Town agency(e.g. capital ❑ 'construction,planning activity,agency regulation,land transaction) 0 (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Location of action-, P0110c), _SOLI Site .A-C,K Pi Present land.use: S 1N G,1✓r2! rNm I)w M'J_ RJ C-4 - Present zoning classification: 12.` t,, , -- - - 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided:rte a W-0 0 (a) Name of applicant: VR%:!�ew%yr_ W 6' 1 AV&-ti l''llW1 �,$ (b) Mailing address: "l•6 ROAD (c) Telephone number:Area Code( 1��'a1� �_��_��✓ � __ ; (d) Application number,if any: - - - - - - --_- - - --- - Will the action be directly undertaken,require funding,or pproval a state or federal agency? Yes No, If yes,which state or federal agency? Idol - P U-1 i ll LUTPd>,_ OP ON- JUA%bB I CTWDM 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. ,J Yes �,: No P.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 0 Yes'n No Not Applicable Attach additional sheets if necessary 4 Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ❑ Not Applicable Attach additional sheets ifnecessary ; NATURAL COAST POLICIES Policy 4. Ndlinimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages S through 16 for evaluation criteria 8 Yes ❑ No F] Not Applicable M!aQ0' - 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 - T 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. \Ae5 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 D NoNot 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 evaluatiop criteria. z 0 Yes O' 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 YeO No RNot Applicable Attach additional sheets if necessary it Y] WORDING 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. ❑;Yes Q NoIRI 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 M—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. 11 Yes M NogNot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ,❑ No Not Applicable PREPARED BY -- - - L-Y�l W__ 1 M TITLE 1 a DATE-MM, qAkj