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HomeMy WebLinkAboutTR-8975 Michael J.Domino,President ®F SUUTjyO Town Hall Annex John M.Bredemeyer III,Vice-President �O �O 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith G � p Telephone(631) 765-1892 A.Nicholas Krupski O Y Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1387C Date: September 6, 2017 THIS CERTIFIES that the existing 62'7"x36'2.5"(2,027sq.ft.) 1 '/2 story dwelling; existing 42''8"x20'7"(858sq.ft.)wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4"(267sq ft in-grade deck on seaward side of dwelling, and for the existing 6.3'x8.2' shed; with the condition to establish and perpetually maintain a non-disturbance buffer landward of the edge of wetlands in line with the extension of the split rail fence, and to create a 4' wide access path to the water; At 605 Long Creek Drive, Southold Suffolk County Tax Map#1000-55-3-25 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January 23, 2017 pursuant to which Trustees Wetland Permit#8975 Dated March 22, 2017,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued,is for the existing 62'7"x36'2.5"(2,027sq.ft.) 1 '/z story dwelling; existing 42'8"x20'7"(858sq.ft.)wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4"(267sq.ft.) in-grade deck on seaward side of dwelling, and for the existing 6.3'x8.2' shed;with the condition to establish and perpetually maintain a non-disturbance buffer landward of the edge of wetlands in line with the extension of the split rai I fence,and t6 create a 4' wide access path to the water. The certificate is issued to KATHLEEN MEGUIN owner of the e of resaid prop% ty. Authorized Signature CC# : C18-18358 t p A, COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 05/02/2018 under Liber D00012959 and Page 797 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 05/02/2018 SUFFOLK COUNT/Y� CLERK 11,11, JUDITH A.PASCALE SEAL SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 05/02/2018 Number of Pages: 6 At: 09:22 : 36 AM Receipt Number : 18-0080510 LIBER: D00012959 PAGE : 797 District: Section: Block: Lot: 1000 055 .00 03 . 00 025.000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $30 .00 NO Handling l $20 . 00' NO COE $5 . 00 NO NYS SRCHG ;'$15. 00 NO TP-584 $0 .00 NO Notation $0 .00 NO Cert.Copies $15 . 00 NO RPT $200 .00 NO Fees Paid $285. 00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County F11 21 Number of pages REQ_OPI-Ero 016 Mau 02 09a22.7-6 AN U1-ITt1 A. FASCALE O Cir This i.LE�t�.document will be public j�FijL}; rUI;Y record. Please remove all L D00012959 Social Security Numbers P-797 prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17 (County) Sub Total Spec./Add. EA-5217 (State) TOT.MTG.TAX R.P.T.S.A. 0, Dual Town Dual County Held for Appointment Comm. of Ed. 5. 00 _ Transfer Tax Affidavit Mansion Tax � � �, The property covered by this mortgage is Cetified,Co or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total YES or NO Other Grand Total `�' If NO, see appropriate tax clause on page# of this istru� t. 4 1 Dist. 3626001 1000 05500 0300 025000 5 Community Preservation Fund Real Property p T S I IIIIII VIII IIID VIII VIII VIII VIII IIII IIII Consideration Amount $ Tax Service R ABA A Agency 02-MAY-1 CPF Tax Due $ Verification - - -- - - Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Compan-y Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# 8 Suffolk County Recordin & Endorsement Pau This page forms part of the attached V aA I o made by: ,(J (SPECIFY TYPE OF INSTRUMENT) 0 6,e T t^., The premises herein is situated in ` SUFFOLK COUNTY-NEW YORK. TO In the TOWN of In the VILLAGE or HAMLET of BOXES 6 THRU 8 MUST'BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12.0104..10/08kk • (over) IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property'taxes, *you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property tax statements., Local property taxes are payable twice a year: on or before January 101h and , on or before May 3151. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding property tax. payment. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst,N.Y. 11757 Riverhead,N.Y. 11901 (631)957-3004 (631)727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes One Independence Hill Shelter Island Town Hall Farmingville,N.Y. 11738 Shelter Island,N.Y. 11964 (631)451-9009 (631)749-3338 - r , East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes ' 300 Pantigo Place 99 West Main Street East Hampton,N.Y. 11937 Smithtown,N.Y. 11787 (631)324-2770 (631)360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington,N.Y. 11743 Southampton,N.Y. 11968 (631)351-3217 (631)283-6514 Islip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Street Islip,N.Y. 11751 Southold,N.Y. 11971 (631)224-5580 (631)765-1803 Sincerely, Judith A.Pascale Suffolk County Clerk dw 2/99 12.0104 06/06kd DECLARATION OF COVENANTS A. THIS DECLARATION made this day of ,�� 20 by� n gx> wad residing hereinafter referred to as "DECLARANT (S) " : Q4 W I T N E S S E T H WHEREAS, DECLARANT (S) Fare thpe� owner (s) of ,certain �ree-al property located on ®� sCPc�1CsV�" �A�1�'� ~�6'� Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section Avg,. f Block �o Lot t4.qr which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the _jurisdictiron of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant i to Chapter 275 of the Town ' Code of the Town of Southold or it-s ,successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a NA.oCs-%AaA4 non-disturbance buffer" adjacent to and landward of NOW THEREFORE, the DECLARANT (S) do/&@@ hereby covenant and agree as follows: j 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and perpetually maintained "non-disturbance buffer" as defined by Chapter 275 of the Town Code: to wit: A vegetated area, as designated by the Board of Trustees, immediately landward of the wetland boundary, shoreline structure, or other line designated by the Trustees where no operations, maintenance, placement of signs or other activities may take place, except that man-made debris may be removed from such area by hand without the permission of the Board of Trustees". An application for a wetland permit may be submitted for the removal of harmful, "invasive" or non-native vegetation; and as depicted eoln (4 the DS� �'5� 91AJ ?9JARo4AEW,?LQ%3 �� ! /d0 6�t A �, n �°' (� �t� ®� see Exhibit A attached; and 2) These cove s shall run with the land and shall be binding on the DECLARANTS -�;!��o• ( ) L_ "- - /their heirs, assigns, purchasers, or successors in interest and may only be modified after a public ",Bearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owners) herm/have duly executed this instrument this day of A. a 20 tl _ OWNER'S SI URE OWNER'S SIGNATURE STATE OF NEW YORK ) COUNTY OFSAN e` "OL s s. On the ` day of in the year 20, before me the unde s gned, a Notary Pub . c in and for said State, personally appeared . �e,a 7 u,o �sonally known to me or proved to me on the basis of satisfactory evidence to be the- individual (s) whose name (s) Mr/are subscribed to the within instrument and acknowledged to me that /they executed the same in /their. capacity, and that by /their signature (s) on the instrument, the individual;�z 41411 ar no��• � ^ " �„';'�"a' ��r �� ��, executed the instrument. DOROTHY t RODRiGM S G MARY RYPUBLi4$ 4 5�of NewYoh a tar , Publicr_� } Qualified is lsuffolk Coun ®1%o I � O Ex*u Odtoler 2V h 2I Y l j .......»5,..................«,..+..._.e.+._.,.....«w......,,.«>.,w.._.....,..,«.,.w,..w......a,...,.w,.+w...,......w.,.....»..ww..,..b...wrv.._...,....,«,,. .i..,..w, w,_.,,..,.,.,.,....x.a.o-.,.w.,..w,.i..o.,....s,n,a.usm.,awmn.,»,z,w,.+..+e,.nw..,,.,....,..vn.w..,.....«w.M w..U.armwe.,...u,«a..,aw...w...,..,v,u.,�n.,.0 a.,,+n...vnmwu'. SCHEDULE "A" ALL that certain plot, piece or parcel of land, situate, lying and being in Southold, Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 9 on a certain map entitled "Map of Yennecott Park situate at Southold, Town of Southold. Suffolk County, New York" , surveyed by Van Tuyl & Son, Greenport, New York, May 1-, 1968 , and filed in the Office of the Clerk of the County of Suffolk on the 9th day of October, 1968 , as Map No. 5187 , which said lot is more particularly bounded and described -according to said map as follows: BEGINNING at a point on the Northeasterly side of Long Creek Drive distant 515. 81 feet Easterly as measured along the Northeasterly side of Long Creek Drive from the corner formed by the intersection of the Northeasterly side of Long Creek Drive with the Easterly side of Tuthill Road; RUNNING THENCE North 12 degrees 38 minutes 00 seconds West 122 feet more or less to the high water mark of Long Creek; THENCE along the high water mark of Long Creek having a tie line of North 80 degrees 17 minutes 20 seconds East 178 .,61 feet; THENCE South 6 degrees 18 minutes 00 seconds East ,,166 feet more or less to the Northerly side of Long Creek Drive; THENCE South 83 degrees 42 minutes 00 seconds West along the Northerly side of Long Creek Drive 87 feet; THENCE North 72 degrees 38 minutes 00 seconds West along the Northeastgrly side of Long Creek Drive 85 feet to the point 11 or place of BEGINNING. tl SITE PLAN FOR MEGUIN RESIDENCE 605 LONG CREEK DR. SOUTHOLD NY SCTM : 1000-55-03-25 AREA 26.048 S.F. SCALE i'= 30' N mSTNG5Pl7r'RPdFBNCg _ 6fU�NGW([M'RACED G��'G6 � , x G � $ o all. Nlxd38•�.w SS;d4iu°W glad • APPROVED BY tI JUL 2 1 2017 BOARD OF 7"RUSTEES. TOWN OF SOUTHOIp Board SnuUlgld Tnwn f brteos _ DATE 7Vty 2S12017 . ROBERT WILSON PO BOX 49 SOUTHOLD NY ug7i JULY zest 2017 NOTE- ALL DATA TAKEN FROM SURVEY BY press JOHN T.METZGER DATED 12/7/2oi6 START permits I drafting ex editing � {�, ` x�����:s�s�� .�rr ���°a�rea��,� ���F�����s �rrx�s '��.• �w;���trn��awa� BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK 017 ~- PERMIT NO. 8975 DATE:, C_H 22.-,_2 ISSUED TO: ICATHI.EEN MEGLTII�1 PROPERTY ADDRESS: 605 LONG CREEK DRIVE, SOUTHOLD SCTM# 1000-55-3-25 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 March 22;2017,and in , consideration of application fee in the sum of$250.00 paid by Kathleen McQuin 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 62171lx3612.5"(2, q{g 027s 1 '/storydwelling; exist'y°ft.� � �u g 42'8"x20'7"(858sq.ft.)wood frame deck attached to seaward side of dwelling; and for the g existin 16'4"x16'4"(267sq.ft.)in-grade deck on seaward side of dwelling,and for the existing � , 6.3'x8:2' shed;with the condition to.establish and perpetually maintain a non-disturbance buffer landward of the edge of wetlands in Iine with the extension of the split raiFfence,and to create a 4'wide access'path to the water; and as depicted on the revised site plan prepared by Robert Wilson;dated July 21,2017,and stamped approved on July 25,2017; and the Survey ` ' prepared by Peconic Surveyors,P.C.,dated December 7,2016, and stamped approved on July =" 25,2017. IN WITNESS WHtREOF,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 Board as of_this date. 1100 S�fNit '.Toho M. B4 demeyer, III coo i _ a Nichola rupslci-Absent ,g y a *pF SOUTy Michael J.Domino, President �O� ol® Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O. Box 1179 Charles J.Sanders v, Southold,New York 11971 Glenn Goldsmith Telephone (631) 765-1892 A.Nicholas Krupski ol�C®U� S� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INS CTION: s L DATE INS 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: 't �l,c�vlC4L�,101,�4, COMMENTS: CERTIFICATE OF COMPLIANCE: so�,� Michael J. Domino, President �o� ®lam Town Hall Annex John M.Bredemeyer I11,Vice-President 54375 Route 25 P.O. Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith 1% ® O Telephone(631) 765-1892 A. Nicholas Krupski `yCOUNFax(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 1St day of construction / % constructed V Project complete, compliance inspection i T_ BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK Iff 4 5K PERMIT NO. 8975 DATE: MARCH 22, 2017 • K : 14 ISSUED TO: KATHLEEN MEGUIN PROPERTY ADDRESS: 605 LONG CREEK DRIVE, SOUTHOLD SCTM# 1000-55-3-25 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 March 22,2017,and in consideration of application fee in the sum of$250.00 paid by Kathleen Meguin 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 6217110612.5" (2,027sq.ft.) 1 !/2 story dwelling; existing 42'89'x2097"(858sq.ft.)wood frame deck attached to seaward side of dwelling; and for the H existing 16'4"x16'4'9 (267sq.ft.)in-grade deck on seaward side of dwelling,and for the existing 6.3'x8.2' shed; with the condition to establish and perpetually maintain a non-disturbance buffer landward of the edge of wetlands in line with the extension of the split rail fence,and to create a 41 wide access path to the water; and as depicted on the revised site plan prepared by I sk 11 Robert Wilson, dated July 21,2017,and stamped approved on July 25,20 7; and the suryey prepared by Peconic Surveyors,P.C., dated December 7,2016, and stamped approved on July "a 25 2017. t}_ 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 Board as of this date. John M. Blfliemeyer, III C. 'A Nicholas i-upski Absent T TERMS AND CONDITIONS The Permittee Kathleen Meguin, residing at 605 Long Creek Drive, 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 inade to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Pennittee 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. The Permittee is required to provide evidence that a copy of this 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. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perforin the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Michael J.Domino,President �*QF S® jyO Town Hall Annex John M.Bredemeyer III,Vice-President, ,`O l0 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith G Q ® a0 Telephone(631) 765-1892 ". A.Nicholas Krupski Fax(631) 765-6641 NT`(,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 22, 2017 Joan Chambers P.O. Box 49 Southold, NY 11971 RE: KATHLEEN MEGUIN 605 LONG CREEK DRIVE, SOUTHOLD SCTM# 1000-55-3-25 Dear Ms. Chambers: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 22, 2017 regarding the above matter: WHEREAS, Joan Chambers on behalf of KATHLEEN MEGUIN, 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 January 23, 2017, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit for the structures, and the installation of a non-disturbance buffer landward of edge of wetlands; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application March 22, 2017, 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of KATHLEEN MEGUIN for the existing 62'7"x36'2.5" (2,027sq.ft.) 1 '/ story dwelling; existing 42'8"x20'7" (858sq.ft.) wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4" (267sq.ft.) in-grade deck on seaward side of dwelling, and for the existing 6.3'x8.2' shed; with the condition to establish and perpetually maintain a non-disturbance buffer landward of the edge of wetlands in line with the extension of the split rail fence, and to create a 4' wide access path to the water; and as depicted on the revised site plan prepared by Robert Wilson, dated July 21, 2017, and stamped approved on July 25, 2017; and the survey prepared by Peconic Surveyors, P.C., dated December 7, 2016, and stamped approved on July 25, 2017. 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: None Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd SITEPLAN FOR MEGUIN RESIDENCE 6o5 LONG CREEK DR. SOUTHOLD NY SCTM : 1000-55-03-25 AREA 26.048 S.F. SCALE 1"= 30' N NgOdi�Z�E , ,78.61 /' /• / //' //'// /'/j/.// // / . CE //' / ./ STINGSPLITRAILFEN / RAISED DECK GEz4 3^ RADE S100WiTHATTA 1iED0149 AND 014B GpgpGE X3'3^ Z y W W_ N OL. 0. G q HS OO, S 83 O°^W N7zd38o0^W S7.Oo FE C C- V EAPPROVED BY.JUL 2 1 2017 -4 BOARD OF 1 RUSTEES TOWN'OF�SOUTIdC!L Southold Town r o T u• DATE MILY 25-2011- _ -7777 ROBERT WILSON PO BOX 49 SOUTHOLD NY u97i JULY 21st 2017 NOTE: r ALL DATA TAKEN FROM SURVEY BY P.1 s S JOHN T. METZGER DATED`12/7/201G permits I drafting I expediting SETR VEY OF PROPERTY A T SO UTHOLD y'OWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. CREEK EDGE OF TIDAL wETLC AS DELINEATED 6Y SUFFOLK ENVIRENVIRONMENTALL CONSULTING, INC. 1000-55-03-25 �� � ON � 8 206 SCALE: 1'= 30' DECEMBER 07, 2016 \ d wI.F vn.F wt-F vl� r� E yta 'u I V E I y TOP 6 TOP B 2p"E OR. t JAN 2 3 2017 - `k '�., +b Gtr o FI. Op ,ZOrq NE G x—x- LOT Lo G` `,"APPROVE® BYN• ' LOT x—x ;� co•1 sly 1T fUil. FIS .0A_ BOARD_ OF I-RUSTEES o` TOWN •OF SOUTHOLD \ I � � I DATE " LOT � u: - �Vl 25 Zoll P pEGK 0.3 W Ir OVT 42 0 l Evia WINc)W GRIM 1 } HOUSE N \ I• � � � Cy�A6E, roti I " 5 \ GMt 420 22 3 _x—x—x- .b �_ I G(; � PORGI t k, I La I'�er N c, 70 N rCD xe �, G Q• a �9 C CA r , Ca.� 72OOaw Gw ^ r 8S 40' cw 42'00"H1 87.00'0. a S83• 0 • MONUMENT • WETLANDS FLAG Ii' �,E pF PI►vEtf .� � FLOOD ZONE5 FROM FIRM 36103C0158H DRIVE JJ MAP EFFECTIVE DATE- 5EPTEMDER, 25, 2009 CREEKM LOT NUMDEK5 REFER TO "MAP OF YENNEGOTT PARK" FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE } ON OGTO15EK 9, 1968 A5 FILE NO. 6173 S„�LIC. NO. 49618 ANY ALTERATION OR ADDITION TO THIS SURVEY 15 A VIOLATION i ; PECONIC SURI/EYORS, P.C. OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. = : (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SECTION 7209—5UDD I V 151 ON 2. ALL CERT I F I GAT I ONS P.0. BOX 909 HEREON ARE VALID FOR TH15 MAP AND COPIE5 THEREOF ONLY IF Pit, SAID MAP OR COPIES DEAR THE IMPRESSED SEAL OF THE SURVEYOR AREA=,26,04 sq-ft. 1230 TRAVELER STREET 16—.108 - SOUTHOLD N.Y. 11971 t i Michael J.Domino, President �Q%,1fFQZCO9 Town Hall Annex John M.Bredemeyer III,Vice-President kr Gym 54375 Route 25 Charles J. Sanders cm P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski yhOa �p� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 46 TO: ICA-- -h6-p7N KF&U1W (�0 ZA MI W t.bRie5 - Please be advised that your application dated ZAIJ 23 2,01-7 has been reviewed by this Board at the regular meeting of kWAP_cW and your application has been approved pending the completion of the following items checked off below. V Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % 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: T 1 ' .iia� b l TOTAL FEES DI,E. $ BY: Michael J. Domino, President (5I Board of Trustees Michael J. Domino, Presid( 6f �FFQ(�-COD ` ,s Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders P.O.Box 1179 Glenn Goldsmith r Southold,NY 11971 A.Nicholas Krupski ?',1 �apl Telephone(631)765-1892 h �c. Fax(631)765-6641 BOARD OF TOWN TRUSTEES l TOWN OF SOUTHOLD Date/Time: ^�- �, Completed in field by: Joan Chambers on behalf of KATHLEEN MEGUIN requests a Wetland Permit for the existing 62'7"x36'2.5" (2,027sq.ft.) 1 Y2 story dwelling; existing 42'8"x20'7" (858sq.ft.) wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4" (267sq.ft.) in-grade deck on seaward side of dwelling. Located: 605 Long Creek Drive, Southold. SCTM# 1000-55-3-25 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 Notic 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: Present were: ✓ J. Bredemeyer ✓ M. Domino ✓ G. Goldsmith V N. Krupski V C. Sanders Other Page 1 of 2 Michael J. Domino,Preside, 1 o�QSUFFO(��oG Town Hall Annex John M. Bredemeyer III,Vice-Presiaent �� y� 54375 Route 25 Charles J. Sanders = P.O.Box 1179 ca Glenn Goldsmith 0 Southold,NY 11971 A.Nicholas Krupski �d' ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Joan Chambers on behalf of KATHLEEN MEGUIN requests a Wetland Permit for the existing 62'7"x36'2.5" (2,027sq.ft.) 1 Y2 story dwelling; existing 42'8"x20'7" (858sq.ft.) wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4" (267sq.ft.) in-grade deck on seaward side of dwelling. Located: 605 Long Creek Drive, Southold. SCTM# 1000-55-3-25 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 Commenl't==* 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. <_25% 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 •� dn-j�;` �' ►�e+ 1 f I 1 , 2 J9Q17 I I-�{ ! _ , r +n;'y•• , `. 1 � • '•n hz�; F�+rK��`'��, • . ! . e% I _.Q.Q.x.'J°. I .r 'K. b,' :m'..:}WiirS'.• - ,t• ' 3 .. ,� .� }��F Southold Town _._. P -- '� - '""�� ,�,' ,;, • .,• _• , v P rd of Tn1S48@S ' m� ,._, t ANtl • -7#�gcxasranr€ zrv�s „._ - t .• - .. ,, •L � �y V•�' �i • O: 6' IVSLLND=Aldsar. . - , •• a'm, AZA 4sr''u.,ze .DL+alLlNac. _ O - "gyp S!4° BSG° G=OM P'e/ /B'Q�^ g- • 5�4�r mr, �r .. 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M „t� L FFT S1.0Ac f' •)r�'•� 'a!['T/dl/_Y-Y � SCA Lt: �/�•JPO' ,'q2 E3 0 I ,'r 'f• -- lot°ssA6♦ y � _. - -��- fe lNTRr cz— sysLvas. iv a ! �' a.AGA3Srmz• t • - tt 34•.3/7'•tJ•ANaJG6 h , l t Roe [Mt • - _- tl v -A4 `•41 DAMPER ; 6 OMSe'R!D �e h i /6S9C iLIDIN4 -H±H ' Lj ''•1• •r -- --__--_ a --.rus 2•S elr' A W 6 c•R89RI Q e • - —_—_ n 7 k 210• '8� � ��b` ? — .� _ Al N!A T b q • "r 711r., tS•7�� L _- _®=p�F/N/SN •P°JiJNJ9N • � O ® - .'fNNli e! tII, , 'I�rfN,/CQT•QIU!'- ' •• ,S ' ! t LL SCAI W Of/NTE,CI OR :L fiYA r/OnJS.d . !�O ,• � 1 ; »w®� wis earsae.n ante eteeoow Ytwtllti s Mw*wr.•,6L. e�fbfl NO.� y? a t�- O ..I. � v f t MM M• issi j; 4', •, "1A7�, � �fi 7■*��M � ,�ii.• .�•�,• y+a� rrm�.iro.. t• 4 �.i.%:.4 n,•�*Fl f9!n��3r��e.,IT),'� T�y� w _ .., _ • _. ,. ..- -. ... ' _1 ,r:,• I ,. T r.+a,• .. .. • _w_+in.�o.s• ..-"I'_^'�I 6']• - .a ., f ,.r, ...w.• - 1 •fi 'i,• '1 'jib, •2W .M. .•w� r) jt J :,p,J .:?I,. 1.. 1 '�:* .'ii'-r PLAN 1/4" 1' MEGUIN RESIDENCE = 605 LONG CREEK DR. SOUTHOLD N .Y. 2'-8„ EXISTING: SINGLE FAMILY RESIDENCE SCTM# 1000-55-3- 25 1 EXISTING HOUSE UNCHANGED ZONE R-40 0.6 ACRES PROPOSED: 42'-8" X 20'-2" AS BUILT WOOD FRAMED DECK 2 x 8 LEDGER "DIGR PA GENERAL NOTES 1-1/2" E - AN RAIL O BAD DECK IN GRADE N 5 ISE s 1. All work shall conform to the requirements of the Residental Code of New York State, County and Town Department Regulations, Utility Company requirements and n best trade practises. 2. Before commencing work the Contractor shall file all documents required by the 10'-0-" -11-" Building Department, pay all fees required by local agencies and obtain all required HANDRAIL @ 36' TYP. _ - - , "DI GR SPA LE permits. TOP RAIL TO BE ADDED AN RAIL O B 3. The Contractor shall visit the site and verify all dimensions and the existing 2-2x844 POSTER S FASTENED �v conditions affecting the work prior to construction. Any discrepancies which would 4x4 ACO POST ANCHORED y = with the satisfactory completetion of the work described herein shall be TO 4x4 TS - interfere TO 6" CONCRETE PIER D 4 RER 10,-2_ 10'-2-" 61 reported to the architect or property owner. Do not Start work until Such conditions Ca have been examined and a course of action mutually agreed upon. Failure to notify 1x6 DECKING a the owner or architect of unsatisfactory conditions will be construed as an acceptance o of the conditions to properly perform the required work. W4. All work is to conform to the drawings and specifications of the architect and UJ engineer consultants. 5. The Contractor is to maintain a complete and up to date set of plans on the ojob site at all times N a 6. The drawings are not to be scaled under any circumstances. 7. It shall be the Contractor's responsibility to ascertain all prevailing procedures including storage and toilet facilities,protection of existing work to remain,access to _ work area, hours of permitted work,availability of water and electric power and all other conditions and restrictions for this particular location in order to execute the g_„ -;; .r,•T -` I work in a careful and orderly manner with the least possible disturbance to the public. ��> � ! ice tf 8. The Contractor shall make the neccesary arrangements to utilities and services nn / temporarily disconnected while I Do DOi; � p y performing the work as required. r ! Ili 9. The Contractor shall provide all dimensions and cut-outs for other trades. JAN 2 3 2017 10. The Contractor shall provide proper shoring and bracing for all remaining structure o , prior to removal of existing structure. W Q S 11. Plumbing, electrical, HVAC and similar work shall be performed by licensed em Southold Town persons who shall arrange for and obtain all required inspections.The General � � �Fn�^rd r,?jn°`^rs Contractor shall be responsible for scheduling all other inspections as required. a o 12. The Contractor is solely responsible for construction safety and shall hold the owner and architect harmless from litigation arising out of the Contractor's failure to ES Z provide construction safety means and methods. CONSTRUCTION NOTES 1. All footings shall rest on undisturbed soil at a minimum of 36" below fin. grade. 2. Poured concrete shall have a minimum psi of 2800 at 28 days unless noted. 3. Sill plates shall be preserved, treated wood and be installed above a 16 oz. copper termite sheild. 4. Shingle siding shall conform to ASTM D 3679 and be installed in accordance with the New York State Building Code and manufacturers specifications. 5. Pilings shall be installed by a licensed contractor to a depth and bearing agreed upon by an engineer and certificates shall be issued stating same. 6. Unless otherwise noted all framing and structural wood components shall be SEC=1'TION 114" #2 or better Douglas Fir. 7. All framing techniques and methods shall be as prescriptive design based on AF&P Wood Frame Construction Manual for One and two Family Dwellings (WFCM) or as specified in R301.2.1.1 8. All building envelope components shall comply with Chapter 6 of the Energy Conservation Code of the State of New York. 9. Fireblocking shall be provided in all wood framed construction in accordance with NYS Code R 602.8 to form an effective fire barrier between stories and HANDRAIL @ 36' TYP. between the to story and roofs ace. TO BE ADDED p ry p 10. Protective panels shall be provided for glazed openings in accordance with NYS code R301.2.1.2 if they are required. 11. All portions of the new structure are designed to comply with local geographic �1xs DECKING and climatic criteria as stated in the following table. 2X8 @ 16" OC DECK JOISTS STRAPPED TO GIRDERS TYP. 2-2X8 ACQ GIRDERS FASTENED TO 4X4 POSTS TYP. 4X4 ACO POST 6" DIA. CONCRETE PIER A- 101 PLAN, SECTION, NOTES PLAN AND SECTION 18" DIA X 10" CONCRETE FTG. SCALE AS NOTED @ 3' BELOW GRADE MIN. NOV 14, 201 6 SEAL: A 101 1 OF 1 PO BOX 49 ROBERT WILSON SOUTHOLD NY 11971 631-294-4241 /� t ( � ` �v •',�+Q Arg' ' oAC A ZMy . S�,\ �, � �.� 1 �/ ��•�i f� R�r y�Y�,t` •�* ��r�9.L�h•� $ 1 y1 r�x����7���/• t �� 605 Long Creek Dr.,Southold If SCTM#- 1000-55-3-25 ;i r y ! fix. },.'� yk' '.�i •3.. x � 't'\ x��+�i.`t� � `�• ,`�,�•� I ,�. `' els' �. } a . u � e?,' Moil `` - 3/ 1. 6/2017 8 : 59 r MA J J;q., JAMA W JL N i 714 A s RWthl. .Meguin A �i`,V 1 1,1404 N�i,., "j, " . J�� ." —1w 'ffl' " f05 L..g C,.k Driv e,Southold ti It A4 -CTM# 1000-55-3-25 414/17 ai 4, 4w IWA wq-- v4z� vu* � .; , -all V. aft r .r , ry . ,y �a 7N.,�so 3 Iti7 .. Photo taken from the North m the South Tan. 3rd, 2017 m 4 �h F , A , t s ,. FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. Z5501 Date Oct 4 , 19 '73 THIS CERTIFIES that the building located at Long,.preek Drive Street Map NoYeAnOcOtt Plock No. Lot No. 9 Southold id.Y. conforms substantially to the Application for Building Permit heretofore filed in this office dated April 24 , 19 73 pursuant to which Building Permit No. 65192 dated . . AP;ra. . .26, 19 7.3, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is Private. one family, .dweMR9. . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to John Leacgek , Owner (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval Pmt . .2b . .1973 . .W. R. Villa UNDLRWRITERS CLRTIFICATL No Sept 25,f 973 by T. uubaaki 110USI NUMMI-R 605 Strut Long 10,ee]�. ArtYP. . . . . . . BLUILIHng I11',11 for f' l t 'r t ,`� r e a t5 Lu`q Geek Drive' O .'. Safety Quest a r Iw "`? !♦ t, err. jig: �: " ,.. Google i OFFICE LOCATION: ®� s®u��®� MAILING ADDRESS: Town Hall Annex AL® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) G P Southold, NY 11971 Telephone: 631 765-1938 a® ® Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: March 17, 2017 Re: LWRP Coastal Consistency Review for KATHLEEN MEGUIN SCTM# 1000-55-3-25 Joan Chambers on behalf of KATHLEEN MEGUIN requests a Wetland Permit for the existing 62'7"x36'2.5" (2,027sq.ft.) 1 '/2 story dwelling; existing 42'8"x20'7" (858sq.ft.) wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x16'4" (267sq.ft.) in-grade deck on seaward side of dwelling. Located: 605 Long Creek Drive, Southold. SCTM# 1000-55-3-25 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 action is INCONSISTENT with the below listed Policy Standards and therefore is INCONSISTENT with LWRP. 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 The as-built residential strucutre was constructed without a Wetland Permit. In the event the action is approved require vegetated buffers landward of the wetlands. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. S y y Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 !► 'F 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., March 15, 2017 the following recommendation was made: CATHY MEGUIN for a single-family dwelling with deck attached to the rear of the house. Located: 605 Long Creek Drive, Southold. SCTM#55-3-25 Inspected by: John Stein, Peter Meeker, Keith McCamy The CAC made an inspection, however, no recommendation was made.-It was difficult to determine the proposed action. John M Bredemeyer 111, President ' � 54375 Main Road town Hall Annex U l Michael J. Domino, vice-Presrderj� P O Box 1179 Janes F. ling, Trustee Southold, New York 11971-0959 Dave Bergen, Trustee G � Charles J. Sanders,"trustee Telephone(631) 765-1892 Fax(631) 765-6641 BOA-RD OF TOWN TRUSTEES D TOWN OF SOUTHOLD To: Southold.Tow6 Building Department FEB e 2 2017 Re: Verification of Building Department Permit Requirements BUII,DINGDBPT, TOWN OF SOUTHOLD SCTM#: 55 3 — 2-5 dYlC�lll/1P RWRR,-r i Property Owner Name: / Date Sent to Bldg- Dept-: �'Z` The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building DepartfnenYs permitting requirements stated-below: YES NO Will the proposed project require a Building Pen-nit? If the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: 714 4, - --- ------ , / /" 21 Si ature" Jflfke viewer Date ff� IL Pie! JAN 2 3 2017 Southold Town an=ZZZ7;L-" John M.Bredemeyer 1H,President Town Hall Annex Michael J.Domino,Vice-President P.O.54375 Main Road Box 1179 James F.King,Trustee Southold,New,York 11971-0959 Dave Bergen,Trustee Telephone(631) 765-1892 Charles J.Sanders,Trustee Fax(631)765-6641 130ARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application E C E V E Administrative Permit AAmendment/Transfer/ExtensionReceived Awlication. 112-3,1-1 - JAN 2 lReceived Fee:$ 2-90X_0 3 2017 Z�6ompleted Application: 2-2,17 Incomplete: ____SEQRA Claisiiic­at rd Type I Type 11 Unlisted 0 -3 ordination:(date sent):_ /LCVWRP Consistency Assessment Form: CAC Referral Sent: ,7 V___'Date of Inspection: Receipt of CAC Report: —Lead Agency Determination: Technical Review: V Public Hearing Held; _—Resolution: Name of Applicant: Cathy Meguin Mailing Address: 605 Long Creek Dr. Southold NY, 11971 Phone Number: (631)765-9303 Suffolk County Tax Map Number: 1000- 55-03-25 Property Location: 605 Long Creek Dr. Southold NY, 11971 SCTM: 1000-55-03-25 600ft. NE of Tuthill Rd. (provide LILCO Pole#,distance to cross streets, and location) AGENT: Joan Chambers (If applicable) Address: PO Box 49 Southold NY 11971 Phone: (631)294-4241 r Cantrell, Elizabeth From: Joan Chambers <joanchambersl0@gmail.com> Sent: Thursday,January 26, 2017 12:11 PM To: Cantrell, Elizabeth Subject: Meguin application letter A Southold Town Trustees permit application was filed by Joan Chambers on behalf of Robert and Kathleen Meguin for their residence at 605 Long Creek Dr. Southold NY 11971 on January 23rd 2017. The residence is a 2027 sq.ft. 1 Y2 story wood frame house. The overall dimensions of the house are 62'-7" x 36'-2'h". Attached to the rear of the house there is an elevated wood frame deck. It's overall dimensions are 42'-8" by 20'-7"for a total area of 858 sq. ft. There is also a wood deck"in grade" attached to the rear of the house. The dimensions of that deck are 16'-4"x 16'-4" for a total area of 267 sq. ft. Thank-you, Joan Chambers i Board of Trustees Applicatzou GENERAL DATA Land Area(in square feet): 26,048sq.ft., Area Zoning: R-40 Medium density residential Previous use of property: Single family residence Intended use of property: Same Covenants and Restrictions on property? _ Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review, and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? 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? _Yes No Prior permits/approvals.for site improvements: Agency Date Southold town building-department April 24th 1973 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?V No Yes If yes,provide explanation: Project Description(use attachments if necessary):, Single family residence with deck attached to rear of house. Board of Trustees Applicatx®ai WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: Single family residence with rear deck Area of wetlands on lot: 70sq.ft. square feet Percent coverage of lot: 0.2% Closest distance between nearest existing structure and upland edge of wetlands: 73.9 feet Closest distance between nearest proposed structure and upland ` edge of wetlands:w 739 feet Does the project involve excavation or filling? V/ No Yes If yes,how much material will be excavated? 0.0 cubic yards How much material will be filled? 0.0 cubic yards Depth of which material will be removed or deposited: 0.0 feet i Proposed slope throughout the area of operations: Flat Manner in which material will be removed or deposited: N/A 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): The wetlands on and adjacent to the lot will not be disturbed. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or-funding,-are subject to public review,and may be subject to further verification. Complete Part 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 l-Project and Sponsor Information Name of Action or Project: Meguin As-built Project Location(describe,and attach a location map): 605 Long Creek Dr. Southold NY, 11971 SCTM: 1000-55-03-25 _ Brief Description of Proposed Action: As built single family residence with deck attached to rear of house. Name of Applicant or Sponsor: Telephone: (631)294-4241 Joan Chambers E-Mail: joanchambersl0@gmaii.com , Address: PO Box 49 City/PO: State: Zip Code: Southold _ NY 11971 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 n n may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action requ ire a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ((�'''''�� Southold town building department, Southold town board of trustees " F 121 3:a:Total acreage of the site of the proposed action? o,s acres b.Total acreage to be physically disturbed? 0.073 acres 2084 sq n house c.Total acreage(project site and any contiguous properties)owned 1125sq ftdeck or controlled by'the applicant or project sponsor? 06 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑ [:]Commercial Commercial [�^�, Zesidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑other(specify): �^_ ❑Parkland Page 1 of 4 e 5. Is the proposed action, NO ' YES N/A a.A permitted use under the zoning regulations? ❑ rZ1 ❑ b.Consistent with the adopted comprehensive plan? 17 1Z I ❑ 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: _ _ Fv; Elv f S. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES LVJ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? El c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ("� ❑ 4. Does the proposed action meet or exceed the state energy code requirements? NO 'YES If the proposed action will exceed requirements,describe design features and technologies: ❑ :❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: _� _ �___� _T_� ❑ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:M_ __� _ _ El ❑ ; 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? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: _ yw '—' ' ❑ i 14. Identify the typical habitat types that occur on,or are I ikely 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? 'M ❑ 16.Is the project site located in the 100 year flood plain? NO -YES- F\-/l ES _Lv 1 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ ,lJ a.Will storm water discharges flow to adjacent properties? [2 NO []YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ®YES Storm water from the roof wll be diverted by,gutters and conveyed to dry-wells by leaders_ Page 2 of 4 18. Does the-proposed action include construction or other activities that result iri'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: 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: _ EJ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE _ Applicant/sponsor name:,_„_,_____ _ _ _ W Date: Signature: _ Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.followtng questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1.; Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? �2._ Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? �� d 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate^ (� reasonably available energy conservation or renewable energXop ort unities? iii.���111 L_J 7. Will the proposed action impact existing: a,public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, �( T El architectural or aesthetic resources? U El 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 'l 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., hould,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 largc or significant adverse impacts and an environmental impact statement is required. nCheck 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 cnvironmeni I I imp t/Is. Town of Southold_Board of Trustees Name of Lead Agency Date t� lU President Print or Type Nal of Responsible ficer in Lead Agency Title of Responsible Officer Signature of Responsibile Officer in Lead Agency Signature of Preparer(if different fiom Responsible Officer) L _P RIND Page 4 of 4 USPS.com®-USPS Tracking® https-.//tools.usps com/go/TrackConfirmAction.action?tRef=fullpage&. . .Je Still H USPS Tracki n ® BrowE g Brow: Tracking Number: 70162070000040701496 Updated Delivery Day: Friday, March 17, 2017 Product & Tracking Information MOE Postal Product: Features: First-Class Mail® Certified Mail'r" Return Receipt Text Updat See tracking for related item: 9590940226626336815444 Email Upd. DATE&TIME STATUS OF ITEM LOCATION March 17,2017, 11:07 am Delivered,Left with BAYPORT, NY 11705 individual Your item was delivered to an individual at the address at 11:07 am on March 17,2017 in BAYPORT, NY 11705. March 17,2017, 11.00 am Notice Left(No Authorized BAYPORT, NY 11705 Recipient Available) March 17,2017, 8:23 am Out for Delivery BAYPORT, NY 11705 March 17,2017,8:13 am Sorting Complete BAYPORT, NY 11705 March 17,2017,7:30 am Arrived at Unit BAYPORT, NY 11705 March 16,2017,7:58 pm Departed USPS Facility MID PROCESSING AND DISTRIBUTION CENTER March 16,2017, 8:55 am Arrived at USPS Facility MID PROCESSING AND DISTRIBUTION CENTER March 15,2017, 11:37 pm Departed USPS Facility WHITE PLAINS, NY 10610 March 15,2017,3:22 pm Arrived at USPS Origin WHITE PLAINS, NY 10610 Facility 1 of 3 3/22/2017 11:19 AM USPS.com®-USPS Tracking® https://tools.usps.com/go/TrackConfirmAction.action?tRef=fullpage&... DATE&TIME STATUS OF ITEM LOCATION March 10,2017,8:46 am Forwarded SOUTHOLD, NY March 10,2017,7:49 am Arrived at Unit SOUTHOLD, NY 11971 March 9,2017,5:04 pm Departed Post Office SOUTHOLD, NY 11971 March 9,2017,2:27 pm Acceptance SOUTHOLD, NY 11971 Tracking Number: 70162070000040701489 Product & Tracking Information Avails Postal Product: Features: First-Class Mail® Certified Mailn" Return Receipt Text Updat See tracking for related item: 9590940226626336815451 Email Upd, DATE&TIME STATUS OF ITEM LOCATION March 15,2017, 10:16 am ®slavered,Left with BROOKLYN,NY 11201 Individual Your item was delivered to an individual at the address at 10:16 am on March 15,2017 in BROOKLYN, NY 11201. March 12,2017,6:59 am In Transit to Destination March 11,2017,5:10 am Departed USPS Facility BROOKLYN, NY 11256 March 10,2017,9:10 am Arrived at USPS Destination BROOKLYN, NY 11256 Facility March 9,2017,9:49 pm Arrived at USPS Facility MID PROCESSING AND DISTRIBUTION CENTER March 9,2017, 5:04 pm Departed Post Office SOUTHOLD, NY 11971 March 9,2017,2:25 pm Acceptance SOUTHOLD, NY 11971 Track Another Package Manage 2 of 3 3/22/2017 11:19 AM Ir r-1 - - _ .y' rU n Ln M.Z Ln a SOUTH�OLz 4 [- 1�1 I1 r a r-9 50UTHOL e 1 1 i - �:� E.' si .'a r- Certified Mad Fee $3.35 1 X971 C3 Cerhfled Mail Fee 0971 C ,-' Extra Services&Fees(check box,add tee ,aApfelpr�ate) ❑Return Receipt(hardcopy) $ '-_1''11�'' �' Extra turnSera ce&Fees(check box,add fee m� ate)- It 0 ❑Return Receipt(electronic) $ i--Il Postmark ❑Return Receipt(hardcopy) $ E:3 ❑Certified Mail Restricted Delivery'-$ _ Here C3 [ICr Return Receipt(electronic) $ Postmark 0 ❑Adult Signature Required qO ❑ Mall Restricted Delivery $ ® Here O �"t - = []Adult dult SSignature Required $ a9 ❑Adult Signature Restricted Deliv $ '�� 0 E]Adult Signature Restricted Delivery$ Postage Postage o $0.49 9� C3 r- $ 3 /09/2017 r $ $0.49 a�t1 �i /2117 O Total Postage and FeQSr� ®� a Total Postage and Fees f ru $ b•! $6.59 .A SentTo �°� Sent To r� 1-- 14 ¢l- -T. ra rcta<<_ 9 -�y$rtCYp 0 Street and pt o.,or PO Box N-- 44g-S._4 S et and Apt N ,or PO Box No. GaO----�Aq---Q—me-K---0r---------------------------------- C3 (� h Crry,State,ZIP+4® 1Qfj__ ------------------------------------------ q Crty take Z1Py+4® �-- -- L VfiL - :•, r °e e e a�• „ Sri)”. ..J -:e r- — . p ® a ru a— • •" u-J °- - e • e -e - a eSOT € I eUR�C-Le 11/120 . 11 �1H . � -° ��- t`�� lr•� •(,� C3 Certified Mad Fee 0 Certified Mad Fee p 0971 r $3.35 0971 r. $3.35 77 $ UtiExtra Services&Fees(check box,add fee aaF{orriArtate) 77 O Extra Services&Fees(check box,add fees ` ❑Return Receipt(hardcopy) $ Pr r r rlr ❑Return Receipt(hardcopy) $ 0 ❑Return Receipt(electronic) $ )1.)(0( ark O ❑Return Receipt(electronic) $ I� mark E:3 ❑Certified Mall Restricted Delivery $ $0-00 ®a`"e ��® r3 ❑Certified Mail Restricted Delivery $• re C) E]Adult Signature Required $ V O []Adult Signature Required $ rye C3 ❑Adult Signature Restricted Delivery$ O []Adult Signature Restricted Delivery$ Postage ✓� Q Postage $0 m 49 C3_ +01.49 1116— C� $ I 19/2017 p Total Postage and F e$ 1�/� 211 p Total Postage and Fees ru $ $.59 ru $ $6.59 Sen To Sent To � �[ .0 a - �4�l'' ray? 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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 MAEURETURN RECEIPT. Sworn to before me this Day of 320 i Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Kath leen and Address: 6G Long Ck DfT. RUber1 ME'y(�in Sf1(Nt�0 ld NY 1 (9 7 I STATE OF NEW YORK COUNTY OF SUFFOLK 06rErr Wi 1Sdn , residing at__U Priscita L& 13;� �A Aly Y ttgy 1 , being duly sworn,deposes and says that on the i_day of /Vl ,ick , 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 $G uth o 1 d ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of NR2Ct� ,20 1 77 5 Notary Public DIANE DISALVO NOTARY PUBLIC-STATE Of NEW YORK No. O1 D1475593 Qualified In Suffolk County My Commission EXPires April 30, 20 j� Michael J.Domino,President � O�Q CDGh Town Hall Annex John M.Bredemeyer III,Vice-President rj may` 2 54375 Route 25 Charles J. Sanders a P.O.Box 1179 Cn Glenn Goldsmith D Southold,NY 11971 A.Nicholas Krupski plyr!f 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 KATHLEEN MEGUIN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO-BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Robert W0sur, , residing at/dba 115- Pr SC it t La. R;yerlea4 IVY lga( being duly sworn, depose and say: That on the 1*4 day of h%grck , 2017, I personally posted the property known as G09' Lona Crea-K Dr Sauakall NY 5CTM : 1000- TT-03-IT by placing the*13oard 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, March 22,2017. Dated: (signature) Sworn to before me this OWday of A&r f.20 Jy I A�w DIANE DISALVO IP/ NOTARY PUBLIC=STATE OF NEW YORK Notary Public NO,.,,07 D1475593 Qualified In Suffolk County MY Commission Expires April 30, 20/9 `f 1000-55-3-24 Anita Schloss 147 Columbia Hts. Apt. 3 Brooklyn NY 11201-2118 1000-55-3-26 Robert Higgins 755 Long Creek Dr. Southold NY 11971 1000-55-4-23.3 Bette Weiskopf 7 Orchard Dr. East Williston NY 11596 1000-55-4-7 Daniel T. Woods 620 Long Creek Dr. Southold NY 11971 1000-55-4-8 Hall Family Irrevocable Trust % Christine Hall 760 Long Creek Dr. Southold NY 11971 ,NUTILt Ulm HtARING 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: KATHLEEN MEGUIN SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing 62'7"x36'2.5" (2,027sq.ft.) 1 % story dwelling; existing 42'8"x20'7" (858sq.ft.) wood frame deck attached to seaward side of dwelling; and for the existing 16'4"x164" (267sq.ft.) in-grade deck on seaward side of dwelling. Located: 605 Long Creek Drive, Southold. SCTM# 1000-55-3-25 TIME & DATE OF PUBLIC HEARING : Wednesday, March 22, 2017 — 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 B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 • Board of Trustees Appliea )n AUTHORIZATION (where the applicant is not the owner) 1, Robert and Kathleen Meguin _residing at 605 Long Creek Dr._ (print name of owner of property) (mailing address) Southold NY, 11971 do hereby authorize (-Agent) Joan Chambers to apply for permit(s) from the Southold Board of Town Trustees on my behalf is signatur rae U 9 ,,•,Board of Trustees Applica ,in AFFIDAVIT Robert R. Meguin, and Kathleen Meguin 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. itore e wner t •.� SWORN TO BEFORE ME THIS F�.. DAY OF ,20 I . e Ndtary Public DOROTHY E RWRIGl.�i;T_ i 1IOTRRY Ptletic,State of New Y0 Q,aaCfied is S�tfisof7 4S��fty 1tnns�'o�Expm Oemier 2 ,i CC AFFLICAiNT/AGEP T/RE'PS',T TATWE TRANSACTIONAL DISCLOSURE FORM T}tc T wn caf Sotitroicl's f'ode rsf Fthics rohitii. coL,fl icts ofi int st on i he L.t of town a iiact&and emnloyecs;'L o�traose 6 lric form i to rout o`t iraiio-i which ai alert t e 'w 'n ao s'I lee' iIi of hitereqj ar 1'allmi it.to se what ver cti rt is tiecessary to avoid same. YOURNAME: Meguin, Kathleen A. (Last name,first name,griddle 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 comparay,,spousc,sibling,parent,or child)have a relationship with any officer or employee of the Town of Sotttliold "Itelationsftip"inalttdcs by blood,nlarriage,or business interest."Business interest"means a business, inetudi'n a,partnerslaip,in.which-thc toN6 officer or employes;has even a partial ownership of(or employment by)a corporation in which the town,6f#icer or entployce owns more-than 5%df the shares. YES _ NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person. __ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the otivner of greater than 5%of the shares of the ccurptarote stock okilae applict nt- (when the opplicdht is wcoriioratiora),, I3)the legal or ben I ficial owner of any intcrest in a hon-corj�trrate entity(When the, applictant is nota corporation), an officer,director,parrtiaer,,bar tnployee'orthe applicaRt;,or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted tbisk day oeA top Signature - —%�, - Print Name C- Form TS l APPLICS VAGENTME PRESENTATYVE TRANSACTIONAL DISCLOSURE FORM The`-Town of,!titriltold's Cone of Flhies prohibits conflicts ot`interest on the part ortoivn officers anti employrres the ri aose air thi form is to nravide infonnafion which can alert the town of nosstble contitcts of interest and allow rt,to take whaievice actipn is neces. a to avoid same. YOURNAME: Meguin, Robert R. (Last name,first name,-tpiddle 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 ccrntpany;spouse,sibling,parent,-or child)have a relationship with any officer or employee of the"Town,of Southold?•"Itelationsllip,iticllldes by blopd,marriage,or business interest."Business interest"means a business, including a partnership`,in which the town,ofticec car employee lots even a partial ownership of(or employment by)a corporation in which thc-down nfficer gar employee owns more than,5%of the shares, YES _ NO V If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold' Title or position of that person_ 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)tht3 owner otgreater than 5%of ilie slialx;s'of the corporate stock of the apptictrnt (when the noplicaiit is a,corporation); 13),tire legal or�benelicial owner of any interest in a norncorporate entity(Wherrthe applicant is not a.coi-poratioril; C)an officer;director,partner,or-employee of-the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Suomi �i day f 44 20091 Sign ure Print Name Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM 1 he Tnivn of Southold Code.of I lii s hittits a:ontf itis ofinterest nn the hart of town f cc�_m an ernrsloyeea. 17re ra�osc r�F ris four"i_ Ttr prxrvidc lnfruirratiorl which call alert ttic town ryfl-6i..ible etinflicts of ihtercst an flow it to tate wl�tevcr,tction it necessary to avoid same. YOUR.NAME: Joan Chambers (Last name,first name,itiddle 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.) a Tax grievance Building Varianee _ ' Trustee Change of Zone Coastal Erosion y Approval of plat J _ Mooring Exemption from plater official map Planning Other (If"Other name the activity.) 'j Do you personally(orthrough yoar company,spouse,sibling,,parent or child)have a relationship with any officer or employee of the Town of Southold'? "Relationship"includes by blond,nlain•iagc,or,business interest."Business interest"means a business, including a parthership;iri which-the town of(iccr or employee has even a partial ownership of(or employment by)a corporation in which the town officer or cmplbyee owns more,titan 5'11%ofthc shares. i YES NO V r 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 i the appropriate line A)through D)and/or describe in the space provided. ' z The town officer or employee or his or her spouse,sibling,parent dr child is(check all that apply): F A)the owner crf greater than S°Pn ofthc.slrares'tsf the ctir°poratp stock cif the appiic#trtt (Whli i 016'apolicant is a corporation); B)•the Icgal or netibial owner of any interest in a non-corpor6te entity(wiiett the uppii�ani is not a carpbratipn); - - Ci)an officer,direct6rR�artarerp or`ernployee oPtlrc applic3ratt;ar ' D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thisd of 200—/ Signature Print Name J n Chambers Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. ANSTRUCTIONS L Allapplicants 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. a 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- urgposed_ action will be evaluated, as to its si ' scant benefieial`and,adverse effects u ori the coastal area which includes,all,of Southold Townl. 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 a<n wer jnust-: c cx laintd in detail listing BothesugortW an non suuporting 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_ h local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION' R SCTM##, 55 03 = 25 PROJECT NAAM Meguin as-built residence The Application has been'submitted to(check appropriate-response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 0 A. 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) 1 Financial assistance(e.g.grant,loan;subsidy) (c) Permit,approval,'license,certification; Nature and extent of action: As built 1-1/2 storey house with deck attached to rear,of,house. o Location'of action:,_ 605 Long Creek Dr. Southold NY, 11971 SCTM: 1000-55-03-25 Site acreage:. 0.6 acres 26,048sq.ft. Present land use: Single family residence Present zoning.classification: R-40 Medium density residential 2. -If an application for the proposed action has been filed with the Town of Southold agency, the following informatiowshall be provided: (a) Name of applicant: Joan Chambers (b) Mailing address: PO Box 49 Southold NY 11971 (c) Telephone number.-Area Code(' ). (631)294-4241 (d) Application number,if any:_ Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes.❑ No t`!I If yes,which state or federal agency? .C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices thaf will-further each policy. Incomplete answers will require that the form be returned for completion. r` IIEYELOPED 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 LWItP Section III—Policies; Page 2•for,evaIuation ' criteria. Yes ❑ NoFJ Not Applicable The residence is in keeping with the architectural style of the neighborhood., Most of the propeapprox 88% iso en wooded s acee. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the, Town of Southold. See LWR.P Section III_Policies Pages 3 through 6 for evaluation criteria Yes ❑ No ❑ Not Applicable No known historic or archaeological resources will be affected. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold® See LWRF Section III—Policies Pages 6 through 7 for evaluation criteria nV Yes ❑ No ❑ Not Applicable The house and deck are small relative to the size of the property Most of the propeqy remains wooded The contours of the property are,unaffected by any of the construction Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4® Minimize loss of life, structures, and natural resources from flooding and erosion. See LWl2P Section III—Policies Pages 8 through 16 for evaluation criteria 12, Yes 0 No El Not Applicable All the construction is outside of the flood plain. The improvements are also set well back from any areas that could be prone to erosion 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'D ND ❑Not.Applicable Waste water from the house is collected and disposed of safely. Storm-water run-off from the house is diverted into d -wells via gutters and leaders. 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 LMW Section III-Policies; Pages 22 through 32 for evaluation criteria. U El F1 Yes No Not Applicable The uses of the improvements in question will not generate waste with the potential to damage marine species in the nearby creek Attach additional sheets-if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section M — Policies Pages'32 through 34 for evaluation criteria. 'Q Yes E]No[] Not Applicable Neither the house nor the deck will produce waste detrimental to the air quality in the Town of Southold. 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 IH-Policies; Pages 34 through 38 for evaluation criteria. 12 Yes 11 NoEl-Not Applicable No unusual solid wastes or hazardous substances will be generated by use of the house or deck. The normal household solid waste that will be generated will be removed and disposed of in an appropriate manner. 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 M—Policies; Pages 38 through 46 for evaluation criteria. 0 YeO No[J Not Applicable Neither the house nor the deck will restrict access or coastal waters or public lands. Attach additional sheets if necessary 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 F7V1 No ❑ Not Applicable No"water-dependent"uses will be affected by the house or deck. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No❑ Not Applicable ` Both the house and deck are set well back (61.2'minimum)from the wetlands. The area on the property immediately adjacent to the creek is left un-improved and undisturbed. 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© Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section M—Policies; Pages 65 through 68 for evaluation.criteria. ❑ Yes ❑ No Not Applicable PREPARED BY . TITLE DATE