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Home My WebLink AboutTR-5727 Board Of Southold Tom Trustees e � � SOUTHOLD, NEW YORK p ::. DATE: M.?x..ch...I.8:,2.0.03 . . PERMIT NO. ... ................ r. �. : LARRY. SEVERINI......................... ISSUED TO , ' Pursuant to the provisions of Chapter 615 of the Laws of. - 1 the State of New York, 1893; and Chapter 404 of the Laws,of the •_ _ State of New York 1952; and the Southold Town Ordinance en- c` titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS r �. WATERS AND PUBLIC LANDS and t IN AND ON TOWN M REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FRO . , LANDS UNDER TOWN-WATERS;!,': and in accordance with the ! Resolution of The Board adopted at a meeting held on :.March 18, ti aid b <s 2003, and in consideration of the sum of �.-..2.0.0._GG.•..--- p Y ( . .�. `{ Suffolk Environmental Consulting •..In.. :voxl,..}�ehalf...o�...-..--• } ...H - -mot .....�.,:..,.�:r... ....:-._...:.a •:-- N. - ..._.. ; > Larr Severini ....... N. Y. and, subject to the of ..._..-.... rid.gehat�n NY............... .. d Terms and Conditions listed on the reverse side hereof, of Southold Towel Trustees authorizes and permits the following: •.`a Wetland Permit to construct a 975 sq,ft,+/-addition to the existing dwelling;a 250 sq.ft+/- ;- attached porch a 187 sq,ft,+/-rear deck/patio addition to the existing rear deck/patio;and a 500 sq.ft.+/-detached garage as per approved plans dated and stamped March 18;2003. ? o- ,s• all in accordance with the detailed specifications as presented in �+ the originating application. 4 _ IN- WITNESS WHEREOF, The said Board of Trustees here- `. Corporate-Seal to be affixed, -and-these- presents to __ by causes its be subscribed by 'a'majority of the said Board as of this date. - i . t"^z C= / K/1Trustees •:L< __ __ s-- s:s--cam„'� `r-•.0 / �:e • : �'�-rr _Yam.-��;•s,ri-.�s�f -_'-.`��„Ya a�.•L. �t� � � `<.M.: _ � n \ s- 4 •R, �Y�sL,-. ��5 �f gyp.'-"2n. TERMS and CONDITIONS The Permittee Larry + N. Y., as residing at , issuance of the Permit does upderstaa and prescribe to the fol- part• of the consideration for the lowing: i. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits wising directly or indirecdy as a result of any open- atroa 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 sty with respect thereto, to the complete'eulusion of the Board of Trustees of the Town of Southold 2. That this Permit is valid for a period of .2 4 �, whkh is considered to be the request estimated time'required to complete the work involved, but should.drees Warrant, for an extension may be made,to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to-maintain the structure or project involved, to provide evidence to anyone concerned that and, orization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and noa-oomplianee 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. G.. 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 or project herein stated without expenses to the Town . of Southold 8. That the said Board will be notified by the Permittee of the completion.of the work auth- orized. 9. That the Permittee will obtain all other permits and consents drat maybe required sap' plemental to this permit which may be subject to revoke upon failure to obtain same. S�FFO(� Albert J.Krupski,President ��,� C� Town Hall James King,Vice-President ti'Z Gy 53095 Route 25 \ Artie Foster o P.O.Box 1179 H Z Southold,New York 11971-0959 Ken Poliwoda Peggy A.Dickerson ifi �� Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 25, 2003 Mr. Bruce Anderson Suffolk Environmental Consulting,Inc. PO Box 2003 Bridgehampton,NY 11932 RE: SCTM#53-01-14 Larry Severini 1795 Pipes Neck Road Greenport,NY Dear Mr.Anderson: The Board of Town Trustees took the following action during a Regular Meeting, held on March 18th, 2003 regarding the above matter. WHEREAS,Suffolk Environmental Consulting,Inc. on behalf of Larry Severini applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated December 27--2 --- —- -- --- - - 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 March 18th, 2003 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; 2 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 Suffolk Environmental Consulting,Inc. on behalf of LARRY SEVERINI request a Wetland Permit to construct a 975 sq, ft,+/-addition to the existing dwelling; a 250 sq. ft+/- attached porch a 187 sq, ft,+/-rear deck/patio addition to the existing rear deck/patio; and a 500 sq. ft. +/- detached garage as per approved plans dated and stamped March 18,2003. 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. Fee must be paid, if applicable and permit issued within six months of the date of this notification. If inspections are required, at a fee of$5.00 per inspection(See attached schedule). FEES: $5.00 Very truly yours, --------------- President, Board of Trustees AJK/cj c cc DEC Building Department Suffolk Environmental Consulting, Inc. Newman Village, Main Street;P.O. Box 2003, Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5198 Bruce Anderson, M.S.,Presidentfit D May 7, 2003 MAY 9 200 Town of Southold Board of Trustees Town Hall Southold Town 53095 Main Road Board of Trustees P.O. Box 1179 Southold,NY 11971 Re: SEVERVVl property Situate: 1795 Pipes Neck Road Greenport; Town of Southold,NY SCTM #: 1000-053-01-014 To whom it may concern, As per your request,please find enclosed herewith: (1) Check in the amount of$ 5.00 in order to cover the additional permit application fee. Kindly issue the requested permit at your earliest opportunity. Should you have any questions concerning this matter, please feel free to contact this office at any time. Thank you in advance for your consideration and attention. Sincerely, Matt D. Ivan enc. r Albert J.Krupski,Presidv. . Town Hall OSUFFO[�C • James King,Vice-President �O�' QG 53095 Main Road J% P.O.Box 1179 Henry Smith CD Southold,New York 11971 Artie Foster y Z Ken Poliwoda O Telephone(516)765-1892 Fax(516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Suffolk Environmental_ Consulting Inc. , on behalf of Larry Severini Please be advised that your application, dated December 27, 2002 has been reviewed by this Board, at the regular meeting of 18- 1003 and the following action was taken: ( X) Application Approved (see below) ( ) Application Denied .(see below) ( ) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees . The fee is 'computed below according to the schedule of rates as set forth .in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION. OF PERMIT FEES: One Inspection @$5.00 TOTAL FEES DUE: $ 5.00 C/. SIGNED: �� PRESIDENT, BOARD OF TRUSTEES BY: LERK, BOARD USTEES 4/98 Town Hall Alberti.Krupski,President suFFO(� 53095 Route 25 James King,Vice-Preside �� CO, • P.O.Box 1179 Artie Foster � Southold,Newyork 11971-0959 Ken Poliwoda o N Telephone(631)765-1892 Peggy A.Dickerson Fax(631)765-1366 col �a° BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD LARRY SEVERINI RE REQUIRED TO CONTACT THE OFFICE OF THETO MAKE AN BOARD OF 72 HOURS PRIOR TO CO TRUSTEES YOU A MMENCEMENT OF THE -CONSTRUCTION INSPECLEOR VOCIAT ON OF THE TO APPOINT MENT FOR A PRE SHALL BE CONSIDERED A VIOLATION AND POSSIB PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1st day of construction % constructed g Project complete, compliance inspection. Albert J.Krupski,Presiden' 'q Town Hall James King,Vice-President QsAFF01�C 53095 Route 25 P.O.Box 1179 Artie Foster � ��j coy� Southold,New York 11971-0959 Ken Poliwoda Peggy A.Dickerson y ? Telephone(631) 765-1892 Fax(631) 765-1366 oy�0l J Sao! 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. l v— INSPECTION SCHEDULE Pre-construction, hay bale line 1St day of construction '/2 constructed Project complete, compliance inspection. i Suffolk Environmental Consulting, Inc. Newman Village, Main Street; P.O. Box 2003, Bridgehampton, New York 11932-2003 (631) 537-5160 Fax: (631) 537-5198 Bruce Anderson,M.S.,President Via Telecovier and Regular Mail January 21, 2003 Southold Town Trustees Albert J. Krupski, President P.O. Box 1179Southold,NY NY 11971-0950 Re: Severini Situate: Pipes Neck Road, Southold SCTM# 1000-53-1-14 Dear Mr. Krupski: This Firm represents Mr. and Mrs. Severini who own the property referenced above. We filed an application for wetlands permit and the public hearing is to be held on January 22, 2002. Kindly adjourn this matter until the next regularly scheduled hearing date. Our request for adjournment relate to certain modifications to the survey before you. Yours t ly, 1 Bruce A. Anderson cc. L. Severini Jan 21 03 12: 03P STROUGH REAL ESTATE 631 -537-5198 p- 1 Suffolk Environmental Consulting, Inc. Newman Village, Main Street, P.O. Box 2003, Brldgchampton, New York-11932-2003 (631) 537-5160 Fax: (631 ) 537-5198 Bruce Anderson, M.S., President Via Telecopier and Regular Mail January 21, 2003 Southold Town Trustees Albeit I Krupski, President P.O. Box 1179 Southold,NY 11971-0950 Re: Severini Situate: Pipes Neck Road, Southold SCTM# 1000-53-1-14 Dear Mr_ Krupski: This Firm represents Mr. and Mrs. Severini who own the property referenced above. We filed an application for wetlands permit and the public hearing is to be held on January 22, 2002. Kindly adjourn this matter until the next regularly scheduled hearing date. Our request for adjournment relate to certain modifications to the survey before you. 1 Yours t ly, Bruce A, Anderson cc. L. Severini s Town Hall. 53095 Main Road cp T P.O. Box 1179 Telephone O Southold. New York 11971 (631) 765-1892 '�O,( SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town Conservation Advisory Council held Wednesday, January 15, 2003, the following recommendation was made: LARRY SEVERINI to construct a 975 sf. addition to the existing dwelling; a 256 sf. . attached porch; a 187 sf. rear deck/patio addition to the existing rear deck/patio; and a 500 sf. detached garage. Located: 1795 Pipes Neck Rd., Greenport. SCTM#53-1-14 The CAC did not make an inspection, therefore no recommendation was made. Suffolk Environmental Consulting, Inc. Newman Village, Main Street, P.O. Box 2003, Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5198 Bruce Anderson,M.S.,President December 23, 2002 Mr. Albert J. Krupski, President Town Hall r ;'U �DEC t.., 53095 Main Road P.O. Box 1179 ' Southold,NY 11971 ULL -- - Re: Severini property Situate: 1795 Pipes Neck Road Greenport; Town of Southold, NY SCTM#: 1000-053-01-014 Dear Mr. Krupski, This Firm represents Mr. Severini who is seeking improvements to the above referenced property. In order to do so, a Wetland Permit from your Board is required. Enclosed herewith please find a completed Wetland Permit Application. Application contents are as follows: (1) Town of Southold Trustees Wetlands Permit Application; (2) Short Environmental Assessment Form; (3) Location Map of subject property(two [2] copies); (4) Survey of the property, prepared by Joseph A. Ingegno,L.S. indicating both existing and proposed structures (two [2] copies); and (5) Check made payable to the Town of Southold in the amount of$200.00 covering the requisite application fee. Hammarth/ 2 By way of this correspondence,and on behalf of Mr. Severini, I request that you commence review of this application. Should you have any questions or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. Ivans enc. cc: L. Severini Pr SEVERINI operly Situate: 1795 Pipes Neck Road; Greenport; Town of Southold, NY AV. r lY F Dq/A e ° c sr r 1 L Pa ,�G PIPES COVE P 7G A i�yrs 4. O S V HELTE ISLAN SITE HE GHT .ro,,, HAGSTROM StreetAtlas 17.OA(c) m SOUTHOTORN OF LO I 17 (UNEWATERLOW B.h9AIc) _ @ urDi 10 • a 2.SA(c) P � 8 ° 19 � 13.1 14 2 4.OAfra r Q S1.SA(c) O Q O R 0, • T •�• .rty 14.1 r4 1.8 to 7.OA(c) TO'•N OF SOUTHOLD x CREEK NNDENMATFN 1AND1 a / p r d m PIPES f SCTM #: 1000 - 053 - 01 - 014 zrf• .<x 4 of •r: Y, ... .:..,.. .�.. -•:.v::..( `} .- ...'. t _.n :•,-,.a.tip-`- � 'C �- 2 •, tin '. '•.�- ! i 4 ^:\ :f s t� y^7 1. x vow^. s.s 1v N 719 0 k� SEE SEC.N0.045 L01E t hr SEE SEC.NNO.045 � .` . MATCH Lp7E ' evlslom h MATCH II-12-96 co 1-IO-9 O P j-16-0 N 71 7 ,� FOR PCL N0. ,} . 04-12-01 LBA(G 045-OSEE �04 3+ O � yti S-004 OO.13-01 'A N :a 10-22-01 _ 4-10-0 3 1a M .. ., p9 V 11.4A(c) .yy r mpiJ (t µ•O so s b , 4 2 BA(c) 19AA(c) 9 11.3A 13.OA(G 7TOtN OF x SOUiHOLDI 17 a4. � P �Su, mNEINdER I B.aA(G m uKm N 1-2 �! to Qs °�Y I L/4%/ ?• 2.5A(c) w _ Qr �13.3 14 - 19 try lk 2.3A(c115.1 /4y � ON 1 p• �l`°1 5� p'L n a ao 1 Q2 39 A1eERjS , c>o BS 2 m .� rsal< r - p 8-!B,"8 ° 1 8 �d SLIA(c) CD do o c b a 20,p� 9 '! 3s/ % r 14.1 I.Bw 4 $` Z !b J�9 ..M i, --+n-- 709N HOW 7.OA(G E a! us Y 9 l!1 a� 9 �/i . 4y mx,,�sart CRE K . ?a4fc1 4 J dER IAMN � . PIPES Albert J. Krupski, President Town Hall John Holzapfel,Vice President 53095 Main Road Jim King P. O. Box 1179 Martin H. Garrell Southold,New York 11971 Peter Wenczel Telephone(631) 765-1892 Fax(631)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use only Coastal Erosion Permit Application X Wetland Permit Application Grandfather Permit Application Waiver/Amendment/C anges Received Application: Received Fee: $ Completed Application Incomplete SEQRA Classification: '' =1 Type I Type II Unlisted {; Coordination: (date se t) { , ,, DEC CAC Referral Sent : Date of Inspection: Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name of Applicant Larry Severini Address 5 Hillcrest Court; Old Tappan, NJ 07675 Phone Number ( 201 ) 784 - 5611 Suffolk County Tax Map Number: 1000-053-01-014 Property Location: 1795 Pipes Neck Road, Greenport, NY provide LILCO ,Pole *, distance to cross streets, and location) AGENT : Suffolk Environmental Consulting, Inc. Address : P.O. Box 2003 Bridgehampton, NY 11932 Phone Number:, (631) 537-5160 Fax: (631) 537-5198 \Q 1 Board of Trustees Application GENERAL DATA Land Area (in square feet) : 14 , 375 square feet Area Zoning: Previous use of property: Private single family dwelling Intended use of property: Private residential dwelling with proposed additions/appurtenances. Prior permits/approvals for site improvements : None to our knowledge Agency Date X No prior permits/approvals for site improvements . Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary) Applicant proposes to construct a 975 sq. ft. f addition to the existing dwelling; a 256 sq. ft'. f attached porch; a 187 sq. ft. f rear deck/patio addition to the existing rear deck/patio; and a 500 sq. ft. f detached garage. 2 Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations : Applicant proposes to construct a 975 sq. ft. f addition to the existing dwelling; a 256 sq. ft. f attached porch; a 187 sq. ft. f rear deck/patio addition to the existing rear deck/patio; and a 500 sq. ft. f detached garage. Area of wetlands on lot: 0 . 0 f square feet Percent coverage of lot: 0 .0 t o Closest distance between nearest existing structure and upland edge of wetlands : > 80.0' f feet Closest distance between nearest proposed structure and upland edge of wetlands : > 80.0' f feet Does the project involve excavation or filling: X No Y e s DEC If yes, how much material will be excavated? N/A cubic yards -`. How much material will be filled? N/A f cubic yards Depth of which material will be removed/deposited: N/A t feet Proposed slope throughout the area of operations : N/A f Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate) : No impact to the wetlands are anticipated due to the project design and location, specifically the positioning of the proposed addition, porch, deck/patio and garage to maximize all associated setbacks from the wetlands located contiguous to subject property. In addition, the existing dwelling has had no negative impact on the wetlands. 3 Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purpose of Proposed Activity: Are wetlands present within 75 feet of the proposed activity? 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: DES 2 6 VOL '! Describe the nature and extent of the environmental impacts reasonably anticipated resulting from the implementation of the project as proposed. (Use attachments if necessary) 4 NOTICE TO ADJACENT PROPERTY OWNER BARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant : Larry Severini SCTM#: 1000-053-01-014 YOU ARE HEREBY GIVEN NOTICE: 1 . That is the intention of the undersigned to request a Permit from the Board of Trustees to: Applicant proposes to construct a 975 sq. ft. f addition to the existing dwelling; a 256 sq. ft. f attached porch; a 187 sq. ft. f rear deck/patio addition to the existing rear deck/patio; and a 500 sq. ft. f detached garage. 2 . That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows :. 1795 Pipes Neck Road; Greenport; Town of Southold, NY 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. 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: Larry Severini MAILING ADDRESS: P.O. Box 334; Wading River, NY 11792 PHONE # : (201) 784-5611 Enc. : Copy of sketch or plan showing proposal for your convenience. 5 .,. A` PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address : Ignatia Foti 324 East Westiew Avenue Leonia, NJ 07605-1812 r Carla A. Carroll 32 Brockmeyer Drive Massapequa, NY 11758-7803 Jean Eckardt 11 Stuyvesant Oval, Apt. 10G New York, NY 10009-2006 Milazzo Family, LLC 137 Kings Highway Hauppauge, NY 11788-4203 STATE OF NEW YORK COUNTY OF NEW YORK I, Diane Wassick, residing at Suffolk Environmental Consulting, Inc. ; Newman Village; Main Street; Bridgehampton, NY, being duly sworn deposes and says that on the 23rd day of December, 2002, 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 their 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, Bridgehampton, that said Notices were mailed to each of, said persons by (certified) (registered) mail . Sworn to before me this Z3 day of 2002 Notary Public Matthew D. Ivans Notary Public of New York No. Ol IV6053859 Qualified in Suffolk County Commission Expires January 22,20�3 6 Board of Trustees Application County of Suffolk ) State of New York ) Diane K. Wassick, 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 REPRESENTATIVE (S) , TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Diane K. Wassick SWORN BEFORE ME THIS 23 DAY OF L)EC• 2002 _ - - tary Public Matthew D. Ivans Notary Public of New York No. 0lIV6053859 Qualified in Suffolk County Commission Expires January 22,2003 7 Dec 20 02 12: 40p "TROUGH REAL ESTATE >31 -537-5198 p. 6 OWNER'S ENDORSEMENT (TO BE SIGNED IF APPLICANT IS NOT OWNER) STATE OF NEW YORK) COUNTY OF SUFFOLK) SS: Larry Seyeriini being duly sworn, deposes and says; I reside at 5 FIillcrest Court; Old Tappan NJ 07675 In the County of New York and the state of New York and I am the (owner in fee) (officer of the Corporation which is owner in fee) of the premises described in the foregoing application and that I have authorized Stitolk Environmental Consulting, Inc. to snake the foregoing application as described herein. ,.gnat e Signature If Corporation,name of corporation and Officer Officer's Title Before me, this day of _ , 20 6Z Noiar} -)ltc - ��'11111i3R® 14-16-4(9/95)-Text 12 617.20 S E Q R PROJECT I.D.NUMBER Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART 1-PROJECT INFORMATION To be completed by Applicant or Project sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Suffolk Environmental Consulting,Inc. SEVERINI 3. PROJECT LOCATION: Municipality Southold County Suffolk 4. PRECISE LOCATION (Street address and road intersections,prominent landmarks,etc.or provide map) 1795-Pipes Neck Road; Greenport,NY 5. IS PROPOSED ACTION: ® New ® Expansion ❑ Modification/aiteration 6. DESCRIBE PROJECT BRIEFLY: Applicant proposes to construct a 975 sq. ft.t addition to the existing dwelling; a 256 sq. ft.f --attached porch; a 187 sq.ft.t rear deck/patio addition to the existing rear deck/patio; and a 500 sq. ft.t detached garage 7. AMOUNT OF LAND EFFECTED: Initially <0.1 acres Ultimately <0.1 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? ® Yes ❑ No If No, describe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? ®Residential ❑Industrial ❑Commercial ❑Agriculture ❑Park/Forest/Open space ❑Other Describe: Private single family residences with related appurtenances. 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENT AGENCY(FEDERAL,STATE OR LOCAL)? ®Yes ❑No If yes,list agency(s)and permit/approvals NYSDEC Wetlands approval; SCDHS approval 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑Yes ® No If yes,list agency(s)and permit/approvals 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? ❑Yes ® No I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: tt D. olk Environmental Consulting,Inc. Date: 12/23/02 Signature: If the action is in the Coastal Area,and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART II-ENVIRONMENTAL ASSESSMENT To be completed by Agency) A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR,PART 617.12? If yes,coordinate the review process and use the FULL EAF. ❑Yes ❑ No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No,a negative declaration may be superseded by another involved agency. ❑Yes ❑No C. COULD ACTION RESULT IN ANY ADVERSE,EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten,if legible) C1. Existing air quality,surface or groundwater quality,noise levels,existing traffic patterns,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: C2. Aesthetic,agricultural,archeological,historical or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna,fish,shellfish or wildlife species,significant habitat,or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted,or change in use or intensity of use of land or natural resources? Explain briefly: C5. Growth,subsequent development,or related activities likely to be induced by the proposed action? Explain briefly: C6. Long term,short term,cumulative,or other effects not identified in C1-05? Explain briefly: C7. Other impacts(including changes in use of either quantity or type of energy)? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? []Yes [I No D. IS THERE,OR IS THERE LIKELY TO BE,CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑Yes ❑No If yes,explain briefly PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above,determine whether it is substantial,large,important,or otherwise significant. Each effect should be assessed in connection with its(a)setting(i.e.urban or rural); (b)probability of occurring; (c)duration; (d) irreversibility; (e)geographic scope; and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed.If question D of Part II was checked yes,the determination and significance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. ❑ Check this box if you have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULL EAF and/or prepare a positive declaration. ❑ Check this box if you have determined,based on the information and analysis above and any supporting documentation,that the proposed action WILL NOT result in any significant adverse environmental impacts AND provide on attachments as necessary,the reasons supporting this determination: Name of Lead Agency r Print or Type Name of Responsible Officer Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different From responsible officer) SEVERINI Proper!y Situate: 1795 Pipes Neck Road; Greenport; Town of Southold, NY F OP/e e c Sr 1 C A y ...PIPES COVE p z, 6 � yo°�5�t �•s ,�rcw�W� yc Q�Ep✓�, .. HELTE ISLAN SITE _, ��,,;�HE GHT .� 2 HAGSTRONStreetAtlas 17.OA1e1 TO'N OF SOU)HOLD I 17 p NNEfM'ALAN UAWY' llY011 tib 10 MAW >4 •4s S a, ' 11 ^ a W ✓� N g12 0 10 m 'SO R7n 14 r 4r 15.1 O• �! .p 2 l5011 4.OA(c) i1.IAly O 5 x C. R .aq 14.1 Sg Y -.. MAW � c TOWN OF SOUTHOLD M 4p CREEK (UHDERvrEA LAW PIPES I d JO/49 9 i a r SUM #: 1000 - 053 - 01 - 014 SURVEY- OF PROPERTY SITUATED AT ° PIPES NECK �° � - �� .° . LOT COVERAGE DATA DESCRIPTION AREA X LOT COVERAGE TOWN OF S O U T H O L D ° ° �' 'DWgY EXISTING HOUSE 1,175 sq. ft. 8.02% SUFFOLK COUNTY, NEW YORK ° -° � . - °. . . PROPOSED ADDITION 1,056 sq. ft. 7.20X S.C. TAX N o. 10 0 0—5 3—01 - 14 F rV ° ° B . PROPOSED PORCH j341 sq. ft. 2.33% SCALE 1 "=20' CONCfuOND h9 S °�3, �N1kONy p�SILL f PROPOSED DECK 650 sq. ft. 4.43% DECEMBER 16, 1997 N oo ' E VAC`4NT `SILL C� PROPOSED GARAGE 500 sq. ft. 3.41% JANUARY 13, 1998 REVISED HOUSE TO 1 -1/2 STY. MARCH 29, 2002 LOCATE NEW DECK TOTAL PROPOSED 3,317 sq. ft. 22.62X APRIL 16, 2002 UPDATE SURVEY 40 lgs, (INCLUDING EXISTING HOUSE) DECEMBER 12, 2002 UPDATE SURVEY & ADDED PROPOSED ADDITIONS 98. '2 E� AREA = 14,658.45 sq. ft. OUN 0 0.336 qC. r r.. ,_ / 9 1I CAPpFD Rf,egR T 4 :r: 7-9 ul 4, (�SFs Mf N0 oRy y o .a _ �j!?t.,Q/—o PUeLJc w Sf '�� °• ,-: 4° $U S c�4,jS c q 20', .�5' -° - - -:�� J4.3• 'Al W � 2 SAS pG��MF c -`52? ::: :.:r / d coax o S 6. / ' O ° -23 2 J4 3 To/sri MQN 3 <'o "� a UNDfRO F'112 s� o�K F ' Mxi T° LE TgNK cp�R UAIo RAIZP MfU�Y i�.::.. TEST HOLE DATA d' S' - (TEST HOLE DUG BY McDONALD GEOSCIENCE ON DECEMBER 12, 2002) J d a 1 coiN S�qr EL. 6.7 0, S 8 *39'20" C- sr�p MIXED SAND & LOAM 49,20' FO n ..... `v I 2, N9 d J ?p /DO d d 1� CO C: ON.. UTILfJY POLE N BR%'C/r '.�_ ^I WATER 2•0, ° -e - 4 PALE BROWN FINE TO COARSE SAND SW NYT \ N 15 S S R •ry ^ n � WATER N PALE BROWN FINE ° d o --�'6AD ORH WIRE$ TO COARSE SAND SW -p, - 17' x 9�g 'V 8 1° n f i�P ° a EDCE OF PAVEMENT a WRICK o CONCp MON. I ' 3 2 0 w . d F)fp_E -6 X ASPHALT ROADWAY" Q S a/�' 10p.00, d WATER N GREY CLAY CH N \ ''77��-- 6 94 x (PUBLIC WATER IN STREET) ROAD i_ 25' WATER IN BROWN FINE CERTIFIED TO: TO COARSE SAND SW LAWRENCE T. SEVERINI MARYELLEN L. SEVERINI COMMONWEALTH LAND TITLE INSURANCE CO. PREPARED IN ACCORDANCE WITH THE MINIMUM TITLE NUMBER: RH80020869 STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE LI.A.L.S. AND APPROVED AN2ADOPTED FOR SUCH USE-'BY�HE EW YOR ATE LAND TITLE ASSOtiAtICN,V- I51' NOTES: PROPOSED A. 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM P R 0 P 0 S E D S E PT I�C SYSTEM D ETA I L HOUSE (NOT TO SCALE) EXISTING ELEVATIONS ARE SHOWN THUS:_5Q_4 ELEV. 12 3' 2. MINIMUM SEPTIC TANK CAPACITIES FOR A 5 BEDROOM HOUSE IS 1,200 GALLONS. FINISHED GRADE FINISH GRADE 8' DIA., 4' LIOUID DEPTH ELEV. 9.3' ELEV. 8.5' � y . 3. MINIMUM LEACHING SYSTEM FOR A 5 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 6 POOLS; 2' DEEP., 8' dta. TOP EL. 8.3' -1' MIN. TOP EL. 7.5 �J11' MIN. ®`�� MIN. 4" DIA. PROPOSED EXPANSION POOL SEPTIC rH LEACHING T 3' CLEAN APPROVED PIP LEACHING �t INV. EL. APPROVED PIPE T,o,I.IK POOL ao SAND N.Y.S. Lic. No. 49668 7 5' min. PITCH 1/4"/1' min. PITCH 1/8"/1' INV.EL 6.7' = POOL to .: COLLAR INV.EL 7.3' INV. EL. ` PROPOSED LEACHING POOL 6'8 a B' 8' UNAUTHORIZED ALTERATION OR ADDITION �--8'— e z TO THIS SURVEY IS A VIOLATION OF ®+ . y -- SECTION 7209 OF THE NEW YORK STATE fv� (��J EDUCATION LAW. PROPOSED SEPTIC TANK DISTRIBUTION POOL OF BOT. EL. 5.0' GROUND WATER COPIES OF This SURVEY MAP NOT BEARING Land � Surveyor 6 POOLS SYSTEM ELEV. 3.0' THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED 4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD SEPTIC TANK (1) TO BE A VALID TRUE COPY. OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. CERTIFICATIONS INDICATED HEREON SHALL RUN 5. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 8) 1. MINIMUM SEPTIC TANK CAPACITIES FOR A 5 BEDROOM HOUSE IS 1,200 GALLONS. LEACHING POOLS (6) ONLY TO THE PERSON FOR WHOM THE SURVEY 1 TANK; 8' DIA. 4' LIQUID DEPTH IS PREPARED, AND ON HIS BEHALF TO THE Title Surveys - Subdivisions - Site Plans - Construction Layout FLOOD INSURANCE RATE MAP No. 36103CO159 G 1. MINIMUM LEACHING SYSTEM FOR A 5 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA TITLE COMPANY, GOVERNMENTAL AGENCY AND ZONE AE: BASE FLOOD ELEVATIONS DETERMINED 2. CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 psi AT 28 DAYS. 6 POOLS, 2' DEEP, 8' dia. LENDING INSTITUTION LISTED HEREON, AND 3. WALL THICKNESS SHALL BE A MINIMUM OF 3", A TOP THICKNESS OF 6- AND A BOTTOM THICKNESS OF 4'. 2_ LEACHING POOLS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE (OR EQUAL) TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 Fax (631)727-1727 ALL WALLS, BOTTOM AND TOP SHALL CONTAIN REINFORCING TO RESIST AN APPLIED FORCE OF 300 psf. LEACHING STRUCTURES, SOLID DOMES AND/OR SLABS. TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. 4. ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT. 3.. ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL). OFFICES LOCATED AT MAILING ADDRESS 5. THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A MAX. TOLERANCE OF t1/4") 4. A 10' min. DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE MAINTAINED. THE EXISTENCE OF RIGHTS OF WAY ON A MINIMUM 3" THICK BED OF COMPACTED SAND OR PEA GRAVEL 5.. AN 8' min. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MAINTAINED. AND/OR EASEMENTS OF RECORD, IF 1380 ROANOKE AVENUE P.O. BOX 1931 6. A 10' min. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED. ANY, NOT SHOWN ARE NOT GUARANTEED. RIVERHEAD, New York 11901 Riverhead, New York 11901-0965 22-165A