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HomeMy WebLinkAboutTR-9007A *OF SOUTH, Michael J.Domino,President �0� Ol0 Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders CA Southold,New York 11971 Glenn Goldsmith y@ Telephone (631) 765-1892 A.Nicholas Krupski ®r�COUM� Fax(631) 765-6641 e BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1342C Date: May 30, 2017 THIS CERTIFIES that the existing+/-I Fx16' wood deck located landward of the bulkhead; and for the existing 4' wide removable beach stairs off bulkhead; At 6970 Indian Neck Lane, Peconic Suffolk County Tax Map#1000-86-7-5.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 18, 2017 pursuant to which Trustees Administrative Permit#9007A Dated May 17, 2017, was issued on 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+/-I Fx16' wood deck located landward of the bulkhead; and for the existing 4' wide removable beach stairs off bulkhead. The certificate is issued to Robert&Patricia Rushin owners of the aforesaid property. Authorized Signature �Ofr SOOT Michael J.Domino,President � y�l� Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders u, �c Southold,New York 11971 Glenn Goldsmith �� Telephone(631) 765-1892 A.Nicholas Krupski Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 51d&1-7 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction % constructed Project complete, compliance inspection. INSPECTED BY: �tI �CnpSV•' COMMENTS: os9ve_ CERTIFICATE OF COMPLIANCE: � (/Ty ` Michael J. Domino, President pF SO ®� ®l® 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 �`� ® a� Telephone(631) 765-1892 A.Nicholas Krupski l�'�®U 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/silt boom/silt curtain 1 st day of construction Y2 constructed Project complete, compliance inspection J P com p P �pE SOljT Michael J. Domino,President ®� yO�® Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders N Southold, New York 11971 Glenn Goldsmith ® �� Telephone (631) 765-1892 A.Nicholas Krupski l`�COUNTY Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9007A Date of Receipt of Application: April 18, 2017 Applicant: Robert & Patricia Rushin SCTM#: 1000-86-7-5.1 Project Location: 6970 Indian Neck Lane, Peconic Date of Resolution/Issuance: May 17, 2017 Date of Expiration: May 17, 2019 Reviewed by: Board of Trustees Project Description: For the existing +/-11'x16' wood deck located landward of the bulkhead; and for the existing 4' wide removable beach stairs off bulkhead. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by John C. Ehlers Land Surveyor, last dated April 10, 2017, 2016, and stamped approved on May 17, 2017. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees S�FFQ(,r Ft Michael J. Domino,Presid p0 COG d b1- Town Hall Annex John M. Bredemeyer II1,Vice-President �� y,, 54375 Route 25 Charles J. Sanders N P.O.Box 1179 Ze Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupskip! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD Date/Time: Completed in field by: Deborah Doty on behalf of ROBERT & PATRICIA RUSHIN requests an Administrative Permit for the existing +/-11'x16' wood deck located landward of the bulkhead; and for the existing 4' wide removable beach stairs off bulkhead. Located: 6970 Indian Neck Lane, Peconic. SCTM# 1000-86-7- 5.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=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 earing 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: I��!s c)K P ��Kru ki Present were. J Bredemeyer M. Domino G. Goldsmith N ps, C. Sanders Other Page 1 of 2 S�FFI?(�'' Michael J. Domino,Presid �Q ell Town Hall Annex John M. Bredemeyer III,Vice-President �� ��,,, 54375 Route 25 Charles J. Sanders x P.O.'Box 1179 Glenn Goldsmith D ' Southold,NY 11971 A.,Nicholas Krupski , �a� �� Telephone 1) 765 31) 6664892 Fax(63 a BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Deborah Doty on,behalf of ROBERT & PATRICIA RUSHIN requests an Administrative Permit for the existing +/-11'x16' wood deck located landward of the bulkhead; and for the existing 4' wide removable beach stairs off bulkhead. Located: 6970 Indian Neck Lane, Peconic. SCTM# 1000-86-7- 5.1 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 5UR\/EY OF PARGEL A --- ------- 5Uf3P 1\1151 ON MAS' OF PAMELA G. MOTTL YI ANE? PATFZ I G I A 6. BUSH I N N FILED IN THE OFFIGE OF THE GLERK OF SUFFOLK COUNTY OGTOBER 16, 2001 AS MAP No. 106cf7 1/1 SITUATE: PEGON I G W E TOWN: SOUTHOL1? I SUFFOLK GOUNTY, NY SURVEYED 03-28-2017, 04-10-2017 lhdian Neck SUFFOLK COUNTY TAX # —_- _ _ _- oad 1000 - 86 - 7 - 51 = f N89'21.00T 616T �7�}�r7�+ p��7,� tr7 150200' CERTIFIED TO: PATIRIICIIA 1LOWRY JOHN TOl[H EY WELLS v ll'L'ilRGO BANK,N.A. 1 # ABSTRACTS,INCORPORATED � f4 QST AMERICAN TITLE INSURANCE COMPANY � ff - APPROVED Y f .:�. BOAR® OF 1 RUSTEES TOWN OF SOUTHOLD I �N APR 2 7 2017 1 ®ATE .«...,.�....�#�._��PCI.�t.!l.�i.'f�'��.a.�...��...._.- � � ,�'v`�r%s'"'��-L--� .r- �.�„.��33'"1''L...:.-.A-••�,y 6 �o 3 1 ops / S ii � � 1 + 19 4 � f Q 1`II O/ �•� � I o L �^ •�,�s maso�� o �� f I \ rf F I Q_ o Q Q31- 6po 0 3 N e oAo11 � �s L � � S del o�q 1 Nuo '• d- 4�y ?� I 2r�` �� i woo X02 0,,, s ytePy` `eoJ 1 k,�' rn - o F� G 4 Go o DETAIL epa \e\�0 O GRAPHIC SCALE I"= 40' °°d N ao y ® o S � ° I 0 yo l 0 y\0 0) N� rc ,L •0 fQ`iO N®lA II_rr rl�i Stu[L .tion L.rri it I, -rl,iri�I F lli. -'1-'- NOTES ® MONUMENT FOUND t m,u r.•..;u `.I ur`,`ulh Lir-. .05 ,, 0� • REB60202 AR FOUND SR, .C� Ic t' I•-r rr fLr r r.rrr tlir r�r �Ir.,r.,`.,,rr.J �p }," ^� �.Y/tl tl r t tr r�fzr.Llz t� Irf i_�rnl ur.lrir�lr�i�- k� $.t�� AREA = 6 i,ll8 S.F. OR 1.54 AGRES GRAPHIC, SGALE I"= 60' JOHN C. EHLERS LAND SURVEYOR. mom OEM 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 rm RWERHEAD,N.Y. 11901 369-8288 Fax 369-8287 0 60 120 IgD REF:C:\UsersUohn\Dropbox\04\04\04-337 update 03-08-2017.pro r� out a - P' FCONIc lr� C�il� JEcT' � �i �p_o1TIbtJ � . SOD pc• rY AMP a r 7Pdi9� i - yp a ►iLP�RrE �tE?'URK xtt Et�rlD�rrhpljc,, ® 1 / If ' ._ /��. �Y�rY�-�•aWD.s�iiGCirl6 3xY7�9 Q TDT49OWB&roTS f dtO.vX �""'`��% Y '' a �' . i IG�,A D C LIIAIAIY act' ., �� r t SlsIL�.SD -/ N - _ ,dict yvr�lNa����D,rim BEET 1 �'z ,4l/6//57^a3-/9g3 kobert&Patricia Rushm 1,970 Indian Neck Lane, oi 1000-86-7-5.1 5/9/17 - 70 t _. - - _�fa _ --. '�.- 'T- .: -i 'ray�7�.f t ,•*4-.i:'-'. �. V, a`i , . jot Ir .mgvog T� ti Sol, / J'E. �' _ ' -w; 7 .r / •, •1 1!_ S� l� # a—� 5"� � ;' {III � • i ifA APB cX d P- Fc0NIc Vit,z a� • sow Ae o •- .ter � � �!'�cr,,�� Pc• 1�rctN�rY ,rte °' v -• 7Z°s:Sib-4477-11W 8 85B lf`mf 4x9 rIllw4.d B � �i- p � Vr GJc��,�i�`iy/�x9':�O t 3�T•M8 8CA11'M _ • ® , 9� rfs� 1' - � ,�, 71d•Q=�ix4�7f�$G'f� 8Y ti / js _ � !�f'•e�1.c�ita¢.�Sy>l'���•/aaYQ.�,�[K/d'dGy .Skf!�l TA TRE G t�'B�r�1id k'3'�Cdr. �r z G L11A14 NYa ° Ar NAVA-MOW ��' ,4ri6vo;-aV-� '3 !liillli!ill 11111!1111�illl lllli Iilll!illi Illi!ill!lilt flllllfrlllll�llllillllll S V F Oiiia COMY CLERIC RECORDS OFFICE ]RECORDING, PAGE Type of Instrument: DECLARATION COVENANT/RESTRICTI Recorded: 07/08/2002 Number of Pages: 5 At; 01:09:19 PM LIBER: D00012195 PAGE: 878 District: Section: Block; Lot: 1000 066.00 07.00 005.001 EBAmn= AND CMMGED AS FOLLOWS Received the Following Fees For Above Instrument Exearpt Exempt Page/Filing $15.00 NO dandling $5.00 NO COB $5.00 NO IRYS SURCEG $15.00 NO TP--584 $0.00 'NO Notation $0.00 NO Cert.Coples $0.00 NO RPT $50.00 NO SCTM $0.00 NO Fees Paid $90.00 THIS PAGE IS A PART OP THE INSTRUMENT Edward P.Romaine County Clerk, Suffolk County 1 2 3 Number ofpages P.ECOR08D TORRENS 2062 Jul 88 OlsO9e19 PH Eduard P.Rwaine Serial K CLTM OF SUFFOLK COUNTY Cortificalc 0 L 0=12195 P 878 Prior af.6� Deed/Mortgage Instrument Deed 1 Mortgage Tax Stamp Itccordlug/riling Stamps /// FEES Page/filing Fee Mortgage AmL Handling 1.Basic Tae TP-594 2.Additional Tax Notation �J Sub Total FA-52 17(County) Sub Total SpecJAssit. CA-5217(Stale) Or Spec./Add. TOT.MfG.TAX 22_ S -1t�+ Dual Town Dual Coutnv Comm.of Ed. 5 Held fw•Apportionment Affidavit • � Transfer Tax Certified Copy Mansion Tut _ Dre preporty covered by this mortgage is or Reg,Copy _ _ will be improved by n one or two fatuily Sub Total 0 dwelling only. Other YES or NO GRAND TOTAL_ 9 IFNO,see appropriate lax clause ou page p /h of Ihls Insarumml. Real Property'r'eeService AgenvVatincodon 16 FCOMMUnity Preservation Fund Comm Dist, Section Block Lot Consideration Amount Stamp 1000 086.00 07.00 005.001 CPF'J'ax Due S 0 Daw* 1000 086.00 07.00 005.002 Improved laitials(.tr 1 auanl Land_ 7 Satisractions/Discharges/Kelcases List Propptarty Owners Mailing Addr+es TD ^ RECORD&RETURN TO: TD Patricia C. Moore, Esq. '1'D 51020 !Iain Road Southold, NX 11971 F. Title Company Information Co.Name n/a Title/I n/a Suffolk Count Recording &Endorsement Page INS page tortmp dofthe attwhed DSC Notice Covenant _ _ made by: (SPECIFY"I'M or,INMUNB T) Pamela G. Hottlev and Patricia G. Ruskin 'lltcpwrlisesherein issituated in and Robert K. Ruahin SUN Oi.KCOUNTY.NEW YORK TO In the•rovnshipsf Southold In the VILLAGE orHAMLEI'ut' Peconic BO\PS 5711[RU 9 MUST HE TYPED OR PIUMI' D IN BLACK NK ONLY FWOR TO RECORDING Olt rum. y_ r, (OVER) DSCLARATION OF COVEKMiTS AND RESTRICTIONS NOTICE COVENANT-Raguleted Tidal Wetland Declaration made as of this Ii day of Tune, 2002, by Pamela G. Mottley, residing at 120 Fast 89th Street, Apt. 2C, New Yor}, NY 10128 and Patricia d. Rushin and Robert K. Ruskin, residing at 120 River kTorth Drive, Atlanta, GA 30328 (herein referred to as "Developery or unec?larantu), and their heirs, assigns, or successors, WITNESSETH WHEREAS, Declarants are the owners in fee simple of certain premises situate at Indian Neck Lane, Town of Southold, Suffolk County, New York, described on the Suffolk County Tac Map as District 1000, Section 86, Block. 7, Lots 5.1 and 5.2, and as more fully described in schedt!le A; and WHEREAS, the Now York State Department of Envircnraental Conservation issued a wetland permit to subdivide a 3.4 acre parcel into (1) 1.5 acre parcel and (1) 1.9 acre parcel, such permit being in conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) . Said permit is conditioned on filing of a Notice Covenant; and NOW THEREFORE, the Declarant, for itself, its successors and assigns, declares that the real property described in Schedule A is *Regulated tidal wetlands" associated with Hog Neck Bay and shall be held, transferred, sold, conveyed and occupied subject to the following: This property is subject to the provisions of New York Environmental Conservation Law (BCL) Article 25 or its successor, and the conduct of regulated activities may occur only pursuant to ECL Article 25 if prior approval is given by the New York State Department of Environmental Conservation (NYSDHC) or its successor. Regulated activities include, but are not limited to the erection of any structure(s); excavation; dredging, grading, and filling; clearing of vegetation; and application of chemicals. .Pamela G- M�ottle Pt&0 ��r- ' Patricia G. itlishin Robert K. Rushin vl State of New Yor}:, County of on the P— day of June, 2002, before me, the undersigned, a notary public in and for said State, personally appeared Pamela 0. Mottley, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity, and that by her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument, and that such individual made such appearance before the undersigned in the City of New Yor}:, State of New York. ERNESTO NEGRO Ypiyc Notary P li Not*Pubt'w.state OI Naw 1 No. 01NE_061764 Oounty atjolified : 72D C*Wd*n 9oww , $J State of Georgia, County ofG'i� ss: tl On the Tday of June, 2002, before me, the undersigned, a notary public in and for said state, personally appeared Patricia G. P_ushin and Robert K. Rushin, personally Ymown to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their capacities, and that by their signatures on the instrument, the individuals, or the person upon behalf of which the individuals acted, executed the instrument, and that such in ividuals made such appearance before the undersigned in the City of iA.J'r#- , State of Georgia. Notary Public #s Return by Mail to: Patricia C. Moore Esq. 9 51020 Main Road Southold, NY 11971 TITLE NUMBER:641-S•01497 Amended 10131101 SCHEDULE'W' DESCRIPTION TAX LOT 005.002(PARCEL B) ALL that certain plot,piece or parcel of land, situate, lying and being at Peconic, in the Town of Southold,County of Suffolk and State of New York, known and designated as Parcel B on Subdivision Map of Pamela G. Mottley and Patricia G.Rushin,filed in the(i-ice of the Clerk of the County of Suffolk on 10116101 as Map#10697,Abstract 414,415, said Parcel being bounded and described as follows: BEGINNING at a point on the southerly side of Indian Neck Road distant 1417 feet easterly from the corner formed icy ft intersection of the easterly side of Robinson Lane with the southerly side of Indian Neck Road; THENCE along the southerly side of Indian Neck Road, North 89 degrees 21 minutes 30 seconds East 84.73 feet; THENCE South 23 degrees 43 minutes 26 seconds East 807.41 feet; THENCE South 13 degrees 41 minutes 05 seconds East 76.54 feet; THENCE South 16 degrees 47 minutes 52 seconds East 61.67 feet; THENCE South 22 degrees 12 minutes 10 seconds East 162.33 feet to the high water mark of Hog Neck Bay; THENCE along the high water mark of Hoeg Neck.Bay, South 63 degrees 21 minutes 47 seconds West 51.80 feet to land now or formerly of Varano and others; THENCE along said land now or formerly of Varano, North 23 degrees 46 minutes 50 seconds West 1142.12 feet to the southerly side of Indian Nick Road and the point or place of BEGINNING. ,w TITLE"NUMBER:641-S-01498 SCHEDULE"A" DESCRIPTION TAX LOT 005.001 ALL that certain plot,piece or parcel of land,situate,lying and being at Peconic, in the Town of Southold, County of Suffolk and State of New York, known and designated as Parcel'A oh'Subdivision Map of Pamela G.Mottley and Patricia G.Rushin,filed in the Office of the Clerk of the County of Suffolk on 10/16/01 as Map#10697,Abstract#'14415,said Parcel being bounded and described as follows: BEGINNING at a point on the southerly side of Indian Neck Road distant 1,502.00 feet easterly from the corner formed by the intersection of the easterly side of Robinson Avenue with the southerly side of Indian Neck Road; THENCE along the southerly side of Indian Neck Road,North 89 degrees 21 minutes 30 seconds East 69.87 feet to the westerly side of land now or formerly of Cukor; THENCE along said land the following (2)courses and distances: 1) South 23 degrees 42 minutes 40 seconds East 531,08 feet; 2) South 23 degrees 47 minutes 00 seconds East 546.76 feet to the high water mark of Hog Neck Bay; THENCE along the high water mark of Hog Neck Bay, South 63 degrees 21 minutes 47 seconds West 82.50 feet; THENCE North 22 degrees 12 minutes 10 seconds West 162.33 feet; THENCE North 16 degrees 47 minutes 52 seconds West 61.67 feet; THENCE North 13 degrees 41 minutes 05 seconds West 76.54 feet; THENCE North 23 degrees 43 minutes 26 seconds West 807.41 feet to the southerly side of Indian Neck Road and the point or place of BEGINNING. 11111111 Illi I Illi 11111 Illll 11111 11111 11111111111111 1111 1111111 II III I I II 1111!ILII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING ]SAGE Type of Instrment: DECLARATION COVENANT/RESTRICTIO Recorded: 07/19/2001 Number of Pages; 11 At: 01:14:13 PM LIBER: D00012130 PAGE: 793 District: Section: Block: Lot: 1000 086.00 07.00 005.001 PX M33MD AND CHARGED AS FOLLOWS Received the Following Fees For Above Instr=ent Exempt Exempt Page/Filing $33.00 NO Handling $5.00 NO COE $5.00 NO TP-584 $0.00 NO Notation $0.00 NO Cert.Copies $5.50 NO RPT $23.00 NO SCTM $0.00 NO Fees Paid $71.50 THIS PAGE IS A PART OF THE INSTRUMENT Edward P.Romaine County Clerk, Suffolk County Number of pages f RECORDED TORRENS 3001 Jul 19 01r14:13 PPI Eduard P.Romafne CLERIC OF $anal it SUFFOLK COIRIV L DOOD12130 Certificate if F 793 Pdarat 0 Deed/Mortgage Instrument Deed/Morigage7ax Stamp Recording/Filing Stamps 4 FEES Page/Filing Fee Mortgage Amo Handling L Basic Tax TP-584 2.Addhional Tax Notation Sub Total G4-r 17(Counly) Sub Taal SpecJAssit. Or EA-5317(State) Spar~/Add. R P.P.S.A. �r'r, TOT.l41'G.TAX Comm.ofr-A QQ_ a , Dual Town Dual County Held fur Apportionment _ Afli • Transfer Tax Certified Copy Mansion'tax The property covered by ibis mortgage is or Reg Copy will be Improved by a one or two family Sub Total dwelling only. Other YP•3 orNO GRAND TOTAL IrNO.son appropriate lar:clause no page fI of this lnstmmmt. 3 Real lrropertyTO(SemieeAgctroyVexifieation 6 Community Preservation Fund 01s oq�. •Q) Dist. section block Lot Considetatian'Amount S_ a4CPT'1-ou Due S `• , improved e q nset� Vacant Land INiC s SatisfaatiunslllischargeslReleases List Property Owners Mailing Address TD RECORD dr,RETURN TO: '1'U r, moo m TD _ i�li)`f�t7f'i3� 11q71 s T1tle Company Information Co.Name 'title I/ Suffolk Copty Reco7r!�n &Endorsement Page This page Curets part of the attached on a r2r ito—n _made by: (SPECIFYnTEOF WSIRtJMi:` r) -RamP fct 001<fIe j The pnadlies hada is situated in - d R a /r• f�US/�/� SUn- 0LKCOUMY,NEW YORK I q�ttrr TO In the Tawnslai)rof 5,DU/Ar:/c�► �J�/iC [.0✓h ��* J� , In tho VILLAGE -) or HAMLET'of t1'L(5L"YLI.G 130XL-S 5 M41W 9 MUST BU TYPrd)OR PRINTED IN BTAX INK ON 111dORT'O RECORDINO OR AI 1M. -- (OVER) W, '. USE THIS PAGE FOR WELLS WHICH MEET XXNIMUM DRINKING WATER STANDARDS AND FOR SUBDIVISION TEST WELLS PRIVATE WELT.. CovatumS DECLARATION OF COVENANTS AND RESTRICTIONS THIS DECLARATION made b Pamela G. Nottley & Patricia G. Rushin y (fIk/a Pamela A. Guinan (f52rmerly 1n own #ts Patricia H. this W/or day 'of wtc;, , k9dGuinan) (1) residing at 1?n East 89rh Srirplafo a't?�+ NY�NV 1n19R �0A n 4i ro North Drive L•. (2). a domestic or ,foreign corporation with off-IMes located a ( a sole proprietorship or partnership- having its principal place of business at hereinafter referred to as the DECLARANT, as the owner of premises described in Schedule "A" annexed hereto (hereinafter referred to as the PREMISES) desires to restrict the use and enjoyment of said PREMISES and has for such purposes determined to impose on said PREMISES covenants and restrictions and does hereby declare that said PREMISES shall be held and shall be conveyed subject to the following covenants and restrictions: 1. WHEREAS, DECLARANT has made application to the Suffolk County Department of Health Services (hereinafter referred to as the DEPARTMENT) for a permit to construct and/or approval of plans for a single family residence, a subdivision or development or other construction project on the PREMISES; and 2. WHEREAS, the PREMISES are to be served by an individual on-- site 'private well; and WHEREAS, the test wells sampled for the PREMISES indicated that test results were within they minimum drinking 'water standards and/or guidelines of the State of New York and results are attached hereto as Schedule C. Each chemical parameter which exceeds 60* of the acceptable level is indicated with an asterisks and wHEREAS, it has been determined that Prater quality of private wells is subject to change; and WHEREAS approval of the DEPARTMENT does not guarantee that the water quality will always meet drinking water standards; and WHEREAS the DEPARTMENT recommends periodic comprehensive ~eater analysis of such swell in order to monitor the water quality to prevent the unknowing consumption of contaminated water, the DECLARANT, its successors, heirs, or assigns agrees that if said water analysis should indicate water SCDHS PRIVATE WELL COVENANTS A- (REV. 1/91) 1 t USE THIS PAGE FOR WELLS WHICH MEET MIXTN M DRINKINGS WATER STANDARDS AND FOR SUBDIVISION TEST WELLS contamination in excess of the minimum drinking water standards and/or guidelines of the State of new York, DECLARANT, its successors, heirs, or assigns may be required to, i. connect to public water, or ii. install necessary water conditioning equipment so as to meet the minimum drinking water standards and/or guidelines of the State of New York. A. As a condition of approval by the DEPARTMENT of the subdivision or development application, the DECLARANT covenants that there shall be no conveyance of any lot in the subdivision unless an easement for waterlines in approved language is provided for simultaneously upon conveyance. Such easement shall be subject to the approval of the DEPARTMENT. 3. The DRCI ARANT, its successors and/or assigns shall set forth these covenants, agreements and declarations in any and all leases to occupants, tenants and/or leseees of the above described property and shall, by their terms, subject same to the covenants and restrictions contained herein. Failure of the DECLARANT, its successors and/or assigns to so condition, the leases shall not invalidate their automatic subjugation to the covenants and restrictions. 4. All of the covenants and restrictions contained herein shall be construed to be in addition to and not in derogation or limitation upon any provisions of local, state, and federal laws, ordinances, and/or regulations in effect at the time of execution of this agreement, or at the time such laws, ordinances, and/or regulations may thereafter be revised, amended, or promulgated. 5. This document is made subject to the provisions of all laws required by law or by their provisions to be incorporated herein and they are deemed to be incorporated herein and made a part hereof, as though fully set forth. 6. The aforementioned Restrictive Covenants shall be enforceable by the county of Suffolk, State of New York, by injunctive relief or my any other remedy in equity or at law. The failure of said agencies or the county of Suffolk to enforce the same shall not be deemed to affect the validity of this covenant nor to impose any liability whatsoever upon the County of Suffolk or any officer or employee thereof. 7. These covenants and restrictions shall run with the land and shall be binding upon the DECLARANT, its successors and assigns, and upon all persons or entities claiming under them, and may be terminated, revoked or amended only with the written consent of the DEPARTMENT. SCDHS PRIVATE WELL COVENANTS AA s e 8. The declarations set forth in- the WHEREAS clauses contained herein shall be deemed and Construed to be promises, covenants, and restrictions as if fully repeated and set forth herein. 9. If any section, subsection, paragraph, clause, phrase or provision of these covenants and restrictions shall, by a Court of competent jurisdiction, be adjudged illegal, unlawful, invalid, or held to be unconstitutional, the same shall not affect the validity of these covenants as a whole, or any other part or provision hereof other than the part so adjudged to be illegal, unlawful, ,invalid, or unconstitutional. 10. Local Law #32=1980 - The DECLARANT represents and warrants that he has not offered or given any gratuity to any official, employee, or agent of Suffolk County, New Yoxk State, or of any political party, with the purpose or intent of securing favorable treatment with respect to the performance of an agreement, and that such person has read and is familiar with the provisions of Local Law #32-1980. L.S. Pamela G. liottley L.S. J.AaZAMLwW_ 19 Patrici G. Rushin —�- -Fvrm�.}1(� hnArC!S L.S. L-S. SCDHS PRIVATE WELL COVENANTS -3- (I-XV. 1/91) i SCHEDULE A TITLE NUMBER:PAC-3266 Amended 6125101 OVERALL DESCIRPTION ALL that certain plot, piece or parcel of land,situate, lying and being in Peconic,Town of Southold, County of Suffolk and State of New York,bounded and described as follows: BEGINNING at a point on the southerly side of Indian Neck Road distant 141,70 feet easterly from the comer formed by the Intersection of the easterly side of Robinson Lane with the southerly side of Indian Neck Road; RUNNING THENCE along the southerly side of Indian Neck Road, North 89 degrees 21 minutes 30 seconds East 146.54 feet to land now or formerly of Cukor; THENCE along said land of Cukor the fallowing(2)courses and distances: 1) South 23 degrees'42 minutes 40 seconds East 531.08 feet; 2) South 23 degrees 47 minutes 00 seconds East 546.76 feet to the mean high water mark of Hog Neck Bay; THENCE along said mean high water mark of Hog Neck Bay, South 63 degrees 21 minutes 47 seconds West 134.30 feet to lands now or formerly of Varano& others; THENCE along said land now or formerly of Varano and others, North 23 degrees 46 minutes 50 seconds West, 1142.12 feet to the southerly side of Indian Neck Road and the point or place of BEGINNING. SCHEDULE C INCLUDE RESULTS OF WATER ANALYSIS USED FOR APPROVAL Or WELL INDICATE ALL RESULTS IN EXCESS OF 50i& OF MINIMUM STANDARDS WITH AN ASTERISK. SCDHS PRIVATE WELL COVENANTS :-6- (REV. 1/91) - .-,.w I - .+w•, ,' i,a a .. wocxJ+IKfV L 0 Q :]i b 'oe 144 CO EST LABORATORIES,INC. ENVIRONMENTAL TESTING 377 SHEFFIELD AVE.•N.BABYLON,N.Y.11703+(631)4224777•FAX(631)422.6770 LAS KO:204040.01 09/11/00 John W. Hallman Limited P.O. Box 423 ; Shelter Island ,Heights, KY 11965 ATTN: SOURCE OF SAMPLE: RushLn, T. , 66SO Indian Neck Lane COLLECTED BY: JH/EooTest DATE COL'D:09/06/00 RECEIVED:09/06/00 SAMPLE: Water sample, (pump discharge)Test Well�t ANALYTICAL PARAMETERS ANALYTICAL PARAMETERS Dichlordiflaomethane ug/L <0.5 1122Tetrechloroethan ug/L <0.5 Chloromethane ug/L <O-5 123 Trichlbropropane ug/L <0.5 Vinyl Chloride ug/L <0.5 Bromobenzene ug/L <0.5 • Bramomethane ug/L <0.5 2-Chlarotoluene ug/L <0.5 ' Chloroethane ug/L <0.5 4-Chloratoluene u8/L <0.5 Trichlorofluomethane ug/L <0.5 m Dichlorobenzene ug/L <0.5 . 1.1 Dichloroethene ug/L 40.5 P Diohlarobenzene ug/L <0.5 , . Methylene Chloride ug/L Q-5 o Dichlorobenzene ug/L <0.5 ; t-1.2-Dichloroethene ug/L <0.5 124 Trichlorobenzene ug/L 40.5 1,1 Dichloroethane ug/L <0.5 Hexachlorobutadiene ug/L 0.3 2,2-Dichloropropane ug/L <0.5 123 Trichlorobenzene us/L <0.5 ; c--1,2-Dichloroethene ug/L <0.5 t-1,3Diahloropropene ug/L <0.5 Bromochloromethane ug/L <03 a-1.3D3chloropropene ug/L <0.5 , 111 Trichloroethane ug/L <0.5 1.1-Diahloropropene ug/L <0.5 Carbon Tetrachloride ug/L <0.5 , 1,2 Diohloroethane ug/L <0,5 Trichloroethene ug/L <0.5 1,2 Dichloropropalne ug/L <0.5 Dibromomethane ug/L <0.5 112 Trichloroethane ug/L <0.S Tetraehloroethens ug/L 1,3-Dichloroprepane ug/L 0.5 Chlorobenzene ug/L <0.5 1112Tetrachloroathan us/L <0.5 • CC: - - � SEMARKS: � Peconic. * Pump ran 1 hour. Pump rate = 20 gpm. A*y:•mple contains 500 ug/L of methyl ethyl ketone. All values are within NY State and Federal limits for potable water. .1 DIRECTOR 9-14-2080 7c3SAM FROM ,J" W HALL44:v LTD 516 749 LI`, r,v 09/13/2008 .14:40 6914225770 ACOTEST LASS INC PAGE 81/82 Vcho"TfisrLABORATORJES,IMM RVVM0WMTAL TASTING 3778Niff A AVE•N.9AaVL0H,H.Y.ilM.(6t1)422.wM&FAx(1tj)4=4M Lae ND:204040.01 09/13/00 Jahn X. Hal taiga Limited[ P.O: lax +429 Shelter Island Heights, IFY 21965 AT1'DT t SUSC8 OF SAMPLE: 8ushin, T., 6650 Indian Neck Lane* COLLEOM BY: 3N/EcoTedt DATE COLD:09/06/08 $BCNIVF.D:09/06/g0 SAMPLE: Water •somple.(pump dSsebargolTeet stella* "ALY=CAL PAUSbMS AVALYTYCAL PARANUM" B0=GUe us/L <0.5 ABASsnese as NM ias/L 0.02 Toluene ug/L <0.5 Nitrate as N mg/L 80.5 Ethwl lenxeae v8/3• <0.5 micri 4e.ft C1 m9/L 24 m + P xylene ag/L <1.0 ISM as LAS mg/L 40.1 a xylene a8/L 0.5 p8 (lab) units 5.9 Styrene ug/L <0.5 Anm=jp ag N mg/L <0.05 Isopropylbenzene ug/L <O.5 Spec. Cond. umbo/am 86' a-Prop9ib*nxene ug/L <0.5 Capper as Cu mg/L 0.0; 199-TpfineWlhenzene uS/L <0.5 size as Zn mg/l. 0.02 dart Dntylbenaene ug/L <6.5 Lead as Pb mg/L 0.005 IU-TrLmethylbenzene u8/L 0.5 Iron as xo mg/L 0.13 sea-Butyibenrcene ug/L <0.5 P-Igopropyltoluene ug/L <0.5 n-RutylbeazeUm us/L ce.g Aldacaxb salfoxide vg/L <1 Aldicarb sullaze us/L <1 Aldliaarb tig/L <1 RMWKS: x Peccmtic. Aldicarba by ELM L4b$10478 ** Pomp ran 1 hour. Pump -rate x 20 Mm. Total Aldlaarb is xithLD MYi5tate 8utdelsne for potable Hater. A.il other values tasted art 'within BY state and Federal limita for potable Mater. DIRECTOR rac 24692 UYSAOH IDd 10220 ARR-26^2001 02.20P FROM 7u:rn54643 P:2/Z ` -LMOTEST LABORATORIES, INC. ENVIROMMENTAL TESTING 377 SHEFFIELD AVE.R-N.BABYLON,IVY 11703•(631)422-5777•FAX(631)422-5770 Email:ecotestlab a@aol,com Wabalte: www.ecotestiabs.com LAB NO:211079.10 04/24/01 Envirotest P.O. Bax 1828 Sang Harbor, MY 11963 A770: Frank Ryan SOURCE OF SAMPLE: Rashin, T., 6850 Indian Neek Lana, Southold COLLECTS() BY: ET/EcoTest DATE COLD:04/23/01 RECEIVED;04/23/01 SAMPLE: Nater sAmple. house—outaide faucet ANALYTICAL PARAMETERS ANALYTICAL PARAMETERS Methyl Ethyl Ketone ag/L <5.0 cc: REMARKS.- Vslue for Diethyl 8th3rl Ketone is within NY State limit for potable water. DIRECTOR rn-- 11436 KYSDOH ID# 10320 APR-25-2001 02:MP FRM. :u:1654643 Ec"OTEST LABORATORIES, INC. ENVINONMENT A1Z 7ES7/1VQ 377 SHEFFIELD Ave.•N.@ARYLON,N.Y.11703.(631)422-6777•FAX(631)422-5770 Ems11: ec0test10b@S01.cGM Website: www.ecotesHabs.com LAB 90:211979-11 04/24/01 Eneirotest P.O. Box 1828 Sag Narbor, XY 11963 ATTN: Prank Ryan SOURCE OF SAMPLE; Rushla, 'T., 6850 Indian Neck Lance. Southold COLLECTED BY: BT/RooTest DATE COL'D:04/23/01 RECRIVED:04/23/01 SAMPLE; Water sample, cnttsge-outside fanoat ANALYTICAL PARAMETERS ANALYTICAL PARAMETERS Methyl Ethel Ketone ug/L <5.0 RECORDED 2001 Jul 19 01:14:15 PH Eduard P.Rouiairie CLEW, OF SUFFOLK COUNTY L ^0170121,30 P 79Z cc: REMARKS: Value for Hethyl Ethyl Ketone is within NY State limit for potable nater. DIRECTO rna 11437 NYSOOR ID# 10320 Rushin Administrative Pe t 1000-86-7-5. 1 i����ztj.x;✓„ :,l�” ..n{~r:tl%c`ia.43FF,J,3*„ EIk":zf` '.-Ym•��lr�.d`Ij'qu rtivi5. (�k'' i.�. 4'C°F<iC�"u,is#1�'ry'4k�r`{,f',�Srjrt,,;y}' �jkx'�i6'`•'� tl y��yn t4s �Y 4m ",o { Y' i�J�:.�R1«r•s,''.�,�r.I.,'.;? ,`�' i19; 6;r aoi<w? �. 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Located: 6970 Indian Neck Lane, Peconic. SCTM# 1000-86-7-5.1 The proposed actions have been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with the below Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The as-built structures were constructed without a Wetlands Permit. The 11' x 16' on-grade platform/deck does not comply with the following Town Code section: §275-11. Construction and operation standards. (6) Platforms. i [Amended 10-11-2005 by L.L. No. 17-2005; 10-9-2012 by L.L. No. 12-2012] (a) Platforms associated with stairs may not be larger than 100 square feet. [Amended 1-29-2013 by L.L. No. 1-2013] (b) Platforms may not exceed 200 square feet and must be landward of the top of bluff. The platform equals 176 square feet and is seaward of the top-of bluff. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Michael J Domino, vice-PresideO 1p 54375 Main Road P O. Box t 179 Jacnes I= Icing. Trustee lthold. New York 1 197 1-0959 Dave Bergen. Trustee G� � Telephone(631) 765-1892 141 Charles J- Sanders.TrusteeFax(631) 765-6641 COWN, ,� BOARD OF TOWN TRUSTEES � �`j�a V TOWN OF SOUTHOLD To: Southold.Tow6 Building Department MAY 5 2017 Re- Verification of Building Department Permit Requirements BIDING OIEPT. TOWN OF SOUTHOLD_ SCTM#: 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 Departinent's'permitting requirements stated below: 4 YES NO Tdl th pr posed protect require a Building Pern �t? Will the proposed-project require a variance determination from eZoning Board of Appeals? Wit I any part of this application be considered as Demolition as -described under Town Code? COMMENTS: Signature o eviewer Date .1'U�" A Michael J Domino, Vice Presidcn54:175 Blain 179�-. P O_ Sox t t79James P fang. Trusteethold, [stew York [1971-0959 Dave Bergen, TrusteeTelephone(631) 765-1892 Charles J. Sanders,Trustce Fae(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To- Southold_Towri Building Department Re- Verification of Building Department Permit Requirements SCTIVI#_ 26- 7—'5. 1 Property Owner Mame_ ' 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 " e Building Permit? Will the proposed project require a Bu[ g Will the proposed project require a variance determination from le Zoning Board of Appeals? Wi[l any pari:of this application be considered as Demolition as -described under Town Code? COMMENTS: 9L5Gc Rim, PRfif Signature o eviewer Date 1 DEBORAH DOTY ATTORNEY AT LAW 670 WEST CREEK AVENUE P.O.Box 1181 CUTCHOGUE,NY 11935-0876 FAX 631-7347702 631-734-6648 _ E V'En DD M AY - 5 2017 May 5,2017 Southold Town ar of T e BY HAND Michael Verity Town Hall Annex 54375 Route 25 PO Box 1179 Southold,NY 11971 RE: Rushin,6970 Indian Neck Lane,Peconic,NY 11958 (SCTM# 1000-86-7-5.1) Dear Mr.Verity: With reference to the above-referenced premises, enclosed please find the following: 1. A copy of an affidavit signed by Patricia G.Rushin regarding SCTM# 1000-86-7-5 and SCTM# 1000-86-7-5.1 (the original affidavit will be provided to you upon receipt); 2. A copy of Zoning Code §100-118 through §100-120 as it existed as of July 7, 1973; 3. A copy of Zoning Code §100-118 through§100-120 prior to Local Law No. 2 of 1983; 4. A copy of Zoning Code §100-119 as it existed as of October 4, 1983; 5. A copy of Zoning Code §100-119 as it existed prior to Local Law No. 1 of 1989 which includes §100-119.2 added 3/28/1985; 6. A copy of Zoning Code §100-239.4 prior to Local Law 6 of 1989 which reflects the added §§4. Please call me if you require anything further. In the meantime,thank you for your assistance. Respectfully submitted, Deborah Doty Encls. DD:bdr cc: Robert K.Rushin&Patricia G. Rushin 05/04/2017 13:35 637 7',17702 DEBORAH DC 1_ SCS PAGE 02 AFFIDAVIT STATE OF GEORGIA ) ) ss. COUNTY OF GLYNN ) PATRICIA G. RUSHIN, being duly sworn, deposes and says: 1. I am over the age-of 18 and am one of the co-owners of the premises known as 6970 Indian Neck Lane,Peconie,NY (SCTM# 1000-86-7-5.1) ("Lot 2. The subject parcel bad been part of a larger lot(SCTM # 1000-86-7-5) ("Lot 95")from which two parcels were split per Southold Planning Board set-off dated October 1, 2001. 3. Lot#5 has been owned by my family since my grandfather Robert P. Davidson purchased it in or about 1940. I have jointly owned Lot#5 or Lot#5.1 since 1962. 4. As a child and an adult, I visited.Lot#5 until the 2001 set-off. I have lived at Lot#5.1 since the set-off. 5. My father George H. Guinan arranged to have a deck built between the retaining wall and the bulkhead. Given my father's health for the several years prior to his death in 1988,1 am confident that the deck was in its current location before 1985. No work (other than replacing broken stair� ffi;as been done on the deck since it was built. •.sI01V `r:off' A�e9N p O��RY PATRICIA G.RUSHIN _� / •U 9m e a SWb n ld' 2emm this: 0 yWiM4q 20.E s���•e�NE 2.2•ZO�,o O�``,b �Q 0tary Public Q , ZONING CODE-as-of 7/7 t97a--------- ---- - § 100-118 ZONING § 100-118 § 100-118. Nonconforming uses. Unless otherwise authorized as a special exception by the Board of Appeals,as hereinafter provided,the following provisions shall apply to nonconforming uses: A. The lawful use of a building or premises existing on the effective date of this chapters° or authorized by a building permit issued prior thereto may be continued although such use does not conform to the provisions of this chapter and such use may be extended throughout the building lawfully acquired to said date. B. A nonconforming use of a building or premises may be changed to a use of the same or higher classification ac- cording to the provisions of this chapter. C. Whenever a district shall hereafter be changed, any then existing-nonconforming use of a building or premises in such changed district may be continued or changed to a use of a similar or higher classification,provided that all other regulations governing the use are complied with. D. Whenever a nonconforming use of a building or premises has been discontinued for a period of more than two (2) years or has been changed to a higher classification or to a conforming use, anything in this section to the contrary notwithstanding, the nonconforming use of such budding or premises shall no longer be permitted unless a variance therefor shall have been granted by the Board of Appeals, as hey Anafter provided. E. A nonconforming building may not be reconstructed or structurally altered during its life to an extent exceeding in aggregate cost fifty percent (50016)of the fair value of the building, unless the use of such building is changed to a conforming use. F. A nonconforming building which has been damaged by fire or other causes to the extent of more than fifty percent (60°/o)of its fair value shall not be repaired or rebuilt unless the use of such building is changed to a conforming use. 20 Editor's Note., for the purposes of this section,the effective date of the chapter was the date of the original enactment,4-0-E7. 10053 " E � �kf E M AY - 5 2011 Southold T64n Boaid ofItustns § 100-120 SOUTHOLD CODE § 100-121 ARTICLE XII Board of Appeals § 100-120. Appointment; membership. The Town Board shall appoint a Board of Appeals consisting of five(5)members,as provided by the Town Law. § 100-121. Powers and duties. In addition to such powers as may be conferred upon it by law, the Board of Appeals shall have the following powers: A. Appeals.To hear and decide appeals from and review any order,requirement,decision or determination made by the Building Inspector. B. Variances. Where there are practical difficulties or un- necessary hardships in the way of carrying out the strict letter of these regulations, the Board of Appeals shall have the power to vary or modify the application of such regulations so that the spirit of the chapter shall be ob- served, public safety and welfare secured and substantial justice done. C. Special exceptions, special permits and other approvals. Whenever a use or the location thereof is permitted only if the Board of Appeals shall approve thereof, the Board of Appeals may,in a specific case and after notice and public hearing, authorize such permitted use and its location within the district in which this chapter specifies the permitted use may be located, subject, however, to the following: (1) Before such approval shall be given, the Board of Appeals shall determine: (a) That the use will not prevent the orderly and reasonable use of adjacent properties or of prop- erties in adjacent use districts; (b) That the use will not prevent the orderly and reasonable use of permitted or legally established 10054 EV(�(3, MAY _ 5 2017 Southo d Town Board of Trustocs ZONING CODE prior to LL No. 2-of 1983 § 100-118 ZONING § 100-118 § 100-118. Nonconforming uses. Unless otherwise authorized as a,special exception by the Board of Appeals, as hereinafter provided, the following provisions shall apply to nonconforming uses: A. The lawful use-of a building or premises existing on the effective date of this chapters 0 or authorized by a building permit issued prior thereto may be continued although such use does not conform to the provisions of this chapter and such use may be extended throughout'the building lawfully acquired to said date. B. A nonconforming use of a building or premises may be changed to a use-of the same or higher classification ac- cording to the provisions of this chapter. C. Whenever a district shall hereafter be changed, any then existing nonconforming use of a building or premises-in such changed district may be continued or changed to a use of a similar or higher classification, provided that all other regulations governing the use are complied with. D. Whenever a nonconforming use-of a.building or premises has been discontinued for a period of more than -two (2) years or has been changed to a higher classification or to a conforming rise, anything in this section to the contrary notwithstanding, the nonconforming use of such building _ or premises shall no longer be permitted unless a variance therefor shall have beer_( granted by the Board of Appeals, as hereinafter provided. - E. A nonconforming building may not be reconstructed or structurally altered during its life to an extent exceeding in aggregate cost fifty percent (50%) of the fair value of the building, unless the use of such building is changed to a conforming use. F. A nonconforming building which has been damaged by fire or other causes to the extent of more than fifty percent (50%)of its fair value shall not be repaired or rebuilt unless the use of such building is changed to a conforming use. 20 Editor's Note: For the purposes of this section,the effective date of the chapter was the date of the original enactment, 4.9-57. 1605 p E C E I kiff E M AY - 5 2017 Southold Town Board a?rushes . d § 100-120 SOUTHOLD CODE § 100-1-21 ARTICLE XII Board of Appeals, § 100-120. Appointment; membership. The Town Board shall appoint a Board of Appeals consisting of five(5)members,as provided by the Town Law. § 100-121.• Powers and duties. In addition to such powers as may be conferred upon it by law, the Board of Appeals shall have the following powers: 1 A. Appeals. To hear and decide appeals from and review any order, requirement, decision or determination made by the Building Inspector. B. Variances. Where there are practical difficulties or un- necessary hardships in the way of carrying out the strict letter of these regulations, the Board of Appeals shall have the power to vary or modify the application of such regulations so that the spirit of the chapter shall be ob- served, public safety and welfare secured and substantial justice done. C. Special exceptions, special permits and other approvals. Whenever.a use or the location thereof is permitted only if the Board of Appeals shall approve thereof, the Board of Appeals may, in a specific case and after notice and public hearing, authorize such permitted use and its location within the district in which this chapter specifies the permitted use may be located, subject, however, to the following: (1) Before such approval shall be given, the Board of Appeals shall determine: t (a) That the use will not prevent the orderly and reasonable use of adjacent properties or of prop- erties in adjacent use districts; (b) That the use will not prevent the orderly• and reasonable use of permitted or legally established pCE � E _ 10054 MAY - 5 2011 Soot}o;d lawn Boaid of TTUst^es ZONING CODE as of 10/4/198.3 § 100-119 SOUTHOLD CODE § 100-121 § 100-119. Corner lots. [Amended 2-1-83 by L.L. No. 2-1983] On a corner lot, front yards are required on both street front- ages, and one (1) yard other than the front yards shall deemed to be a rear yard, and the other or others, side yards._No obstruction to vision exceeding thirty (30) inches in height above curb level shall be erected or maintained at street intersections within the triangle formed by the street lines of such lot and a line drawn between points along such street lines thirty (30) feet distant from their point of intersection. § 100-119.1. Fences, walls and hedges. [Amended 5-29-73; 2-1-83 by L.L. No. 2-19831 Subject to the provisions of§ 100-119, fences, walls, hedges or other live plantings within five (5) feet of the property lines may be erected and maintained, subject to the following height limitations: A. When located in the front yard along the front yard property line, the same shall,not exceed four (4) feet in height. B. When located along side and rear lot lines, the same shall not exceed six and one-half(6V2) feet in height. C. When located other than in the front yard area or along side or rear lot lines, the same shall not exceed eight (8) feet in height. ARTICLE XII Board of Appeals § 100-120. Appointment; membership. The Town Board shall appoint a Board of Appeals consisting of five (5) members, as provided by the Town Law. nD, E ( t E I If E DD 11 MAY� r...� § 100-121. Powers and duties. LI liMAY - 5 2011 ' In addition to such powers as may be,conferred upon it by law, the Board of Appeals shall have the following powers: Southold lown Board of Trustees 10054 4-25-83 - ZONING CODE prior to LL-No. l of 1 § 100-119 SOUTHOLD CODE § 100-119.2 § 100.1.19. Corner lots. [Amended 2-1-33 by L.L. No- 2.19831 On a corner lot, front yards than the front yards shall de mea to front- ages, and one (1) yard other be a rear yard, and the other or others, side yards. No obstruction to vision exceeding thirty (30) inches in height above curb level shall be erected or maintained at street intersections within the triangle formed by the street lines of such lot edt di tena line d frawn rom between points along such street lines thirty( ) their point of intersection. § 100-119.1. Fences. walls and hedges. [Amended -29-73; 2-1-83 by L.L. No, 2-19831 Subject to the provisions of § I.00-119, fences, walls, hedges or other live plantings within five (5) feet of the property linesemat -be erected and maintained, subject t® the following g limitations: _ A. When located in the front hall not along the front exceed four 4) feetrd in property line, the sarn height. B. When located along side half(6'/z) feet inlheight a same shall not exceed six and on C. When located other than � shall not exceed eight (8ard area or 11fe along side or rear to , in height. § 100-119.2. Building setback fron, eater bodies and wetlands. [Added 3-26-85 by L.L. No.4-19851 Notwithstanding any other provisions of this chapter, the following setback requirements shall apply to all buildings located on lots ad- jacent to water bodies and wetlands. A. Lots adjacent to Long Island Sound. - (1) All buildings located on lots adjacent to Long Island Sound, and upon which there Shall be etback not less bluffts a E I V E landward of the shore or bee M AY - 5 2017 10054 4-25-85 Southold Town Boar of Trustees 100-119.2 ZONING § 100-1I9.3 than one hundred(100) feet from the top of such bluff,or bank. (2) Except as otherwise provided in subsection A(1) hereof, all buildings located on lots .adjacent to Long Island Sound shall be set back not less than one hundred (100) feet from the ordinary high-water mark of Lang Island Sound. B. [Amended 5-17-88 by LL. No. 15-1988] All buildings located on lots upon which a bulkhead, concrete wall, riprap or similar structure exists .and which is adjacent to tidal water bodies other than sounds shall be set back not less than seventy-five (75) feet from the bulkhead. The following exceptions will apply: (1) Buildings which are proposed landward of existing buildings. (2) Lands which are not bulkheaded and are subject to a determination by the Board of Town Thwees under • Chapter 97 of the Cade of the Town of Southold. (3) Docks, wham, pilings, boardwalks, stairs, promenades, walkways, piers, which are accessory and separate from existing buildings or accessory structures. C. All buildings located on lots adjacent to any freshwater body shall be set back not less than seventy-five (75) feet from the edge of such water body or not less than seventy-five(75)feet from the landward edge of the freshwater wetland, which- ever is greater. 100-119.3. Stormwater r°ux°off. [Added 8-11-87 kv la.l. No. 1:3- 19871 Rainfall and ,torm«•ater runoff inks roads or streets is 1wohihited from existing or })rorlosed residential or commercial construction. C� EflVE M AY - 5 2011 10054.1 !E-3fi-rata Southold Town Board of Trustees ZONING CODE prior to LL No. 6 of 1989 § 100-239.4 SOUTHOLD CODE § 100-239.4 § 100-239.4. Building setback requirements adjacent to water bodies and wetlands. (Added 3-14-89 by L.L. No. 3- 1989] I ML Notwithstanding any other provisions of this chapter,the following Iff setback requirements shall apply to all buildings located on lots adjacent to water bodies and wetlands, WL A. Lots adjacent to Long Island Flound. (1) All buildings located on lots adjacent to Long Island Sound and upon which there exists a bluff or bank landward of the shore or bead shall be set back not less V than one hundred(100)fc;?t from the top of such bluff or bank. (2) Except as otherwise prm ded in Subsection A(1)hereof, all buildings located on lots adjacent to Long Island Sound'shall be set back not less than one hundred(100) feet from the ordinary high-water mark of Long Island )or Sound. B. All buildings located on lots upon which a bulkhead, concrete wall,riprap or similar'stiueture exists and which are adjacent to tidal water bodies other tbansounds shall be set back not less than seventy-five (75) feet from the bulkhead. The AL exceptions will apply: . (1) Buildings which are propc:;;L-d landward of existing ,W buildings. A (2) Lands which are not bul-kheaded- and are subject to a W determination by the E(w d of Town Mustees under Chapter 97 of the'Code of,the Town of aouthold. (3) Docks,wharves, pilings, 'ioardwalks, stairs, promenades, walkways and piers, wh:--h are accessory and separate from existing buildings c.- accessory structures. ... C. All buildings located on lots adjacent to any freshwater body VF shall be set back not less than sevanty five (75)feet from the edge of such water body or not less than seventy-five(75)feet from the landward edge of the fresliwater wetland, whichever W is greater. AOL DE I VE 'v MAY - 5 2017 - - r Southold Town _ Board Tru ee - ' DEBORAH Dom ATTORNEY.AT LAW 670 WEST CREEK AVENUE P.O.Box 1181 CUTCxoGUE,NY 11935-0876 FAX 631-7347702 631-734-6648 BY HAND April 27,2017 Board of Southold Town Trustees Town Hall Annex 54375 Route 25 PO Box 1179 Southold,NY 11971 RE: Rushin, 6970 Indian Neck Lane,Peconic,NY 11958(1000-86-7-5.1) Administrative Permit for Wood Deck from Mid-1980s Dear Members of the Board: Enclosed please find an original and two photocopies of the survey of the above-referenced premises. You will note that the survey is last dated 4/10/2017. Also enclosed are an original and a photocopy of certain pages of the administrative permit application packet to reflect the inclusion of the less than 4'wide removable stairs for access from the outer bulkhead to the beach. Please call me if you require anything further. In the meantime,thank you for your assistance. Respectfully submitted, Deborah Doty Encls. DD:bdr $3� s APA 2 7 2017 ` Southold-sewn Michael J.Domino,President o*oF SO yQ� Town Hall Annex t� 54375 Route 25 John M. Bredemeyer III,Vice-President P.O.Box 1179 Charles J. Sanders Southold,New York 11971 Glenn Goldsmith ® YOB Telephone(631) 765-1892 A.Nicholas Krupski ''�CQUNT'��� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit . ;�.- ?; Amendment/Transfer/Extension ,e Received Application:fi1$`11 r i ��� I Received Fee: $ 1001,06 T 8 2017 - Completed Application: E Incomplete:, - SEQRA Classification: Type I_ Type H Unlisted Southold town W Lead Agency Determination: Coordination:(date sent): �. LWRP Consistency Assessment Form Sent: CAC Referral Sent:, Date of Inspection: Receipt of CAC Report: Technical Review: _ Public Hearing Held: .54.17 Resolution: Legal Name of Property Owner(s): Robert K. Rushin & Patricia G. Rushin Mailing Address: PO Box 188 Peconic NY 11958 Phone Number: 631-734-6545 Suffolk County Tax Map Number: 1000 - 86-7-5.1 Property Location: 6970 Indian Neck Lane, Peconic, NY 11958 (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): Deborah Doty, Esq Mailing Address: -PO Box 1181, Cutchogue, NY 11935 Phone Number: 631-734-6648 _ Board of Trustees Applic' ion GENERAL DATA Land Area(in square feet): 67,118 Area Zoning: R-80 Previous use of property: private one-family dwelling Intended use of property: private one-family dwelling Covenants and Restrictions on property? x Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes x 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 x No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes x No Does the structure (s) on property have a valid Certificate of Occupancy? Yes No See below Prior permits/approvals for site improvements: Agency Date See attached list No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No Yes If yes,provide explanation: Project Description (usq attachments if necessary): Administrative permit M x Id:f for a 10ooff dec which ha existed since the mid-1980s or before and for less than 4' wide removable stairs from outdr bulkhead to the beach RUSHIN-Prior Permits/approvals for Site Improvements TRUSTEES Ice permit 4/8/1986 Permit#4236 10/1/1993 Permit# 5522 4/26/2002 Permit# 5523 4/26/2002 BUILDING DEPT Pre-existing certificate of occupancy for the property before the subdivision 2/6/1986 Certificate of occupancy for the addition and alteration to the house 9/12/2002 Certificate of occupancy for the alteration to the accessory garage 9/12/2002 ZBA #4662 1999 Board of Trustees Appliea _ on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: No change Area of wetlands on lot: 0 square feet Percent coverage of lot: n/a % Closest distance between nearest existing structure and upland edge of wetlands: n/a feet Closest distance between nearest proposed structure and upland edge of wetlands: n/a feet Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: n/a Manner-in which material will be removed or deposited: n/a co m +W U) b 0 0 3 a) Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by ro reason of such proposed operations (use attachments if appropriate): a Existing wood dec4 will have no negative impact on the waters of the 0 .d Town of Southold a ca 61 Z20 Appendix.B Short Environmental Assessment Form Instructions for Completing; Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part l based on infonnation 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: Wood deck Project Location(describe,and attach a location map): 6970 Indian Neck Lane, Peconic, NY (SCTM 1000-86-7-5.1) Brief Description of Proposed Action: Administrative permit for a wood deck which has existed since the mid-1980s or before.'', and for ,less than 4' wide removable stairs from outer bulkhead to the beach. Name of Applicant or Sponsor: Telephone: 621-734-664 Deborah Doty, Esq. E-Mail: Address: 670 West Creek Ave, PO Box 1181 City/PO: State:NY Zip Code: Cutchogue 11935 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 x may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? 1.54 acres b.Total acreage to be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.54 acres 4. Check all land uses that occur on,adjoining and near the proposed action. F-1 Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial [Residential(suburban) ❑Forest ❑Agriculture EJ Aquatic [:]Other(specify): ❑Parkland Page I of 4 Y 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations9 a ❑ ❑ b. Consistent with the adopted comprehensive plan'? ❑ ❑ x❑ 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: unsure ❑ ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES 0 El 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? x❑ ❑ 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: El 1-1n/a 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: n/a ❑ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment. n/a ❑ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ ❑ b.Is the proposed action located in an archeological sensitive area? ❑ ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain 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? n ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 0 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline El Forest ❑Agricultural/grasslands ❑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 /a 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ ❑ ❑NO DYES a.Will storm water discharges flow to adjacent properties? b.Will storm water discharges be directed to established cony-yance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO [—]YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? 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: 51 F] 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? ❑ El Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsorname: Deborah Doty, Esq. Date: 4/1 Si nature: i 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 l 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? E 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate El reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: EJ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, F if 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 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 VJ El problems? ❑ 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. ❑ 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 enviioninental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental im acts 7 Town of Southold-Board of Trustees /" Name of Lead Agency Date Ir�/t4 o vv,-I M President Print or Ty e Na n of R sponsibl Officer in Lead Agency Title of Responsible Officer Signature of Respon§ible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 ol'4 {, -.aoard of Trustees Applica,__ 1>n AFFIDAVIT Robert K. Rushin & Patricia G. Rushin 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. dlaSignature of Property Owne SWORN TO BEFORE ME THIS "— DAY OF 20 1 -( Notary Pu is DEBORAH DOTY Notary Public, State of New York No. 02DO4829478 -Suffolk County Commission Expires February 28, 20 Board of Trustees Applica, on AUTHORIZATION (where the applicant is not the owner) I, Robert K Rushin & Patricia G. R„ d,ding at 6970 Indian Neck, Lane, (print name of owner of property) (mailing address) Peconic, NY 11958 do hereby authorize (Agent) Deborah Doty, Esq. to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and em to ees.The u ose of is to rovide information which can alert the town of ossible conflicts of interest and allow it to take whatever action is this form necessary to avoid same. YOURNAME: Rushin, Robert K. and Rushin, Patricia G. (Last name,first name,.middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or*employment by)a corporation in which the town officer or employee owns more than 5%of the shares. NO X YES - If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted s 2 y of r Signature • Print Name G. Rushin Form TS I APPLICANT/ACENTMEPRESENTATIVE TRANSACTIONAL DISCLOSURE.FORM The Town of Southold's Code of Ethics rohibits conflicts of interest on the art of town officers and employees.The u ose of this form is to rovide information which can alert the town of ossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Deborah Doty Doty, Deborah as attorney for Rushin (Last name,first name,.raiddle 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 Trustee x Variance --- Coastal Erosion Change of Zone Mooring Approval of plat planning Exemption from plat or official map 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 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 x ' 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 applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this da�Dot��7 SignaturePrintName eborah y 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 pro-posed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.noi thfork.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# 1000 _ 86 _ 7 - 5.1 and removable wood access stairs PROJECT NAME wood deck administrative permit The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑ 1. Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant,loan, subsidy) (c) Permit, approval, license,certification: ❑ Nature and extent of action: Administrative permit for existing wood deck and existing removable wood stairs from outer bulkhead to beach ! 4 Location of action: 6970 Indian Neck Lane,' Peconic, NY +4 Site acreage: 67,118 Present land use: Private one-family dwelling Present zoning classification: R-80 2. If an application for the proposed action has bt�,n filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Deborah Doty, Esq. (b) Mailing address: PO Box 1181 Cutchogue, NY 11935 (c) Telephone number: Area Code ( ) 631-734-6648 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No❑ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Pest Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ❑x Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LV IW Section III—Policies Pages 3 through 6 for evaluation criteria 0 Yes ❑ No x❑ Not Applicable f Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ❑x Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize Ioss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ❑Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ ❑ Yes No 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 [—] No U 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 LNVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye� Non Not Applicable Attach additional sheets if necessary 1 WORKING COAST POLIC �L.7 Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable PREPARED BY Deborah Doty TITLE Attorney DATE ! DEBORAH DOTY s' ATTORNEY AT LAW 670 WEST CREEK AVENUE P.O.Box 1181 CUTCxoGUE,NY 11935-0876 FAX 631-7347702 631-734-6648 BY HAND April 18,2017 Board of Southold Town_ Trustees Town Hall Annex 54375 Route 25 PO Box 1179 Southold,NY 11971 RE: Rushin, 6970 Indian Neck Lane,Peconic,NY 11958 (1000-86-7-5.1) Administrative Permit for Wood Deck from Mid-1980s Dear Members of the Board: With reference to the above-referenced premises,enclosed please find the following: 1. The original application packet and one photocopy; 2. The original Affidavit, Transactional Disclosure Forms, and Agent Authorization Form together with one photocopy; 3. Three true photocopies of the survey of the premises; 4. Three copies of current photographs of the deck; p 5. Three copies of 1993 site plan of the premises; and 6. One copy of Covenants and Restrictions. Also enclosed is my check#10224 payable to the Southold Town Clerk in the amount of$100.00 for the application fee. Respectfully submitted, Deborah Doty Encls. DD:bdr cc: Robert K. Rushin&Patricia G. Rushin APR 18 2017 5aut�;erd�ovm.M,-, a A ROB,'( r:i,"_1inu H, CE � V ED STATS OV GEORGIA AFFIDAVIT EMAY 2011 'D ss. COUNTY OF GLYNN ) Southold Town PATRICIA G.RUSMN,being duly sworn,deposes and says. 1. I Mn over the aga of 18 and am one of the co-owners of the premises koown as 6970 Tndian Ne&1,ane,Peconic,Ny (SCTM# 1000.86-7-5.1) ("Lot#5.1"). 2. The subjeek parcel bad been part of a larger lot(SCTM # 1000-86-7-5)("Lot 05")from which two parcels were split per Southold planning Board set-off dated October 1,2001. 3, Lot#5 has been owned by my family since my grandfather Robert P.Davidson purchased it in or about 1940. I have jointly owned Lot#5 or Lot#5.1'since 1962. 4, Asa child and an adult,l visited Lot#5 until the 2001 set-off 1 have lived at Lot#5.1 since the setoff, 5. My father George H. Guinan arranged to have a deck built between the retaining wall and . the bulkhead. Given my father's bealth for the several years prior to bis death in 1988,l am con- dont that the deck was in its current location before 1985. No work (other than replacing broken stair i����has been done on the deck since it Nvas built. 0�A A,�: ' PATRICIA G_RUSEftN m�aap Rk S tga n Ieforvrrte this i ¢ co � s 0 otary Public I SUR\/EY OF PARGEL A SURD I'l I S I ON MAS' OF PAMELA 6. MOTTL.EY AND PATR I G I A 6. RUSH I N N FILED IN THE OFFICE OF THE CLERK OF SUFFOLK GOUNTY W E OGTOBER 16, 2001 AS MAP No. 106ci7 SITUATE: PEGON I G TOWN: SOUTHOL.D S SUFFOLK GOUNTY, NY SURVEYED 05-28-2017, 04-10-2017 Indian Neck Road SUFFOLK GOUNTY TAX # 1000 - 86 — 7 - 5.1 '�4i N8q°21'30"E 6181' 150200 cCIERTEF ID TO: PATRICIA LOWRY JOHN TOUR EY WELLSIFARGO BANK,N.A. ABSTRACTS,INCORPORATED QST AMERICAN TITLE INSURANCE COMPANY � APR 2 7 2017 N - a�:ts,h� r4 0 0� 30 y +t Nl N + ® o 1 °byn I 1 py I o ' i �N 0 cKi gga t �o`tr' O \ ono O + `c 0i' X44 S \� d iT, DETAIL GRAPHIC, SGALE 1"= 40' p � s F r� O� 01 ' \ o \moi /0o era 's, 's, 2 y o o`r - O\ I Ell—_ NOTES. _I' -j ® MONUMENT FOUND ' ' .��;', ® REBAR FOUND 0 20 CJ�O AREA = 6-7,118 S F. OR 154 ACRES GRAPHIG 5GALE It,- 60JOHN C. EI ILERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 O 60 120 180 REF:C:\UsersUohn\Dropbox\04\04\04-337 update 03-08-2017.pro