HomeMy WebLinkAboutTR-6925 James F.King,President �mof SoUry� Town Hall Annex
Jill M. Doherty,Vice-President 54375 Main Road
P.O.Box 1179
Peggy A.Dickerson
Southold,New York 11971-0959.
Dave`Bergen
• OQ Bob Ghosio,Jr. Telephone(631) 765-1892
� �
�yCOUMY,N Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
#0407C Date: February 27, 2009
THIS CERTIFIES that the addition to the existing dwelling, framed covered porch and
storm leaching pool for roof run-off
At 3190 Park Avenue, Mattituck,New York
Suffolk County Tax Map# 123-8-20.1
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated 6/25/08 pursuant to which Trustees Permit#6925 Dated 7/23/08 and
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 addition to the existing dwelling, framed covered porch and storm leaching pool for
roof run-off
The certificate is issued to JAMES &CAROL MIKELBANK owner of the
aforesaid property.
1 .
Authorized Signature
James F. King,President ti Town Hall,53095 Main Rd.
Jill M. Doherty,Vice-President . P.O.Box 1179
Peggy A.Dickerson Southold,NY 11971
Dave Bergen '�J� ��� 'Telephone(631)765-1892
Bob Ghosio,Jr. 1 �' Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: J
v Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1st day of construction
% constructed
Project complete, compliance inspection.
INSPECTED BY:
COMMENTS: _0r\�,. 0 Q-V
CERTIFICATE OF COMPLIANCE:
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James F. King,President ��QF so(/rgo Town Hall
Jill M. Doherty,Vice-President 53095 Route 25
Peggy A. Dickerson P.O. Box 1179
Southold,New York 11971-0959
Dave Bergen
G
Bob Ghosio, Jr. Telephone(631) 765-1892
COUNTY, Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line
1 st day of construction
Y2 constructed
—Z Project complete, compliance inspection.
p�QQI 11/j� :4' 1.� rrr,� ,.1 ,`�r1.;i i7r�:.1 ��,I.1C rlr/r•,,- .�' li�i'iV iS'i, _ F.. i•.rJr:;` ,� ��r�i irr•
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BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD NEW YORK
.,-F •� a
i
PERMIT NO. 6925 DATE:'JULY 23, 2008
• ISSUED TO: JAMES & CAROL MIKELBANK f
✓� PROPERTY ADDRESS: 3190 PARK AVE., MATTITUCK
SCTM#123-8-20.1
AUTHORIZATIONS,
r
4 Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of
a Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on
July 23,2008 in consideration of application fee in the sum of$250.00 paid by James&Carol Mikelbank and
subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes
/:•, s
and permits the following:
Wetland Permit to construct an addition to the existing dwelling, framed covered ,.
a ` porch and storm leaching pool for roof run-off, and as depicted on the plan prepared b
P gP � P� P P P Y ,
Jeffrey T.Butler dated June 16, 2008.
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,
V and these presents to be subscribed by a majority of the said Board as of this date. 111/1 z
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TERMS AND CONDITIONS
The Permittee,James&Carol Mikelbank residing at 3190 Park Ave. Matttituk,NY, as part of
the consideration for the issuance of the Permit does understand and prescribe to the following:
l. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation-performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is valid for a period of 24 months,which is considered to be the estimated
time required to complete the work involved,but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this 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
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be.no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized,or if, in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation,the said Permittee will be
required,upon due notice,to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work
authorized.
9. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
James F.King,President QF SOUly� Town Hall
Jill M. Doherty,Vice-President ,`O l0 53095 Route 25
Peggy A.Dickerson P.O. Box 1179
Southold,New York 11971-0959
Dave Bergen
Bob Ghosio,Jr. �l� �� Telephone(631) 765-1892
�DU
Fax(631) 765-6641
NTI,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
July 23, 2008
Jeffrey T. Butler, P.E.
206 Lincoln St.
Riverhead, NY 11901
RE: JAMES & CAROL MIKELBANK
3190 PARK AVE., MATTITUCK
SCTM#123-8-20.1
Dear Mr. Butler:
The Board of Town Trustees took the following action during its regular meeting held on
Wed., July 23, 2008 regarding the above matter:
WHEREAS, Jeffrey T. Butler, P.E. on behalf of JAMES & CAROL MIKELBANK 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 June 25, 2008, 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, in accordance with Chapter 268, said application was found to be Exempt
from the Local Waterfront Revitalization Program policy standards, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on July 23, 2008, at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,
2
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 275 of the
Southold Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect the
health, safety and general welfare of the people of the town,
NOW THEREFORE BE IT,
RESOLVED, that the Board of Trustees approve the application of JAMES & CAROL
MIKELBANK to construct an addition to the existing dwelling, framed covered porch
and storm leaching pool for roof run-off, and as depicted on the plan prepared by Jeffrey
T. Butler dated June 16, 2008.
Permit to construct and complete project will expire two years from the date the permit
is signed. Fees must be paid, if applicable, and permit issued within six months of the
date of this notification.
Inspections are required at a fee of$50.00 per inspection. (See attached schedule.)
Fees: $50.00
Very truly yours,
0 �
James King
President, Board of Trustees
JFUms
James F. King,President *OF SU�jyo Town Hall
Jill M. Doherty,Vice-President ,`O l0 53095 Route 25
P.O. Box 1179
Peggy A. Dickerson Southold,New York 11971-0959
Dave Bergen
p� Telephone(631) 765-1892
Bob Ghosio,Jr. Q ��y'04UNTY Fax(631) 765-6641,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CO-mi WN[hank
Please be advised that your application dated o has
been reviewed by this Board at the regular meeting of 7/@al0 g
and your application has been approved pending the completion of the
following items checked off below.
Revised Plans for proposed project
Pre-Construction Hay Bale Line Inspection Fee ($50.00)
1" Day of Construction ($50.00)
'/2 Constructed ($50.00)
Final Inspection Fee ($50.00)
Dock Fees ($3.00 per sq. ft.)
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:
0 0
TOTAL FEES DUE: $
G� � -
BY: James F. King, President
Board of Trustees
- b��ggFFO(,�Cdek
Donald Wilder,Chairman Town Hall,53095 Main Rd.
Lauren Standish,Secretary w P.O.Box 1179
��, • ��" Southold,NY 11971
Telephone(631)765-1892
Fax(631)765.-6641
Conservation Advisory Council
Town of Southold
At the meeting of the Southold Town Conservation Advisory Council held Wed., July 16,
2008, the following recommendation was made:
JAMES & CAROL MIKELBANK to construct an addition to the existing dwelling, framed
covered porch and storm leaching pool for roof run-off.
Located: 3190 Park Ave., Mattituck. SCTM#123-8-20.1
The CAC did not make an inspection, therefore no recommendation was made.
Ogt1�F0�,{-C'
James F.King,President �� p P.O.Box 1179
Jill M.Doherty,Vice-President a� Gy Southold,NY 11971
Peggy A.Dickerson CO* . Telephone(631)765-1892
Dave Bergen WO Fax(631)765-6641
Bob Ghosio,Jr. 'F
Southold Town Board of Trustees
Field Inspection/Worksession Report
Date/Time:
JAMES & CAROL MIKELBANK request a Wetland Permit to construct an
addition to the existing dwelling, framed covered porch and storm leaching pool
for roof run-off. Located: 3190 Park Ave., Mattituck. SCTM#123-8-20.1
Typp,,o�f area to be impacted:
�-,'Saltwater Wetland Freshwater Wetland Sound B y
Distance of proposed work to edge of wetland
Part f Town Code proposed work falls under:
hapt.275 Chapt. 111 other
Type of Application: Wetland _Coastal Erosion _Amendment
Administrative_Emergency Pre-Submission Violation
Info needed:
.�: fro -cc
` ePS� l e,& 0- �T 4 f\ "CC-Yx Sc'
Modifications:
Conditions:
Present Were: _L- J.King �J.Doherty_P.Dickerson D. Bergen_ B.Ghosio,
D. Dzenkowski Mark Terry other
Form filled out in the field by
Mailed/Faxed to:
Date:
Environmental Technician Review-
Thomas M. Ludlow
105 Ole Jule Ln.
Mattituck, NY 11952
Telephone/fax (631) 298-5080
Southold Town Board of Trustees
Town Hall
53095 Route 25
Southold, NY 11771
Date: February 9, 2009
Dear Mr. King and Trustees,
I am writing in,reference to the Residence of Mr. James Mikelbank, located at
3190 Park Ave. in Mattituck. The tax map number for this property is #1000-123-08-
20.1. The permit number is 6925. My name is Tom Ludlow and I am the builder for the
Mikelbanks. I am writing to request a final inspection on the property as we have
completed the work. Thank you in advance for your attention to this matter. Please call
me with any questions you may have about the project. I can best be reached on my cell
phone which is 631-680-2651 or the office number above.
Sincerely, /;'
OFFICE LOCATION: MAILING ADDRESS:
Town Hall Annex P.O.Box 1179
54375 State Route 25 �Q$�FFO(,�co Southold,NY 11971
Main Rd.&Youngs Ave. �O Gy Telephone:631 765-1938
Southold,NY 11971 1 Fax: 631 765-3136
o
N Z
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
To: Jim King,President
Town of Southold Board of Trustees
� } Jul
From: Scott Hilary,LWRP Coordinator '
Date: July 16,2008 SCl'ti'Old
Bur of irus ces
Re: Proposed Permit to Wetland Permit for JAMES& CAROL MIKELBANK
SCTM#123-8-20.1
Jeffrey T. Butler,P.E.on behalf of JAMES& CAROL MIKELBANK requests a Wetland Permit to construct an
addition to the existing dwelling, framed covered porch and storm leaching pool for roof run-off.Located: 3190 Park
Ave.,Mattituck. SCTM#123-8-20.1
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold
Town Code and the Local Waterfront Revitalization Program(LWRP)Policy Standards. Based upon the information
provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to
me, it is my recommendation that the proposed action is EXEMPT pursuant to Chapter 268: Waterfront
Consistency Review,Exempt/Minor Actions which are not subject to review.
§ 268-3. Definitions
MINOR ACTIONS --Include the following action,which are not subject to review under this chapter:
BB. Additions to the landward side of an existing dwelling constituting less than 25%of the original structure,
except in a Coastal Erosion Hazard Area, (Added 6-6-2006 by L.L.No. 7-2006]
e
_l
Office Use Only
C astal Erosion Permit Application
etland Permit Application Administrative Permit
Amendment/Transfer/Extension
-ITe'-ceived Application: OLS
.,/Received Fee:$ _
npleted Application _
Cin
_incomplete �._.. --�� � 1
_SEQRA Classification:
Type I Type II Unlisted
Coordination:(date sent) JUN 2 5 2008
X'AC Referral Sent:
,Plrt-e of inspection: Q►
_Receipt of CAC Report: Southold Town
_Lead Agency Determination: Beard oI Trustees
Technical Review:
—_PGblic Hearing Held: 0
Resolution:_
LAL)R-P In
Name of Applicant 0 fA( d91 A !LZ, A 1V X
Address &'CVb®r I,? 3'®9 '" MA
Phone Number:(
Suffolk County Tax Map Number: 1000 - 2-
Property Location: S—Ou w V/� f �i° 3 f � ��
6 7,7, 0 / e`x,,, 5-,r- o - IPA x-ooe-
(provide LILCO Pole#, distance to cross streets, and location)
AGENT: ge a" �� =
(If applicable)
Address: °
/ 1 �'�✓Lra .J �� Phone: (5'._�/ — '' z wo—
c�l�
Board of Trustees Application
GENERAL DATA
Land Area(in square feet): 25,220 SQ; 1 ,
Area Zoning: R-4O td O—244 �oo-CoN Fogm i o& Lo r
Previous use of property: RW71;)eNGer
Intended use of property: N�Ci
Prior permits/approvals for site improvements:
Agency Date
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
No Yes
If yes,provide explanation:
Project Description(use attachments if necessary):
oVa 7eD &ppm ON To (ZES(P&NC6
I e rbay �Amey l3_r SM Pr .
SrolZM U5NC41t4&PwL FbQ PabPosep
120OF 1?4UN OFF
t
Board of Trustees Application
WETLAND/TRUSTEE LANDS APPAL,I�C,ATION DATA
Purpose of the proposed operations: pO�jE'D �17D11TbN fib
,A�t i� oDDSED LE�,G1-�I NCT Root fo 2. PbaF Pkwa nc
Area of wetlands on lot: I .'�O square feet
Percent coverage of lot: 4,51 %
Closest distance between ne .rust existing structure and upland
edge of wetlands: Q 2 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 2 1 feet
Does the project involve excavation or filling?
No Yes
If yes,how much material will be excavated? cubic yards
How much material will be filled? d cubic yards
Depth of which material will be removed or deposited: 4. J feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited:
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
Board of Trustees Application
COASTAL EROSION APPLICATION DATA
Purposes of proposed activity: App n o N Tip QE�t DeIC�
Coyece=p FoRcH XwR ARM Ly .{ WaFoa_
Are wetlands present within 100 feet of the proposed activity?
V No Yes
Does the project involve excavation or filling?
No V Yes
If Yes,how much material will be excavated? cubic yards)
How much material will be filled? 0 (cubic yards)
Manner in which material will be removed or deposited: TAG
Describe the nature and extent of the environmental impacts reasonably anticipated resulting
from implementation of the project as proposed. (Use attachments if necessary)
&0� RODE la2tjow \&hLL t5e 1?Vewey
�i� C�uTr s 4 1LMD . 0 PIZOR�� S Rt�
2 LE-6S OF n+ff CX(ST'r w, `L' SNrAPE ccWNk:6
T4ER ,.RE Tf-2E IS U ME I M DACE
ON LAB P5QS iRb& 14 T Na I M PACr
TNT' PE�i�c�3A�y
3oard of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
I, 5 residing at 31670
rint owner of property) (mailing address)
Gt ►V�I NY do hereby authorize
(Agent)
P15.Ue� to apply for permit(s) from the
Southold Board of Town Trustees on m behalf.
aAln,/,A
wner's signature)
James F.King, President ��QF SO(/�yO Town Hall
Jill M. Doherty,Vice-President ,`O l0 53095 Route 25
P.O.Box 1179
Peggy A. Dickerson Southold,New York 11971-0959
Dave Bergen G
Bob Ghosio,Jr. �� �Q Telephone(631)765-1892
Iy10ou Fax(631) 765-6641
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 C
Za7ZW , residmg at 2 l Z14," J�
being duly sworn, depose 6nd say:
That on the 2n day of TUJV 200e, I personally posted the property known as
by placing the Board of Trustees official poster where it can easily be seen, and that I have
checked to be sure the poster has remained in place for eight da s prior to the date of the public
hearing. Date of hearing noted thereon to be held C.JOd C . a Coe ~-
0(Ltj a boll- &'Co
Dated: -7 124 0 r IA'4z
(signature)
Sworn to before me this
2,,V day of J-a( 2002
Notary Public
GINA A.LOCKE
No.01 L06057960
Notary Public,State of New York
Qualified in Suffolk County My Commission Expires 04/30/201/
PROOF OF MAILING OF NOTICE
ATTACH-CERTIFIED MAIL RECEIPTS
Name/Address/SCTM:
Joe Bendowski Paul Carey
3060 Park Avenue 125 Patience Place
Mattituck,NY 11952 Mooresville,NC 28117
SCTM#: 1000-123-08-19 SCTM#: 1000-123-08-27
Douglas William Pollock Thomas Bass
36 Mitchell Road 17 Buckeye Road
Port Washington,NY 11050-4140 Glen Cove,NY 11542
SCTM#: 1000-123-08-21 SCTM#: 1000-123-08-22.5
Ronald Massab
9 Main Street
Southampton,NY 11968
SCTM#: 1000-123-08-22.4
STATE OF NEW YORK
COUNTY OF SUFFOLK
Melissa C.Butler,residing at 206 Lincoln Street,Riverhead,NY 11901,being duly sworn,
deposes and says that on the 30d'day of June,2008,deponent mailed a true copy of the
Notice set forth in the Board of Trustees Application,directed to each of the above named
persons;that the addresses 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 Shoreham,NY,that said Notices were mailed to each of said persons by
certified return receipt mail.
Sworn to before me this 2 hot
Day of 2008
Notary Public
GINA A.LOCKE
No-OIL06057960
Notary public,State of New York
Qualified in Suffolk County
My Commission Expires o4/30/20JL
• Board of Trustees Application
County of Suffolk
State of New York
= f ly 1 . 5un-e ' 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 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
SWORN TO BEFORE ME THIS DAY OF 0._ G� 220 0 9-
' Notary Public i1
ALICE M.SHAUGHNESSY
Notary.Public State of New York
Nm;§-4528113
Qualirw in Suffol Coup
Commission f�ires, 20ib
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pumose of
this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME:
(Last name,fiVf name,middle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other",name the activity.)
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business,
including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of hares.
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 owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
B)the legal or beneficial owner of any interest in a non-corporate entity(when the
applicant is not a corporation);
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted th s� day of 200 d
Signature
Print Na e
Form TS 1
>a
Town of Southold
LWRP CONSISTENCY ASSESSMENT EO1ZM
A. UNSTRUCTIONS
I. All applicants for permits* including Town of Southold agencies, shall complete: this C'('Al for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review 1-mv. 'l`his
n,sscssment. Is intended to supplement other information used by a Town Of S0utlI0ld n,cncy in
making a deternnrna.tron of consistency. *ISxcepl 1ninor exeny)t actions, including Blllldillg Pel-mils
cruel udhl- not located livid n.the Coastal. Erosion Hazard Area.
2.. 13clo-e answering the questions in Section C, the preparer of this form should review Ilse Csempt
minor action list, policies and explanations of each policy contained in the Town of SoUtllokl Loc,11,
Waterii-ont Revitalization Program. A proposed action will be evaluated as-to ins ilirnit
bencrt-Icial and adverse effects upon the coastal area(which includes all Of Southold "I_oN.Vll)_
3. 1 f any quc;stion in Section C on this form is answered "yes" or "no", then the proposed ,ichon tivi1.1
affect the achievement of the LWRP policy standards and conditions contained in I.he consistency
review law. Thus, each answer must be explained in detail, lasting both suppoa taaa� aradf II1d1II?-
stapporting :facts. If aun action cannot be certified as consistent with the LWRP policy standards anti
conditions, it shall not be undertaken.
A copy of[lie LWRP is available in the following places: onlin tr.the Tc>w�a-ca,1=S��u11a��I�L�;
website (sou tholdtown.northfork.net), the Board of Trustees Of y e t1k I�.141111� l-. d 17 1111 1rll, il
I
local libraries and the Town Cleric's office.
kkf JUN 2 5 2008
l.. H)E'GSCR➢PTiON OF SITE AND PROPOSED ACTION
Southold To`in
Board of Trustees
l'ROJI",CT NAME -----
The Application has been submitted to (check appropriate response): l�
Town nW aa•d ❑ Planning Board❑ Building Dept. ❑ ]Board of Trustees LJ
1. Category of Town of Southold agency action(check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital ❑
construction, planning activity, agency regulation,land transaction) F—I
(1)) 1,ma.ncial assistance (e.g. grant, loan,subsidy) �J
(c) I-crnut, approval, license, certification:
Nature Wl� extent of action: _f�
- ----
r7
1,0catiol1 of acholl:
SlIc
]'W.Wlt 1,111d LISC:
Ili-csci-it roving cl, 'ficatiori:..on 1 assi
11'all application for the proposed action has been -filed with the Town of Southold agency, [lie ('011m.\i'M'!
Hil'Ormalioii shall be provided:
(a)) Naiiie ol',ippl
(b) Mailing address: "L/
; Al
(C) TC1Cj)1_10DC IlUmber: Area Code
(d) ApplicationnUniber, if any:
Will the; action bbedirectly undertalcen, require ftinding, or approval by a state or federal agency'?Yus EI No E< If yes, which state or federal agency?__-.--------_----
C. Ev,,duatc the project to the following policies by analyzing how flic project will further support
iiot support the policies. Provide all proposed Best Management Practices that will further each p4n'icy.
Incomplete answers will require that the form be returned for CORIIII)Ieti011.
DEVELON-ij) COAST POLICY
11olicy 1. Foster a pattern of development in the Town of Southold that enhances conxinunity charadeir,
preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal locatiopi, anad
iniiiihnizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation
criteria.
—] No D Not Applicable
:�v---w- D
j Z7 Z!Fd—
Minch additional sheets if necessary
J'oficy 2. Protect and preserve historic and archaeological resources of the Town of Southold. Sec
LWR11 Section 1.1.1— Policies Pages 3 through 6 for evaluation criteria
LI Yes 0 No [� 1 Not Applicable
----------
Att�icli ziddifit)mfl sheels ihiccessaiy
Policy 3. Enhance visual quality and protect scenic resources throughout tiie crown of soalfllwW. See
LWRP 'Slection 11.1, - Policies Pages 6 through 7 for evaluation criteria
Y cs [—
No nV"N" ot Applicable
...........
------------------
AMICII additional Sheds irl)eCcssary
NATURAI, COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and crosion. See UY'V`RP'
Secdon i I R - Policies Pages 8 through 16 for evaluation criteria
No Not Applicable
'5
Allitch additional sheets if iecessary
Policy 5. Protect and improve water quality and supply in the Town of Southold. See IMRP Section UH
- Poficius Pages .1.6 through 21 for evaluation criteria
1-1Ves El No I?rNo't Applicable
----------- —------
AiLich aidditioiiid sheets il-iiecesszily
:Policy 0. Protect and restore the quality and function of the Town of Southold ecosystems inchiding
Significant Coastal .Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
thriwgh 32 For evaluation criteria.
Yes No Not: 2'.,p,.,1icablc
Attach additional shcc(.,i lhiccessary
1,0fic), 7. Protect -,laid improve air quality in the Town of Southold. See LWRP Section M qloflcies
J'ages 32 thi-ougli 34 for evaluation criteria.
Yes E] No [_L Not Applicable
..........
Attack additional sheets if necessary
11oficy 8. Minimize environmental degradation in Town of Southold from solid waste and luizar(Jous
stil)stancesandwastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
El Yes I I No V"Not Applicable
PUB9,W COAST POLICIES
]'()Iicy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and padblic
resomrces Or the 'gown of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evahmflon
Criteria. 11"
Ye.0 No Not Applicable
WORK i NG' (..'OAST POL.1 CiRI,0''
Policy 11). Protect Sontliold's waiter-dependent uses and promote siting of new water-dependent asses in
siiiiabie locations. See LWRII Section III—Policies; Pages 47 through 56 for evaluation criteria.
Elves [I No [:Zj/ Not Applicable
Attach addilic)11a1 shcCIS ii'necessary
I,ofiq i Promote sustainabie use of living marine resources in Long Ishand Sound, 1-he
E.Simary -'Ind Town Waters. See LWRP Section Ill—Policies; Pages 57 through 62 for evaluafion
L-1 Yes 11 No El Not Applicable
...........
------—------
Att,ich a(klitioiial sheets if iecesswy
!'obey 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Iqlaz'Tes
02 1hroagh 65 for evaluation criteria.
El Yes 0 No Z Not Applicable
Attach iid(litioiiiil sheets if necessary
I'olicy 43. Promote appropriate use and development of energy and inineral resources. See LW- '-RAIP
Section R11 —Policies; Pages 65 through 68 for evaluation criteria.
F-1yes D No EJ-11 Not Applicable
—---------
PREPARED 13Y ,z, ,(2 ze 1� d,,TITLE ,
- D A T E
l•
C
Butler Engineering 206 Lincoln Street
Architectural and Engineering Services Riverhead, NY 11901
Tel: (631) 208-8850
Fax: (631) 727-8033
LETTER OF TRANSMITTAL
DATE: 6/23/08 PROJECT NO.:
TO: Lauren Standish
Town of Southold Trustees
FROM: Jeffrey T. Butler RE: Mikelbank Application
WE ARE SENDING YOU: ® Attached ❑ Under Separate Cover Via
The following items:
ED Prints ❑ Sample ❑ Specifications
Plans ❑ Document ❑ Shop Drawings LE
Letter ❑ Change Order
COPIES DATE NO. DESCRI TtQN
3 Copies of site plan
3 Applications Southold Town
1 Check for$250.00 boara oT irustees
THESE ARE TRANSMITTED AS CHECKED BELOW:
❑ For your use ❑ Resubmit copies ❑ Submit copies for distribution
❑ As requested ❑ For signature ❑ Return corrected prints
❑ For review and comment ❑ Forbids due ❑ Returned for corrections
❑ Prints returned after loan to us
REMARKS: Lauren,
Please review application packet and call with any questions.
Thank you,
Jeff Butler
COPY TO SIGNED
J rey T. Butler
If enclosures are not as noted,kindly notify us at once
ABBREVIATIONS LINE / 5YMI80L LEC END �
ABV --- ABOVE GA --- GAGE, GAUGE PROPERTY LINE
AFF --- ABOVE FIN15HED FLOOR GV GALVANIZED
AF& --- ABOVE FIN15HED MET --- METAL SETBACK LINE — — • — — • — — • — — •—
GRADE AG --- ABOVE GROUND NT5 --- NOT TO SCALE
EXISTING TO BE Ew F« v
BG --- BOTTOM OF CURB O.H.--- OVER HEAD .•.•••••••••••••••••••••••••••'•'• .••..••..••'.••. M. .4
BI --- BOTTOM OF 15LAND PLG5 --- PLACES REMOVED/RELOGATED
GB --- CATCH BASIN PVC, --- POLYVINYL CHLORIDE HATER w $ $
GONG --- CONCRETE PP --- POWER POLE
GON5T --- CONSTRUCTION RCP --- REINF. GONG. PIPE ELECTRICAL
GONT --- CONTINUOUS/GONTINUE REINF --- REINFORCED .
CPR --- COPPER 5D --- STORM DRAIN
DIAM --- DIAMETER 5T --- STEEL GAS C76— ,
DIP --- DUCTILE IRON PIPE TO --- TOP OF CURB
D W--- DOUBLE HALL TI --- TOP OF ISLAND
EX15T --- EXISTING TERM --- TERMINATE TELEPHONE T T
FO --- FLOOR DRAIN U/L --- UNLEADED
FO --- FUEL OIL VIF --- VERIFY IN FIELD SANITARY SERER '
F/G --- FIBER &LASS NO --- HASTE OIL
FT --- FOOTING HAM --- HELPED HIRE MESH FENCE £
OVERHEAD ELEGTRIG—••—••—•• —•
�� LOG ATION MAP
I , GONG. CURB
NO SCALE
:
i Q 6 \ CAST IRON FRAME AND COVER TO&RAPE TEST HOLE ® pRp ADDITION TO:
9/ CAMPBELL 1162 G OR APPROVED EQUAL
FINAL GRADE SINGLE FAMILY RESIDENCE
rA " PARKING SPACE SITUATED AT
PPE 'P,� Mix. _ — 6" THK CONG MATTITUCK
® ® ® ® ® ® COVER FLOW ARROH
® ® ® ® ® ® I TOWN OF SOUTHOLD
♦ s F 0 ® ® ® ® ® ® SUFFOLK COUNTY, NEW YORK
FND ♦SSO N(j 3' MIIN.. ® ® ® ® le ® ® 3' MIN.
g?w F I ® ® ® ® U_ ® ® CATCH BASIN $.C.T.M.# 1000-123-08-20
MOx. ® C� ® ® LL ® ® I WRAP STRUGIVRE9
F F+ ® ® ® ® W ® ® HITH FILTER FABRIC BASED ON ORIGINAL SURVEY BY:
® ® ® ® ® ® GA5 VALVE D4
1 \ ♦ ,I, I I LOUIS W. TREUMAN, JR.
\ s/ /I/ I , P.O. BOX 229
\ ` 6'-0' DIAM. NON-RATEABLE HATER VALVE SELDEN, NY
\ NJ ry SOIL
\ GNP WR MANHOLE COVER MH TEL: (631) 698-4429
\ ,� C OWNER:
Z 1 / COLLAR MATERIAL 6" MIN. UTILITY POLE
(PENETRATION) JAMES & CAROL MIKELBANK
1 ` \ l RATEABLE SOIL LIGHT P05T 1� (631) 298-5745
\ ♦ 4 \ • m
\ _ _ _ _ _ MONUMENT POSTAL DISTRICT: MATTITUCK U m
° \ UNDERLYING SAND AND GRAVEL STRATA SCHOOL DISTRICT: MATTITUCK � p
\ ♦ / > STAKE FIRE DISTRICT: MATTITUCK01
\ �33 I.COLLAR t7�TH Is NOT REQUIRED WHEN RATEABLE MATERIAL EXISTS FOR FULL t�-M � ELECTRIAL SERVICE: LIPA
\ / 2 WLLAIR MATERIAL SHALL BE CLEAN sRAVEL Cat BAW RUN. HYDRANT tiYo WATER SERVICE: SCWA W r
c 1 \ ?o \ 3.ALL DRNNASe STRUCTURES MU5T BE WRAPPED WITH FILTER FABRIC. ZONING DISTRICT: R-40
\ USE: S NC a^ m
EX' STORM LEACHING POOL (SD) SINGLE FAMILY RESIDENCE p
5TK. SITE IS IN GROUNDWATER MANAGEMENT ZONE '-+ d- �- ••
+\• x
XZ �
1 EXISTING ZONING INFORMATION: o
1 SHEDPROPO 1 , , CQ o
ro Q0, Ex. RESIDENCE R-40 ZONE < In
' 34 SOFT. ti 5TK' ` ,\ 100-244 NON-CONFORMING LOT `Q
ADDITION �Vc '-`� 10'M �'� � �
�N LOT AREA: ±25,220 SQ.FT. (.58 AC.) E 4
1q5� ►� PROP. C .
o
PORCH �� `� 8�6� PROPOSED VIP x 4' EFF. DEPTH LEACHING POOL TO LO�TTCCOVERAGE:OUIrt�I1�IERITS m
kn 1 z Z _ EXCEPT ROOF RUNOFF FROM LEADERS AND
REQUIREMENT: 20% MAX 5,044.02 SQ.FT.
N o a 2 GUTTERS. CONTRACTOR TO LOCATE EXISTING ( • ,.
b 103 N+ HATER SERVICE AND SANITARY 5Y5TEM. EXISTING: 6.63% (1,672 SQ.FT.)% J
v� $ I, MAINTAIN A 20' SEPARATION BETWEEN PROPOSED PROPOSED: 7.16% (1,806 SQ.FT.)
STORM DRAINAGE AND SANITARY SYSTEM.
a EXISTING ONE TORY 1 rn 2. MAINTAIN A 10' 5EPARATION BETWEEN PROPOSED FRONT YARD SETBACK: .
1 STORM DRAINAGE AND HATER SERVICE LINE.
1 51NGL�1FAMILGt.F ELLIN& • EX. ;
REQUIREMENT: 40' MIN ENGINEER:
5a STK. EXISTING: 57.8' E4
Z 1g20� N 233' 3s. EXISTING PROPOSED: N/C ��-
-d o CELLAR �.t� J �REY T
ENTRANCE SIDE YARD SETBACK:
REQUIREMENT: 15 MIN
` EXISTING 1 EXISTING: 18.76' 2-
DECK PROPOSED: N/C
0�
{ TOTAL SIDE YARD SETBACKS:
_ REQUIREMENT: 355' MIN JEFFREY T. BUTLER, P.E.
252 TE SQ FT. % 1 EXISTING: 37.96'
1 ex• PROPOSED: N/C
Q v
REAR YARD SETBACKS: M
REQUIREMENT: 50 MIN -�
EXISTING: 108.46' v
1 PROPOSED: N/C O Q m
1
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1 eNEAo 1 $ O LL o o
EX15� LNG 00 z z m >
' SAFE DIG < .m <
ion x. 1 Before You Dig, Drill Or Blast! A Q <
�../ CALL US TOLL FREE 1-800-962-7962 < Q
NY Industrial code rule 753 requires noless than Z #
more than to days otceng s notice,but not 5 7— : p N p
, 5�
1 C O 10
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ew
°F i � JUY� 2 5 2008 _..> z z IJJ
APPROVED BY
1 Al �` ,�� BOARD OF TRUSTEES F�ard of Trt,stePs
,,� �' ,� •�, �J� TOWN OF SOUTHOLD
SITE PLAN //� ; � �� � DATE 7 31/de PAOE :
20 10 0 20 40 60 &0 100
GRAPHIC SCALE I" = 20'-0"
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