HomeMy WebLinkAboutTR-8372 John M. Bredemeyer III,President o��rF S0(/rTown Hall Annex
Michael J.Domino,Vice-President l P.O.O Route 25
P.O.Box 1179
Glenn Goldsmith Southold,New York 11971
A.Nicholas Krupski G Q
�► ® �O Telephone(631) 765-1892
Charles J.Sanders O Fax(631) 765-6641
NTY,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1301C Date: November 14, 2016
THIS CERTIFIES that the construction of an 8'x38' second-story deck above an existing
first floor deck,• construct a 10'x12' first floor addition 5'x7' steps and a 6'x44' two-story addition onto
existing dwelling,• construct an 18'x35'pool with pool equipment area on landward side of dwelling;
construct=a 25'x28' garage; and install gutters to leaders to dMyells to contain roof runoff, with the
condition to establish and subsequently maintain a 20' wide landscaped buffer landward of wetland
boundary and the addition of a d_rD well on seaward side of house connected to gutters and leaders;
At 755 Lupton Point Road,Mattituck
Suffolk County Tax Map#1000-115-11-4.1
Conforms to the application for a Trustees Permit heretofore filed in this
' :
office Dated August 23,2013 pursuant tomhich Trustees Wetland Permit#8372
Dated February 19, 2016,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 construction of an 8'x38' second-story deck above an
existing first floor deck, construct a 10'x12' first floor addition,5'x7' steps, and a 6'x44' two-story
addition onto existing_dwelling,• construct an 18'x35' pool with pool equipment area on landward side of
dwelling; construct a 25'x28' garage; and install gutters to leaders to drywells to contain roof runoff,• with
the condition to establish and subsequently maintain a 20' wide landscaped buffer landward of wetland
boundary and the addition of a drywell on seaward side of house connected to gutters and leaders.
The certificate is issued to CAROLYN R.AMEEN owner of the
aforesaid property.
'O.A. 't", o
Authorized Signature
f
CC# : C17-2242
COUNTY CLERK'S OFFICE
STATE OF NEW YORK
COUNTY OF SUFFOLK
I, JUDITH A._PASCALE, Clerk of the County of Suffolk and the Court
of Record thereof do hereby certify that I have compared the annexed with the original
DECLARATION
recorded in my office on 01/18/2017 under Liber D00012896 and Page 944 and,
that the same is a true copy thereof, and of the whole of such original.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County
and Court this 01/18/2017
SUFFOLK COUNTY CLERK
—-'-i=C a 7'�a_a ca�2
[� JUDITH A.PASCALE
SEAL,
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DECLARATION Recorded: 01/18/2017
Number of Pages: 6 At: 02 :56:01 PM
Receipt Number : 17-0009709
LIBER: D00012896
PAGE: 944
District: Section: Block: Lot:
100-0 115 .-00 11 . 00 004 .001
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $30 .00 NO Handling $20 .00 NO
COE $5 .00 NO NYS SRCHG $15.00 NO
TP-584 $0 .00 NO Notation $0 . 00 NO
Cert.Copies $7 .50 NO RPT $200.00 NO
Fees Paid $277.50
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
F-il F2_1
RECORDED
Number of pages 2017 an 18 02:56:ul _PM
•JUDITH A. PASCALE
CLERK OF
�
This document will be public =UFFOLk` GOl_IhaT4'L D00012896
record. Please remove all P 944
.Social Security Numbers
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee Mortgage Amt.
1. Basic Tax
Handling 20. 00 2. Additional Tax
TP-584 Sub Total
Notation Spec./Assit.
or
EA-52 17 (County), Sub Total Spec./Add.
EA-5217 (State) TOT.MTG.TAX
a� �1 �� Dual Town Dual County
R.P.T.S.A. W
� Held for Appointment
Comm. of Ed. 5. 00 Transfer Tax
Affidavit gw, � Mansion Tax
/1'(fertified Copy The property covered by this mortgage is
or will be improved by a one or two
43- urcharge 15. 00 s� family dwelling only.
Sub Total �/ �- YES or NO
Other
Grand Total If NO,see appropriate tax clause on
page# of this instrument.
4 1 Dist. i000 iz5oo zioo 0040015 Community Preservation Fund
3314272 '
Real Proper "P T S Consideration Amount $
Tax Servic R LPA A III�tIIIlt�III I�I III II I�
Agency 18-JAN47 CPF Tax Due $
Verificatio
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
^- RECORD & RETURN TO: Vacant Land
17s5- TD 5 �---�
TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name
www.suffolkc6untyny.gov/clerk Title#
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached �� �-- made by:
(SPECIFY TYPE OF INSTRUMENT)
The premises herein is situated in
r SUFFOLK COUNTY,NEW YORK.ll �d Z
TO In the TOWN ofG � O
In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
12-0104..10/08kk _ (over)
9 `
DECLARATION OF COVENANTS
f �,,�,A�,
THIS DECLARATION made this A day of 20L, by rQ) {/l &Le,_0
O� �a residing at '2 �14eA 7"/l �� • - ?GCG/� .
hereinafter referred to as "DECLARANT(S) " :
W I T N E S S E T H
WHEREAS, DECLARANT(S) is/are the owner/(s) of certain real property located
on ��j� �( /✓�U� � t"7L?ck Town of Southold,
County of Suffolk, State of New York, described in the Suffolk County Tax Map as
District 1000, Section A5_1 Block _, Lots [ which is more
particularly bounded and described as set forth in Schedule "All annexed hereto,
hereinafter referred to as the Property;
WHEREAS, the Property is situated on lands within the jurisdiction of the
Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant
to Chapter .275 of the Town Code of the Town of Southold or its successor, and
various activities conducted upon the property may thus be subject to the
regulation and approval of the Trustees prior to being conducted;
WHEREAS, the DECLARANT(S) therefore made application to the Trustees for a
permit pursuant to the Wetlands Law of the 'Town of Southold to undertake certain
regulated activities; and
WHEREAS, as a condition of the granting of a Wetlands Permit to undertake
such regulated activities, the Trustees required that a J®CV1cleGfp �`.
"non-turf buffer" adjacent to and landward of
NOW, THEREFORE, the DECLARANT(S) do/does hereby covenant and agree as
T
follows:
1) Upon the substantial completion of the aforementioned permitted
activities there shall be established and perpetually maintained
"non-turf buffer" as
defined by Chapter 275 of the Town Code, to wit: "A designated area
where turf grass, pesticides and fertilizers are not permitted." and as
depicted on the �#-
All that certain plot, piece or parcel of land, with the buildings and improvements thereon erected,
situate, lying and being on Lupton's Point in Mattituck, Town of Southold, County of Suffolk and
State of New York, bounded and described as follows:
BEGINNING at a point on the northerly side of a 20 foot dght er formed byf way lstant 72the intersection of said northerly feet easterly as red
along the northerly side of said right of way from the corn
side of right of way with the easterly side of Marratooka Road; .
RUNNING THENCE along the land now or formerly of t of way;North 4 degrees 03 minutes 40 seconds
West, 208.48 feet to the southerly side of a 15 foot g
THENCE along the southerly side of said right of Y h water ugha monument Northine of Deep Hole C eek78 degrees 47
minutes 10 seconds East 110.79 feet to the mean g
THENCE southeasterly along Deep Hole Creek measuredpn
former) of tie line
i a bearing South 49 degrees 00
minutes 57 seconds East, 44.78 feet to land now
Y
THENCE along said land now or formerly of s)West, 9 the follo24 wing
et;two.(2) courses and distances.
(1) South 28 degrees 44 minutes 00 second
(2) South 10 degrees 14 minutes 50 seconds East, 100.00 feet to the northerly side of the said 20 foot
right of way;
THENCE along the northerly side of said 20 foot right of way the following two (2) courses and distance
(1) South 79 degrees 45 minutes 10 seconds West, 95.24 feet;
(2) Thence North 73 degrees 28 minutes 50 seconds-West, 4.76 feet to the point or place of
BEGINNING.
TOS
ETHER WITH a right of way ov r the 20 foot wide private road to an from
of said 20 it el sr ereby
road
conveyed to Marratooka Road, and t and from Deep Hole Creek at the e
wher it adjoins Deep Hole Creek on a easterly end of Lupton's oint.
BEING ND INTENDED TO BE the sa a premises conveyed to th party of the first part b deed dated
April 9, 2 13 recorded May 13, 2013 in iber 12729 page 472.
As a result o"this conveyance, title to the operty will be held by Car lyn R. Ameen as to a fi (50%)
percent inter�t and Deaneal Carltony Forb s as to a fifty (50 heeewit rce t interest in the premise , subject
to the terms of a Agreement between the p ies o
TOGETHER with al ight, title'and interest, if an of theteartlines thereof the of; T GETHER with the rt in and to any streets nd
roads abutting the ab ve described premises to t center
appurtenances and all t e estate and rights a nthofthefi
ante Y unto the parst pity of the s art in an t cond part;r the heirs or
TO HAVE AND TO HOL he premises he g
successors and assigns of
a party of the second part forever.
onin the nartv of the first part ovenants that the party of4e first part has not do%e or suffered anything
Y
la :Z 0/.0 GIBS oLnf 11h & e VeW ,l s e y Exhibit "A" �r
12 attached; and (((
These covenants shall run with the land and shall be binding on the
DECLARANT(S) , his/her/their heirs, assigns, purchasers, or successors in
interest and may only be modified after a public - hearing and upon
resolution of the Trustees.
IN WITNESS WHEREOF, the owner(s) has/have duly executed this instrument this
' TT
day of i , 20
O IS SIGNATURE
OWNER'S SIGNATURE
STATE OF NEW YORK )
COUNTY OF J ss: -
On the / day of in the year 20/7 before me the
�
/fund rsi ed ,--;i--Not Public n and for said State, personally appeared
6,itrr6Q� personally known to me or proved to me on the • basis of
satisfactory evidence to be the individual (s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that "he/she/they executed the same in
his/her/their capacity, and that by his/her/their signature(s) on the instrument,
the individual or the persons on behalf of which the in 'vidual (s) acted, executed
the instrument.
Notary Public
JOIN A.MAKI
NOTARY PUBLIC,STATE OF NEW YORK
Registration No.OIMA6164838
Qualified in Suffolk County
Commission Expires April 3Q,2019
2
BOARD OF SOUTHOLD TOWN TRUSTEES
l SOUTHOLD,NEW YORK
]PERMIT NO.L372 DATE: FEBRUARY 19,2014
ISSUED TO: CAROLYN R.AMEEN
PROPERTY ADDRESS: 755 LUPTON POINT ROAD,MATTITUCK
SCTM# 115-11-4.1
1�
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in
accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 19,2014,and
inconsideration of application fee in the sum of$250.00 paid by Glenn E.Just and subject to the Terms and
Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the
following:
Wetland Permit to construct an 8108'se.cond-story deck above an existing first
floor deck;construct a 101x12' first floor addition,5'x7' steps,and a 6'x44' two-story
7� addition onto existing dwelling; construct an 181,x35' pool with pool equipment area on
landward side of dwelling; construct a 251x28' garage; and install gutters to leaders to
drywells to contain roof runoff;with the condition to establish and subsequently
` maintain a 20'wide landscaped buffer landward of wetland boundary;and the
addition of a drywell on seaward side of house connected to gutters and leaders; and as
depicted on the survey prepared by John T. Metzger,Land Surveyor,last dated
February 25,2014 and stamped approved on March 25,2014.
is
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,
4 and these presents to be subscribed by a majority of the said Board as of this date.
1 _
FOLt
Jok' ,/
f
LOT COVERAGE SURVEY OF PROPERTY
OHOUSSEG- '1007. tL
N SEC - Age AT MATTITUCK --
••BRICK- 360•q.tl. ,
s"E°- j3 Esq.( TOWN OF SOUTHOLD
loser 37D 1862%¢t1 MAR 2 4 2014
PROPOSED SUFFOLK COUNTY, N.Y.
HOUSE- 1370 agJI. -HDECKOUSE 1000-115-11-4.1- 366�q.lt. 1000-115-11-4.1 �:�
BRICK - 360 c,11, SCALE. 1'=30'
POOL - 630•g.(1.
GARAGE- 700 sq.11.•, MARCH 12, 2013
3646 i ft. ,
3646122370-164JY. AUG 14, 2013 (PROPOSED ADOTNS.)
AUG. 28, 2013 (ADDTNS) d
OCTOBER 22 2013 To og�aphy)
APPROVED BY Nov.a,zas ILor c0v�T
JAN.9,2014(SEPTIC SYSTEAU
�'BQARD OF TRUSTEES FEB.23,2a4 h•a•lue.1 •y.
TC1ll�'.O SOUTFlOtD ' ���'
)ATE- -3 25 14,
`
'✓� c°UNTY Oi.
F 11Q �-
"E o• sR
' RIGHT OF WAY
N? '47
CCL
F'
,7�e 9P� •"J]At,_Q,(//�p oo 04(1'
PROP.2nd. 7a �ad0
411
2STY. qp OVER E% 044
IST dC��9 Z f UN\40,
W PROP. qq,, •. �� D ry JO g gij,VH
Z o ADDITION
26.3' �. ..Lq , Q-,+' ��s• T2
2STY. 2'R ,a�.` R k
lei• ,s. �
/ •^' Gj A
d 15.2' + E°A
R• a 1�b PROP.
1 STY.
w � AODMON
000 a
RAIN RUNOFF CONTAINMENT ' c
DWEWNG: 1,528 Sq. Ft. T {
1,528 x 0.17 x 1 = 260 Cu.Ft. n N Z
`•a Provida'S DWa. 6'0x 6'Deep Z• 8 m O,O
Conn cted by Cutters k Leaders N tT
B 20' a OP— A�
° <
p� 9.GARAGE
(D t'A.DRIVEWAY Tm.,
i c� rn
O p4 O C
9d r \ys ,W Dv
EM OF PAMUiNT PTOPTpolNT FOA
N13 Dew 'I✓ 1 RIGHT OF WAY
20
CERTIFIED TO: 4E OF Newt
CAROLYN R. AMEENELEVATIONS AND CONTOU S4�E CED
FIRST AMERICAN TITLE INSURANCE COMPANY r \,
TITLE # SP 29126-S TO N.G.V.D. DATUM. �0,� 1
FLOOD ZONE FROM'FIRM M� U 36103C0482H
SEPTEMBER 25, 2009 Mn
AREA=22,570 SO. FT.
<'C' Ab 493"e
TO TIE UNE . 5
100% OF LOT CLEARED N.Y.S. LIC. NO. 49618
ANY ALIERA77ON OR ADD17ION TO THIS SURVEY IS A VIOLA71ON CONIC YORS P.C.
OF SEC77ON 72090E THE NEW YORK STATE EDUCATION-W. (631) 765-5020 FAX (63f) 765-1797
EXCEPT AS PER SECTION 7209-SUBDIWSION 2.ALL CER7IFICA77ONS P.O. BOX 909
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 TRAVELER STREET
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF 7HE SURVEYOR SOU77IOLD, N.Y 11971 13-129
WHOSE SIGNATURE APPEARS HEREON
6/27/14
John,
Ed Hanus came into the office Friday morning to point out that his neighbor,Ameen at 755 Lutpon Pt.
Rd. has removed his hay bale line and silt fencing and has re-located the silt fencing onto Mr. Hanus'
property. I told Mr. Hanus that we normally do not get involved with property line issues, however
Ameen has not reinstalled the hay bale line and the construction has supposedly commenced. Andy
said he was going to take a ride down there sometime today(Friday)to at least get him to put up the
hay bales again. Mr. Hanus has supplied us with photos of the silt fencing relocation.
Mr. Hanus also continued to state that his neighbor planted trees to block his view. I told Mr. Hanus
there is nothing we can do about obstruction of view. Ameen planted a couple of bushes in an
established lawn area which doesn't normally require a permit from this office. In addition, Hanus
mentioned that an on-grade brick patio was reconstructed without any permits a few months ago,
however Andy said that he wouldn't address that issue because it was likely that it was constructed
before the Trustees went onto the property for the current permit and probably saw it,and nothing was
addressed at the time.
Andy wanted me to supply you with this information since you were the one who had been previously
involved with these parties. Mr. Hanus was looking to meet with you to explain these items to you, but I
mentioned that the Bay Constables have a heavy workload'and that they may not be able to do so, but I
would deliver the message! In case you need to contact Mr. Hanus, his number is 298-4708 or cell-655-
2369.
pE C EIE
JUN 2 8 2014
Southold Town
Board f Trustees
John M.Bredemeyer III,President �o�X\®f SOUr/y®lam Town Hall Annex
Michael J.Domino,Vice-President 54375 Route 25
P.O.Box 1179
Glenn Goldsmith
Southold,New York
11971
A. Nicholas Krupski G @�
Telephone(631) 765-1892
Charles J.SandersCOU Fax(631) 765-6641
NV
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: I I Iq Ale,
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
'/2 constructed . , . ; " � �
�
: �P tP !Lb aTn s C �n�
ler 7 ao l� Lem
Project complete, compliance inspection.
INSPECTED BY:
COMMENTS:
CERTIFICATE OF"COMPLIANCE:
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TOWN OF SOUTFat'OLD 4 Co
u -� ���, �.eekeva4wr SUFFOLK COUNTY,• N. Y.ba�,�vw. a,-F o r -�•-e. 1000--11511'-4.1 <
1 --30 —1
e�e va SCALE.•
ca- f I s below `�� A,d•o /l d ee, ) MARCH 12 2013 '
� v�,�,.�. ��r 0.s 'G �-ti•Q�:� AUG 28 440?AApDlt orRiOPOSEO ADDTNS.) �
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�$ CESSPOOL IS ONLY 1S' FROM FLOOD ZONE LIN04,
,,h AND ONLY 45 FROM MEAN HIGH'WATER xti��� � •�(� ��,.�,✓� oP
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• � � �, X10.79 •` '�'
OF WAY N78`47 `'� '�F sr
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he 1 `E� �t
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a eA
Y.- C,� .� $i �' b4/'/'��r ` '�►� \. .e /1� b FLp�SNF AD
a�)adv a�vr►-�-o $Y Z O 2STY. . d PROP. 2n + SNF 40,E
lav S h a v �w \, "^�g,�4'f- FLR;QErK(8•) ry�
PROP. VER EXISTNG ��• �� �O� W
ADDITION \. �,•.
Yn�n2 0 � % J sf
G r'een l•r.� IC wk'Ora r8ec 26..' ��\ r • ,(
can't' 2 . �icQ[i s� �h( S �i^t G/c' f U 0 (1��0o u l I jn
'"era P o -••:tq�• ry6?� \��x• ,O� • (e s f�j e•��2 �,p i,ed
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{k
John M. Bredemeyer III, President �OguFFQ(,f-� Town Hall,53095 Main Rd.
Michael J. Domino, Vice-President ��� OG�_ P.O. Box 1179
James F. King y Southold,NY 11971
Charles J. Sanders Gy Telephone(631)765-1892
Dave Bergen �l 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
1st day of construction
'/ constructed
Project complete, compliance inspection
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
PERMIT NO. 8372 DATE: FEBRUARY 19,2014 '.
ISSUED TO: CAROLYN R. AMEEN
',- PROPERTY ADDRESS: 755 LUPTON POINT ROAD,MATTITUCK 1)
t �J
SCTM# 115-11-4.1
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in ;
accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 19,2014,and
in consideration of application fee in the sum of$250.00 paid by Glenn E.Just and subject to the Terms and
Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the
following: r
f Wetland Permit to construct an 8'x38' second-story deck above an existing first
floor deck; construct a 10'x12' first floor addition, 5'x7' steps, and a 6'x44' two-story
addition onto existing dwelling; construct an 18'x35' pool with pool equipment area on
landward side of dwelling; construct a 25'x28' garage; and install gutters to leaders to
drywells to contain roof runoff, with the condition to establish and subsequently
f< maintain a 20' wide landscaped buffer landward of wetland boundary; and the
addition of a drywell on seaward side of house connected to gutters and leaders; and as
depicted on the survey prepared by John T. Metzger, Land Surveyor, last dated
t February 25, 2014 and stamped approved on March 25,2014.
j IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,
� and these presents to be subscribed by a majority of the said Board as of this date.
.r
k �gpfrFOJ,�
the
1�x ��1 �v
rg � A s
TERMS AND CONDITIONS
The Permittee Carolyn R. Ameen, residing at 755 Lupton Point Road, Mattituck,New York as part
of the consideration for the issuance of the Permit does understand and prescribe to the following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages,of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto,to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is.valid fora zperiod 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been
recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction
to the deed of the subject parcel. Such evidence shall be provided within ninety(90)
calendar days of issuance of this permit.
9. That the said Board will be notified by the Permittee of the completion of the work
authorized.
10. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit,which may be subject to revoke upon failure to obtain same.
11. This permit does not convey to the pennittee any right to trespass upon the lands or
interfere with the riparian rights of others in order to perform the permitted work nor does
it authorize the impairment of any rights,title,or interest in real or personal property held
or vested in a person not a party to the pen-nit.
John M.Bredemeyer III,President 'of so yo Town Hall Annex
Michael J.Domino,Vice-President �� lQ 54375 Main Road
.IL P.O.Box 1179
James F.King,Trustee T Southold,New York 11971-0959
Dave Bergen,Trustee G
Charles J.Sanders,Trustee � Q Telephone(631)76511892
COU Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
February 19, 201.4
Mr. Glenn E. Just
J.M.O. Environmental Consulting
PO Box 447
Quogue, NY 11959-0447
RE: CAROLYN R. AMEEN
755 LUPTON POINT ROAD, MATTITUCK
SCTM# 115-11-4.1
Dear Mr. Just:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, February 19, 2014 regarding the above matter:
WHEREAS, J.M.O. Environmental Consulting on behalf of CAROLYN R. AMEEN
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 August 23, 2013, and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council and to the Local Waterfront.Revitalization Program Coordinator for their findings
and recommendations, and,
WHEREAS, the LWRP Coordinator issued a recommendation that the application be
found Consistent with the Local Waterfront Revitalization Program policy standards,
and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on February 19, 2014, 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 have found the application to be Consistent
with the Local Waterfront Revitalization Program, and,
RESOLVED, that the Board of Trustees approve the application of CAROLYN R.
AMEEN to construct an 8'x38' second-story deck above an existing first floor deck;
construct a 10'x12' first floor addition, 5'x7' steps, and a 6'x44' two-story addition onto
existing dwelling; construct an 18'x35' pool with pool equipment area on landward side
of dwelling; construct a 25'x28' garage; and install gutters to leaders to drywells to
contain roof runoff; with the condition to establish and subsequently maintain a 20' wide
landscaped buffer landward of wetland boundary; and the addition of a drywell on
seaward side of house connected to gutters and leaders; and as depicted on the survey
prepared by John T. Metzger, Land Surveyor, last dated February 25, 2014 and
stamped approved on March 25, 2014.
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: $0.00
Very truly yours,
John M. Bredemeyer II
President, Board of Trustees
JMB/amn
i
John M. Bredemeyer III, President �OgUEFO(�-C Town Hall Annex
Michael J. Domino, Vice-President ��4 �Gy 54375 Route 25, P.O.Box 1179
James F. King Southold,NY 11971
Charles J. Sanders O �► Telephone(631)765-1892
Dave Bergen ��Ol �a0� Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO: V ( and eevt
Please be advised that your application dated 23 -3 has been
reviewed by this Board at the regular meeting of 2 and
your application has been approved pending the completion of the following items
checked off below. I
)Dl 1,vi`c�e. lane�sea�e� bt.�-�1- IandwQi-4
Revised Plans for proposed project o-(- we-�tangy , b6(,Lr)d0_rJ r ad A4)bn W
qu-WrS, IeaderS + dr wdl on SeQwo-ri
Pre-Construction Hay Bale Line Inspection Fee ($50.00) aP h6U$e-
1 st Day of Construction'($50.00)
Y2 Constructed ($50.00)
V 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: $
BY: John M. Bredemeyer III, President
Board of Trustees
3�20/1�F
3
Dear Mr. King,
I'm writing this letter to you because you have something which is very rare in town hall,
common sense.
This letter is regarding the proposed additions to 755 Lupton point Road, Mattituck.
When this house was built it was common to install two cesspools. The first for the
solids and the second for the liquid. Where it says concrete cover on the plan is
probably the first pool. It looks to be about 50' +or-from the water. The second would
be even closer. The bottom of these must be flushed out by moon tides, storms and
j hurricanes. A bad situation.
If the B of T's oks this addition, I suggest that they require the pools to be placed
between the house and the road. Common sense?
Thank you for your time.
, VE
J
SEP 1 8 2013:'
. :. Southold Town '
ar fT e
Carolyn R.Ameen
7S5 Lupton •• Road,Mattituck
SCTM#115-11-4.1
2/12/14
Carolyn R.Ameen
✓may s, 755 Lupton Point Road,Mattituck
f — SCTM#115-11-4.1
2/12/14
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55 Lupton Point Road,Mattituck
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/12/14
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% •BRICK - 36.O sq 11..
SHED - 86 S 11 TOWN OF .SO UTHOLD
J'r�66122570 882%q.[t
MAR 2 4 2014
PROPOSED SUFFOLK COUNTY . N. Y.
HOUSE - 1570 sq.11. 1000-115-11-4.1 3ttuti o c;uo��,
DECK - 386 4q.11.
BRICK - 360 sq,11.
POOL - 630 sq.f1. SCALE.', 1'-30' r f Tr e
GA1t'AGE - 700 x0l. MARCH 12, 2013
364s s 3646122570 �v .I AUG. 14, 20I J (PROPOSED ADD TNS.)
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CERTIFIED TO: df N!~Nt
CAROLYN R. AMEEN -
FIRST AMERICAN TITLE INSURANCE COMPANY ELEVATIONS AND CONTOU �Y�fY�L CED
TITLE # SP 29126—S TO N.G.V.D. DATUM. �Q\7
FLOOD ZONE FROM FIRM TT M . i U 36103CO482H
SEPTEMBER 25, 2009
AREA=22,570 SO. FT. �=
A'a.
TO TIE LINE S
100% OF LOT CLEARED N.Y.S. LIC. NO. 49618
ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A, VIOLA77ON CONIC EYORS, P.C..
OF SECTION 72090F THE NEW YORK STATE EDUCA77ON LAW. (631) 765-5020 FAX (631) 765-1797
EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FICA•770NS P.O. BOX 909
HEREON ARE VALID FOR .THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 13-129
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y 11971
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John Bredemeyer, President gUFFoI,tc Town Hall Annex
Michael J. Domino, Vice-President 54375 Route 25
James F. King ti = P.O. Box 1179
Charles J. Sanders o . Southold, NY 11971
-4 ,r �a Telephone (631) 765-1892
Fax (631) 765-6641
Southold Town Board of Trustees
Field InspectionMlork Session Report
Date/Time: f2- /
J.M.O. Environmental Consulting on behalf of CAROLYN R. AMEEN requests a
Wetland Permit to construct an 8'x38' second-story deck above an existing first floor
deck; construct a 10'x12' first floor addition, 5'x7' steps, and a 6'x44' two-story addition
onto existing dwelling; construct an 18'x35' pool with pool equipment area on landward
side of dwelling; construct a 25'x28' garage; and install gutters to leaders to drywells to
contain roof runoff, and in accordance with Chapter 236 of the Town Code. Located:
755 Lupton Point Road, Mattituck. SCTM# 115-11-4.1
Typ of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
Distance of proposed work to edge of wetland
Part of Town Code propos d work falls under: Chapt.275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Info needed:
Modifications:
Conditions:
Present Were: ""J. Bredemeyer M. Domino J. King C. Sanders
Bay Constable Other
Form filled out in the field by
Mailed/Faxed to:
Date:
i
I
James F.King,President �p�OgpFFO(,�.C4G P.O.Box 1179
Bob Ghosio,Jr.,.Vice-Presi dent s S Southold,NY 11971
Dave Bergen y Telephone(631 765-1892
John Bredemeyer Fax(631)765-6641
Michael J.Domino
Southold Town Board of Trustees
Field Inspection/Work Session Report
Date/Time:
J.M.O. Environmental Consulting on behalf of CAROLYN R. AMEEN requests a
Wetland Permit to construct an 8'x38' second-story deck above an existing first
floor deck; construct a 10'x12' first floor addition, 5'x7' steps, and a 6'x44' two-
story addition onto existing dwelling; construct an 18'x35' pool with pool
equipment area on landward side of dwelling; construct a 25'x28' garage; and
install gutters to leaders to drywells to contain roof runoff, and in accordance with
Chapter 236 of the Town Code. Located: 755 Lupton Point Road, Mattituck.
SCTM# 115-11-4.1
Type of area to be impacted:
Saltwater 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:
Modifications:
Conditions:
Present Were: J. King B. Ghosio D. Bergen,
J. Bredemeyer Michael Domino D. Dzenkowski other
Form filled out in the field by
Mailed/Faxed to:
Date:
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L.w.v„• u.. v v.�r — -- �r --a— ��.. --x-- m NOTICE COUNTY OF SUFFOLKK K 'gt av 90UTNOtD. SECTION NO
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NceunryunmrNMMea,xY lt4gt M mcT 175
PROPERLY MAP ,7
Office Location: ¢ ®� Mailing Address:
Town Annex/First Floor,Capital One Bank 53095 Main Road
54375 Main Road(at Youngs Avenue) ; , `' P.O.Box 1179
Southold,NY .119711 Southold,NY 11971-0959
http://southoldtown.northfork.net
BOARD OF APPEALS
TOWN OF SOUTHOLD
Tel. (631)7654809 Fax(631)765-9064
January 24, 2014
Glenn E. Just
P.O. Box 447
Quogue,NY 11959-0447
RE: ZBA Application#6711—Am ee-I
Dear Mr.Just:
Transmitted for your records is a copy of the Board's January 233, 2014 Findings,
Deliberations and Determination, the original of which was filed with the Town. Clerk
regarding the above variance application.
Before commencing any construction activities, a building permit is necessary.
Please be sure to submit an application along with a copy of this determination to the
Building Department.
If you have any questions,please call the office.
Sincerely,
Vicki Toth
Encl.
Cc: Building Dept.
�i
i
Office Location: so Mailing Address:
Town Annex/First Floor,Capital One Bank 53095 Main Road
54375 Main Road(at Youngs Avenue) P.O.Box 1179
Southold,NY 11971 l Q Southold,NY 11971-0959
Cou�m,��'
http://southoldtown.northfork.net
BOARD OF APPEALS
TOWN OF SOUTHOLD
Tel. (631)765-1809 Fax(631)765-9064
FINDINGS,DELIBERATIONS AND DETERMINATION
MEETING OF JANUARY 23,2014
ZBA FILE 6711
NAME OF APPLICANT: Carolyn R.Ameen SCTM#1000415-11-4.1
PROPERTY LOCATION: 755 Lupton Point Road(adj.to Deep Hole Creek)Mattituck,NY
SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this
application and determines that this review falls under the Type 11 category of the State's.List of Actions, without
further steps under SEQRA.
SUFFOLK COUNTY ADMINISTRATIVE CODE:. This application was referred as required under the Suffolk
County Administrative Code Sections A 14-14 t o 23, and the Suffolk County Department of Planning issued its
reply dated December 30, 2013 stating that this application is considered a matter for local determination as there
appears to be no significant county-wide or inter-community impact.
LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency
review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. The LWRP Coordinator issued a recommendation dated December 23, 2013. Based upon the
information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the
records available to us, it-is our recommendation that the proposed action is INCONSISTENT with LWRP policy .
standards and therefore is INCONSISTENT with the LWRP.Based upon the mitigating conditions imposed in this
decision,the Board finds the application CONSISTENT with the LWRP.
PROPERTY FACTS/DESCRIPTION:. Subject property is improved with a two story frame dwelling with
attached porch and patio. It is located in the R-40 zone district and is non-conforming with 22,570 sq. ft. It has
95.24 feet of frontage on Lupton Point Road (20' Right of Way), 208.48 feet along the western. property line,__ _
110.79 feet along the northern property line, 44.78 feet on Deep Hole Creek and 198.24.feet.along the eastern
property line as shown on the survey dated March 12, 2013, last updated November 21, 2013 prepared by John T.
Metzger,LLS.
BASIS OF APPLICATION: Request for Variance from Article XXII Section 280-116B and the Building
Inspector's October. 10, 2013 Notice of Disapproval based on an application for building permit for additions and
alterations to existing single family dwelling,at; 1)less than the code required bulkhead setback of 75 feet.
RELIEF REQUESTED: The applicant requests a variance for additions and alterations to the existing home,
including a second floor deck that is proposed at 63.4 feet from the bulkhead where the code required a 75 foot
bulkhead setback.
ADDITIONAL INFORMATION: During the hearing the applicant's agent was asked to provide information on
the condition of the septic system and its location. On January 10, 2014 the ZBA received the requested
information.
i
Page 2 of 3—January 23,2014
ZBA#6711—Ameen
SCTM#1000-115-11-4.1
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on January 9,2014 at which time written
and oral evidence were presented. Based upon all testimony, documentation,personal inspection of the property
and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and
relevant and makes the following findings:
1. Town Law §267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of
the neighborhood or a detriment to nearby properties. The Lupton Point Rd., area consists of approximately 22
described lots which predate zoning. The subject dwelling on the property has been in existence since prior to
zoning with no evidence of adverse impacts.
2. Town Law V67-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible
for the applicant to pursue, other than an area variance. The present home has been in existence prior to zoning
and is located within the 75 foot bulkhead setback.
3. Town Law 4267-b(3)(b)(3). The variance granted herein is not mathematically substantial, representing 15%
relief from the code. However, the proposed second floor deck is proposed above an existing deck and will
maintain the same setback that presently exists.
4. _Town Law U67-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential
community will have an adverse impact on the physical or environmental conditions in the neighborhood. The
applicant must comply with Chapter 236 of the Town's Storm Water Management.Code and shall comply with the
determination made by the LWRP Coordinator.
5. Town Law§267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the
Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the
limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase..
6. Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of additions and alterations while preserving and protecting the character of the
neighborhood and the health, safety and welfare of the community.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under
New York Town Law 267-B, motion was offered by Member Weisman (Chairperson), seconded by Member
Schneider,and duly carried,to
GRANT,the variance as applied for, and shown on the plans prepared by Charles Thomas, Architect, pages 1-5,
dated 7/13/2013and the survey dated March 12, 2013, last updated November 21, 2013 prepared by John T.
Metzger,LLS. Subject to the following conditions;
CONDITIONS:
1. Proposed second story deck shall remain open to the sky.
2. A perpetual 20 foot wide landscaped buffer shall be installed landward of the tidal wetland line as shown
on the survey.
That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued.
Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a
possible denial by the Building Department of a building permit, and may require a new application and public hearing before
the Zoning Board of Appeals.
Page 3 of 3—January 23,2014 -
ZBA#6711—Ameen
SCTM#1000-115-11-4.1
Any deviation from the variance(s) granted herein as shown on the architectural drawings, site plan and/or survey cited
above, such as alterations, extensions, or demolitions, are not authorized under this application when involving
nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other
feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are
expressly addressed in this action.
The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of
nonconformity.
Vote of the Board.• Ayes:Members Weisman (Chairperson), Schneider, Dantes, Horning.Absent:Member Goehringer. This
Resolution was duly adopted(4-0).
c
Leslie Kanes Weisman,Ch&uperson
Approved for filing /a?l/2014
James F.King,President *QF SO!/T�, Town Hall Annex
Bob Ghosio,Jr.,Vice-President � , 54375 Main Road
O P.O.Box 1179
Dave Bergen Southold,New York 11971-0959
John Bredemeyer cn
Michael J.Domino �► Telephone(631) 765-1892
Ql,Y• � �� Fax(631) 765-6641
DUffN
BOARD OF TOWN TRUSTEES D E C E D U E
TOWN OF SOUTHOLD
To: Southold Town Building Department AUG 2 6 2013
Re: Verification of Building Department Permit Requirements BLDG.DEPT.
TOWN OF SOUTHOLD
SCTM#: _ l
Property Owner Name: Ca n kin r , }tI'YI�P P h
Date Sent to Bldg. Dept.:
The Office of the Board of Trustees is forwarding the above referenced application for
verification of the Building Department's permitting requirements stated below:
YES NO
Will the proposed project require a Building Permit?
Wil a proposed project require a variance determination from.
e Zoning Board of Appeals?
Will any part of this application be considered as Demolition as
described under Town Code?
COMMENTS:
' C ize)
Signature of R wer Date
OFFICE LOCATION: O�'�'QF S�V jyOl MAILING ADDRESS:
Town Hall Annex Q P.O. Box 1179 .
54375 State Route 25 Southold, NY 11971
(cor.Main Rd. &Youngs Ave.) Q
Southold,NY 11971 Telephone: 631 765-1938
�.
Fax: 631 765-3136
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
if
MEMORANDUM
SEP 1 7 2013
To: Jim King, President Southold lbwn
Town of Southold Board of Trustees Boar of rru to
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: September 13, 2013
Re: LWRP Coastal Consistency Review for CAROLYN R. AMEEN
SCTM# 1000-115-11-4.1
J.M.O. Environmental Consulting on behalf of CAROLYN R. AMEEN requests a Wetland Permit to
construct an 8'x38' second-story deck above an existing first floor deck; construct a 10'x12' first floor
addition, 5'x7' steps, and a 6'x44' two-story addition onto existing dwelling; construct an 18'x35' pool
with pool equipment area on landward side of dwelling; construct a 25'x28' garage; and install gutters to
leaders to drywells to contain roof runoff, and in accordance with Chapter 236 of the Town Code.
Located: 755 Lupton Point Road, Mattituck. SCTM# 115-11-4.1
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 actions
are CONSISTENT with the LWRP provided that the Board:
1. Clarify the setback to the wetland.
2. Considers the establishment of a vegetated buffer landward of the wetland line.
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
Peter Young,Chairman Q Town Hall,53095 Main Rd.
Lauren Standish,Secretary P.O.Box 1179
Southold,NY 11971
��lJ Off` 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.,
September 11, 2013 the following recommendation was made:
Moved by John Stein, seconded by Doug Hardy, it was
RESOLVED to SUPPORT the application of CAROLYN AMEEN to construct an 8'X 38'
second story deck above an existing first floor deck, a 10'X 12' first floor addition, 5'X 7'
steps, 6'X 44' two story addition 18'X 35' pool, pool equipment, 25'X 28' garage and
drywells.
Located: 755 Lupton Point Rd., Mattituck. SCTM#115-11-4.1
Inspected by: John Stein, Doug Hardy
Vote of Council: Ayes: All
Motion Carried
Q.M.O.
Environmental Consulting Services
VF
September-2, 2013 SEP - 6. 2013
Southold Town
Mr. James King, President
Board of Town Trustees
Town of Southold
Town Hall Annex
54375 Main Road, Southold, NY 11971
Re: Application for Carolyn R. Ameen
755 Lupton Point Road, Mattituck
S.C.T.M.No. 1000-115-11-4.1
Dear Mr. King:
Enclosed please find are four copies of the updated survey for this
project. It has been revised to depict the dimensions of the
proposals as well data for the rain runoff containment. I have also
enclosed .copies of the .building plans. Should you or any member
of the Board have any questions or comments regarding this matter
please feel free.to contact me at any time.
Mo pect 11 ,
0
Glenn . Just.
Phone (631) 653-0607 • Fax (631) 653-3348
121. Jessup Ave • 2nd Floor • P.O. Box 447
Quogue, New York 11959-0447
`? J James F.King,President �*Of S yO Town Hall Annex
Bob Ghosio,Jr.,Vice-President 64375 Main Road
P.O.Box 1179
Dave Bergen Southold,New York 11971-0959
John Bredemeyer CO-
Michael J.Dominoes �� Telephone(631)765-1892
Fax(631)765.6641 i.
I
BOARD OF TOWN TRUSTEES i.
TOWN OF SOUTHOLD
Office Use Only
i
Coastal Erosion Permit Application
Wetland Permit Application Administrative Permit
/ Amendmentfrransf /Ex nsion D
V ceived Z3 Application:
_ ecE- CE IV ED
eived Fee:$ D a
Completed Application 23 3
Incomplete AUG 2 3 2013
_SEQRA Classification:
Type I Type II Unlisted
_Coordination:(date sent) Shoic
✓LWRP Consistency Assessment Form [IBoard'
of 1-u.
AC Referral Sent: 2
Date of Inspection: 3
Receipt of CAC Report:
_Lead Agency Determination:
Technical Review:
.
Public Hearing Held:
Resolution: 1
Name of Applicant Carolyn R. Ameen
Mailing Address 755 Lupton Point Road
Mattituck,NY 11952 phone Number:( ) 8 3 9-8 0 9 9
Suffolk County Tax Map Number: 1000- 115-11 -4 .1
Property Location:_ 755 Lupton Point Road, Mattituck
(provide LILCO Pole#,distance to cross streets,and.location)
AGENT: Glenn E. Just-JMO Environmental Consulting
(If applicable)
Address: P.O. Box 447
Quogue,NY 11959-0447 Phone:653-0607
<ard of Trustees Applicatit. _,
•r
GENERAL DATA
Land Area(in square feet): 22,570
i
Area Zoning:
family le
Previous use of property: Single y dwelling
Intended use ofproperty: Single family dwelling
Covenants and Restrictions on property? Yes x No
If"Yes",please provide a copy.
Will this project require a Building Permit as per Town Code? x Yes No
If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review
and Elevation Plans will be required. .
Does this project require a variance from the Zoning Board of Appeals? Yes x No
If"Yes",please provide copy of decision. i
Will this project require any demolition as per Town Code or as determined by the Building Dept.? I .
Yes x No
Does the structure(s)on property have a valid Certificate of Occupancy? x Yes No
i
1
Prior permits/approvals for site improvements: unknown
Agency Date
1
No prior permits/approvals for site improvements. 1 r:
Has any permitlapproval ever been revoked or suspended by a governmental agency? x No Yes
If yes,provide explanation:
Project Description(use attachments if necessary):
Please see attached
I
Cantrell, Elizabeth
From: gjustl02l5@aol.com
Sent: Wednesday,August 28, 2013 10:55 AM
To: Cantrell, Elizabeth
Subject: Ameen-Mattituck
Liz- Here is the project description. Applicant proposes to construct a 8'x38'second story deck above an existing first
floor deck, a 10'x12'first floor addition, a 5'x7' steps, a 6'x44'two story addition, a 6'x32'two story addition, a 18'x35' pool,
pool equipment, a 25'x28'garage and dry wells.
i
Applicant proposP-,>ko construct additions to an f-x-isting single
family dwelling, _�and story deck over an exisl'._ first story
-deck, pool and garage.
B 'd of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: Additions to single family dwelling
r
1.
t
i
Area of wetlands on lot: 350 square feet
I.
Percent coverage of lot: %
Closest distance between nearest existing structure and upland
edge of wetlands: 5 5 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: 66 feet
Does the project involve excavation or filling? i
No x Yes
i
If yes,how much material will be excavated? 185 cubic yards for pool i
How much material will be filled? 0 cubic yards
Depth of which material will be removed or deposited: 3 ' -1 0 ' feet
Proposed slope throughout the area of operations: 1 :1
Manner in which material will be removed or deposited: Backhoe
Statement of the effect,if any,on the wetlands and tidal waters of the town that may result by
reason of such proposed operations(use attachments if appropriate):
The project as proposed should have no negative impacts
upon the wetlands or waters of Southold Town
l
617.20
Appendix C
State Environmental Quality Review
SHORT ENVIRONMENTAL ASSESSMENT FORM
For UNLISTED ACTIONS Only
PART I-PROJECT INFORMATION To be completed by A licant or Project Sponsor)
1. APPLICANT/SPONSOR 2. PROJECT NAME
Carolyn R.Ameen Proposed additions to a single family dwelling
3. PROJECT LOCATION:
Municipality Mattituck County Suffolk
4. PRECISE LOCATION(Street address and road intersections,prominent landmarks,etc.,or provide map)
755 Lupton Point Road
Location map and survey enclosed
5. PROPOSED ACTION IS:
New ❑✓ Expansion Modificationfalteration
6. DESCRIBE PROJECT BRIEFLY:
Please see attached
7. AMOUNT OF LAND AFFECTED:
Initially 0.01 acres Ultimately 0.01 acres
8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS?
121 Yes No If No,describe briefly
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT?
0 Residential11 Industrial Commercial Agriculture Park/Forest/Open Space Other
Describe:
Single family dwellings
10. DOES ACTION INVOLVE A PERMIT APPROVAL,OR FUNDING,NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY
(FEDERAL,STATE OR LOCAL)?
nYes No If Yes,list agency(s)name and permit/approvals:
Southold Town Trustees&N.Y.S.D.E.C.
11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL?
Yes No If Yes,list agency(s)name and permit/approvals:
12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION?
Yes No
I CERTIFY THAT THEXQORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE / 3
Applicant/sponsor name: Glegg E.Yst 0 agent Date:
Signature:
If the acti n is in Coastal Area, and you area state agency, complete the
Coas I essment Form before proceeding with this assessment
OVER
1
Reset
Applicant proposes to construct additions to an eykting single
family dwelling, _:,)nd story deck over an exist_ _ first story
deck, pool and garage.
i
PART If- IMPACT ASSESSMENT o be com p feted by Lead A end.
A,DOES ACTION EXCEED ANY TYPE t THRESHOLD IN 6 NYCRR,PART 61TA? if yes,coordinate the review process and'use the FULL EAR
❑'Yes. Q No
a. WLI,ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN-6 NYCRR,PART 617.67 If No,a negative
declaration may be superseded by another involved agency.
0 Yes L7 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 aF flooding problems? Explain briefly:
C2. Aesdietto,agr(cralturai; fdtaeologica4 tdgtortc,or other natural nr cultural resburm;or community or neigftborhood character?Explain bdefl--
d3. Vegetation or fauna,fish,shelifls 'or wildlrfespedes,significant habitats,or threatened orendWered species?Explain briefly:
C4. A community's existing plans or goals as officWfly adopted,or&change in use or intensity of use of(and or other natural resources?Explain briefly:
Cs. 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-CS? Exptain briefly:
C7:Other impacts ftdryding than es in use of either quantity or type of energy? — — -' --- "lain brief):---- -�.. ... .. •---
D.WILL THE PROJECT HAVE AN IMPACT pN THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITIi:AL
ENVIRONMENTAL AREA LCEA17 jlf .es,eetain bdefl .
Yes Q No
E. IS THERM OR IS THERE UKELY To$ 22t i OVERSY 52&TED TO POTENTIAL ADVERSE€NV.IRONMENTAL IMPACTS? If yes lain
0 Yes a No
PART Ill-IMM MINATMON OF=N(FICANCE(To be completed by Agency)
INSTRUCTIONS: Foreachadvefseeffectidenitfed above,determine whetheritissubstawtial,large WVorlantorotherwisesignirmnt Eadt
effect should be assessed in connefdion WM its(a)setting(Le.arban or rural);(b)probatfifity of oocunir g;(o)duration;(d)1mverAlydy,(e)
geographic scope;and(q magnitude. If necessary,add attachments or reference suppoffg materials Ensure that explanations contain
wMalw t detati to show that el(relevant adverse impacts have been identified and adequately addressed. N question d ofpart fi was checked
yes,thedete(MhtationofaignificanwmustevaluatethepotentialimpadvfthepmposedadwnentheeWmnmentalCharacteristicsoftheCFA
Check ffris box ifyou have l* dW orle ofmore potentially large orsWtfrficantadverse impacts wMM MAY occur.Then pr oceed diredly to the
EAF anWor prepare a posits dedarafon.
Check ihLs box ifyoufiave determined,based on the information and analysis above and any supporting documentation,that the proposed a
V WLL NOT mutt In any signficant adverse eWronmental impacts AND provide,oa attachments as neoe ary, the reasons supporting thi
determination.
Board of Trustees /� /�
`r Na4ble
Agency Date +
�V President
E1
Print or Name ofZOr n Lead Agency Title of Responsible Officer
Qgw Z't
James F. King,President Town Flail.53095 Main Rd.
Bob Ghosio,Jr.,Vice-President P.O. Box 1179
Dave Bergen `fi Southold,NY 11971
John Bredemeyer '�j� �Q Telephone(631)765-1892
Michael J. Domino Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application of
CAROLYN R. AMEEN
COUNTY OF SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS
I,Glenn E. Just , residing at/dba 121 Jessap Avenue
Quogue, NY
being duly sworn, depose and say:
That on the(10#ky of� "�' ) 20 f,� I personally posted the property known as
Ameen, 755 Lupton Point Road, Mattit»ck
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 days prior to the ate of the public hearing.
Date of hearing noted thereon to be held Wednesday, Septeuiber 20
Dated:
(signature)
Sworn to before me this
�'�4day of�r-p 20 /3
. � r
Notary Public
PATRICIA M. MC CHESNEY
Notary Public,State of New York,c .
No.01 MC4667610
Qualified in Suffolk County
Commission Expires Sep.w0,a'
it
fM J i
li
I
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS i
I I
Name: Address:
i
'Mr. Edward A. Hanus 635 Lupton Point Road, Mattituck,NY 11952 i •
Suffolk County 330 Center Drive, Riverhead, NY 11901-014.5 ' !
Kreiling Family 2007 Irv. Trust P.O. Box 757, Mattituck, NY 11952 ;.
' I
Mr. Michael G. Mitchell, P.O. Box 870, Mattituck, NY 11952-0870 !} �
STATE OF NEW YORK I
COUNTY OF SUFFOLK i
Glenn E. Just residing at 121 Jessup Avemw '+
Oubaue,NY ,being duly sworn,deposes and says that on the
day o 20j_j,deponent mailed a true copy of the Notice
set forth in the Board f Trustees Application,directed to each of the above named
persons at the addresses set opposite there respective names;that the addresses set
I
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 wer
' ailed at they nited fates Post .
Office at Manorvi l l e, NY ,that said Noti were ed to ch o said ons by
CERTIFIED MAIL7RETURN RECEIPT.
Sworn to before me this 2 '
Day of S e.,g, - b,,20 13
Notary Public -
.1_
GINA A.LOCKE II
No.09 L06057960 !�.
Notary Public,State of New York
Qualified In Suffolk County
My Commission Expires 04130120 5
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sneer,Apt No.;
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cfyware, tt Mattituck NY 1195 -
PS Form Mattituck
:00 August 2006See Reverse for Instructlorm
h�o�oguFFo��.�oG
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oy�o1
John Bredemeyer, President Town Hall Annex
Michael J. Domino, Vice-President 54375 Route 25
James F. King P.O. Box 1179
Charles J. Sanders Southold, NY 11971
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application of
CAROLYN R.AMEEN
COUNTY OF.SUFFOLK)
STATE OF NEW YORK)
AFFIDAVIT OF POSTING
TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS
\yx _,residing at/dba la l -BSc a�
being dul orn, depose and say:
That on the k9 darof Sep66A I , 201?,,I personally st d the prope known as
9 tA - f
by placing the Bdarrof Trustees official poster w ere it can easily be 4een, and that I have
checked to be sure the poster has remained in place for eigh days p 'or to the date of the public
hearing. Date of hearing noted thereon to be held Wednesd Se ember 18 2013.
Dated:
(signa e)
Sworn to before me this
�}�day of Feb 201 L' No.01L060579 0
Notary Public,State of New York
Qualified in Suffolk County I
My Commission Expires 04/30/20 f 5-
2
Notary Public
NOTICE OF HEARING
NOTICE IS HEREBY GIVEN that a public hearing will be held by the
SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road,
Southold, New York, concerning this property.
OW N E R(S) O F R E C 0 R D: Coro lyn i9m cer)SUBJECT OF PUBLIC HEARING-
Construct :an 8 x38 second-story deck above an existing first floor deck; construct a 10'x12' first floor addition, 5'x7' steps, and a 6'x44' two-story
addition onto existing dwelling; construct an 18'x35' pool with pool equipment area on landward side of dwelling; construct a 25'x28' garage; and
install gutters to leaders to drywells.to contain roof runoff., and in accordance with Chapter 236 of the Town Code.
TIME & DATE OF PUBLIC HEARING:
CJ eckn so 1� 3
If you have an interest in this project, you are invited to view the Town file(s)
which are available for ins ection rior to the day of the hearing during normal
business days between the ours o 8 a.m -and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631 ) 765- 1892
�td of Trustees Application
i
f
County of Suffolk
State of New York
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.
i
Signatu4 of Property Owner
SWORN TO BEFORE ME THIS___0 ' " DAY OF 20
No)ifiy Public .
CHRISTY SEYMORE
Notary Public,State of Now York
No,01SE6131664 ?
4ua8fled In Suffolk County �J
Commission Expires August 06,20.
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'rd of Trustees Appliaatior_:
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AUTHORIZATION
(where the applicant is not the owner)
1,1�,lfrbkjo An 4—e b? residing at -755 LVPk'3
(print owner of property) (mailing address)
JMO Environmental j
Consulting do hereby authorize '
(Agent) }
to apply for permit(s)from the
Southold Board of Town Trustees on my behalf.
I
(Own s signature)
I-
state Of-- �E,E r; a before Me CHRIS7Y SEYMORE
���d61r�C�cii 1r!r�:�;
/3 �'b rfle or liv, Notary Public,State of New Yortt
this day of No,01SEGI M$9a
Vodtoced a,idenNiUt°a)N�!® 4ualifled in Suffolk ust�ntv20
My comnn sslon expires e� Commission Exp
e`6atGry si�r�afure_. _--. I
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Environmental Consulting Services
To whom it may concern:
Please be advised that we have authorized the firm of J.M.O.
Environmental Consulting Services to act as our agent on our behalf in
applying for certain approvals through your agency and others involved
with this project. J.M.O. Consulting Services has been retained to
coordinate all approvals necessary through your and other involved
agencies, as well as our architect, engineer and contractors. We request that
all communications, correspondences, notices, approvals and calls be
addressed directly to the offices of J.M.O. Environmental Consulting
Services.
Signature.
Dated
of fore ms
State of _ be
tore was 2 no edged �W�16fY��YMOk�E
the foreQptn� t Tome or.has Notary I�ubllo,State of Now York
this day Of n �- No.01 SEW 31594
Odd as identifire qualified in Suffolk county ✓�
�COM 101i s1APrr commission Expires August 06,20-w,
Notary cinn�@ure -
Phone (631) 653-0607 • Fax (631) 653-3348
121. Jessup Ave • 2nd Floor • P.O. Box 447
Ouogue, New York 11959-0447 -
APPLICANT/AGENTMEPRESENTATIVE :
TRANSACTIONAL DISCLOSURE FORM
Dc
T o d' e i in n the wn o and s e f
this form is to provide inforination which can alert the town Of nossr'b1 gmat: s of ktma and ailow it to take whatever action is
;•
ngggg
'to avoidsame. =
YOURNAME: Just, G1enn,E :•
(Last name,fiist name,griddle initial,unless you are applying iri th.c name of
someone else or other entity,such as a company.If so,indicate tho.other
persores or company's name.)
NAME OF APPLICATION:'(Check all that.apply.)
Tax grievance Building
Variance Trustee
Change of Zone Coastal Erosion. I
Approval of plat Mooring f.
Exemption from plat or official map Planning
Other i
(If"Other,name the activity.)
i
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 busnwm ititeresL"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 shams.
YES NO x I
Ifyou answered"YES",complete the balance of this form and date and sign where indicated. ff'
I
Name of person employed by the Town of Southold
Title or position of that person `
Describe the relationship between yourself(the applicant/agpWreptesentative)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(eheck all that apply):
A)the owner of greater than 5%of the shares of the corporate stock ofthe appficpnt .
(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 i
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
'1.
Submitted this ay 200
IE
Signature-
_ Print Name
Form TS.1
i s
APPLICANT/AGENT/REPRESEN'rATTNEE
TRANSACTIONAL DISCLOSURE FORM
Jhe Town of Southold's Code of Ethics prohibits conflicts of interest on the tart of town o cots and�mnloyees The nim�ose of
this LOM1 to rovide inforination which can alert the town of possible ggaflirU of ihteM andall=it to take wh fever action rs
DOr=to avoid same.
YOUR NAM :
(Last name,Aist name,4iddle initial,unless you are applying iri the name of
someone else or other entity,such as a company.If so,indicate,the.otim !
persons or company's name.) !
NAME OF APPLICATION: (Check all that.apply.)
Tax grievance Building
Variance Thistee
Change of Zone Coastal Erosion I
Approval ofpiat Mooring
Exemption from plat or official map Planning t
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,rigarriage,or busmess ihteresL"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 i
in which the town officer or employee owns more than 5%of the shares.
YES NO
ifyou answered"YES",complete the balance ofthis form and date and sign where indicated.
�.
Name of person employed by the Town of Southold i
Title br position of that person !
Describe the relationship between yourself(the applicant/agent/representadve)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,of child is(check ail'that apply): I`
A)the owner of greater than 50/6 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(whets the I "
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 f 200 �3 '
signature. ;►
_ PrintName Loan'
Form TS.1
County of 014PU9Tv MOREre 104
t
SUM d � � wa6 ackn. Notary Public,State of NowrYork
{o�Doing in 2 ° _. 7o me or hatNo.01Sc811594
this d8Y Of U" 0181ified it &Mft County llt _3
iP—rodeced 8.S ld8 Cxpit N n 3 ' ion Expire s te 06,2Q®
Icy COMmts>�ion
140wrY sionolure
d� k Town of Southold
Erosion, Sedimentation & Storrh-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION s.0 T.M d THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
1 0 0 0—1 1 5—1 1 —4 .1 STORM-WATER GRADING DRAINAGE AND EROSION CONTROL PLAN j
sic on -Mood— —Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF N—EW--YG—RX �.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels? 9 Will this Project Retain AD Storm-Water Run-Off
(Include Total Area of all Parcels located within 22,570
Generated by a Two(2')Inch Rainfall on Site?
the Scope of Work for Proposed Construction) (S.F./Acres) (This Item will include all run-off created by site —
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 activvity? (S F.r AdaS) impervious surfaces.) ! .
PROVME BRIEF PROJECT DESCMMON tRovide Adder orw Pn--NK*Q 2 Does the Site tunesPlan and/orIIndicating
e&Ldcaw All Proposed
n?This
Drainage Structures lndlcailng Size B Lticatton?This
Rem shall Include all Proposed Grade Changes and
Slopes Controlling Surface Water Flow. .
3 Does the Site Plan and/or Survey describe the erosion and sediment control practices that will be used to
control site erosion and storm water discharges. This
Please see attached 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 ❑ L i
Existing Grade Involving more than 200 Cubic Yards r
of Material within any Parcel? I•.
5 Will this Application Require Land Disturbing Activities .❑
Encompassing an Area in Excess of Five Thousand l"
(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(.1 OW)feet of a Weiland or —
Submission of a SWPPP is required for all Construction activtttea involving son Beach?
disturbances of one(1)or more acres;.Including disturbarmes of less than one acre that
7 Will tiiere 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 soli disturbances of teas than one(1)acre where One Hundred(100')of Horizontal 1}istailce?
the DEC has determined that a SPDES permit Is required for storm water discharges. :+
(SWPPP s Shall meet tha Minlmuin Requirements of the SPDES General Permit g Will Driveways,Parking Areas or other Impervious i I
for Storm Water Discharges from Conatructfon activity-Permit No.GP-010-0e1.) Surfaces be Sloped to Direct StomrWater Run-Off F-1
1.The SWPPP shag be prepared prior to the submittal of the NOI.The Not shalt be into and/or In the direction of a Town right-0f-way?
submitted to the Department prior to the commencement of construction activity.
Z The SWPPP shall describe the erosion and sediment control practices and where Will this Project Require the Placement of Material.
required,post-constnrdlon storm water management practices that Wil be used and/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pollutants in stem water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder aXt/
compliance with the terns and conditions of this pentilt.In addition,the SWPPP shall Area?Rhb item vdn nor monocle ft inswoon or onvewar Apmm) j
Identify potential sources of pollution which may reasonably be expected to affect the i .
quality of storn water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark i
3.All SWPPPs that require the post-construction storm water management practice is a Box end the conskuWon site disbubance is between%000 S.F.81 Acm to area, j
Component shall be prepared by a qualified Design Professional Ltcersed In New York a Storm-wate,Grndhng,Drainage 3 Erosion Control Plan to Required by the Town of r
that is knowledgeable in the do Southold and Must be Sub nittsd for Review Prior to Isauance of Build PemdL €I
9 P dpIBB end praWtces Of Storm Water Management M0M A cnedL Maik N)andror Answerfor ears,Question is Requhed Tore Complete Applkallon)
STATE OF NEW YORIL cc
COUNTYOF.... 9. '.:C�.1.. ..........Ss
That I,..Glion... :a..: ....being duly sworn,deposes and says that he/she is the applicant for Permit, '
(Name of ladtvi;i ai signing .
Andthat he/she is the ...... D .�. .......................................................... r
•. �(Ovine Contraclw,iigerd;C«pwate officer.'etaj !.
Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to f
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;
/-3
............. ..........................
z c• b41 (5igrokreorAppliant)
FORM OBi/'I D:'' 'Nptas+yMob is State,of New York i'
No,G1MC4667610
E'ualified in Suffolk County
Commission Expires Sep.30, � .� .
Project description for Carolyn R. Ameen
755 Lupton Point Road, Mattituck
S.C.T.M.No. 1000-115-11-4.1
Applicant proposes to construct an 8'x38' second story deck above
an existing first,floor deck, a 10'x12' first floor addition, 5'x7'
steps, a 6'x44' two story addition, a 6'x32' two story addition, a
18'x35' pool, pool equipment, a 25'x28' garage and dry wells
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 mfonnation used by a Town of Southold agency in �.
making a.determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
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 or'"no , then the proposed action will I
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each answer must be egnlained in detail. fisting both sunuorting and non-
sunuorting facts. If an action cannot be certified as consistent with the LWRP policy standards and
conditions,it shall not be undertaken.
A copy of the LWRP is available in the following places: o '
website(southoldtown.northfork.net),the Board of Trustee ce, the Planning Dep , all
local libraries and the Town Clerk's office. AUG 2 3 2013
B. DESCRIPTION OF SITE AND PROPOSED ACTION
Southold Town
SCTM# 1 1 5 11 _ 4 .1 Board of T s e
PROJECTNAME Proposed additions to a single family dwelling, pool
and garage
The Application has been submitted to(check appropriate response):
Town Board ❑ Planning Board❑ Building Dept ❑ Board of Trustees ❑ i
1. Category of Town of Southold agency action(check appropriate'response):
3
(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: '
Please see attached
Applicant proposes,to construct additions to an existing single
family dwelling, and story deck over an exist first story
deck, pool and garage.
Location of action:
755 Lupton Point Road, Mattituck `•
Site acreage: 22,570 s q, f t, i.
Single family dwelling
Present land use: i
Present zoning classification:
2.' If an application.for the proposed action has been filed with the Town of Southold agency,the following
information shall be provided: I.
Carolyn R. Ameen
(a) Name of applicant: ,
(b) Mailing address: 755 Lupton Point Road
I
Mattituck, NY 11952
(c) Telephone number:Area Code( ) 6 31 -8 9 0-8 0 9 9
(d) Application number,if any: unknown '
Will the action be directly undertaken,require funding,.or approval by a state or federal agency?
Yes El No❑ If yes,which state or federal agency? N.Y.S.n.F.C.
i
. I.
C. Evaluate the project to the following policies by analyzing how the project will further support or
not support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
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
I
The proposed additions, pool and garage should not negatively ifp9-'
the character of the community Tt ; s felt that this poiect
is consistent with this policy
Attach additional sheets if necessary
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 should not have any impacts. upon any historiccO
_ or archaeological resources of the Town. It is felt that this
project is consistent with this policy
Attach additional sheets if necessary
Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See 1
LWRP Section III-Policies Pages 6 through 7 for evaluation criteria
L -Yes ❑ No ❑ Not Applicable
The project will have no impacts uponthe visual Quality or scenic
resources' of the Town. It is felt that this project is consisten-
with this policy
Attach additional sheets ifnecessary
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP
Section III-Policies Pages S through 16 for evaluation criteria
Fil—
Yes ❑ No ❑ Not Applicable
Thp proposed nrn}eCt will not nAnga t-hprnrngi nn nr flan inn pf
natural resources or structures_ It is felt that this project
is consistent with this policy
Attach additional sheets if necessary
Policy 5. Protect and improve water quality and supply in the Town of Southold.See LWRP Section HI
-Policies Pages 16 through 21 for evaluation criteria
�- Yes ❑ No ❑Not Applicable
i
The project will have no impact *upon the quality or quantity of
potable water in the Town_ Tt is felt that is project is '
consistent. with this policy
Attach additional sheets if necessary
Policy 6. Protect and restore the'quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III-Policies; Pages 22
through 32 for evaluation criteria.
❑ ❑
Yes No Not Applicable
The project will not negatively impactthe duality or function
of any of the Town' s ecosystems, wetlands or areas of Significant
Coastal Fish and Wildlife Habitats. It is felt that this project
is 'consistent with this policy
i`
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
WYes ❑No❑ Not Applicable
The project will have no negative impacts upon air quality. It
is felt that this protect is consistent with this policy
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria.
Q�6es ❑ No ❑ Not Applicable
The protect does not involve the use of or the disposal of
solid waste or hazardous substances and wastes. It is felt
that this project is consistent with this policy '
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III;Policies;Pages 38 through 46 for evaluation
criteria.
YesO No❑ Not Applicable
The project will not deny access to, or the public use of,
or the recreational use of, coastal waters, public lands and h
public resources of the Town. It is felt that this project
is consistent with this policy
Attach additional sheets if necessary
WORIKING 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
E
The project will have no impacts upon Southold' s
water-dependent uses or the siting of new
water-dependent uses. It is felt that this project i..
is consistent with this policy
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Es
tuary and Town waters. See LWRP Section III--Policies;Pages 57 through 62 for evaluation criteria.
❑ No❑ Not Applicable `
Tha rr,3 aci- wi 1 l haven nn i m=ar-t- upnn t-hr-_ auhai-a i nahl rm 11SP of �.
living marine resources in Deep Hole Creek, Town waters or
the Peconic Estuary. It is felt that this project is
consistent with this policy
- I
Attach additional sheets if necessary j
Policy 12. Protect agricultural-lands-in the Town of Southold. See LWRP Section III-Policies; Pages
62 through 65 for evaluation criteria.
❑ Yes ❑ No H Not Applicable
The project. does not involve agricultural lands. It is felt
that this policy. is not applicable to this project I..
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
i
Section III-Policies;Pages 65 through 68 for evaluation criteria.
❑ Yes ❑ No Rr Not Applicable
The project does involve the development of- energy or
mineral zesources. It is felt that this policy is not
applicable to this applicatmon
PREPARED By Glenn E. .Just TITLE - Agent DATENa&3