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HomeMy WebLinkAboutTR-5269 S;:v�� ;�2\\ .Eve F� ", 1 jaw.` -Wi> •(td\ '�f`r' �2:wa Ea* � .� � �IGYv"'- 4� `•�.••. loop- J96- JS / .c c.... fir' �cY � L 4 <�, - y �••�•->` ti�' an ;�- �..... � .. a.�.-.gam ►�'/�'' _.".. r _.. f Board Of Southold .Town Trustees SOUTHOLD, NEW YORK .M �. fi 00 PERMIT NO =+ DATE. ................................. January 24,2 1 .'i ALVIN}<W BER N & ELLENISSUED TO ....... ..........B'U:C;:: BII�IIIER..:BE<RMAN is Ant t n :.. Pursuant to the provisions of Chapter 615 of the 'Laws of the State of New York, 1893; and Chapter 404 of the Laws of the } r;< State of New York 1952. and the Southold Town Ordinance en- { titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS ... •d' IN AND ON TOWN WATERS AND PUBLIC LANDS and the %:. REMOVAL OF SAND, GRAVEL-OR OTHER MATERIALS FROM \ LANDS UNDER TOWN WATERS;'-.." and in accordance with the "�. Januar 24, ` Resolution of The Board adopted at a meeting held on ..................Y..... .. ` r. ' 2001 and in consideration of the sum of $.........150.......00.............. paid by tt �'�� �<• {7�9 F. Q.n. Berman.... ..•Ellen } airweather...Brown;:_ :h ha1#�:e£.::Alvir�- t.r Buch i d r-Berman rien N. Y. and. subject to the of .......................,.................................................................. 1 .' . ' Terms and Conditions listed on the reverse side hereof, of Southold.Town Trustees authorizes and dermits the following: ..' Wetland Permit to install a stairway 4 foot wide down face of slope.and bluff to gain residential sx �- `�_• access to shoreline as well as put a French drain in the rear of the yard before construction. Once P. ,., the construction of the house occurs showing.that there are drywells surrounding the house,hay bales be placed and no clearing passed the Coastal Erosion line. q all'-in accordance with the detailed specifications as presented in '•• "� the originating application. * ;;raring IN WITNESS WHEREOF, The said Board of Trustees Mere- ; affixed and these resents to ate Seal to be p by causes its Corporate � ���• Y: be subscribed by a'majority of the said Board as of this date. 'Henry Smith (absent) ' Trustees �: �19 dk'f r t �tIM \ ,�,� .. '� � vim. �� 1. ,r• -•� RMINR ?��•�^ :.tea � ,. A`�J '���`� r � � A� �^`` �. � `'� f�',��ti TERMS and CONDITIONS The Permittee Alvin Berman &•Ellen Buchbinder-Barman - - residing at 216 Hill Crest Drive ��-tH; i�r}t N. Y., as parr of the consideration for the issuance of the Permit does understand and prescribe to the fol- lowing: 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 open- ' ation 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 Penmittee 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 mos. which is considered to be the estimated time'required to complete the work involved, but'should circumstances warrant, request for an extension may be made to the Board at a later date. I That this Permit should be retained indefinitely, or as long as the said Permittee wishes to provide evidence to anyone concerned that anth- to maintain the structure or project involved, orization 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 Petaiittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town . Of Southold. 8. That the said Board will be notified by the Permittee or the completion,of the work auth- orized. 9. That the Permittee will obtain all other permits and consents that may be required sup- plemental to this permit which may be subject to revoke upon failure to obtain same. Albert J.Krupski,President Town Hall James King,Vice-President 53095 Route 25 Artie Foster �� D�j P.O.Box 1179 Ken Poliwoda o y1 Southold,New York 11971-0959 Peggy A. Dickerson H = Telephone(631) 765-1592 Oy Fax(631) 765-1366 �j01 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 21, 2002 Ms. Amy Martin C/o Fairweather Brown 413 Main Street Greenport,NY 11944 Re: Alvin Berman &Ellen Buchbinder-Berman 415 Hillcrest Drive North Hillcrest Estates Orient,NY SCTM#13-2-8.16 Gentlemen: The following action was taken at the Southold Town Board of Trustees Regular Meeting on November 20, 2002 RESOLVED that the Southold Town Board of Trustees grant a one year extension to Permit #5269 dated January 24, 2001 to install a stairway 4 toot wide down face of slope and bluff to gain residential access to shoreline as well as put a Fiench Drain in the rear of the yard before construction. Once the construction of the house occurs showing that there are drywells surrounding the house, hay bales be placed and no clearing passed the Coastal Erosion line. However, this determination is not a determination from any other agency. If you have any questions please contact our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President,Board of Trustees AJK: cj c Cc: Building Department FAIRWEATHER-BROWN DESIGN ASSOCIATES,INC. P.O.Box 521 413 Main Street Greenport,N.Y. 11:944 631-477-9752 (fax)631-477-0973 October 22, 2002 Board of Town Trustees Town of Southold Town Hall Annex P.O.Box 1179 Southold,New York 11971 Re: Berman 1000-13-2-8.16 Permit#5269 issued 1/24/01 Please renew the above referenced permit, as work has yet to begin on this part of the project. Attached please find$10. fee as required ThPy �ou. as ag Albert J.Krupski,President, OSVFFO(�C - Town Hall James King,Vice-President �.Z. �Gy 53095 Route 25 c � P.O.Box 1179 Henry Smith Southold,New York 11971-0959 Artie Foster co W Ken Poliwoda Telephone(631)765-1892 y?f�•( ���� Fax(631)765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 29, 2001 Ms. Amy Martin c/o Fairweather-Brown 413 Main Street Greenport,NY 11944 Re: Alvin Berman&Ellen Buchbinder-Berman 216 Hillcrest Drive North Hillcrest Estates Orient,NY SCTM#13-2-8.16 Gentlemen: The following action was taken by the Board of Town Trustees during a Regular Meeting,held on January 24, 2001,regarding the above matter. WHEREAS, FAIRWEATHER-BROWN on behalf of ALVIN BERMAN &ELLEN BUC HBINDER-BERMAN applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 12, 2000 and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on January 24. 2001 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, WHEREAS,the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of ALVIN BERMAN & ELLEN BUCHBINDER-BERMAN for a Wetland Permit to install a stairway 4 foot wide down face of slope and bluff to gain residential access to shoreline as well as put a French drain in the rear of the yard before construction. Once the construction of the house occurs showing that there are drywells surrounding the house, hay bales be placed and no clearing passed the Coastal Erosion line. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified when project is started and on completion of said project. FEES: NONE Very truly yours, Albert J. Krupski, Jr. . President, Board of Trustees AJK/cj c cc: DEC Army Corp. of Engineer's Dept. of State = Town Hall. 53095 Main Road P.O. Box 1179 Telephone O, 0� Southold. New York 11971 (631) 765-1892. SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Thursday, January 18, 2001, the following recommendation was made: Moved by Scott Hilary, seconded by Bob Ghosio to TABLE the Wetland Permit Application of ALVIN BERMAN &ELLEN BUCHMINDER-BERMAN 13-2-8.16 to construct a stairway down the bluff to the beach. 215 Hillcrest Drive North, Orient The CAC Tabled the application because more information is needed with regards to the dimensions of the stairs, and the height off the bluff. The CAC is concerned about the potential negative impact the proposed project will have on the sensitive bluff system. Vote of Council: Ayes: All Motion Carried Qp P.D. 5 M0.6p w. - 25 7.9 7.10 g ` A - _ -. �• 3AA(G - 2.4 A(G 1.3A(c)� 4 `1 GGO _ 11 icy - a� am 2 E.21. LEA LTA 3r r . nu 8.198.2 1.7 a. L7A N•�P $ 8.22 Ald •\ - '-- ,Ap�cl _ _ d _ - 221 8.17 ��• cy •. d +,A LOA(G a ^,jQ•a '; 09 8.24 kp b an �n \ z 3 \ p 6 L3A(c) A a 8.13 ,� nm CRF e.26 P•_'_. 5.2 fi Qo < ST e �� &� ' s 8.34 �\ 5.1 9.1 v e• a 8.12 8.27 A(c 'a ) 12 1 \ L2A(G y"-,: 'ID ,ap• - 4 c '� M - g ,as ,a ,�+8 11 m - ® - ~__.__ +® 8.31 9.2 3 L2A(G BJO SAA(G 8.10 .. ,o. 15�1 J• a(Eg1A8GE �� I - .. �� �'� - 9 L6A(U '•...50.1'. d 102 ,� q 20 8.29. "se .•� 8.37 y Basw NO.z, \ 2.6A ',G 836 \ u Zy- .3 ~�L7A(G ••8 me an 2 FOR PCL.N0. °' a� ¢ "� 'O j SEE SEC.NO. PCL NO 1 11• 7 _ O38-0I-007.1 _ w 10.1 - SEE SEC. 3 n 3 +t. 'b :d 8.7 B.OA I.OA m �c 9 G 018.03-030J •� �+ 6.1 `b- "C"'. •4 , 2.1A(G s LOA(G 7.� �— URGE WE - r . ASIN� MATCH QiEd L No.0 w ' 1661 +N MI 3- HATCH - 1 5.2 - - - ', • - WRARACE O - S�. P ri r �oSAFF04co Town Hall Albert J.Krupski,President h�O �y 53095 Main Road James King,Vice-President c 1 P.O.Box 1179 . Henry Smith ti = Southold,New York 11971 Artie Foster O O 0� Telephone(516) 765-18.92 Ken Poliwoda ��l Fax(516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DEC 1 2 � Office Use Only Coastal Erosion Permit Application Wetland Permit Application Grandfather Permit Application Waiver/Amendment/Ch g s / Received Application: Received Fee:$ 15--b - Completed Application Incomplete SEQRA Classification: Vv Type I Type II . Unlisted Coordination: (date. sen ) CAC Referral Sent: l Date of Inspection: Receipt of CAC Report: Lead Agency Determinatio Technical Review: Public Hearing Held: Resolution: Name of Applicant AIJc`n T"o-rM ���i✓h ��Gh �l t1�C�L' ralf�i'1 Address !�O u_TTd n 1Tj"et 1 9 �,- N� IQV 1 ©OZZ Phone Number: ( ) Suffolk County Tax Map Number: 1000 - 13 -2 -- � Property Location: �of I �-�� �JC�eSr NIOC, 90R2T_* CRie-ht (provide LILCO Poles#, distance to cross streets, and location) AGENT: m `—� j 9`� `a r,- T j&I (If applicable) Address: :f o f 2c�ET�-��fe )r�� S t G1�9 S Soce aTES S 1 © 'B o 52. 1 Phone FAX# : 477 18 of Trustees Applicati'l GENERAL DATA Land Area (in, square feet) : 7� , 1-4 1ii Area Zoning:^�251 S7,Ec��IG Previous use of property: On JeVe O,2e-� Intended use of property: �a, 1& IVm P-e-6 de )G`P-, Prior permits/approvals for site improvements: Agency Date ®n L CM 7 8 6 ems- v fi 7ic,d�mc� No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? -✓ No Yes If yes, provide explanation: Project Description (use attachments if necessary) : CoWh JO1y ea-CA 2 B -*f Trustees Appiicatio,, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: o l Y1S !- - 5�Q Pick G-CCeSS to s ko(e�� Area of wetlands on lot: square feet Percent coverage of lot: ® o Closest distance between nearest existing structure and upland edge of wetlands: TA feet Closest distance between nearest proposed structure and upland edge of wetlands: feet5-3d' � Does the project involve excavation or filling? V No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: cZS Manner in which material will be removed or deposited: elz4 9 � 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) : 3 AUTHORIZATION (where applicant is not the owner) ��. ill�� ►UGC. b6Y, 4- A residing at &atv-r) d- t K C' 1V l IV 4 oo2-7— (mailing address) do hereby authorize Amy K. Martin_ or other of Fairweather-Brown Design Associates Inc. to act as my agent to apply for all permits necessary for the proposed work to be performed at I-QT 14 � .Iiejve, YVOR��I` ( Owner's signs e) EL] of Trustees Applicati, COASTAL EROSION APPLICATION DATA Purposes of proposed activity: -td C:fTP1.(/f� �'� ��� s 'Pro M DI-9 12o -i- u- i00 Are wetlands present within -9-5-feet of the proposed activity? No vs Yes Does the project involve excavation or filling? - V/ No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) �o b e �S I OrJ I D .SUiol�®Y� _i7� �SGT.{ IE. I CC f7�t Y1G ��'►-��-fv�es � sfrucfu►'e-�s W e S 3611� GQ i {'ur h"UnC-e V) Qs rf 4 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: SCTM#1000-j`�- � - (}��M YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: ,8v/ 2 . That the property which is the subject of Environmental Review-- is located adjacent to your property and is described as follows : 3. That the project which is subject to Environmental Review under Chapters 32, 37, or 97 of the Town Code is open to public comment on: You may contact the Trustees Office at 765-1892 or in writing. The above referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal . OWNERS NAME: -lt)/n G��C'n e M QA) MAILING ADDRESS : `Svft o }�/aG�2 /�� /00 C' OYezo YoN-x Ne o Vol/ iooaa PHONE _-4ivt -tea a-f73 7 Enc. : Copy of sketch or plan showing proposal for your convenience. S L*of Trustees Applicatir County of Suffolk State of New York Rm � G�,�}rQTi� BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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 TOWN 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(S) , TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature 010 0 � SWORN TO BEFORE ME THIS DAY OF , Notary Public 7 i ostal Service (DomesticCERTIFIED MAIL,RECEIPT Ordy,'No Insurance Coverage Provided) FAIRWEATHER DESIGN ASSOCIATE -- BAY SHORE, NY 11706 X Postage. $ 0.34 UNIT P.O.Box 521 a ,�5� Certified Fee 1.90 o`A(��ji r 413 Main Stree• o Return Receipt Fee 1.50 e f I w Greenport,N.Y. 1; ru (Endorsement Required) g� 631-477-9752 (fax)631- C3 LlW'(� I Restricted Delivery Fee C KX Y t r3 (Endorsement Required) ��` l7 Total Postage&Fees LE 3.74 01i1 IAA 0 = Nam as rint CI rly)(to be completed by mailer) m Ir Street,Apt.No.; rq PfL�ox No. Board of Town Trustees o t;;,S le;ZrP+17— G /� i Town of Southold PS Form : O Town Hall AnnexSee Reverse for Instructions - .,?• P.O. Box 1179 $ 0.34 ttPl 7 D. Postage - Southold,New York 11971 a ! 1 Certified Fee 1.90 ! ��ostrn Mere j' Return Receipt Fee 1.50 �� ru (Endorsement Required) YXX�t Re: Berman O Restricted Delivery Fee t� 1°k.+`i�� `,y 1000-13-2-8.16 E3 (Endorsement Required) , Certified Mailing for Trustees Hearing of 112L o Total Postage&Fees $ 3.74 01i16�01 Na a Please riot CI ((to be completed by mailer) m -•--------------------- " i U.S. Postal Service 13-2-8.17 Louis & Caren DerondeCERTIFIED MAIL RECEIPT 29 Monbray Ave (Domestic Provided Bayshore,N.Y. 11706 Co a I NEW YORK, NY 10016 13-2-8.15 William& Sharlene Yu Postage $ 0.34 A".I- grl4,: 465 East 16th Street / O Certified Fee 1'90 Brooklyn,N.Y. 11226 r 1 `V fiaosrmarl� ;j ru Return Receipt Fee (Endorsement Required) 1.50M NZ y+ Restricted Delivery Fee p3 13-2-7 Amal &Catherine Chaudhuri O (Endorsement Required) 330 East 38th Street 43 G I= 3.74 of fG7l7i�✓ , New York,N.Y. 10016 p Total Postage a Fees $ m N lease P int learly)(tp be completed by ma ler) ---- 13-2-8 Carmela Contantino o- StreP,f,A t.No.;or O Box No�� _— -- """" """" "" 260 Garfield Place city,fare,ZIP � Brooklyn,N.Y. 11215orm 0,July 1999 See DO/6 Reverse- m BROOKLYN, NY 11215 a Postage $ 0.34 UNIT ICU 0944 S Certified Fee � 1.90 5n �,a ost Return Receipt Fee c ere O (Endorsement Required) 1.50 �y '! Restricted Delivery Fee C erg•'.: N�t XM O (Endorsement Required) -eyCM 1 Total Postage&Fees $ 3.74 0 1� S m Na lease Pr t Cle o be completed by mailer) - •------p— St et,Apt.No.;or x N Er r City State,otP+4 PS Form :, See Reverse for Instructions Albert J. Krupski,President �OSVFFO��C Town Hall James King,Vice-President �5% �r/y .53095 Route 25 Henry Smith c P.O.Box 1179 Artie Foster va = Southold,New York 11971-0959 Ken Poliwoda p� Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES : TOWN OF SOUTHOLD ----------------------------------- In the Matter of. the Application of COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING I, residing at o/00 beincj duly sworn, depos and say: That on the /5111'day of \,_�Al , 200/, I personally posted the property known as .for A9 i/ C,e Szr g�ff6 , jgz, i. oleie.Ajr A y by placing the Board of Trustees official poster where it can f 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 blic h a ng. ate of hea in noted thereon to be hel s .' . Dated: C� Asirur6)e Sworn to be ore me this day of 2001 ota Public LYNDA M.BOHN NOTARY PUBLIC,State of New York No.01 B06020932 Qualified in Suffolk County Term Expires March 8,201;1y4 AUTHORIZATION (where applicant is not the owner) ?,Per) -at" Alv' v) T residing at• 5-0 &eor) a- f g- e, A` IV 0027- (mailing address) do hereby authorize Amy K. Martin, or other of Fairweather-Brown Design Associates Inc. to act as my agent to apply for all permits necessary for the proposed work to be performed at �QT 14 �J; eie5l ' Wo P-T�' Akre-Df gfaf�eS Cie( fit ( Owner's signs e) 1•q-!fi•a(2/87)—Text 12 ; PROJECT I.D. NUMBER 617.21 SEC'; Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I—PROJECT INFORMATION (To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR 2. PROJEC7,NAME / Rm y rn J�R T/N /FH/A GeJ 3/rff �-f3/�'o 6eJ�1/ �.�X M✓�"/V 5. PROJECT LOCATION: 4, / ©/P/E/✓IT / T Municipality o /# TIC///,-,e as7— 4725 County k5o_7�Al' 4. PRECISE LOCATION (Street address and road intersections, prominent landdmaarks, etc., or provide:nap) 5. IS PROP,98ED ACTION: rr----11 New ❑Expansion tJ Modificationialteration 6. DESCRIBE PROJECT BRIEFLY: K> y D&)AI �S•Co/�.E t� f�.CIJ� 7`O C�t� 7. AMOUNT OF LAND AFFECTED: Initially °o� acres Ultimately acres d. WILL ROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING I—ND USE RESTRICTIONS? Yes ❑No If No,describe briefly 9. WHAPRESENT LAND USE IN VICINITY OF PROJECT? r es. ❑�!ndustrial ❑Commercial ❑Agriculture Park/ForestlOoen space I_t Other 1 Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY(FEDERAL, STATE OR LOCAL)l L!Yes L'4o If yes, list agency(s)and permit/approvals 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ U Yes' No if yes, list agency name and permittapproval 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE .MODIFICATION? ❑Yes ❑No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Applicantlsponsor name: . Date: Signature: 22 If the action is in the Coastal Area, and you are a state acency, complete the iCoastal Assessmen•. Form before proceeding with this assessment OVER `KART il—=NVIRC.NM. N TA' IcMEN I , o J@ _cr.-.Cierej _-y Agenc, FA. .`.OES AC-:CN EXCEa.. ..NY _ -. �HCLJ !N 3 NyC=F. .ne review _rocess ant usa :ne F'JL_ _-A . • I As I— NO B. WILL .kCT:CN RECE!`E CCCSCINA-c-3 REVIEW AS, RCVIOE7 =JR'JNLiSTED -iCNS iN 9 NYC RR. ?AnT 71i. if No. a negative _ec:are nnay ]e sucerseCec :y anctner:nvolved agency. 17—yes No CCULO ACTICN RESUL7:N ANY ADVERSE EFFECTS ASSCC:A7=-D WITH -:-E FOUZ-VIING::Answers may ne nancwritten. J :egrblal I t. Existing air =ality, 3uriac2 or'yrounawater cualily or :uantlty, .ncise :evets• -3x:st:ng :raitic zatterns• selic .vas;e xccuc:::;n or 7!sc: I potential !or erosion, --rainage or'loosing problems? :slain oneily: C2. Aesthetic, agricultural, arc::aeological, historic, or otner natural or cultural 'escurces: or community or;erg:ecrnood c:arac:er? Exclain c• C3. vegetation or .fauna. 'Isn. sneilfisn or wildlife soec!es, significant naoitats, or threatened or encangerea =cec:es? =plain orlatly: C;. A community's existing plans or goals as oific:aily aeooted,or a change in use or intensity of use of!and or other natural resburcas?EXplain CS. Growtn, suoseeuent.evewoment.or felatea ac::vities likely to be induces by the Cr000sea ac:ion? Exo lain orfefly. C5. Long :erm, snort term• cumuiadve,or other erfects not identified in C.-CS? =Xoiain zriefly. I Ctner!moac:s dric:acing cr.anges in use of etcher quantity or :ype at energy)? briefly. I I ;5 -:-tE.=.E•CR is THERE _Kc!'' -C BE. :NTRGVE?.S'( ?E!.iTEC 70 ?OTENT!AL ACVERSE =NvIRONMENTAL i i _'!es _NO :(Yes, =XClaln 7fieflV (PART III—OETEAMINATION OF SiGNIFICANCS (To be comoleted by agency) INSTRUCTIONS: For each adverse effect identified aeove,determine whether it is substantial,large, important or otherwise signifi• Each effect should be assessed in connection with its (a) setting (i.e. urpan or rural); (b).probaoility of occa.Jog; (c) duratid. irreversibility; (e) geograonic 5coce: and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure explanations contain sufficient detail to snow that all relevant adverse impacts have been identified and adequately aCdressec Checx this box if you have identified one or snore potentially large or significant adverse imoac:s which `.ir occur. -hen orocaed airec:ly to the FUL! LAF anelor prepare a positive-declaration. ChecX this box if you have determined, based on the information and analysis above and any sucoortir. documentation, :hat the pr000seo action ';,TILL NOT result inlny significant adverse environmental imcac- ANU provice on attachments as necessary, the reasons supporting this determination: i i !rent Jr :vae N.,rne 71 <ejZon%.ore):moil :n.eda .♦gent•/ slit of <v oonsioie I.jfrictr i ;gnJlL'rC')f OIr,Ct.fl lesconbore'_R,Ctf-n :eaa .♦gencv i,gnatute.)t r'•'eadltl tlr _,wer•rnf :ram re)Oan1101t J�tc n 5URVEY OF LOT #I4 MAP OF HILL CREST ESTATES N - FILED AUG.I5, I83 W e E AS MAC' # -1218 SITUATE: ORIENT TOM: SOUTHOLD SUFFOLK COUNTY, NY WOO'�_ \ /_ - ' - - p 00 AMENDED 04-0720-00 05-22-00, 01-14-2000, 10-061-00 — - b\vEE- 2{j 2' , - , � - , - of-,, , UNTY TAX # p ,- r ,,Gc�yt"-' I SUF IDOOG�3 2 - 5.16 - �d�f � CERTIFIED TO: Ve - , , tiP�a�� / ALVIN BERMAN 30 tea►, geatea oo r�ti°� ELLEN BUGHBINDER-BERMAN slope s `� NkqEALTH LAND TITLE � Test Hole # I GOMMO NSURANGE COMPANY from Filed Mop Top Soil 1. � — �Npry — — OF 9\O 0 Sandy Laam 3 9`3�'9 Flne /c�j9G cYG F✓ — w h _ Q. of -"--- ,/ ��- Cloy ' CO t. (; - L• l' I IN C\\9 NOTES: MONUMENT -unauthorized alteration p additionsto a survey map bearing a licensee landrsurveyor' seal is vim at son of sec[ion 72og. sub-0 ivision 2, of the p PIPE s J\ o 10 Q. ,�� Lam. � Naw York State Education Law.' ',(y Q „\-i/O -only cities from the prig inai or to is survey stooped seal with an considerede to be vslidYtrue AREA = 74,4-11 SF OR 1.11 ACRES wiEh �9q •Cb, , �� e°°`e5_ t 'Cer[if Scat Sens Indicateenneretn signify that to is •� su vey was prepared i accordance Milo[he ez ELEVATIONS REFER TO MSL NGVD'2G "/ate LNG `fy at ing tide pf Pradtelpe far Lane Surveys adapted by the New ytrk State Association pf Praf ass ion al OP _ I)� f Q. Lana surveyors. said c rti Picati one shall run only V , to the person for whom the c ey is prepared. �t r/ and on his behalr to the title son ny, gpvernmen- �.• 2 tal agency and lending institution listen hereon, and GOA5TAL ER05ION HAZARD LINE ANNOTATED �r Otis IVO. 5. 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( , i � r �f � _ , _ � I r,Y . . - / / / . . 1. % .. / � - �I ¢ .+� / / �� ,. .. � >' , �. � � �"� � . , , , r, , . . /' ( ., i 1 1 � � � h' r � , � � k � i (� � . '� � _ f , � �`"� ',,. \ `' 1 � + V' '_" � ' ,a. ALL RIGHTS RE5ERVED 7 , . .. ': / � '` � �• � ,�°' " �I `> ., . 6 � p � g TtiEa�PLANS ARC AN 1F�STRUMENT OF � �� � / ~� I / " ' � ' \ ''.,�;,;�„ � �� � � `A-, � 1 ' r ,- ' ' µ SERVICE AND ARE THE PROPERTY bF � , � , �,` �� � � ....---" � <!' cA , �� THE ARCHITECT. INFRINGEMENTS WILL ", , "� � � I l / � � /' ROCK WAIt`A�C�t�1G LINE � +� ui r ;� , . �,. - ' � t " � f � I , � �„ � ._.�.�.- ------ ""'�"` . ~� , � o e .. - BE PROSECUTED. 4 . ,. �� , � 68 � 5 r i `, , . 170. 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' . � , BASED ON SURVEY FOR �' . . . _ 4 . _ , {{ °� . ALVIN'BERMAN - � r - - `� � , . . ' I ID A � � r ELLEN BUCHB N ER—BERM N - ,� , �w � � I ,SURVEY OF LOIf'#14 .. ` , ' CLAY `-t MAP OF HILL CREST ESTATES .. - � _ . - - � � ' � "' � � � I - • PROJECT TITLE 1 - SECTION ONE 'FILED AUG. 15;. t 983 � , , .. .. . - � - � ,, , ,; A � i °� _ ('' 'A5 M P J�72 I8 : 6' � NM , IT . S TUATE ORIEN , N W � CONSTRUCTION ` . ., TOWN: SOUTHOLD � ;;~ ; . , . . - - , �� w � , - '; „ . � SUFFOLK COUNITY, N.Y. - - _�� " � - .. . . SUFFOLK COUNITY TAX NO: , ... . �. . � ,;`,` .. 1000-1� 2-8.it 6 -t.- ~. ,, ,. � 2 6 I 5 5 50 4 ,. ' '. ' ,. 0 ,. � , T � . ,. _ AREA"= 74,47 II S.F. OR i .71 ACRES , . ,: . . : , , 4 8 0 20 30 2 2 .70 7576 .. 78 SO 82 8 86 °86 86 88 9 � ,,� DRAWING ITLE . ELEVATIONS RFIFER TO M5L NGVDD'25 , �.. � � � � I , _ , .- - . , � , � a . ', COASTAL'EROS!ION HAZARD LINE ANNOTATED . , .. � ' ' n ' FROM NY DEC COASTAL EROSION HAZARD MAPS ' , , , 'ti - . ' _ S " �° . . � � � .. 1 . � � SITE PLANS , �� - " ' • " . . . . _ , ,: . . ' .. , , , . , � - f: � . . . ,. . . �� ` , .. . . . ;: ,. - s _ � �� . . { DATE SCALE ; ' 1 � �;. � > 3 � �' ro 5 � I A r � � , � o D 5� `f � PL N � � , . , , ;� 1 . � � - ,:. , . ,. � r ISSUE . _.. r_ 1 11 ��;;� . .. I .. SCALE I —30 0 a }i�■11 , ,. ;, , d , ;� . v K ,, ` , � r x.- � DRAW1 NG Nb. ,. r , � . . r ,. . _ �� _ . . , . 1' . . , , - d;; - - R IS A VIOLA?10N OFTI$ D , 1 , , ... �� ae A .. , � - E A J'. , . , _ � UNLE88 ACTINQ UNDER TI$ O 71. �� , { � DIRECTION OF A LK�PISED Q O � i . , , � �� �,. 'k�' ,. ARCHJTECT TO A1.1'ER ANY � .f, 1 W REM ON TH S DRAwIN(II ., - .. - � ANY WAY.ANY AU11iORIZED ;. . 'ALTERATION MUST E - r , +.c' > , , T EALE D AND .. � NO ED S . s � _ . ., ,_ � - / ,: r DC�:^L'G71`J J.00ORDANCE i .. t" . . .'. „ . - - , <' , , , � ,. �, � � .• .. ., a v - _ s: , ,' 1h', , , . �. „ ,.. , 1 ;« .- . { , ;' ., ,' .. ,. , , . . ., .. a - - `� , . .. ' „, a N RE1=. 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