Loading...
HomeMy WebLinkAboutTR-7426A Jill M.Doherty,President - Town Hall,53095 Main Rd. James FDave Bergen P.O.Box 1179 g 4 ' Southold,NY 11971 Bob Ghosio,Jr. �l �` Telephone(631)765-1892 John Bredemeyer '�' 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 V - . Pre construction, hay bale line 1st day of construction Y2 constructed l/ Project complete, compliance inspection. Jill M.Doherty,President *QF S��ry Town Hall Annex James F.King,Vice-President O`� ��� 54375 Main Road Dave Bergen P.O.Box 1179 J Southold,New York 11971-0959 Bob Ghosio,Jr. A John Bredemeyer '.� �O Telephone(631) 765-1892 OI,YCOU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 7426A Date of Receipt of Application: October 26, 2010 Applicant: Betty Sullivan SCTM#: 43-5-2 Project Location: 380 Inlet Lane, Greenport Date of Resolution/Issuance: November 17, 2010 Date of Expiration:.November 17, 2012 Reviewed by: Board of Trustees Project Description: To construct a second-story addition and two-story addition to the existing single-family dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter. 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Nathan Taft Corwin, III, last dated August 2, 2008, and .stamped approved on November 17, 2010. Special Conditions: None. Inspections: Hay bale line inspection prior to construction &final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Jill h Doherty, Preside t Board of Trustees JMD:eac Jill M.Doherty,President ti Town Hall,53095 Main Rd. James F.Dave Bergen P.O.Box 1179 g ' ` Southold,NY 11971 Bob Ghosio,Jr. P� fits' Telephone(631)765-1892 John Bredemeyer Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: Please be advised that your application dated 02. OK,cZI O has been reviewed by this Board at the regular meeting ofi(1oerA6er /7,,2cloand your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project V Pre-Construction Hay Bale Line Inspection Fee $50.00 1 st Day of Construction ($50.00) % 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: TOTAL FEES DUE: $ IOI� v BY: Jill M. Doherty, President Board of Trustees e»� �t,.� "�"�:� aka`"+ .;'�. " • t. �. .:z``• � ''-'R Lax r '�`.akR."gtS.•�:�� ,.'., �• �: � 1�K aid►+. '!k: K x , I� s ,j;4%UFFQ(141 Jill M.Doherty,President CQ P:O.Box 1179 James F:King,Vice-President �� G�� Southold,NY 11971 Dave Bergen ti Telephone(631)765-1892 Bob Ghosio,Jr. ,a, atFax(631)765-6641 John Bredemeyer Oy '`;IV Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: b 'Catherine Mesiano, Inc. on behalf of BETTY SULLIVAN requests an Administrative Permit to construct a second-story addition and two=story addition to the existing single-family dwelling..Located: 380'Inlet Lane, Greenport. SCTM#43-5-2 T e-of area to be impacted: altwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion _Amendment Administrative_Emergency Pre-Submission Violation Info needed: l C) S Modifications: - Conditions: 42 Present Were: `-J/King `J.Doherty "J. Bredemeyer�i[� Bergen v B.Ghosio; N---D�Dzenkowski other Form filled out in the field by Mailed/Faxed to: Date _ --wP.ROP.ER7x�C�' — .... - T� s s 10 s _ F� 6EE)EC Iq.4J6 s36 sEO.No.ol6 'N4 J N yy w 8 Wra t'g Y WTGt lutEF7 2 s s O. TOWNOF rash 6 I . z sounmEO sG1T14D 9 , 4 } 1.lPtc1 2.6Mm ' —N— sr.amrtsc6u. n 4 9. V z E. 6PIc1 N 6 T y ri 3s TOWN m OP O y °IPO 22 a b'm SPITNID GF vs Il 36.2—TI v v ° JS 16[ xettiaau l/+N � S nN a 16 na - v ' s Q wt✓ Ss - RFFiYAO,Q ° TOWN oc n °• E .. m :¢ l s,u6• 6WTNOE0 °W e JB 6 ,dS 20 S B 's y9 T Ae ri P°E f0 GARDINERS BAY - p II R ai s it s ]NEW TdN:na ' O E . 9 �6TPtE 6 m x 63 ypatcl • n +N x . STER3IN6 fREEx Z . Y Oe y +y 3 U 4 Y/ lu N a mall S d lv3 ,l, tla,m I S�i is S _ COUNTY OF SUFFOLK Q E SOUTHOLD secnoN No NOTICE O° E; ; 1211 2 � � __, -- __ " DTI-,�.—M1. o Real Property Tax Service�A�ency y —�-- . G Cotnty Center Rrtxt'A M p _____ a ter.xnrctln -- —_ )Irt4l NN,s lPx Wv66 ,F° IGLLEN{EfTI (ml-YU E 6 —_— EeN®nn u. —_ —_ —_ —_ _ xttxou,s0TT6x 6[W16LON a,a �wso` P 11 zw.,o lOOO .PROPERTY MOP Ur.ra 21 .��ltl atm err I2IP�o. 6t°(NP@TT iax-1 AEEICJ. OFFICE LOCATION: �QF SO(/�y MAILING ADDRESS: Town Hall Annex ��� �l0 P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 N Telephone: 631 765-1938 p Fax: 631765-3136 olycom LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Jill Doherty, President j �C I .0 Town of Southold Board of Trustees r NOV 1 0 2010 From: Mark Terry, Principal Planner ! LWRP Coordinator So;;11;o!c oovri Date: November 10, 2010 - Pond of Tr e`s Re: Proposed Wetland Permit for Betty Sullivan SCTM# 1000-43.-5-2 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 CONSISTENT with the denoted following Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Betty Sullivan 380 Inlet Lane,Greenport,NY SCTM#1000-43-05-02 Office Use Only _Coastal Erosion Permit Application _Wetland Permit Application V Administrative Permit Amendment/Transfer/Exten ion fib XceivedApplicationnj �Q deceived Fee-$ mpleted Application [o -SEQomplete l� C E n g 17 SE RA Classification: _ ` Type I Type fI Unlisted _Coordination:(date sent)) i SAC Referral Sent: en 0- OCT 2 6 2010 -Date of Inspection: _Receipt of CAC Report: _ J _Lead Agency Determination: Southold Tmn Technical of Trustees Review: j/Public Hearing Held: Resolution: Name of Applicant: Betty Sullivan Address: 380 Inlet Lane, Greenport, NY Phone Number: 631-862-0640 SUFFOLK COUNTY TAX MAP NUMBER: 1 000-43-rJ-2 PROPERTY LOCATION: 380 Inlet Lane, Greenport, NY (provide LILCO Pole#, distance to cross streets, and location) AGENT: Catherine Mesiano, Inc. Address: 12 Mill Pond Lane East Moriches, NY 11940 cmesianogoptonline.net Phone: 631 878 8961 or 553-3992 Betty Sullivan 380 Inlet Lane,Greenport,NY SUM#1000-43-05-02 GENERAL DATA Land Area(in square feet): Area Zoning: R-40 Previous use of property: single family dwelling Intended use of property: same w/ addition Covenants and Restrictions: Yes X No If"Yes",please provide copy. Does this project require a variance form the Zoning Board of Appeals Yes X No Prior permits/approvals for site improvements: Agency Date Trustees -Amendment to Wetland Permit#5258 October 17, 2007 Trustees -Amendment to Wetland Permit#5258 September 17, 2008 NYSDEC 2008 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): 2nd story and 2 story addition to the existing single family dwelling as approved 9/17/2008 per Wetland Permit#5258 Betty Sullivan 380 Inlet Lane,Greenport,NY SCTM#1000-43-05-02 Board of Trustees Application Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: addition to existing dwelling Area of wetlands on lot: _square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? X No Yes If yes,how much material will be excavated?_cubic yards How much material will be filled? n/a cubic yards Depth of which material will be removed or deposited:_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): NO NEGATIVE EFFECT ON WETLANDS OR TOWN WATERS IS ANTICIPATED AS A RESULT OF THE PROPOSED ACTION. DRYWELLS WILL BE UTILIZED FOR CONTAINMENT OF STORMWATER RUNOFF. Town of Southold U Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ��00o 4- p 5 D Z STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN agog- e3`"ct(o� �iTo — o� CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORKASSESSMENr Yes No a. What is the Total Area of the Project Parcels? Include Total Area of all Parcels located within '� Will this Project Retain All Inch Rainfall o Run-Off the Scope of Work for Proposed Construction) . 5,A Generated by i Two(all Inch Rainfall on Site? (S.F./Aces) (This item will include all run-off created by site f ❑ b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of construction activity? (S.F.l Aces) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages asNeeded) Drainage Structures Indicating Size&Location?This ,/ ❑ Item shall include all Proposed Grade Changes and oZ tn� •y oZ sor v a�d r Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion ❑ , t Gn.t..� ) -�t r- 2- and sediment control practices that will be.used to v control site erosion and storm water discharges. This — item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural a Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities l Encompassing an Area in Excess of Five Thousand �/ (5,000 S.F.)Square Feet of Ground Surface? — 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to ✓ including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for stone water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious FJ / for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the NOI.The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder — compliance with the terms and conditions of this permit In addition,the SWPPP shall Area?(This Item will NOT Include the Installation of Driveway identify potential sources of pollution which may reasonably be expected to affect the Aprons.) quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.&1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit (NOTE: A Check Mark(4)and/or Answer for each Question is Required fora Complete Application) SPATE OF NEW YORK, 5 n COUNTY OF.........: ��..........SS That I,....1., �GmW.fln�G�a'l`signlng.%- �' ...........being duly sworn,deposes and says that he/she is the applicant for Permit, Docume p y Andthat he/she is the ....................... .�...�...L .... ........... ............................... . .. ..... .............................................................. (Owner,Contractor,Agent,*Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this.application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; ...............................................day of.._.-....,.,....... .......................,20, NotaryPublic: _.,...... ..----................. ... ............................................................................ (Signature of Applicant) FORM - 06/10 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I-PROJECT INFORMATION To be completed b A licant or Project Sponsor) 1. APPLICANT/SPONSOR 2. PROJECT NAME Betty Sullivan Betty Sullivan 380 Inlet Lane,Greenport 3. PROJECT LOCATION: Municipality Greenport County Suffolk 4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map) 380 Inlet Lane,Greenport,NY 5. PROPOSED ACTION IS: New . 0 Expansion ❑Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 2nd story and 2 story additions to existing single family dwelling 7. AMOUNT OF LAND AFFECTED: Initially <1 acres Ultimately <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? 0 Residential Industrial Commercial Agriculture Park/ForesUOpen Space Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL,STATE OR LOCAL)? ❑Yes W No If Yes,list agency(s)name and permit/approvals: 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? Yes No If Yes,list agency(s)name and permittapprovals: NYSDEC 2008 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 Applicant/sponsor e: Catherine Mesiano,Inc. agent for sullivan Date: 10/13/10 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 1 Reset PART II- IMPACT ASSESSMENT(To be com feted by Lead A end A. DOES ACTION EXCEED ANY TYPE 1 THRESHOLD IN 6 NYCRR,PART 617.4? If yes,coordinate the review process and use the FULL EAF. Yes a No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR,PART 617.E7 If No,a negative declaration may be superseded by another involved agency. a.Yes - a 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 or quantity,noise levels,existing traffic pattern,solid waste production or disposal, potential for erosion,drainage or flooding problems? Explain briefly: No C2.Aesthetic,agricultural,archaeological,historic,or other natural or cultural resources;or community or neighborhood character?Explain briefly: No C3. Vegetation or fauna,fish,shellfish or wildlife spedes,significant habitats,or threatened or endangered species?Explain briefly: No C4.A community's existing plans or goals as officially adopted,or a change in use or intensity of use of land or other natural.resources?Explain briefly: No C5, Growth,subsequent development,or related activities likely to be induced by the proposed action?Explain briefly: No C6. Longterm,short term,cumulative,or other effects not identified in C1-05? Explain briefly: No C7. Other impacts(including changes in use.of either quantity or type of energy? Explain briefly: 'No D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL•AREA CEA? If yes,explain briefly: aYes . a No E. IS THERE,OR IS THERE LIKELY TO BE CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? If Yes explain: Yes a No PART III-DETERMINATION OF SIGNIFICANCE(To be completed by Agency) INSTRUCTIONS; Foreach adverse effect identified above,determine whether it is substantial,large,importantorotherwise significant Each effect should be assessed in connection with its(a)setting(i.e.urban or rural);(b)probability of occurring;(6).duration;(d)irreversibility;(e) geographic scope;and(f)magnitude. If necessary,add attachments or reference supporting materials. Ensure that explanations contain suffident detail.to show that all relevant adverse impacts have been identifled.and adequately addressed. If question d of part If was checked yes,the determination ofsignificance mustevaluate the potential impact ofthe proposed action on the environmental characteristics of the CEA. Check this box if you have Identified one or more potentially large or signifloant adverse impacts which MAY occur.Then proceed directly to the FULI EAF and/or prepare a positive declaration. Check this box If you have determined,based on the informaflon and analysis above and any supporting documentation,that the proposed scoot WILL NOT result in any significant adverse environmental impacts AND provide,on attachments-as necessary,the reasons supporting thi determination. Board of Trustees ! Name of Lead Agency Date Jill M.Doherty President P nt or Type Name of Rim pores le Officer in Lead Agency Title of Responsible Officer Itl Signature of Re nsib a Officer i ead.Agency Signature of Preparer(If different from responsible officer) V Betty Sullivan 380 Inlet Lane,Greenport SCTM 1000-43-5-2 ` County of Suffolk State of New York BETTY SULLIVAN BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/ SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT 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 ARRISING 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. / l J�Aj Bgtty rh- Sworn to before me this C day of 0.4 0 IO Rf Meta �Ublic ' lwf�rli�C�y�twt q IC mi3 Betty Sullivan 380 Inlet Lane,Greenport SCTM 1000-43-5-2 . AUTHORIZATION I, Betty Sullivan residing at 380 Inlet Lane, Greenport, NY 11944 do hereby authorize Catherine Mesiano, Inc. to apply for permits from the Southold Board of Town Trustees on my behalf. tty S ' 'an Date: to a 11 r a Sworn to before me thisQ day of OCULL , 20 JO. Qua Public up Newy ::DW3 Betty Sullivan 380 Inlet Lane,Greenport SCTM 1000-43-5-2 APPLICANT TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part; of town officers and employees.The purpose 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: -BETTY SULLIVAN ,4- NATURE OF APPLICATION: (Check all that apply.) Tax grievance Variance Change of zone Approval of plat Exemption from plat or official map Other(If"Other," name the activity) WETLANDS PERMIT Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer;or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered "YES,"complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position�of that person Describe the relationship between yourself(the applicant) 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 noncorporate entity(when the applicant is not a corporation); C) an officer, director, partner, or employee of the applicant; or D) the actual applicant. DESCRIPTION-OF RELATIONSHIP - _ Submitted this � day=Q- , 2010 Signature Print name Sullivan Betty Sullivan 380 Inlet Lane,Greenport,NY SCTM#1000-43-05-02 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1.All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permit and other ministerial permits not located within the Coastal Erosion Hazard Area 2.Before answering the questions in Section C,the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program.A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3.If any question in Section C on this form is answered"yes",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law.Thus, the action should be analyzed in more detail and,if necessary,modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions.If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net),the Board of Trustees Office,the Planning Department,all local libraries and the Town Clerk's office. B.DESCRIPTION OF SITE AND PROPOSED ACTION scTM# 1000-43-5-2 The Application has been submitted to (check appropriate response): Town Board Planning Dept. Building Dept. X Board of Trustees ZBA 1. Category of Town of Southold agency action(check appropriate response): (a)Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) (b)Financial assistance (e.g. grant, loan, subsidy) (c) Permit,approval,license, certification: Nature and extent of action: 2nd story and 2 story addition to the existing single family dwelling as approved 9/17/2008 per Wetland Permit#5258 Betty Sullivan 380 Inlet Lane,Greenport,NY SUM#1000-43-05-02 Location of action 380 INLET POND LANE, GREENPORT Site acreage: Present land use: SINGLE FAMILY DWELLING Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a)Name of applicant: BETTY SULLIVAN (b) Mailing address: 380 INLET POND LANE, GREENPORT, NY 11944 (c) Telephone number: Area Code 631-862-0640 (d)Application number,if any: #5258 Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes No If yes, which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III — Policies; Page 2 for evaluation criteria. Yes No Not Applicable The ,proposed action is to be conducted on an improved site. Construction of the addition at this site is consistent with the area. Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria Yes No Not Applicable The proposed project is not located near any historic sites or districts. Policy 3.Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes No Not Applicable The subiect site is developed with a single family dwelling. Policy 3 has no relevance to the proposed action. Betty Sullivan 380 Inlet Lane,Greenport,NY SCTM#1000-43-05-02 NATURAL COAST POLICIES Policy 4.Minimize loss of life,structures,and natural resources from flooding and erosion. Yes No Not Applicable The proposed actions will be undertaken in accordance with current FEMA standards, which address and prohibit conditions that are conducive to flooding and erosion. Policy 5.Protect and improve water quality and supply in the Town of Southold. Yes No Not Applicable The subject site is developed with a sin leg family dwelling. Policy 5 has no relevance to construction of the proposed addition. Policy 6.Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. Yes No Not Applicable The subject site is developed with a pre-existing single family dwelling. Staked hayba/es will be utilized during construction to prevent stormwater runoff into the wetland. Additional drywells, if necessary, will contain stormwater runoff when the proiect is complete. Policy 7.Protect and improve air quality in the Town of Southold. Yes No Not Applicable It does not appear that Policy 7 is relevant to construction of the proposed additions. Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. Yes No Not Applicable The subject site is developed with a single family dwelling. Any solid waste, etc. is disposed of at the Town landfill. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. Yes No Not Applicable Construction of the proposed additions will have no impact on public access to, and recreational use of, coastal waters, etc. 00 Betty Sullivan 380 Inlet Lane,Greenport, NY SCTM#1000-43-05-02 WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III — Policies; Pages 47 through 56 for evaluation criteria. Yes No Not Applicable It does not appear that Policy 10 is relevant to construction of the proposed additions on a residentially developed lot. Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III — Policies; Pages 57 through 62 for evaluation criteria. Yes No Not Applicable It does not appear that Policy 11 is relevant to construction of the proposed addition on a residentially developed lot. Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. Yes No Not Applicable It does not appear that Policy 12 is relevant to construction of the proposed additions on a residentially developed lot. Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies;Pages 65 through 68 for evaluation criteria. Yes No Not Applicable It does not appear that Policy 13 is relevant to construction of the proposed additions on a residentially developed lot. FIN 17V OL.AW OFFICES OF DENNIS C. COLLINS, P.C. 407 EAST MAIN STREET,SUITE 8,P.O.Box 391,PORT JEFFERSON,NEW YORK 11777 T*F—I.EPHONE(631)331-0642 Leal Assistant FACSIMILE(631)473-9054 Lisa A. Coffey i1 tl July 28, 2010 E OCT 2 6 20110 Southold Board of Town Trustees i Town Hall 53905 Route 25 Sol',;iolci Tov""' P.O. Box 1179 co_rd ei Trustees Southold,New York 11971-0959 Re: Betty Sullivan 380 Inlet Pond Lane, Greenport SCTM #43-5-2 Gentlemen, We hereby request a two year extension of permit 45258, an amendment to which was last approved by the Board of Trustees on September 17, 2008. Construction would be commenced within that period of time. Thank you for your consideration. Very truly yours, l ennis C. Collins, Esq., as attorney for the applicant DCC:Iac cc: Catherine Mesiano CATHERINE MESIANO , INC . 12 MILL POND LANE EAST MORICHES , NY 11940 PHONE / FAX : 631 - 878 - 8951 e - mail : cmesiano@optonIine . net October 26, 2010 Jill Doherty, President Southold Board of Town Trustees ro Box 1179 -- it Southold, NY 11971 RE: Betty Sullivan OCT 2 6 2010 _.j 380 Inlet Lane, Greenport, NY —sOT;"-1 oT, -—..q--. SUM # 1000-43-05-02 6natd of Trustees Dear Ms. Doherty: I am the agent for the above referenced applicant. Ms. Sullivan is requesting an Administrative Permit, as directed by your office, to extend Wetlands Permit # 5258 last amended September 17, 2008 for a 2nd story and 2 story addition to the existing single family dwelling, as illustrated on the enclosed plan. Enclosed please find the following: 1. Application, 2. Transactional disclosure 3. Release 4. Authorization 5. Survey prepared by Nathan Corwin, L.S. 6. Short EAF 7. LWRP form Please note that you already have a check for the application fee. Thank you for your consideration. Very truly yours, Catherine Mesiano, President Enclosures APPROVED BY L'F"3ARD OF TRUSTEES SURVEY OF PROPERTY TOWN OF SOUTHOLD ' SITUATED AT mANHANS - GREENPORTET NE - JZ-10 TOWN OF SOUTHOLD f jj� OCT 2 6 2010 ze, SUFFOLK COUNTY, NEW YORK R T S.C. TAX No. 1000-43-05-02 C" T Nn 2 A irnje SCALE l "=30' OCTOBER 4, 1999 FEBRUARY 28, 2000 LOCATED WETLAND FLAGS 8- N101F z MARCH 7 ADDED PROPOSED ADDITIONS NV10TOR J- RAUOH ET. AL. JUNE 17, 2000 REVISED SITE PLAN o W 0 INGRID J. B. MADSEN 401 AUGUST 18, 2000 ADDED TOPOGRAPHICAL SURVEY En _e U DECEMBER 2, 2000 SET LATH FOR D.E.C. INSPECTION 9 00500 JUNE 5, 2001 SURVEY UNDER CONSTRUCTION 1=)Z S 87 E 4'Dlz�rm EXIST. OUT51DE 'rp 6 '0) DECEMBER 3, 2001 FINAL SURVEY FOUND PIPE DRYPIELL SHOP%--R 4 WOOD Q IEN-f.0 APRIL 20, 2007 UPDATE SURVEY AND ADDED PROPOSED ADDITIONS X 0-7'S, 0.4'E PLATFORM 246.93' FLAG NOVEMBER 7, 2007 ADDED DRYWELLS O TO 5E REMOVEX, WALL -V9�40'f-' .9L AUGUST 2, 2008 ADDED PROPOSED DECK ADDITION WUUO TIE WALL 2 0.4'N 10100101- CONC FOMUOND 0 0 36.9' N �$ / WALL J,2 0 i 2.2'S, 3.2 W PROP05M AREA 23,139.74 sq. ft. 0 ..t - 9� GARAGE 9 % 0,---. 2 STORY TO TIE LINE 0.531 ac. ADDITION ITION aIL WATER VALVE CIS. -f— . HYDRANT PROP SM C� :224' ADVI 1 ' NOTES: 0 W (n C41i CV ap 1. FLOOD ZONE INFORMATION TAKEN FROM: Uj 01 FLOOD INSURANCE RATE MAP No. 36103CO176 G MAY 4, 1998 La CONC 00 AIL 0 APRON 0 ZONE AE: BASE FLOOD ELEVATIONS DETERMINED N 8 z T 35. C3 ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); N m 4.0 BASE FLOOD ELEVATIONS DETERMINED 23' 10 14 0 S ca. fr< 6.0' 2. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM LLJ 0 0 C' _6 EXISTING ELEVATIONS ARE SHOWN THUS: 6� FIRST FLOOR G.FL- GARAGE FLOOR a 0 18,n I(-,-V) .0 '6 1 0'm 'n cli 0 z '0 0 0 L0 6.01 z: 2 , 2 L0 0 50.0- CO AL i�; A� W-IVA2ER-_SERVICE:W 0' 9 (0 (S �� UNAUTHORIZED ALTERATION OR ADDITION _--23& LOT COVERAGE OVER ADJACENT AREA TO THIS SURVEY IS A VIOLATION OF WATER —————— U) FLAG. N) SECTION 7209 OF THE NEW YORK STATE ER 32.3' 0 METER 7s.o. 11L Q) (ADJACENT AREA = 21,928 sq. ft.) EDUCATION LAW. z 'b X DESCRIPTION AREA X LOT COVERAGE d COPIES OF THIS SURVEY MAP NOT BEARING 0 FOUND LI I- CIV EXISTING HOUSE 1,403 sq. ft. 6.40X THE LAND SURVEYOR'S INKED SEAL OR CD CONC. MON. 183.9' FOUND & GARAGE EMBOSSED SEAL SHALL NOT BE CONSIDERED 4'DlMrm TR PIPE 2.0 TO BE A VALID TRUE COPY. L DRYINELL 100. LI EXISTING DECKS 535 sq. ft. 2.44X CERTIFICATIONS INDICATED HEREON SHALL RUN 00 N 87*05)00)9 1 ONLY TO THE PERSON FOR WHOM THE SURVEY "C 0 TOTAL EXISTING 1,938 sq. ft. 8.84X 'X W I G I IS PREPARED, AND ON HIS BEHALF TO THE PROPOSED ADDITIONS 537 sq. ff. 2.45X TITLE COMPANY, GOVERNMENTAL AGENCY AND N101F 215. LENDING INSTITUTION LISTED HEREON, AND 8 TOTAL EXISTING 2,475 sq. ft. 11.29X TO THE ASSIGNEES OF THE LENDING INSTI- D TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. JOHN V. RYAN & PROPOSED JOAN A. RYAN o THE EXISTENCE OF RIGHTS OF WAY ti AND/OR EASEMENTS OF RECORD, IF at ANY, NOT SHOWN ARE NOT GUARANTEED. DRAINAGE SYSTEM CALCULATIONS: PREPARED IN ACCORDANCE WITH THE MINIMUM Nathan Taft Corwin III STANDARDS FOR TITLE SURV_QC&AS"ESTAQLISHED ROOF AREA: 1,956 sq. ft. BY THE L.I.A.L.S. AND AP OVE 4AN 1,956 sq. ft. X 0.17 = 333 cu. ft. FOR SUCH USE BY T, N 333 cu. ft. / 42.2 = 8 vertical ft. of 8' dia. leaching pool required TITLE ASSOCIATION. yA Land Surveyor PROVIDE (2) 8' dia. X 4' high STORM DRAIN POOLS Successor To: Stanley J. Isaksen, Jr. L.S. Joseph A. Ingegno L.S. CERTIFIED TO: Title Surveys — Subdivisions Site Pions — Construction Layout BETTY SULLIVAN PHONE (631)727-2090 Fax (631)727-1727 OFFICES LOCATED AT MAILING ADDRESS 4AND S 1586 Main Road P.O. Box 16 N.Y.S. Lic. No. 50467 Jamesport, New York 11947 Jamesport, New York 11947 7q--1 R-