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HomeMy WebLinkAboutTR-9406 Glenn Goldsmith,President �QF Sy Town Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Y John M.Bredeme III er k � � Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 oI��DUNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 13, 2020 Patricia C. Moore, Esq. 51020'Main Road Southold, NY 11971 RE: 'DAVID°HERMER & SILVIA CAMPO 3675 NASSAU POINT ROAD, CUTCHOGUE SCTM# 1000-111-9-4.2 Dear Ms. Moore: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, February 12, 2020: WHEREAS, Patricia C. Moore, Esq., on behalf of DAVID HERMER & SILVIA CAMPO applied to the Southold Town Trustees for an Amendment to Wetland Permit#9406 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated December 20, 2019, and WHEREAS, said application was referred to the Southold Town Conservatio'n 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 was found to be Exempt from the Local Waterfront Revitalization Program policy standards, 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, 2 RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Wetland Permit#9406 to remove and replace in-place the existing northerly wood retaining wall with a 27 linear foot long concrete retaining wall; and as depicted on the site plan prepared by Shawn F. Leonard, Architect, last dated December 12, 2019, and stamped approved on February 12, 2020. 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: None This is not a determination from any other agency. Sin rely, el4ennods i Board of Trustees GG:dd N W E S N I �c,'fA+RpG I �NEG18 PDRDORET A+ ERTEE LRE GT p NO vJAyy �2� ) _Y R ► Np RO� 3I r oep5ED "INK ..- H NI4ADE -r10` + 5•F' �.F.) I D13 1 � 1` 1 JTA1R �X2�-� R -_ OLD a FR01� Iq P-eL' A-f ED }0' wt)F N I r K I/`a/ ypG NI p�F SETS LUFF TO 6E RE ,/A.-7'/1 9.5' �AN�R 1�OP pF 8 Y // 9►5 yhDE 1T• I \—+ SED � � o z\ w 5.0 I JG�1 �L J II/2 FI'pRYvJE�EN(,INEER �' °O �w q4.6 N n 9 PIEATF� M► A G PcR �IyyAGE O b� (P TSE•A N'NG � ' 1'f IN o PROE . / STAININGA J A0 +/ �' Q 0 +` +I/2q/+� EDpFNGE EXIST W11 TI OPRSENrnSRA3 I 40T-4 X RET CLOO 7- O -)60 A LL 49-41 /O/ m Z 1 -0/ -{ 0 O ISO r OFzA�N� N /�/ _ O �/ 11.4, /' D 'y- Z- ` 1 7.0' rn Z � G• BypG p,y� / /' � �� � v� / / �3� A6•�' I o PRppST'� o / ' j (�� QJ d � Z 1 W Rpp. GONE // / 4J 5 0 2 SDI PptJD`�GAP011A / AEJ E pIT `/ /I c Ip 31 O, 2�� STS. g.0 51F'm l /Z/ C NSE• puT Y O 10� (✓� � �\J� / /' ' / r� GFsa71 PART AND F OuR �'' O Z A 1` N / 6R0 .sa•e, FLINT / -I i s / F F c' P 0' / •C� sT EP / / tv F p ON) 6 C / // / 5•F• IT+ LE 1 ADD yA6pp I A A' 104.2 / ' AA.�1 / �ZOF'rn W I102 o Q - 68.4 T Q❑ / /I �Lu� _ S- I O �l'S Q CA fop's �( /s; / T � � Pto �� s I ' m n. i LLi V-1 W I ' A�•2 / __ G / p IST EDRi N LANDSCAPELIEY — aL�yGE 2 6 N V .► FE F ►�/ ���G -" 100 SEF BANK r� _ � � �' ' / LANDSGP' T� 4J/ / • I C ���G��� OCG� —� // ' a/y _ '/ P � AGE EXISTING LOT C—OVERAGE �y /' .�-� APPROVED BY AREA UPLAND OF TOP OF BLUFF: 311078 S.F. _ '� // // �� �' �6OBOARD OF IRUSTEES TOWN OF SOUTHOLD EXISTING HOUSE * DECKS, PROPOSED ADDITION, -- DECKS 4 PERGOLA -- 4,815 S.F. N 4,815 S.F. / 31,078 S.F. x 100 - 15% AG° DATE �� t1 t 2, 2020 PROPOSED LOT' COVERAGE Np.N DEC 2 0 209 EXISTING = 4,815 S.F. PROPOSED PICKLEBALL CT. - 1,500 S.F. TOTAL - 6,315 S.F. DRAINAGE CALCULATIONS 6,315 S.F. / B1,078 S.F. x 100 = 20% NOTES: O MAIN HOUSE / SQUASH SITE PLAN FOR THE ROOF = 11607 S.F. HE-RM-EWCAMPO RESIDENCE SURVEY INFORI"IATION FROM SURVEY 11607 S.F. x 0.167 x 1.0 = 268 C.F./42.22 = 6.35 L.F. PREPARED BY PECONIC SURVEYORS, P.C. USE: (Q-8'(P x 8' DEEP LEACHING POOL SITUATE LAST DATED SEPTE:I"IBER 6, 2018 O f'(AIN HOUSE TOPO BASED ON APPROX. r ISL DATUM ROOF - 60q S.F. NASSA U POINT EXISTING CONTOUR ------------ 42' ------------ 60q S.F. x 0.167 x 1 .0 = 102 C.F./42.22 = 2.42 L.F. PROPOSED CONTOUR A2' USE: (I)-8'4P x 4' DEEP LEACHING POOL 70I�1N OF SOUTI--TOLD — SUFFOLK COUNTY, N .Y. EXISTING SPOT ELEVATION + 16.0' SCALE: I " INCH = 201 FEET PROPOSED SPOT ELEVATION 16.01 O ROOF / PARKING ROOF = 1,530 S.F. PREPARED: q/12/18 PARKING - 2,036 S.F. TAX MAP PREL-II"IINARY: I0/01 /18 = 3,566 S.F. DISTRICT 1000 3,566 S.F. x 0.167 x 1.0 = 5q6 C.F./42.22 - 21 .22 L.F. REVISED: 10/16/18 SECTION III USE: (3)-8'O x 8' DEEP LEACHING POOL REVISED: II/8/18 BLOCK Oq LOT 4.2 D PICKLEBALL COURT ISSUED TO G.C. : 11/27/16 N�,,°� O1" E AREA: 40,g33 SQ.FT. 30 x50 = 1500 S.F. x 0.167 x 1 .0 = 251 C.F./22.34 = 11 .24 L.F. REVISED: (-O.g41I AC.) USE: (2)-G'($> x G' DEEP LEACHING POOL 0I/10/iq 60 O 1/26/1 q O DRIVEWAY - 02/5/I q � 02/7/I q ,, '�s GRAPHIC SCALE I -20 0 SHAWN LEONARD, A. I. DRI VEWAY = 2,q40 S.F. T T 2,q40 S.F. x 0.167 x 1 .0 = 4ql C.F./42.22 = 11.63 L.F. 04/8/1 q "-.-Ojp �.1 A R C H 1 T E C 1 USE: (I)-8'(P x 12' DEEP LEACHING POOL 12/12/lq . r 320 Hampton Road, Southampton N.Y. 11968 20 O 20 40 60 (631) 287-5557 Fax (631) 287-5558 2019/12/1210:28:21 r" Glenn Goldsmith, Pre; � OHOVFFO(41CSG� Town Hall Annex Michael J. Domino,Vice-President ,� y� 54375 Route 25 John M. Bredemeyer III � a P.O.Box 1179 A.Nicholas Krupski Southold,.NY 11971 Greg Williams p! , Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: a ' Completed in field by: i Patricia Moore, Esq. on behalf of DAVID HERMER & SILVIA CAMPO requests an Amendment to Wetland Permit #9406 to remove and replace in-place the existing northerly wood retaining wall with a 27 linear foot long concrete retaining wall. Located: 111-9-4.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback WaiverRequired 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet = 3 Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 y Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: `� J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other OFFICE LOCATION: ®��® ®� MAILING ADDRESS: Town Hall Annex ''_ _ ® 'P.O.Box 1179 54375 State Route 25 rz Mfr, Southold, NY 11971 P2, H- (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 _ " �� Telephone: 631765-1938 ® Fax: 631765-3136 COU ,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: February 7, 2020 Re: LWRP Coastal Consistency Review DAVID HERMER & SILVIA CAMPO SCTM# 1000-111-9-4 DAVID HERMER & SILVIA CAMPO requests an Amendment to Wetland.Permit#9406 to remove and replace in-place the existing northerly wood retaining wall with a 27 linear foot long concrete retaining wall. Located: 3675 Nassau Point Road, Cutchogue. SCTM# 1000-111-9-4 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "B" which states: B. Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site (inplace), including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without a permit and shoreline erosion control structures (including, but not limited to, groins, jetties, bulkheads, filled piers) located within Great Peconic Bay, Cutchogue Harbor, Little Peconic Bay, Hog Neck Bay, Noyack Bay, Southold Bay, Shelter Island Sound, Pipes Cove, Orient Harbor, Gardiners Bay, Long Island Sound, Fishers Island Sound and Block Island Sound (excluding all creeks); The action is not located within a CEHA. 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: Damon Hagan, Assistant Town Attorney Peter Young,Chairman o Town Hall,53095 Main Rd. Lauren Standish,Secretary d P.O.Box 1179 Southold,NY 11971 ����` Telephone(631)765-1889 J* Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 5, 2020 the following recommendation was made: DAVID HERMER & SILVIA CAMPO to Amend Wetland Permit#9615 for the existing wood retaining wall to be removed and replaced in-kind with concrete retaining wall 27 If. Located: 3675 Nassau Point Rd., Cutchogue. SCTM#111-9-4.2 The CAC did not make an inspection, therefore no recommendation was made. z,4 j `�,` 't- Town Ball Annex Michael J.Domino,President ��j�S�~ f/Q John M.Bredemeyer III,Vice-President "`� l4` 54375 Route 25 P.O.Box 1179 GIenn Goldsmith v C Southold,New Fork 11971 A.Nicholas Krupski ;~ Telephone(631)765-1892 Greg Williams 3�0�, �� Fax(631) 765-6641 Out BOA)£8,)ID ®1F TOWN TRUSTEES TOWN OF SOUTHOLD - ----- This Section For Office Use Only Coastal)Erosion Permit Application Wetland Permit Application g( Administrative Permit DEC 2 0 2019 Amendment/Transfer/Extens ion Received Application: _ Iz-z4•I9 Received Fee: $ 50.00 Completed Application: Incomplete: / SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination,Date: _ Coordination:(date sent): _ I,WRP Consistency As essment Form Sent: 1 31'20 CAC Referral Sent: ��ZZ•2o _ Date of Inspection: _�'S•�O Receipt of CAC Report: Technical Review: Public Hearing Held: 2.J2•ZD _ Resolution: _- Owner(s) Legal Name of Property (as shown on Deed): Mailing Address: ` C0/lec?e pk/m Phone Number: _L71711 Suffolk County Tax Map Number: 1000- `r Property Location: — J ' (If necessary,provide LILCO Pole#, distance to cross streets,and location) } AGENT(If applicable): Mailing Address: ` o atl&4-All X'�Iel Gd1, )-.19.f Phone Number: /6 j 1 7(, -- 43.E 6 Board of Trustees Application GE,NERAL DATA Land Area(in square feet): YO, 12) -'3 Area Zoning: /I Previous use of property: —-� Intended use of property: _ �,�%�,;/t lam;i;e-iLn'I L� / Covenants and Restrictions on property? Yes ^� _No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes ;X No -Nfa, ' gs °B 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 ?4 No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? )Yes Does the structure (s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency, Date ��`-�.�5 -�w �• ��'�� _rte. , �r�/� __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): yll5 VV" q i e�,Q� 64!/) rcm tywJ C Atp la,, r I i 0 - i!Y tAi L/onjr rek — '���� v'i 'a Board of Trustees Application WETLAND/TRUSTEE ILAINDS APPLICATION DATA Purpose of the proposed operations: ¢ ,:p u:-de_n Area of wetlands on lot: r/ square feet Percent coverage of lot: -611 Closest distance between nearest existing structure and upland edge of wetlands: feet �' Closest distance between nearest proposed structure and upland edge of wetlands:3�'/?, feet fin .f < f.� t Does the project involve excavation or falling? 'X No Yes If yes, how much material wil l be excavated?1,77W -,'v ,-a cubic yards How much material will be filled?/'i _.cubic yards Depth'of which material will be removed or deposited: 6-, feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 6-111, 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): 61Z20 Appendix B Short E'nvironmentralAssessment Form instrue9ions for+L'diarmictirlR Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part l based on information currently available. If additional research or investigation would be needed to Fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -1Project and Sponsor Information —_—^ -� Name of Action or Project: U:•C(� �l-�l�J??i'r^ sh"121 Project Location(describe,and attach'a location map): �tJ.75 f'/�:.aSc'�GZ p4e,c�_ l�orzG�, l���c�tc� Brief Description of Proposed Action- Name of Applicant of Sponsor- - — j Telephone:(� ) 65 '1 % C.'t7Ye.' sG Address: U T City/PO. —� State: Zip Code: 1 Does the proposed action only involve the legislative adoption of a plan, local law,ordinance, NO YES administrative rule,or mgulation9 [E]If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that l�may be affected in the municipality and proceed to Pail 2. If no,continue to question 2. — 2- Does the proposed acrron require a permit,approval or ftmding from any other governmental Agency? NO YES If Yes, list agency(s)name and permit or approval: 3.a Total acreage of the site of the proposed action? — —�_5_ ,___acres b.Total acreage to be physically disturbedol:7__acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor9 �_ acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agricultwe) ❑Industrial ❑Commercial ( Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): _______—____ ❑Parkland Page I of 4 S. Is the proposed action, N® YES N/A a A pei pitted use under the zoning iegulations? u F r-I I—I b Consistent with the adopted comprehensive plan? „ Lel ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? - 7 fs the site of the proposed action-located in,or does tt adjoin,a state listed Critical If Yes, identify;—_----- Environmental Area? NO _yLEJS the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or neat the site of the proposed action? g- ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? l 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies. 10. Will the proposed action connect to an existing public/pi ivate water supply? I NO YES If No,describe method for piovidmg potable water, I I Will the proposed action connect to existing wastewater utilities? [NO— YES If No,describe method for providing wastewater tieatm ent. — — --�1fj � ` 12 a.Does the site contain a structure that is listed on either the State of National Register of Historic NO YES Places? � ❑ �b. Is the proposed action located in an archeological sensitive area? 13 a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES 11 wetlands or other waterbodies regulated by a federal,state or local agency? ❑ M— b Would the proposed action physically alter,or encroach into,any existing wetland of waterbody? ,if Yes,identify the wetland or water body and extent of alterations in squaie feet or acres: 14 Identify the typical habitat types that occur on,or are likely to be found on the protect site Check all that apply. ErShorelme ❑Foi est ❑Agi icultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Subui ban 15. Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal govei nment as threatened or endangered? ' 16 Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, _ j a Will storm water discharges flow to adjacent properties? ®NO ❑YES aC a b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ( If Yes,briefly describe: ®NO YES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size- ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed X10 YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? IfYes,describe: _ -_-_-______-_ - ___-_._ ___-- __ _ ❑ I APP'VIE$M THAT THE JIN F®RMAT ION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsornam_�- Ear°cam _� r��Cr Date. Signature. Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" --- ------ _�__- ------- __ � No,oa• Moderate i ¢ small to laarge impact impact f may may i occult occur i t Will the proposed action create a material conflict with an adopted land use plan or zoning f F] i regulations? F] _— 12. Will the proposed action iesult in a change in the use or intensity of use of land? - — ❑ 3. Will the proposed action impair the character of quality of the existing community? 4 Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect eXlstin g infrastructure for nmss transit,biking or walkway? 6. Will the proposed action cause an increase in the use of encrgy and it fails to incorporate ~ ❑ reasonably available energy conservation or renewable energy opportunities? 7 Will the proposed action impact existing ❑ a. public/private water supplies? _ b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? t 9. Will the proposed action result in an adverse change to natural resources(e g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or I Model arc snnali to !alga impact i 1111pact may I may, occur occur- 10. W111 the proposed action result in an increase!n the potential for erosion,flooding or drainage Q problems? I I Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur";or if there is a need to explain why a particular element of the proposed action may or will not result lit a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that thermpact may or will not be significant Each potential Impact should be assessed considering Its setting,probability Ofocctliling, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts Check this box d'you have determined,based on the information and analysis above,and any suppolting docifinenta-I On,1 that the proposed action may result in one or more potentially large of significant adverse impacts and an l environntenta(impact statement is required F1Check this box if you have determined,based on the information and analysis above,and any suppoltrng documentation, that the proposed action will not result in any significant adverse environmental Impacts. Town of Southold-Board of Trustees Name of Lead Agency-� -J— - - — - -- -- -Date <'e ( r �rD j President Print or Type Name f Respoonsible Of cerin Lead Agency Title of Responsible Officer Signahue o Responslbl f icer in Lead A_—ency Signature of Preparer(!t different fiont Responsible Officer) �RPNT Page 4 of 4 Board of Trustees Application County of Suffolk State of New York DAVID IHIlERMIER& SILVIA CAMPO,BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. 11, y •'•r "I _� David Hermer �ia-C—arnpa Sworn to before me this day of 39 , 2019 i 'ary blic JAIME C. PIRA®® Nzftnj Public,State o4 New No.®9716073762 GuagiPed in Richmond Countg Commission moires April 29,202, Bard ®f Trustees Application AUTHORIZATION (where the appdiicant is not the owner) DAVID HERMER and SILVIA CAMP®, as owner of premises 3675 Nassau Point Road, Cutchogue, NY(sctm: 1000-111-9-4.2-4-16.4) residing at 9 College Point Road, Brooklyn, New York 11201 do hereby authorize our attorney, Patricia C. Moore, to apply for permit(s) and appear before the Southold Board of Town Trustees on my behalf. (owner's signature) SILVIA CAMP® .- Bir , owner s signature) ( g ) DAVID HERMER APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) 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. HERMER, DAVID&CAMPO,SILVIA AND MOORE,PATRICIA C (Last name,first name,middle initial,unless you are applying in the name of someone else of other entity,such as a company. If so,indicate the other person or company name) NATURE OF APPLICATION (Check all that apply) Tax Grievance Variance Special Exception If"Other", name the activity- Change of Zone Approval of Plat Exemption from Plat of Official Map Other Trustees X Do you personally,(or through your company,spouse,sibling,parent, or child)have a relationship with any officer or employee of the Town of Southo1d9 "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 piraal ownership of(or employinent by) a corporation in which the Town officer or employee owns more than 5%of the shares YES NO X Complete the balance of this fbin and date and sign below where indicated. Nan-ie of person employed by the Town of Southold. Title of position of that person Describe that relationship between yourself(the applicant) and the Town officer or employee. Either check the appropriate line A through D(below)and/or describe the relationship in the space provided The Town officer or employee of his or her spouse,sibling,parent,or child is(check all that apply). A)the owner of greater than 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation), B)the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); Cl'a:n Officer,di.,.ctcr,p-MI-er,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of e/U�!/��/ i �� Signature-} ( �f DAVID HERMER SILVIA CAMPf atrieia C.Moore BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF HERMER/ CAMPO MAILING Applicant's Land Identified as 1000-111-9-4.2 ---------------------------------------------------------------x COUNTY OF SUFFOLK) STATE OF NEW YORK) I, JULIA SPANBURGH, residing at Riverhead, New York, being duly sworn, depose and say that: On the 31St Day of January, 2020 deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the persons listed on the attached list at the addresses set below their respective names; that the addresses set below the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said notices were mailed at the United States Post Office at Southold, New York, that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Attached hereto is the white receipt post-marked by the Southold Post Office on said date. a LIA SPANBURG Sworn to before me this d a of J'�/%,7-,� Oo 0 2,0 (N ary Public) MARGARET C RUTKOWSKI NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 RU4982528 Qualified in Suffolk County a �� My Commission Expires June 3, U.S. Postal',Servic-6 fU Domestic M4 ii Only Er N7ExtraServices , L ('� } t 1 All t-1 1 - '� Certified Mail Fee JJ C t ad Fes $ T/ EXtra Services&Fees(check box,add fee as appropriate) &Fees(check box,addfeeesappropdte) ,.-j ❑Retum Receipt(hardcopy) $ Receipt(hardcopy) $ Return Recei t electronic /;/\ ,61 O ❑Return Receipt(electronic) $ y..T��" , I� ❑ p( ) $ / {T•� 1RlarkA � ❑Certified Mall Restricted Delivery $ ! - '�dark\\� ' p ❑Certified Mall Restricted Delivery $ /, He ♦" I O ❑Adult Signature Required $— ��, He r•,L� O ❑Adult Signature Required $ / �, ❑Adult Signature Restricted Delivery$ /t. i []Adult Signature Restricted Delivery$ i '� a C3 ---T ` 9 7 1+ 1 p Postage JAA,l31 2app ifl O Postage, — - — Jw�.3 i0�n Ir l M t m i `O 179Michael&Jean Maher � ,_, Jamie and Nancy Santiago r- PO Box 7560 --- ) r 3745 Nassau Point Road ---------------- Garden City,NY 11530 1 Cutchogue,NY 11935 lung= — TM ■ • 0 I U&Postal Service DopnlyI+I ■TIFIED d D ■ e Er bomeStic mail oniyrr PM Certdted Mad Fee $ Extra Services&Fees(check box,add fee as appropnate) , i Certified Mad Return Receipt(hadcopy) $ -%a 7 r-q �Os[rad M [:]Return Receipt(electronic) $ = $ Pe �2 I O ❑Certified Mail Restricted Delivery $ ere `�_ Extra SeN1ceS& ees(checkbox,add fee as appropriate) oy O []Adult Signature Required $ / r_ ! � ❑Return Receipt(hardcopy) $ []Adult Signature Restricted Delivery$ ���/Al� t�� Return Receipt(electronic) $ ystm�rk � F^+ �r VV , //�� r3 []Certified Mall Restricted Delivery $ °^r, Here �, Postage �j�0/�'T' p ❑Adult Signature Required $ •' / 0 []Adult Signature ResWctedDelNery$ M Postage � 0 .� CO Youngman '- o Michael&Arlene Youn g -................ ------_ -- M ' 201 E 17d` Street Apt 29H 10007 I-----'---�--"'-,-° � ; t New York,NYea ' Timothy Radin&Julie Aronowitz-Radin E3 : 190 E 72nd Street Apt 6C ° t New York,NY 10021 :---------------- f BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF SIGN HERMER/CAMPO POSTING Regarding Posting of Sign Upon Applicants Land Identified as 1000-111-9-4.2 ---------------------------------------------------------------x COUNTY OF SUFFOLK) STATE OF NEW YORK) I, BETSY PERKINS residing at Mattituck, New York being duly sworn, depose and say that: On the 4th day of FEBRUARY, 2020, 1 personally posted the property known as 3675 NASSAU POINT ROAD, CUTCHOGUE NEW YORK by placing the board of Trustees official Poster where it can easily be seen, and that I have checked to be sure the post has remained in place for eight (8) days prior to the date of the public hearing. Date of Hearing to be held on Wednesday, FEBRUARY 12, 2020. f Betsy Perkin Sworn to before me this day ofFEB° , 20'aO Not ry Public MARGARET C RUTKOWSKI NOTARY PUBLIC,STATE OF NEW YORK Registration No.01RU4982528 Qualified in Suffolk County My Commission Expires Juno 3,_a �` 3 I • • I ■ Complete items'1,2,and 3. ■ Print your name and address on the reverse A. Srature so that we can return the card to you. X y ❑Agent ■ Attach this card to the back of the mailpiece, ❑Addressee or on the front if space permits. B Rece�d by(Printed Name C. Date of Delivery 1• Article Addressed to: D. Is delivery address different from item 17 ❑Yes If YES,enter delivery address below. ❑No Timothy &Julie Radin 190 E 72nd Street Apt 6C New York,NY 10021 II��I�I�I 3. Service Type CI ❑Adult Signature 1:1Priority Mall Express® IN III 1111111110111111111111111111 ❑Adult Signature Restricted Delivery 11Registered MaiITM 9590 9402 5397 9189 4392 18 ❑Certified Mall@ �' ❑Registered Mail Restricted ❑Certified Mail RestrictedDelivery 2. Article Number ❑Collect on Delivery Delivery ❑Return Receipt for Merchandise i i lsfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation*~+ El Insured Mall ❑Signature Confirmation i ❑Insured Mall Restricted Delivery (over$500) Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 -- ---- _-_ Domestic Return Receipt 4 • ® COIKPLETE THIS SECTION• 0 W,u ■ Complete items 1,2,and 3. A. SI tura ■ Print your name and address on the reverse X Agent so that we can return the card to you. ❑Addressee pe}c ■ Attach this card to the back of the mailpiece, B• eceived b (Printed Name) C. Date of Delivery or on the front if space permits. ® 1. Article Addressed to: D. Is delivery address different from item 1? n❑Yes If YES,enter delivery address below: t �"- Jamie and Nancy Santiago 3,74-5c Nassau Poitit Road Cutchogue,NY,1193 5 3.II SII II IIII III I III I I Illill I II II I II I II III Service Type ❑Priority Mall Exp—G) ❑Adult Signature ❑Registered MaiITM' Ni ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted as ❑Certified Mail@ Delivery 9590 9402 5283 9154 8598 41 ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label E]Collact on Delivery Restricted Delivery ❑Signature Confirmation'" E3 Mail ❑Signature Confirmation 1 ❑Insured Mail Restricted Delivery Restricted Delivery (over$500) i i! PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt NUTILk: Uim HLARING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD : DAVID H E RM E R & SI LVIA CAM PO SUBJECT OF PUBLIC HEARING : For an Amendment to Wetland Permit #9406 to remove and replace in-place the existing northerly wood retaining wall with a 27 linear foot long concrete retaining wall. Located : 3675 Nassau Point Road, Cutchogue. SCTM# 1000-111 -9-4.2 TIME & DATE OF PUBLIC HEARING : Wednesday, February 12, 2020 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 I \i Town of Southold LWII1;1P CONSISTENCY ASSESSIMNT(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 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 pzoposed action will be evaluated as to its simuficant beneficial and adverse effects upon the coastal area(which includes all of Southold,rovai). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer anuust be ex[pNined ha dett:aaQ, lusting both soupportuig, and Flon- supporting 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: 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 SCTMN «i PROJECTNAME i r The Appdneatnon has been submitted to(check appropriate response): Town Board ❑ Manning Board❑ Building Dept. ❑ Board of Trustees ustees 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: 6 4 Location of action: 3L>7D K1,jA- I6eULeA// I �5 Site acreage:__ Present land use: c��ff t: f �,•, crv�C � / � �ftt. 6i� Gl f Present zoning classification: 7` 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: 1-'2cu,'1f (b) Mailing address: cj' Calleg r /tic e Ar/ '/D BtDn;cla/l /1/y (c) Telephone number: Area Code( } q'17 1-170 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No L/�/NJ If yes, which state or federal agency? Ce IEvOnuate the Project to the following policies by analyzing how the project awiRl further support or not support the policies. Provide all proposed Best Management Practices that awn➢0 further each policy. Incomplete answers swn➢➢ require that the form the returned for completion. D1L'VE11,0PED)COAST PQfJC1' Policy 1. Foster a pattern of devellopment in the Town of Southold that enhances community character, preserves open space, Makes effffncieunt use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of devellopmente See LWU Section III—PoRicies9 ]Page 2 for edallmtion criteria. ❑ Yes No ❑ Not ApplicabRe r S F�vr� Z, 22&!� �e �z,,,(5 Le, Attach additional sheets if necessary PoRicy 20 Protect and preserve historic and ar°chaeologicad resources of the Town of Southold. See LWRP Section III—Pollicies Pages 3 through 6 for edalluatnon criteria ❑ Yes ❑ No M Not Alplpducabile Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold, See 1LWRP Section III—policies Leges 6 through 7 for evaluation tion ctrittetriz F-1 Yes ❑ leo Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize Ross of life, stt>ranettuures9 and natural resources from flooding and erosion. See lLWRP Section Bffh—Policies ]gages 8 through 16 for evaluation criteria ❑ Yes ❑' No W Not Applicable Attach additional sheets if necessary Polliey 5, ]Protech and impro-ve water quahtty and supply nn the Town off.SoauthoRd. See]LWRP Section III —]policies ]gages 16 through 21 for evaluation criteria ❑ Yes ❑ No �'' Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the ganaiitty and function of the Town of Southold ecosystems including Significant Coastal Fish and WiRdRiffe Habitats and wetlands. See ILV 1W Section HI—FoRldes9 Pages 22 through 32 fur evaluation criteria. ❑ ❑ n Yes No Not Applicable Attach additional sheets if necessary — Policy 7. Protect and improve air quality in the Towyn of Southold. See ILW]fBIP Section III[ — Po➢icics Pages 32 through 34 for evaluation criteria. Yes ❑ No® Not Applicable Attach additional sheets if necessary (Policy 8, Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See ILVVRF Section III—IPo9icics9 Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No 1� Not Applicable PUBLIC COAST POLICIES CI(IES Policy 9, Provide for public access 2o, and recreational use of, coastal waters, public panel's, and pubk resources of the Town of Southold. See It WRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Y¢�] NOE] Not Applicable Attach additional sheets if necessary WORKING COAST POLICES Poky 10. Protect Southold's water-dependent uses and Promote sAting of new water-dependent Lases in suitable locations. See ILWIIBP Section III—Poncies9 Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living Marine resources in Long Island Sound, the Peconic Estuary and Town waters. See;i,WRP Section III I—Popicies9 Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No W Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of SouthoM. See ILWRP Section III— Policies; Pages 62 tlbrou gh 65 for evaluation criteria. ❑ Yes ❑ No® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energY and nnnnerap resources. See LWRP Sectuon III—]Policies; Pages 65 through 68 for evaluation criteria. ❑ Wes ❑ No L'-\j Not Apnp Ricalbpe ]PREPARED BUY " � �''('II'LE, ,,L � DATE/ � ) Michael J. Domino, President `ropsuFFo(,��oG Town Hall Annex John M. Bredemeyer, III, Vice-President ` oma y� 54375 Route 25 Glenn Goldsmith i N ,? " P.O. Box 1179 A Nicholas Krupski y� • �o �� Southold, NY 11971 Greg Williams of , �. Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction constructed When project complete, call for compliance inspection; ' BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO.9406 DATE: MARCH 20,2019 " ISSUED TO: DAVID HERMER&SILVIA CAMPO PROPERTY ADDRESS: 3675 NASSAU POINT ROAD,CUTCHOGUE SCTM#1000-111-9-4.2 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 March 20,2019,and in consideration of application fee in the sum of$250.00 paid by PayW Hermer & Silvia Campo and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and s. permits the following: Irw Wetland Permit for the existing 3,519sq.ft.dwelling that includes an as-built 1,400sq.ft.landward addition;existing 913 sq.ft.wood deck along the sides and seaward side of dwelling with 78sq.ft.of stairs to ground;existing second- story addition over existing first floor; existing 5.6' diameter fire pit seaward of dwelling; existing 27.1'and 31' landscaping retaining walls;existing A/C units,generator and concrete slabs; propose to resurface existing 913sq.ft. decking; lower existing 8'x8' hot tub into ground 18"in-place to make even with deck; relocate existing 54sq.ft. wood steps from deck to ground on northeast side of dwelling landward of existing location,new steps being 4'x14' and facing front yard; proposed 81x161 pergola on top of existing deck on seaward side; install drywells to contain roof runoff for parking area and pickle ball court,and in accordance to Chapter 236 of the Town Code-Stormwater Management;on south side of dwelling existing 10'x10' covered entrance and existing landscape retaining walls running landward consisting of 15'x78'x15'x10 linear feet,then running south 75'to covered entrance,and retaining walls connecting to additional landscape retaining walls beyond 100'from bluff; on landward side of dwelling, ry existing gravel parking area and 30 linear feet of retaining walls connecting to additional 1001 linear of feet retaining walls; existing sanitary system to remain,retaining walls,relocated driveway,walkways,landscaping,regrading ±600 cubic yards clean fill,and 1,500sq.ft.pickle ball court all landward of 100' from top of bluff; install buried propane tank and relocate generator and generator slab from north side of dwelling to landward of addition; for the existing 100.48 linear foot long wooden bulkhead; replace existing low-landscape lighting fixtures and additional low landscape lighting fixtures to trees,flag pole and to of bluff,and to install and perpetually maintain a 101 wide non- turf buffer along the landward edge of the top of bluff;with the condition that all lighting has to be dark sky �''' compliant; and as depicted on the site plan prepared by Shawn Leonard,AIA,dated February 15,2019,and r. stamped approved on March 20,2019. 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 the 20'h day of March,2019. t" Avn 3 U coo 4- TERMS AND CONDITIGi.6 The Permittee David Hermer& Silvia Campo residing at 3675 Nassau Point Road, Cutchoguue, 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 for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. 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. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee 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 permit. Michael J.Domino,President �'�XOF SO[/T�o Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0' 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 GregWilliams Fax(631) 765-6641 Fax iN BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 20, 2019 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: DAVID HERMER & SILVIA CAMPO 3675 NASSAU POINT ROAD, CUTCHOGUE SCTM# 1000-111-9-4.2 Dear Mrs. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 20, 2019 regarding the above matter: WHEREAS, Patricia C. Moore, Esq., on behalf of DAVID HERMER & SILVIA CAMPO 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 October 1, 2018, 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 recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the distance from the structure to the top of the bluff was established; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application March 20, 2019, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the structure complies with the 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, - and, RESOLVED, that,the Board of Trustees APPROVE the application, of DAVID HERMER & SILVIA CAMPO for the existing 3,519sq.ft. dwelling that includes an as-built 1,400sq.ft. landward addition; existing 913 sq.ft. wood deck along the sides and seaward side of dwelling with 78sq.ft. of stairs to ground; existing second-story addition over existing first floor; existing 5.6' diameter fire pit seaward of dwelling; existing 27.1' and 31' landscaping retaining walls; existing A/C units, generator and concrete slabs; propose to resurface existing 913sq.ft. decking; lower existing 8'x8' hot tub into ground 18" in-place to make even with deck; relocate existing 54sq.ft. wood steps from deck to ground on northeast side of dwelling landward of existing location, new steps being 4'x14' and facing front yard; proposed 8'x16' pergola on top of existing deck on seaward side; install drywells to contain roof runoff for parking area and pickle ball court, and in accordance to Chapter 236 of the Town Code-Stormwater Management; on south side of dwelling existing 10'x10' covered entrance and existing landscape retaining walls running landward consisting of 15'x78'x15'x10 linear feet, then running south 75'to covered entrance, and retaining walls connecting to additional landscape retaining walls beyond 100' from bluff; on landward side of dwelling, existing gravel parking area and 30 linear feet of retaining walls connecting to additional 100' linear of feet retaining walls; existing sanitary system to remain, retaining walls, relocated driveway, walkways, landscaping, regrading ±600 cubic yards clean fill, and 1,500sq.ft. pickle ball court all landward of 100' from top of bluff; install buried propane tank and relocate generator and generator slab from north side of dwelling to landward of addition; for the existing 100.48 linear foot long wooden bulkhead; replace existing low-landscape lighting fixtures and additional low landscape lighting fixtures to trees, flag pole and top of bluff; and to install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the top of bluff; with the condition that all lighting has to be dark sky compliant; and as depicted on the site plan prepared by Shawn Leonard, AIA, dated February 15, 2019, and stamped approved on March 20, 2019. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection: (See attached schedule.) Fees: $50.00 Very truly yours, d Michael J. Domino President, Board of Trustees MJD/dd 4 of 04 Michael J. Domino, President �o� oGy� Town Hall Annex John M. Bredemeyer, III, Vice-Presidenty 54375 Route 25 Glenn Goldsmith P;O. Box 1179 A Nicholas Krupski 4w,' ao�;{' Southold, NY 11971 Greg Williams Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD gyp ® ,TO: DAVID HERMER & SILVIA CAMPO c/o PATRICIA MOORE, ESQ. Please be advised that your application dated October 1, 2018 has been reviewed by this Board at the regular meeting of March 20, 2019 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) — (Silt boom) 1St Day of Construction ($50.00) % Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) xx The Permittee is required to provide evidence that the non-turf buffer condition of the 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. 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- J41J . , , ,,t,Z.tq • TOTAL FEES DUE: $ 50.00 BY Michael J. Domino, President Board of Trustees N W E S z = oPoSE � rn 3 goA r 11/2q/1SpR WEL ENGINEER d _ DEN >3 OS PROPEp QTR -AGE Ep �"� 4APROP I n O� IFOR q 561 c-�.F.) IR IEX15� NS RFAGFp q13 5' I a �LY FR (5-r A, 5fA F3E REQ 78 /1a EX1�GATEp Y NOV �5Tp1R5 ►+�� 3 a WIDE v Nip/F �TOOF' OF 8 -rO 0E REpRAGON LAD a:-7'i .r 9.5' N S /�� 1/ g.5 3. ' n 5.0' I �A 0 /E`/ERGREE ( Z V w l WDE 5.0' I 5 0091,48EAT-1 05 ' A-7-C' � 7- 9 1 f1E 0 M o O a STEP 1 �./FafJ�i FASTIGLIA 8 4q 6 O �( (j p1,ATF VL M 10.0 BETA m 1 TAWiN6 gxIST. WCO� +' EV EEENEXSISTING , � 3 t ' -'0 O V-1000 r'16 � < Q VIA -G 9- 49.4 O ISOt 1 0y -1� 0 � rnl ® PARj O� ➢ 1` PROPSTY 'c:' IGIA-rING © 0 m 5 0 2 pDtTION I//CII/ C L L 11 6 A // -r / 03 W EYP) pL Q C} TW a yTEPg 0 6. 1 STY. 8.0' FIR PI 1 M C 1 A Z pE WAIL a 31.0' 2/2 N5E• UT LANpSGP 3 i 22' N / GF a 617 3' FR• yaA1-KO Z 11 P< RTIP - FLOOR O OypS � . / D N� c.�I 70 GROFNFNI F-2OOT CIO LANDSCAPE LIGHTING S.F DIT 10 �/ 102. � 4S, w �3'E INC• AD 0 � / 61 (30) UPLIGH-rS Q Z AQ 1 ATEA 68'4' '2 P g )e /' 3 � RE pRA_�pR ED UNIT AGPOI-E 1���1 F I,IGI"1TING � Z (8) BLUFF LIGHTS O I �� O r_N�RANGE N — ,�'" (I) FLAGPOLE LIGHT � So 9 / m �vURIE� � 45 / / 1 � O ��� � OOt (15) WALL LIGHTS IPJ O P oPANE TANK �,�al / C S o w C� 1/ �� • � (12) STEP LIGHT 0 N-r"NG U / I O / 44.5' � 2• I Q in G5O' FASTIGLIA 1-IORNSEAI'I O Q gTEF'TYP)TIN N O Q ��ANpgGAPE WALL 8 UTI LI� ( AI-NrlE 2 r-1'N `{ 3 pLAN7ING5 O COPPER BEACr-I Q 6� 4a,�, -_ / �aE�p/`' 1OOH OF gAr1K _— \T%\".0 TOP EXISTING LOT COVERAGE -�'' °��F��G APPROVED BY AREA UPLAND OF TOP OF BLUFF: 311078 S.F. _.,�� It V4 BOARD OF IRUSTEES z � 5�a 3 p�F TOWN OF SOUTHOLD EXISTING HOUSE 4 DECKS, PROPOSED ADDITION, ,� DECKS t PERGOLA - 4,815 S.F. N 4,815 S.F. / 31,078 S.F. x 100 - 15% �ANT�AG DATE y kzc.y- Zo, 2olq PROPOSED LOT COVERAGE NAND �� EXISTING = 4,815 S.F. PROPOSED PIGKLEBALL CT. - 1,500 S.F. TOTAL - 6,315 S.F. DRAINAGE CALCULATIONS 6,315 S.F. / 31,078 S.F. x 100 = 20% NOTES: O C"IAIN HOUSE / SQUASH LANDSCAPE t LIGHTING PLAN FOR THE: SURVEY INFOP-r-lATION FRO" SURVE r ROOF = 1,G07 S.F. HERMER/CAMPO RESIDENCE PREPARED BY PECONIC SURVEYORS, P.G. 1,607 S.F. x O.IG7 x 1.0 = 268 C.F./42.22 = 6.35 L.F. LAST DATED SEPTET-IBER G, 2018 USE: (I)-8'(P x 8' DEEP LEACHING POOL SITUATE TOPO BASED ON APPROX. 1"ISL DATUI"i O r IAIN HOUSE MASQ SA U POINT EXISTING CONTOUR ------------ 42' ------------ ROOF - GOq S.F. PROPOSED CONTOUR 42' 60q S.F. x 0.167 x 1.0 = 102 C.F./42.22 = 2.42 L.F. EXISTING SPOT ELEVATION USE: �1)-8'cp x 4' DEEP LEACHING POOL +16 0' TOWfJ OF SOUTI--{OLD — SUFFOLK COUNTY, N .Y . PROPOSED SPOT ELEVATION 16'0' C ROOF / PARKING — SCALE: IINCH = 20' FEET O ROOF = 1,530 S.F. PREPARED: q/12/IS TAX I"IAP PARKING - 2,036 S.F. I"IG f,` f✓ g. 3,566 S.F. PRELIINARY: 10/01/18 REVISED: 10/IG/18 DISTRICT 1000 3,5GG S.F. x 0.167 x 1 .0 - 5qG G.F./42.22 - 21 .22 L.F. SECTION III USE: x 8' DEEP LEACHING POOL REVISED: II/8/IS BLOCK Oq f I D PIGKLEBALL COURT LOT 4.2 ISSUED TO G.C. : 11 /27/18 _ .,-- _.... .. AREA: 40,833 SQ.FT. 30'x50' = 1500 S.F. x 0.167 x 1.0 = 251 C.F./22.34 = 11.24 L.F. REVISED : (0.g411 AG.) USE: (2)-G'(P x 6' DEEP LEACHING POOL OI/15/iq ' O DRIVEWA'r 02/15/1q 'ty SHAWN LEONARD A. I. A. ,. DRIVEWAY = 2,840 S.F. GRAPHIC SCALE: i"=20' A T T ,,, 2,840 S.F. x 0.I67 x 1 .0 4ql G.F./42.22 = II .63 L.F. K 1 1 a USE: (I)-8' x 12' DEEP LEACHING POOL � r�R ZQ� 320 Hampton Road, Southampton N.Y. 11968 20 0 20 40 60 , c i T^svn (631) 287-5557 Fax (631) 287-5558 -^- 2019/02/28 10:4a 32 suFFoc� Michael J. Domino, Presi' ' �Q �'� Town Hall Annex John M. Bredemeyer III,Vice4bubTuent ��� ��� 54375 Route,25 Glenn Goldsmith o P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams ' 6X_ Telephone(631)765-1892 ��1 �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Tirrie: 3 d- Completed in field by: Patricia Moore, Esq on behalf of DAVID HERMER&SILVIA CAMPO requests a Wetland Permit for the existing 3,519sq.ft. dwelling that includes an as-built 1,400sq.ft landward addition; existing 913 sq.ft.wood deck along the sides and seaward side of dwelling with 78sq.ft of stairs to ground, existing second-story addition over existing first floor; existing 5.6' diameter fire pit seaward of dwelling; existing 27 V and 31' landscaping retaining walls; existing A/C units, generator and concrete slabs; propose to resurface existing 913sq.ft. decking; lower existing 8'x8' hot tub into ground 18"in-place to make even with deck, relocate existing 54sq ft.wood steps from deck to ground on northeast side of dwelling landward of existing location, new steps being 4'x14' and facing front yard; proposed 8'x16' pergola on top of existing deck on seaward side, install drywells to contain roof runoff for parking area and pickle ball court, and in accordance to Chapter 236 of the Town Code-Stormwater Management,on south side of dwelling existing 10'x10' covered entrance and existing landscape retaining walls running landward consisting of 15'x78'x15'x10 linear feet,then running south 75'to covered entrance, and retaining walls connecting to additional landscape retaining walls beyond 100'from bluff;on landward side of dwelling, existing gravel parking area and 30 linear feet of retaining walls connecting to additional 100' linear of feet retaining walls; existing sanitary system to remain, retaining walls, relocated driveway,walkways, landscaping, regrading±600 cubic yards clean fill, and 1,500sq.ft. pickle ball court all landward of 100'from top of bluff; install buried propane tank and relocate generator and generator slab from north side of dwelling to landward of addition;for the existing 100.48 linear foot long wooden bulkhead, replace existing low- landscape lighting fixtures and additional low landscape lighting fixtures to trees,flag pole and top of bluff, and to install and perpetually maintain a 10'wide non-turf buffer along the landward edge of the top of bluff. Located:3675 Nassau Point Road, Cutchogue. SCTM# 1000-111-9-4.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet - 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice/of Hearing Card Posted: Y / N Ch. 275 V Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 411 m4 U@ ddl, 51zw Caebaj� l 8'G�rn lQ Sl �K, �4J l(�I�cv�i 04 5.041 -Idy6 A 0- I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: V J. Bredemeyer V M. Domino G. Goldsmith `� N. Krupski G. Williams Other �• � � � yj ' (-��• .r(r s� }� /yh Y '„ ,/ '' ,,A t{, / �l ,f✓`A(+ Vit' ,d•��� ,`\•„_. �` ' , ei �';t �,�i ,. i' Dom/ '”% �i � i�!J. jw .3 •., ^ .. r s�l J ,�. ,, R` a Jt /�yJ„ .rr, ;i . ',y . 7.1 .t ik. Y � •�, �/ ,a•, t� .?�• •SIJ ..� �µ1 �' Jarr,,�� r �. `+ � � 9�4+!'Jyy�,�, '1�� .�,` c ,' ! ��' ,♦ try�.,'' . s Cdr, r t�;-, _ �:• tit � . i -.i. ,'\ 1, r - {' ♦��, i' F �`' v {- � � _ ,y, •.,1 + ., , '.'.• tf ;j��• �'�,0� A �t� � .'fat`. .�"4 /r t�� - •� ti;tt,�4i'. ?' �..:r -'' ':'�;: ♦tT"_r4_ - �-�;/1q Y - .t.Z n.���� ..�'3,W �'' '+ `'.t�`:�:�-.-"- 4 .4`y,.,Y�`'rr>e. 'YY'� iy ,x..-„. 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OFFICE LOCATION: ®��® ® MAILING ADDRESS: Town Hall Annex - - ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) elm Southold, NY 11971 P Tele hone: 631765-1938 � '�� �&"' �® LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: March 8, 2019 Re: LWRP Coastal Consistency Review for DAVID HERMER & SILVIA CAMPO SCTM# 1000-111-9-4.2 Patricia Moore, Esq. on behalf of DAVID HERMER & SILVIA CAMPO requests a Wetland Permit for the existing 3,519sq.ft. dwelling that includes an as-built 1,400sq.ft. landward addition; existing 913 sq.ft. wood deck along the sides and seaward side of dwelling with 78sq.ft. of stairs to ground; existing second-story addition over existing first floor; existing 5.6' diameter fire pit seaward of dwelling; existing 27.1' and 31' landscaping retaining walls; existing A/C units, generator and - concrete slabs; propose to resurface existing 913sq.ft. decking; lower existing 8'x8' hot tub into ground 18" in-place to make even with deck; relocate existing 54sq.ft. wood steps from deck to ground on northeast side of dwelling landward of existing location, new steps being 4'x14' and facing front yard; proposed 8'x16' pergola on top of existing deck on seaward side; install drywells to contain roof runoff for parking area and pickle ball court, and in accordance to Chapter 236 of the Town Code-Stormwater Management; on south side of dwelling existing 10'x10' covered entrance and existing landscape retaining walls running landward consisting of 15'x78'x15'x10 linear feet, then running south 75' to covered entrance, and retaining walls connecting to additional landscape retaining walls beyond 100' from bluff; on landward side of dwelling, existing gravel parking area and 30 linear feet of retaining walls connecting to additional 100' linear of feet retaining walls; existing sanitary system to remain, retaining walls, relocated driveway, walkways, landscaping, regrading ±600 cubic yards clean fill, and 1,500sq.ft. pickle ball court all landward of 100' from top of bluff; install buried propane tank and relocate generator and generator,slab from north side of dwelling to landward of addition; for the existing 100.48 linear foot long wooden bulkhead; replace existing low-landscape lighting fixtures and additional low landscape lighting fixtures to trees, flag pole and top of bluff; and to install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the top of bluff. Located: 3675 Nassau Point Road, Cutchogue. SCTM# 1000- 111-9-4.2 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, the proposed action is recommended as INCONSISTENT with the LWRP. The distance from the structure to the top of bluff(regulated feature) is not provided and should be required to comply with Chapter 275 Wetlands and Shoreline. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction. 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. A Wetland Permit for the as-built structures was not found in Town Records. In the event the action is approved; to further Policy 6 the following is recommended: 1. Require that the non-turf buffer retain existing trees and vegetation due to the close proximity of the structures to the top of bluff. Planted vegetation should be native and salt tolerant. 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: Damon Hagan, Assistant Town Attorney ����Qg�yFFO�►�.�aG Peter Young,Chairman c Town Hall,53095 Main Rd. Lauren Standish,Secretary Cn d P.O.Box 1179 Southold,NY 11971 �j►�� ����` Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., March 13, 2019 the following recommendation was made: Moved by James Abbott, seconded by Caroline Burghardt, it was RESOLVED to SUPPORT the application of DAVID HERMER & SILVIA CAMPO to lower the existing hot tub 18" into ground to make even with,the deck, addition to existing dwelling, wood deck, fire pit and landscaping retaining wall. Existing deck to be resurfaced; relocate wood steps, proposed pergola on top of existing deck, install drywells, proposed 10' non-turf buffer at top of bluff and vegetated buffer on bluff landward of bulkhead, and for the existing wood_bulkhead. Gravel parking area, retaining walls and new sanitary system landward of 100' from top of bluff. Located: 3675 Nassau Point Rd., Cutchogue. SCTM#111-9-4.2 Inspected by: Peter Young, James Abbott, Caroline Burghardt Vote of Council: Ayes: All Motion Carried February 27, 2019 Project Description: For all existing structures and Alteration A. Existing Permit#8791A: Existing 8'x 8' Hot Tub—to Lower into ground 18" in the existing location to make even with the deck B. Existing house (3,519 sq ft)with 1,400 sq.ft.addition,existing 913 sq ft wood deck and 78 sf wood stairs,existing 2nd floor addition over existing first floor.existing 5.6 round fire pit, existing 27.1' and 31' landscaping retaining wall,existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced; D. Relocate 54 sq.ft.existing wood steps from deck to ground on north/east side of house landward of existing location, new steps being 4'x 14' and facing front yard E. Proposed 8'x 16' pergola on top of the existing deck F. Proposed roof drywells,drywells for parking area and pickle ball court,as required pursuant to Town Code 236 G. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) H. Existing 100.48' linear feet of wood bulkhead. I. Replace existing low landscape lighting fixtures and additional low landscape lighting fixtures to trees,flag pole and top of bluff. (shown on attached landscape plan) J. On South side of dwelling: 10'x 10'existing covered entrance,existing landscape retaining walls running landward of dwelling, north 15'x 78'x 15'x 10' linear feet then running south 75' to covered entrance, and retaining walls connecting to additional landscape retaining walls beyond 100'from bluff. K. On North side of dwelling: Existing Gravel Parking area and 30 LF retaining walls within 100'of top of bluff connecting to additional 100' LF of additional retaining walls L. Additional activity is landward of 100'from top of bluff,which includes but not limited to, existing sanitary system to remian, retaining walls, driveway,walkways, landscaping,regrading,@ 600cy of clean fill and 1,500 sq.ft. pickle ball court(building permit #43493); and relocate driveway M. Buried propane tank and generator relocate from north side of house (within 100')to landward of proposed addition M Proposed landscaping to landward side of dwelling as shown on attached plan. D ECEIVE MAR - 1 2019 Southold Town Board of Trustee February 27, 2019 Project Description: For all existing structures and Alteration A. Existing Permit#8791A: Existing 8'x 8' Hot Tub to Lower into ground 18" in the existing location to make even wi b the deck B. Existing house (3,519 sq ft)with addition,existing 913 sq ft wood deck and 78 sf wood stairs, existing 2nd floor addition over existing first floor. existing 5.6 round fire pit, existing 27.1' and 31' landscaping retaining wall, existing AC units C. Existing 913 sq.ft deck proposed to be resurffa,ce�d• D. Relocate wood steps from deck to ground.on-� east side of house landward and facing front yard E. Proposed 8'x 16' pergola on top of the existing deck F. Proposed roof drywells are required pursuant to Town Code 236 G. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) rsncl-1an�C ing: an ing -5t�3'steer irrg �fGl� .�trac-t�le-ste�s-te-beach- �rmad I. Existing 100.48' linear feet ofJbulkhead. J. All activity landward of 100' from top of bluff• *^FT •. a__/_ ^ (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans prepared by Shawn t D, C t�, Leonard,Architect last dated 1/28/19) l5 Co O'Y'C5- _ — m cv�vyi� t--JJ'(s o-A s cd a o4 �✓U Yv-rC QLUCLUICA L+kI a_ll �—E – vwl — (S' '° Z s I.'G �S ,a l(}' / +6 S 6ti1 kt,v�JA 5-fcU - 75 I-^ 4a L V1cc> ' M ►V 22s�7 SG/k �^'���IcwiGt WCei✓c� Sc � Y eQvCe Wim ' G1 :'`"�`'`�, I�f✓m�� cou�U ( '',ty Lf o.Mo� ��Y�6�e�v�►��-Q� p C 0EVE FEB 272019 Southold Town Board of Trustees Hoard of Trustees Application AUTHORIZATION (where the applicant is not the owner) DAVID HERMER and SILVIA CAMP®, as owner of premises 3675 Nassau Point Road, Cutchogue, NY (sctm: 1000-111-9-4.2-4-16.4) residing at 9 College Point Road, Brooklyn,New York 11201 do hereby authorize our attorney, Patricia C. Moore, to apply for permit(s) and appear before the Southold Board of Town Trustees on my behalf. (owner's signature) SILVIA CAMP® DJ (owner's signature) DAVID HERMER D EC" E V E MAR - 1 2019 sout`o!d town Board of 1'r!sines APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) 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: HERMER,DAVID&CAMPO,SILVIA AND MOORE,PATRICIA C. (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company. If so,indicate the other person or company name) NATURE OF APPLICATION:(Check all that apply.) Tax Grievance Variance Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other Trustees X 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, to 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 Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself (the applicant) and the Town officer or employee. Either check the appropriate line A through D(below)and/or describe the relationship in the space provided. The Town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation), B)the legal or beneficial owner of any interest in a non-corporate entity (when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of Signature—b DAVID HERMER `7 E � Matricia MAR - 2019 Soutiloid Tov�n �oaru of Trustees - j a 61 Z20 AppencGx B Short Environmental Assessment Form ;instruetions_for,Coml)letitilz Part l -Project Information. The Applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to frilly respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor'Information Name of Action or Project: ui w Ai-P`.v✓MV- l-%a Lich a Project Location(describe,and attach'a location map): 3075 ,Yasscu-e /Torn 4`"Ahc IVY 11135 Brief Description of Proposed Action: J`/`trvc�"lJ�s � e� �Ierrss��� 5(v�z4vs�s J ' Name of Applicant or Sponsor: Telephone:(631) 765- q 3 b Cr a, C "oore E-Mail: PC_M06_k-9 LV1L(oohnQ S CO/11 Address: SJ7,,_Mc U nl City/PO: State: Zip Code: /V 11q71 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES s administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that F may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,•approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •_! acres 4. Check all land uses that occur on,adjoining and near the proposed action. } ❑Urban El Rural(non-agriculture) ❑Industrial ❑Commercial Residential(suburban) El Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland ry p 4'!I Page 1 of 4LtJ L BAR 2010 Southold Town Board of I;us±ees f 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? M,/ n 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:'_ D 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? D c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: R-1 El 10. Will the proposed action connect to an existing public/private watef"supply? NO YES If No,describe method for providing potable water: a El 11.Will the proposed action connect to existing wastewater utilities? _T NO YES If No,describe method for providing wastewater treatment: Ela 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic -NO YES Places? b. Is the proposed action located in an archeological sensitive area? _ X 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain' NO YES wetlands or other waterbodies regulated by a federal,state or local agency? F-1 rL±gi b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square Feet or acres: �X�5 f2/I�7 S,NVy�7lyer 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: MoShoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? bnti 16.Is the project site located in the 100 year flood plain? NO YES Tx 17.Will the proposed action create storm water discharge,either from point or non-point sources? 1V0 YES If Yes, a.Will storm water discharges flow to adjacent properties? ®NO DYES © �, b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: [Y]NO DYES Page 2 of 4 l8. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size- 19.Has the site of the proposed action or an adjoining property been the location of an active or closed '.,NO YES solid waste management facility? If Yes,describe: ® ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND'ACCURATE TO THE BEST OF MY KNOWLEDGE – — 1 ;Applicant/sponsornamj� _�"l,��GC.{Cc. C. -• ��O/� Date:--- -�•�.� Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the Following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? (� ❑ 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? El 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? EA1 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ;❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? ❑ Page 3 of 4 No,or Moderate small to large impact impact may may occur occur V IQ. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. QCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental un acts. Town of Southold-Board of Trustees I I M1chaei41 Do°renin® Date President _ Print o Type Nar e of Responsi Officer in Lead Agency Title of Responsible Officer "Signature of Res &sible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)' PRINT Page.4 of 4 1 BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF SIGN HERMERICAMPO POSTING Regarding Posting of Sign Upon Applicant's Land Identified as 1000-111-9-4.2 ---------------------------------------------------------------x COUNTY OF SUFFOLK) STATE OF NEW YORK) I, BETSY PERKINS, residing at Mattituck,New York being duly sworn, depose and say that: On the 1 lth day of March, 2019, I personally posted the property known as 3675 Nassau Point Road, Cutchogue,New York by placing the board of Trustees official Poster where it can easily be seen, and that I have checked to be sure the post has remained in place for eight(8) days prior to the date of the public hearing. Date of Hearing to b held on Wednesd y, March 201h at or about 5:30 p.m. detsy Perk s Sworn to me this day of March, 2019 No ary Public MARGARET C RUTKOWSKI NOTARY PUBUC,STATE OF NEW YORK Registration No.01RU4982528 Qualified in Suffolk County my Commission Expires June 3, ON DELIVERY I SENDER: MPLETE THIS SECTION COMPLETE THIS SECTION ■ Complete items 1,2,and 3. A. Signature ❑Agent X ■ Print your name and address on the reverse ❑A dress so that we can return the card to you. ■ Attach this card to the back of the mailpiece, B Rerleivgd by rioted N e) C. Date f Del' ery , �r( � N 3 or on the front if space permits. y D ■ _■ ` '1. Article Addressed to: ___— —--- —- D.Is delivery address different from it 1 Yes � ` 0 3 a j ? > s- o - -----—-— If YES,enter delivery address below: ❑No m ��n 00 �- -3 165 z Cst � x =i ma = W'o m co a Michael J Youngman — .. y Ln y 00 .0 'w m I Arlene M Youngman CL a o i..z- �' _ o a ai f 201E 17th St.,Apt 29H N' ca ° c c i New York,NY 10007 C? ti F+ 3 CL N 3. Service Type ❑Priority Mail Expresso I{ y -4 � 0 (, m I IIIIII111111IIIIIIIIIIII� ���IIIIIIIIIIIIII IIII C -a r r m Q- O. ❑Adult Si0 13 Adult gnature Restricted Delivery ❑Registered Mail Restricted I -Z. W N W ❑Certified Mail® pelrvery WCi = I N o, Q c 9590 9402 3554 7305 8059 22 ❑Certified Mail Restfiotd Delivery ❑Merchandiselptfor ; e a, co 3 Ort ❑Collect on Delivery ❑Signature ConfirmafionTM' j ❑Collect on Delivery Restricted Delivery 1 N a o — m `< : 2. Article Number(Transfer•from service labeO ❑Insured Mad ❑Signature Confirm i Q1 o dp • Restricted Delivery C3 ` 'v. ❑(over$500j I Restricted Delivery 7o m Domestic Return Receipt CD 1 PS Form 3811,,July 2015 PSN,7530=02-000-9053 Q CD 11❑❑00000W - - - - - - o^33a99�aco a u SENDER: COMPLETE THIS SECTION COMPLETE THI �-•-wC2 • Ma iRC C-a g:2. igCL .A SECTION• DELIVERY o, >>'C 3 d d m y�. I ■ Complete items 1,2,and 3. A SI ature o o e . . ■ Print your name and address on the reverse X - ❑Agent m -<<��®gym o. m I i y o I so that we can return the card to you. E3 Addressee CL ' m rt CL CL v j ■ Attach this card to the back of the maiipiece, B. cel ed b (Printed Name C.,pate of Delivery i i; o a m �' or on the front if space permits. C " o ° a 1. Article Addressed to: T j CL m Ct Z --- D. Is delivery address differen om item 17 13 Yes a m If YES,enter delivery address below: a� oQ PD Jaime A Santiago �� �,n U c3 (�/Ij a 11 El n ❑❑❑ o� ; Nancy SantiagoCD N mm ca CD a%2ma � 3 a s3 w g, 0 3745 Nassau Pt.Rd. m Q�z o Cutchogue,NY,11935 j C O ii o m g 11Ela1 ❑13 III .. IIIIIIffIIIIIIIII u ®m az ° . S9ntrre 13Registered MaliTmag 11111111- IIIIIIIIfillIIIIIIII Adult i® El dui nature Restricted Delivery El Registered Mail Restricted I m vsi 9590 9402 3554 7305 8059 39 p Certified d Mail Restricted Delivery Q Retu Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label) 13Collect on Delivery Restricted Delivery 11 Signature ConfirmtionTM i ❑Insured Mail ❑Signature Confirmation ❑Insured Mail Restricted Delivery Restricted Delivery (over$500 PS Form:3811:,:JUIy 2015 PSN 7530-02-000-9053 Domestic Return Receipt d ,1 —_--- - -- ---- - ---- w i Postal ■ ® © ® ■ CERTIFIED k © ■ ■ I. Ln I. O � CE) _ • _ • • n ,"- -s• r.:a • rTv •'• '1• S 1. \ •' `"" M • 1 � 2 = t z' L n Lr1 Certified Mad Fee �LD Ln Certified Mad Fee 0 $ C3 s 1:3 Extra Services&Fees(check 6ax,add fee as appropriate) ��, 1--3 Extra Services&Fees(check box,add lee as appropriate) y; iAC.� ❑Return Receipt(hardcopy) $ k 4� ❑Return Receipt(hardcopy) $ 1 �� C3 ❑Return Receipt(electronic) $ MAE ��t p 4 d []Certified Mail Restricted Delivery $ tl 7 ❑Return Receipt(electronic) $ !� Postmark .3' ❑ E]Certified Mail Restricted Delivery $ Here �� C3 E]Adult Signature Required $ Q []Adult Signature Required• $ 2017 ,a E]Adult Signature Restricted Delivery$� ❑Adult Signature Restricted Delivery$ (f� �At i L ii t:j Postage f O Postage ru .ND $ , - -- ---—- ,) ru N 'I Michael J Maher r-q Timothy Radin ------------------ � Jean M Maher o Julie Aronowitz Radin M Attn:TPS i 190E 72nd St.,Apt 6C it PO Box 7560 % New York,NY 10021 Garden City,NY 11530 o r%- CG CG V;"< g� = i i,� � [ 3; €{ ..i ;s,., tt Y;.•;• tw,.:,-t, ' ) t w, Fx1. I irn Ln Certified Mad Fee LP) Certified Mad Fee C-3 °� Ip 1= Extra Services&Fees(check box,add fee as appropri Extra Services&Fees(checkbox;add/ee as appropnete) r,- 0 ❑Return Receipt(hardcopy) $ MAR 1 1 �Q�9 �,� I 3 ❑Return Receipt(hanicopy) $ �}�y�~ ❑Return Receipt electronic $ 19 !1 0 ❑Return Receipt(electronic) + $ `� Postmar p(electronic) Postmar f E3 ❑Certified Mail Restricted Delivery $ Here /I I C3 ❑Certified Mail Restricted Delivery $ Her���. � [I Adult Signature Required' $ / (� ❑Adult Signature Required 1 $ {� El Adult Signature Restricted Delivery$ E]Adult Signature Restricted Delivery$ C3 Postage USPS, I p Postage / $ $ ji - r`° Jaime A Santiago I r` ' Michael J Youngman rar-q ------------------ o Nancy Santiago ----------------- o Arlene M Youngman 3745 Nassau Pt. Rd. 201 E 17th St.,Apt 29H -'----------------- Cutchogue,NY 11935 New York,NY 10007 i I - I I 1 Ii L PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: peA STATE OF NEW YORK COUNTY OF SUFFOLK uviag iLai y %N,Oi:ii, iicYvz;6S zW-'U say-z;that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of , 20 Notary Public BOARD OF TRUSTEES TOWN OF SOUTHOLD:NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF HERMER/CAMPO MAILING Applicant's Land Identified as 1000-111-9-4.2 COUNTY OF SUFFOLK) STATE OF NEW YORK) I, BETSY PERKINS,residing at Mattituck,New York, being duly sworn, depose and say that: On the 11TH Day of March, 2019, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the persons listed on the attached list at the addresses set below their respective names; that the addresses set below the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said notices were mailed at the United States Post Office at Southold,New York, that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Attached hereto is the white receipt post-marked by the Southold Post Office on said date. BE SY PE S Sworn to before me this 3 T�f ' da of March, 2019 tary Public) MARGARET C RUTKOWSKI NOTARY PUBLIC,STATE Of NEW YORK Registration No.01 RU4982528 Qualified in Suffolk County / My Commission Expires June 3,_SGS Michael J. Domino,President �*qf S�(/jjyo Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q O Telephone (631) 765-1892 Greg WilliamsO Fax(631) 765-6641 �y00UIV% BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD PUBLIC HEARING FOR THIS PROPOSED PROJECT TO BE HELD ON WEDNESDAY, MARCH 20, 2019 AT OR ABOUT 5:30P.M. IN THE TOWN HALL MEETING HALL PROJECT DESCRIPTION FOR: Patricia Moore, Esq. on behalf of DAVID HERMER & SILVIA CAMPO LOCATED: 3675 NASSAU POINT ROAD, CUTCHOGUE SCTM# 1000-111-9-4.2 For a Wetland Permit for the existing 3,519sq.ft. dwelling that includes an as-built 1 ,400sq.ft. landward addition; existing 913 sq.ft. wood deck along the sides and seaward side of dwelling with 78sq.ft. of stairs to ground; existing second-story addition over existing first floor; existing 5.6' diameter fire pit seaward of dwelling; existing 27.1' and 31' landscaping retaining walls; existing A/C units, generator and concrete slabs; propose to resurface existing 913sq.ft. decking; lower existing 8'x8' hot tub into ground 18" in-place to make even with deck; relocate existing 54sq.ft. wood steps from deck to ground on northeast side of dwelling landward of existing location, new steps being 4'x14' and facing front yard; proposed 8'x16' pergola on top of existing deck on seaward side; install drywells to contain roof runoff for parking area and pickle ball court, and in accordance to Chapter 236 of the Town Code-Stormwater Management; on south side of dwelling existing 10'x10' covered entrance and existing landscape retaining walls running landward consisting of 15'x78'x15'x10 linear feet, then running south 75' to covered entrance, and retaining walls connecting to additional landscape retaining walls beyond 100' from bluff; on landward side of dwelling, existing gravel parking area and 30 linear feet of retaining walls connecting to additional 100' linear of feet retaining walls; existing sanitary system to remain, retaining walls, relocated driveway, walkways, landscaping, regrading ±600 cubic yards clean fill, and 1,500sq.ft. pickle ball court all landward of 100' from top of bluff; install buried propane tank and relocate generator and generator slab from north side of dwelling to landward of addition; for the existing 100.48 linear foot long wooden bulkhead; replace existing low- landscape lighting fixtures and additional low landscape lighting fixtures to trees, flag pole and top of bluff; and to install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the top of bluff. NUTI- Lt: U1= Ht: AK1NG NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: DAVID HERMER & SILVIA CAMPO SUBJECT OF PUBLIC HEARING : Please see attached Project Description Page posted with this notice. TIME & DATE OF PUBLIC HEARING : Wednesday, March 20, 2019 ® at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD *- (631) 765-1892 ` 1 February 27,2019 Project Description: For all existing structures and Alteration A. Existing Permit#8791A: Existing 8'x 8' Hot Tub—oto Lower into ground 18" in the existing location to make even wit} the deck B. Existing house (3,519 sq ft)with'arition, existing 913 sq ft wood deck and 78 sf wood stairs, existing 2"d floor addition over existing first floor.existing 5.6 round fire pit,existing 27.1' and 31' landscaping retaining wall, existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced- `/'x 1q D. Relocate wood steps from deck to groun7one_ast side of house landward and facing front yard E. Proposed 8' x 16' pergola on top of the existing deck F. Proposed roof drywells are required pursuant to Town Code 236 G. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) n ing: an ing . ' ' an mg to 31 wi a airy I. Existing 100.48' linear feet of ulkhead. J. All activity landward of 100'from top of bluff'-n-"* �`- � (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans prepared by Shawn 0"x Leonard,Architect last dated 1/28/19) cS Co ve'red e v'A-a-" a a""" . a - RAwvw,vt-c L✓wl is aro. s cd Md �✓a c�L zL4 a�' �?r • ' t x "�g ',c �5� x i�' s' x 13' x G� s, . v` -fa Ct� d ewe bN Nom' 5'6 - 75 '►,-4 -a 6,e rer t o..e a a1 j 100 N-� s rre ,ra l It�a� Cout�t�, D EC rI E D , MAR ® 1 2019 Soutrold Toven Board of Trustees 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 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 affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer-must be explained in-detail, listing both.supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not'be uiudett kon. 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. D E C E B. HE- 0 DESCRIPTION OF SITE AND PROPOSED ACTION SCTM#, MAR - 1 2019 PROJECT NAME La V/d finm e4- P,5 Southold Town Board of Trustee The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate'response): (a) Action undertaken directly by Town agency(e.g. capital 0' 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: L1l� 17ii?' OU C�I� Tlu 5 February 27, 2019 Project Description: For all existing structures and Alteration A. Existing Permit#8791A: Existing 8'x 8' Hot Tub-oto Lower into ground 18" in the existing location to make even with the deck B. Existing house (3,519 sq ft)withra clition, existing 913 sq ft wood deck and 78 sf wood stairs, existing 2nd floor addition over existing first floor. existing 5.6 round fire pit,existing 27.1' and 31' landscaping retaining wall, existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced- `/'x I D. Relocate wood steps from deck to ground oneast side of house landward and facing front yard E. Proposed 8'x 16' pergola on top of the existing deck F. Proposed roof drywells are required pursuant to Town Code 236 G. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) n ing: an ing . ' �• ' an ing o wi a ai � I. Existing 100.48' linear feet of4ulkhead. J. All activity landward of 100'from top of bluff ����� (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans prepared by Shawn Leonard,Architect last dated 1/28/19) �5 Levered eco N« 0.r,8- _ - �.cvwr�c G✓G,G(s a-n Scci.�. c�,,.t� �✓'nw-E �1 c1� - U�-� �u't'- � w to' -1a be re�(o,redl off- nr�N L 6 CD /,,4,6Gle�vw��Q 711I Lh9A( Co v v i; Location of action: 3(o75 A&SSau Site acreage: / ,,9cre Present land use: M h&1,.la Present zoning classification: k7 //0 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: lt)at-d H-er-/rer a-o rt'- X lr a CA.m,ob (b) Mailing address: 9 Cdf/eg e Rae e 9� � h�Nh /✓!/ (c) Telephone number: Area Code( )T/7) 970 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? 'o' Yes ❑ No If yes,which state or federal agency? 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. 1)]JVI LOPED�C0AST-T0LICY 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. R]Yes ❑ No ❑ Not Applicable Ln(/5 6 1a:d$e-- Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Section III—Policies Pages 3 through 6 for evaluation criteria F] Yes,❑ No 14J Not Applicable Attach additional sheets if necessary 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 Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No FLVAJ1 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —PoIicies Pages 16 through 21 for evaluation criteria 0• Yes F] No ®Not Applicable 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 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. ❑, Yes '❑ No"�`i Not Applicable 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. ❑ Yes ❑.No Not Applicable 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. ❑ Ye�] No® Not Applicable Attach additional sheets if necessary 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 Di No Not Applicable Attach additional sheets if necessary 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 ` Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑. No N Not Applicable Attach additional sheets if necessary 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 L Not Applicable PREPARED 9 —_-- - _ _ LL . _ ----_=--- '1iTLE_ DATE I Michael J. Domino, President SufFO(,��o�� .0OGy Town Hall Annex John M. Bredemeyer, III, Vice-Presidento 54375 Route 25 Glenn Goldsmith N ,zc P.O. Box 1179 A Nicholas Krupski y • �� Southold, NY 11971 Greg Williams dol , c dao Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES TO: SOUTHOLD TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS '_ irk- -� D SCTM#: � � �� p' D Property Owner Name: tfawQe_ CfF P® FEB - 2019 Date Sent to Bldg. Dept: 2.4.1q TOWN OF SOUTROLD 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? Will the proposed project require a variance determination from the Zoning Board of Appeals? J Will any part of this application be considered a Demolition as described under Town Code? COMMENTS: Signature of Reviewer Date y , PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold,New York 11971 Tel: (631)765-4330 Fax. (631)765-4643 February 1,2019 Southold Town Board of Trustees Main Road PO Box 1179 Southold,NY 11971 ! FEB - 1 2019 g RE:David Hermer&Silvia Campo s SCTM: 1000-111-09-4.2 Permit for existing structures Dear President Domino and Board This application is for a Trustee's permit for the EXISTING STRUCTURES The house was constructed prior to the Trustee's jurisdiction(100'from the top of the bank). The owner is renovating the existing structure. In order to make repairs to the existing structure the existing structures should have a trustee's wetland permit A prior application included replacement of exiting retaining walls and replacement of the beach stairs. The building department advised that a zoning board variance is required before the existing retaining walls and existing platform on the beach stairs may be replaced. We have removed that work from the application We will re-apply for the replacement of the retaining walls and beach stairs AFTER zoning board review, however maintenance and repairs to the existing house and deck can continue with a Trustee's permit for the existing structures Please place this application on your monthly calendar at your earliest available date We have included a proposed pergola on the existing deck,if this or any other work cannot be done at this time I will remove it from the project description Verytrulx,.yours; ) ---P-ricia C.Moore Michael J.Domino,President :'��(��s'a�ry® Town Hall Annex John M.Bredemeyer III,Vice-President �4' 6437b Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G �p Telephone(631)765-1892 Greg Williams ,E Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application 1II =Wetland Permit Application ; �sJ Administrative Permit OCT ` 1 2018 Amendment/Transfer/Extension Received Application: /6,/i/f S t�.�d Tc�lvn ceived Fee:$ 2M.00 Boarf'of Tn;it-cs i��Celompleted Application: Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): A 2,1Y �LWRP Consistency Assessment Form Sent: � , CAC Referral Sent: , ✓ Date of Inspection: i IL Receipt of CAC Report: Technical Review:_ Public Hearing Held: f/,A Resolution: Owner(s)Legal Name of Property (as shown on Deed): David Hermer/Silvia Campo Mailing Address: 9 College Place Apt 4D Brookvin N Y Phone Number: 917-470-5146 Suffolk County Tax Map Number: 1000 - 111-09-4.2 Property Location: 3675 Nassau Point Road, Cutchogue NY 11935 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Shawn F Leonard Architect P. C Mailing Address: 320 Hampton Road, Southampton NY 11968 �p Phone Number: (631)287-5557 C� �� November 30, 2018 Project Description: For all existing structures A. Existing Permit#8791A: Hot Tub—Amend to Lower into ground 18" in the existing location to make even with the deck B Existing house (3,519 sq ft) with addition (out of jurisdiction), existing 913 sq ft wood deck and 78 sf wood stairs,existing 2nd floor addition over existing first floor. existing 5.6 round fire pit, existing 27.1' and 31' landscaping retaining wall, existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced; D. proposed 8'x 16' pergola on top of the existing deck E. Proposed roof drywells are required pursuant to Town Code 236 F. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) G. existing wood beach access (stairs and landing: landing 8.3'x 9.5', to 3' steps to 6.5' x 5'landing to 3'wide stairs to 6.5 x 5' landing to 3' wide stairs to 9.5 x 9.5 landing to 3.8 x 3.5 landing to retractable steps to beach. H. Existing 100.48' linear feet of bulkhead. I. All activity landward of 100' is out of Trustee's Jurisdiction (proposed addition, retainingwalls and steps, new gravel driveway all as shown on plans prepared by Shawn Leonard, Architect last dated 1/15/19) FEB ® 1 2010 }�"A i J. Board of Trustees Appy', )n GENERAL DATA Land Area(in square feet): 40,993 sq.ft. Area Zoning: R-40 Previous use of property: single Famliy Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? Yes __L_No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes x 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. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes _xNo Does the structure(s)on property have a valid Certificate of Occupancy? x OE H E Prior permits/approvals for site improvements: Agency Date DEC � � 201 Building Department 5/4/18 - Southold Town Board of Trustees- No r s eeNo 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): _ Proposed 8'x 8'hot tub. Proposed new deck o be Board of Trustees ApplL' -ion j WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: t ..r i Area of wetlands on lot: C7 square feet Percent coverage of lot: (O % Closest distance between nearest existing structure and upland edge of wetlands: O feet T� 0-1-61'Iff Closest distance between nearest proposed structure and upland edge of wetlands: (50 feet To Does the project involve excavation or filling? _No s�dj Flov�t> If yes, how much material will be excavated? QW-v� r cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: O feet -:1 V _ �c FREE Proosed slope throughout the area of operations: I, Manner in which material will be removed or deposited: W ®�C ® 3 M anwo Town Board of Trustees 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): 1U,;I WY kl k- 1 s yvsells vlf-e r r / Yrg c December 3,2018 Project Description Hermer/Campo—3675 Nassau Point Road, Cutchogue Sctm: 1000-111-9-4.2 : For all existing and proposed improvements A. Existing Permit#8791A: Hot Tub—Amend to Lower into ground 18 in the existing location to make even with the\deck B. Existing house (3,519�q ft)with addition(out of jurisdiction),` isting 913 sq ft wood deck and 78 sf wood stairs,existin 2"d floor addition over existing fit`floor.existing 5.6 round fire pit, existing 27.1'and 31' lands,aping retaining wall,existing AC units C. Existing 913 sq.ft deck prod to be resurfaced; D. Proposed 8'x16' pergola onto of the existing deck E. Proposed roof drywells are required pursuant to Town Code 236 F. Existing wood landscape retaining wads(north)to/be replaced with concrete block material(26' x 1.2'within trustee jurisdiction) balance of retaining walls beyond 100'; replace two existing wood landscape retaining walls on seawa d side of house with 27.1'and 31'concrete block retaining walls(in place) G. Existing silt fence,in place,during constctio H. Proposed 10' Non-Turf buffer at top ofthe blu (and vegetated buffer on bluff landward of bulkhead) I. Replace existing wood beach aces in kind and in place(length and width)and replace existing rail road tie retaining wall (as needed), replace existin%beach access with retractable stairs dimensions of stairs and landing: landing 8.3'x 9.5',to steps to 6.5'x 5' landing to 3'wide stairs to 6.5 x 5' landing/3'wide stairs to 9.5 x 9.5 Ia 'ng to 3.8 x 3.5 landing to retractable steps to beach. J. Existing 100.48' linear f et of bulkhead. K. All activity landward of 100' is out of Trustee's Jurisdiction (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans preparey Shawn Leonard,Architect last dated 11/29 18) DEC - 3 2018 Southold Town Board of Trustees i d 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part l based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. nn E C 2LS � �(j Part I -Project and Sponsor Information 7 1 fl- — 3 Name of Action or Project: DEC awl f-e 1 /J/4//A _Z)F Project Location(describe, and attach'a lo-ca�tion map): 0�ltJ d, CtAAr4® 0C Board f Tr f� Brief Description of Proposed Action: 7 70S �- � Name of Applicant or Sponsor- LE-Mail: elephone;} I ® 0 y '/ 0 jW/BJP1V11q �f lIY992 Address: City/PO:� State: Zip Code:� 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 9 ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? _acres 4. Check all land uses that occur on,adjoining and near the proposed action. F-1 Urban El Rural(non-agriculture) ❑Industrial E]Commercial M<esidential(suburban) ❑I~orest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 • r II 5. Is the proposed action, NO REN/A a. A permitted use under the zoning regulations? F] El b.Consistent with the adopted comprehensive plan? ❑ ❑ ❑ C 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ FPr 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ElF ! 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? NIS ❑ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action c ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to,an existing public/private water supply? NO YES ! If No,describe method for providing potable water: ❑ I 11.Will the proposed action connect to existing wastewater utilities? NO YES i If No,describe method for providing wastewater treatment: ❑ i 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? F]b.Is the proposed action located in an archeological sensitive area? ❑ dh 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: I 14. Ide ify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline El Forest ❑Agri cultural/grasslands El Early mid-successional ❑ Wetland ❑Urban ❑Suburban- I 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? E( ❑ 16.Is the project site located in the 100 year flood plain? NO YES I 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? [i✓ NO DYES L ❑ b.Will storm water discharges be directed to established conveyance systems(runoffAd storm drains)? If Yes,briefly describe: [ p DYES f i Page 2,of 4 f{ • _ 1 { 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 1 i 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? j If Yes,describe: ❑ i 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE i Applicant/spons e: Date: Signature i Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following 1 questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" i No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? ❑ ❑ { 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ F-1- 4. 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? ❑ ❑ i 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? ❑ { 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: El F]a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ El or aesthetic-resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, El Elwaterbodies,groundwater,air quality,flora and fauna)? i Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion;flooding or drainage ❑ 1:1 problems? I 11. Will the proposed action create a hazard to environmental resources or human health? j Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. j i ' t I a i E I ' I . i I 1 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an { environmental impact statement is required. F1Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will,not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President f Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) I I PRINT Page 4 of 4 i December 3,2018 Project Description Hermer/Campo— 3675 Nassau Point Road, Cutchogue Sctm: 1000-111-9-4.2 : For all existing and proposed improvements A. Existing Permit#8791A: Hot Tub—Amend to Lower into ground 18"in the existing location to make even with the deck B. Existing house (3,519 sq ft)with addition(out of jurisdiction),existing 913 sq ft wood deck and 78 sf wood stairs,existing 2nd floor addition over existing first floor.existing 5.6 round fire pit, existing 27.1'and 31' landscaping retaining wall,existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced; D. Proposed 8'x 16' pergola on top of the existing deck E. Proposed roof drywells are required pursuant to Town Code 236 F. Existing wood landscape retaining walls(north)to be replaced with concrete block material(26' x 1.2'within trustee jurisdiction) balance of retaining walls beyond 100';replace two existing wood landscape retaining walls on seaward side of house with 27.1'and 31'concrete block retaining walls(in place) G. Existing silt fence,in place,during construction H. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) I. Replace existing wood beach access in kind and in place (length and width)and replace existing rail road tie retaining wall(as needed), replace existing beach access with retractable stairs dimensions of stairs and landing: landing 8.3'x 9.5',to 3'steps to 6.5'x 5' landing to 3'wide stairs to 6.5 x 5' landing to 3'wide stairs to 9.5 x 9.5 landing to 3.8 x 3.5 landing to retractable steps to beach. J. Existing 100.48' linear feet of bulkhead. K. All activity landward of 100'is out of Trustee's Jurisdiction (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans prepared by Shawn Leonard,Architect last dated 11/29/18) 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 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 affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting 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: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Offic e an �p , e , local libraries and the Town Clerk's office. t-� �'' UD B.- DESCRIPTION OF SITE AND PROPOSED ACTIONu =- 3DEC SCTM# L Southold Town PROJECT NAME a of Trus The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(a•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: December 3, 2018 Project Description Hermer Cam o—3675 Nassau Point Road Cutcho ue p / P g � Sctm: 1000-111-9-4.2 : For all existing and proposed improvements i A. Existing Permit#8791A: Hot Tub—Amend to Lower into ground 18"in the existing location to f make even with the deck B. Existing house (3,519 sq ft)with addition(out of jurisdiction),existing 913 sq ft wood deck and 78 sf wood stairs,existing 2nd floor addition over existing first floor.existing 5.6 round fire pit, 1 existing 27.1'and 31' landscaping retaining wall,existing AC units C. Existing 913 sq.ft deck proposed to be resurfaced; D. Proposed 8'x 16'pergola on top of the existing deck E. Proposed roof drywells are required pursuant to Town Code 236 j F. Existing wood landscape retaining walls(north)to be replaced with concrete block material( 26' x 1.2'within trustee jurisdiction) balance of retaining walls beyond 100';replace two existing wood landscape retaining walls on seaward side of house with 27.1'and 31'concrete block retaining walls(in place) G. Existing silt fence,in place,during construction H. Proposed 10' Non-Turf buffer at top of the bluff(and vegetated buffer on bluff landward of bulkhead) I. Replace existing wood beach access in kind and in place (length and width)and replace existing j rail road tie retaining wall(as needed), replace existing beach access with retractable stairs j dimensions of stairs and landing: landing 8.3'x 9.5',to 3'steps to 6.5'x 5'landing to 3'wide stairs to 6.5 x 5'landing to 3'wide stairs to 9.5 x 9.5 landing to 3.8 x 3.5 landing to retractable steps to beach. J. Existing 100.48' linear feet of bulkhead. K. All activity landward of 100'is out of Trustee's Jurisdiction (proposed addition, retaining walls and steps, new gravel driveway all as shown on plans prepared by Shawn Leonard,Architect last dated 11/29/18) a i I' i ' I i i Location of action: /f/d Site acreage: Acw Present land use: f s'frit am Present zoning classification: IL qc> 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: �1 rww e ro b (b) Mailing address: 0 ��i-e ��Q� y �/''T �?X� �rr�. AUy JF (c) Telephone number:Area Code( ) V/`/- V70 — (d) Application number,if any: N l 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? 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. x Yes No n Not Applicable 7'Q 611Z6M29 07 Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWR.P Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes / ❑ No I�l Not Applicable f Attach additional sheets if necessary 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 Ef Yes ❑ No ❑ Not Applicable s 0 Jed Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section IH—Policies Pages S through 16 for evaluation criteria ® Yes ❑ No ❑ Not Applicable CA S i Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ©Not Applicable 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; Page's 22 through 32 for evaluation criteria. ❑ ❑ Yes No N' rtpplicable 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. F] Yes [] No f'v ' Not Applicable 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. El_Yes ❑.No.� Not Applicable 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. Ye� � Not Applicable No Attach additional sheets if necessary I n WORIUNG COAST POV1__ [ES 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 4 Not Applicable Attach additional sheets if necessary 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 ` Attach additional sheets if necessary Policy 12. Protect agricultural lWIII ands in the Town of Southold. See LRP Section —Policies; Pages 62-through 65.for-evaluation criteria. ❑ Yes ❑ No© Not Applicable Attach additional sheets if necessary 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 [XI Not Applicable PREPARED BY W&&,ct- e_4� � TITLE DATE XV-3-11'r Shawn F . Leonard, Architect P . C . October 17, 2018 TOWN OF SOUTHOLD Board of Town Trustees r a 54375 Route 25 _ 4,' ` P. O. Box 1179 Southold, New York 11971 ll OCT 1 8 ?018 RE: Hermer/Campo Residence 0�� 3675 Nassau Point Road, Cutchogue S.C.T.M. # 1000-111-09-4.6 Dear Board of Trustees, Please find attached one (1) original and one (1) copy of the updated "General Data" pages 1 and 2 to include the "proposed new deck to be rebuilt in kind"for the above-mentioned site. Also included are four(4) updated site plans. If you require and additional information, please do not hesitate to contact our office. Sincerely, Richard Mato WE: A-60l //W1260 HUT ttMF-0W Grr_ W-a -rik6- To 0 �LA-�P�iLS�' Srt1-t,es �tK� SA-d0 � � �Vt56D ��� ���-°�� to lG•l� i ICE b�S /+IUT 0r 1fl 7 NOT- , OT I �i II _ 320 Hampton Road atlsG � Southampton, NY 11968 e A' Pe poit7- 7a11��-' Tel:(631)287-5557 CO V Va5A-V 01J e2Ef�iMDllt/(r Fax: (631)287-5558 E-Mail. rich@shawnleonardarchitect.com r d- �QF'SQU� Michael J.Domino,President • .�, _ �� ' John M.Bredemeyer III,Vice-President IC ll Annex Town Hall Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �, � - p Telephone(631)765-1892 Greg Williams ®��c ���� Fax(631) 765-6641 4UN�, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only 11 J) LL2 Coastal Erosion Permit Application I -i Wetland Permit Application Ell J Administrative Permit OCT ` , 2018 Amendment/Transfer/Extension Received Application: /��/��� Souiliold fnlvn �eceived Fee: $ .�0 _ Board of TrnstpP ompleted Application: Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. _ Positive Dec. Lead Agency Determination Date:_ Coordination:(date sent): A 2,/Y �LWRP Consistency Assessment Form Sent. _— CAC Referral Sent: Date of Inspection: l 7i19 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Owner(s) Legal Name of Property (as shown on Deed): David Hermer/Silvia Campo Mailing Address: 9 College Place, Apt 4DBro_okyln N Y Phone Number: 917-470-5146 Suffolk County Tax Map Number: 1000 - 111-09-4.2 Property Location: _3675 Nassau Point Road, Cutchogue NY 11935 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): Shawn F Leonard Architect P. C. Mailing Address: 320 Hampton Road, Southampton NY 11968 Phone Number: (631)287-5557 r. Board of Trustees Applical n GENERAL DATA Land Area(in square feet): 40,993 sq.ft. Area Zoning: R-40 Previous use of property: single Famliy Residence Intended use'of property: single Family Residence Covenants and Restrictions on property? Yes x No If"Yes",please provide a copy. 4 Will this project require a Building Permit as per Town Code? Yes x 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. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes x No Does the structure(s)on property have a valid Certificate of Occupancy? x Yes No Prior permits/approvals for site improvements: Agency Date Building Department 5/4/18 No prior permits/approvals for site improvements. 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):Proposed 8'x 8'hot tub. Proposed new deck o be built in kind. Board of Trustees Applica, �n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Proposed 8'x 8'hot tub. Proposed new deck to be rebuilt in.kind. Area of wetlands on lot: -o- square feet Percent coverage of lot: o % 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? __-Q- cubic yards How much material will be filled? -o- cubic yards Depth of which material will be removed or deposited: -o- feet Proposed slope throughout the area of operations: 0% Manner in which material will be removed or deposited:, N/A 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): 5 4 61 Z20 Appendix B Sli ort Environmental Assessment Form Instr'uctiotis4for Coini&tiha' ' Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses v become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part l-Project and Sponsor Information Name of Action or Project: i Hermer/Campo Residence Project Location(describe,and attach a location map): 3675 Nassau Point, Cutchogue, NY 11935 Brief Description of Proposed Action: Proposed 8'x 8'hot tub Name of Applicant or Sponsor: Telephone: (631)287-5557 Shawn F Leonard, Architect P. C. E-Mail:shawn@shawnleonardarchitect.com Address: 320 Hampton Road City/PO: State: Zip Code: Southampton NY 11968 1.Does the proposed action only involve the legislative adoption of a plan;local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that X may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: a ❑ 3.a.Total acreage of the site of the proposed action? 0.9411 acres b.Total acreage to be physically disturbed? 0.0015 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.9411 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban El Rural(non-agriculture) [:]Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 4 1 5. Is the proposed action, NO YES. N/A a.A permitted use under the zoning regulations? ❑ a l] b.Consistent with the adopted comprehensive plan? —1 ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 0 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ❑ S. a.Will the proposed action result in a substantial increase in traffic above present levels? NO 1 YES- F1 ❑ s b.Are public transportation service(s)available at or near the site of the proposed action? [K] ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies; - - ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES i If No,describe method for providing potable water: rj ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ ❑ } 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ ❑ b.Is the proposed action located in an archeological sensitive area? ❑ ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ El Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline El Forest ❑Agricultural/grasslands El Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 0 ❑ 16.1s the project site located in the 100 year flood plain? NO YES X ' 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES ❑X ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: []NO AYES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: _ FI F-1- �XJ ; 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe:_ Fx_1 El I AFFIRM THAT THE 1 �TYV P,ROV/ D AABO E IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE L Applicant/sponsor name:11 Date: Signature: ' Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" F 'No,or Moderate small to large impact impact may may occur occur , F Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? ❑ ❑ 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the El El of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate Cl El'` reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? El F-1 Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage Elproblems? _ 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. i Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. FJCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application AF'FIDAVI'T' David Hermer/Silvia Campo BEING DULY SWORN DEPOSES ANIS AFFIRMS THAT HE/SME IS THE APPLICANT FOR THE ABOVE DESCRIBED PE IT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORD 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 BOLD THE TOWN OF SOUTHOLD ANIS THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING TRIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUE}BY THE BOARD OF'TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Pro erty Owner of Property Owner SWORN TO BEFORE ME THIS DAY OF 30&V_, 20 g do Notary Public DIANA K00 Notary public.State of New York N0.01 KO6328315 Qualified in Oueens county MY Commission Expires Jul 27,2019 'Board of Trustees Application I I AUTHORIZATION (Where the applicant is not the owner) I/We, David Hermer/Silvia Campo , owners of the property identified as SCTM# 1000-111-09-4.2 in the town of Cutchoaue ,New York,hereby authorizes Shawn F Leonard,Architect P.C. to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Ow er's Signature ropert �,ner'sSignature SWORN TO BEFORE ME THIS C� I DAY OF 1� ,20 J,4 W . otary Public' 3 DIANA K00 Notary Public-State of New York N0. 01 K06328315 Qualified in Queens County ,'ommission Expires Jul 27,2019 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURF,,FORM The Ta n o nuthold' C de crEthioprobibitsconfliLis of rote st on the Rart of town n veers and omployees.The puMpge_q_f this form is to provide infariiltt ion which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Hermer,David (Last name,first name,.griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance __ _ Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ Planning Other (if"Othe(',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)(have a relationship with any officer or eanployce of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest7'means n business, including a partnership,in which the town officer or cmployee has evcn a partial ownership of(or employment by)a corporation in which the town officer or employee owns mon 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/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided "Phe 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); 13)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of (,8.. 2007_ Signature �- Print Name_J)&I t D N L�INV—_A. Form TS l APPLICANT/AGENTJPRF,SENTATIVF, TRANSACTIONAL DISCLOSURE FORM 'Che Lown of ggllftlil's Code of Elhio prohibits cqnflicts qfiqqrMt.jw the M-Qf town Wricers anL d emplovecs.ne P e 'UrMQf this form isIQ-12 vide inthrination wliiQb can ale[I the lomm of RgBible conflicts cif'nterest and allow it 12 takee Wbawyeraglion i neogmsw to meold same. YOUR NAME: Campo,Silvia (Last name,first name,piddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other-,name the activity.) Do you personally(or through your company.spouse,sibling,parent,or child)have a relationship with any officer or cinploycc 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/agent/representative)and the(own officer or employee.Either check the appropriate line A)through D)andior 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 orbenoricial owner of any interest in a noncorporate entity(when the applicant is not a corporation); Q an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 2-) day of 20f Signature Print Name S.tL-.VA C-A-y" Form TS I AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The 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: Leonard,Shawn F (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit X Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submit4thik—al—dad a to ber 0 18 Signato Print Name Shawn F Leonard r-. � f Town of Southold f 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 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--.it's; sigililkant' beneficial and adverse effects upon the coastal area(which includes all_of Southold TownZ 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained:in,detail, listing both supporting-and icon- suppor-tii facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,its-hall na 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. k B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 111 - 09 - 4.2 PROJECT NAME Hermer/Campo Residence t The Application has been submitted to(check appropriate response): Town.Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Rx- 1. 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: a Nature and extent of action: 1" Proposed 8'x 8'hot tub �" Location of action: 3675 Nassau Point Road Site acreage: -- 0.9411 _ Present land use: Single Family Residence 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: s (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code( ) (d) Application number,if any:. Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes EiNo l' If yes,which state or federal-agency? z - -- - ; 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. 7 t 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 J minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ` Yes a No Q Not Applicable 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 .0 Yes El No 2 Not Applicable Attach additional sheets if necessary 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 [j] Not Applicable - -- -- - - Attach additional sheets if necessary 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 ❑ Yes ❑ No 2 Not Applicable Attach additional sheets if necessary _- Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes ❑ No n Not Applicable 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. 0 ❑. Yes No Not Applicable Attach additional sheets if necessary t Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes 0 No xl Not Applicable b r; 4 t Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous E substances and wastes. See LWRP Section III—PoIicies; Pages 34 through 38 for evaluation criteria. 0 Yes '� No Not Applicable r 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. YeZ] No❑x Not Applicable Attach additional sheets if necessary 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. 0 Yes ❑ No 0 Not Applicable Attach additional sheets if necessary 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 0 Not Applicable Attach additional sheets if necessary 5 Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III -Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies; Pages 65 through 68 for evaluation criteria. 0 Yes ❑ No 0 Not Applicable PREPARED BY R) e`1 a_V- 0j �`'I0.,Z� - TITLERO(Q-C� P��`CF"l i b-d DATE