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TR-9508
/ 1 Michael J.Domino,President �QF SO(/�y Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� Old 54375 Route 25 P.O.Box 1179 Glenn Goldsmith 1 [ Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams '� �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1653C Date: October 23, 2019 THIS CERTIFIES that the existing 20'x42' in-ground swimming pool; and to remove and replace existing+/-54'x36' pool patio with new brick pavers in same location and elevation as existing; and for the existing shed;and to install a line of silt fencing seaward of the work during construction; At 1370 Jackson Street,New Suffolk Suffolk County Tax Map#1000-117-10-10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 22, 2019 pursuant to which Trustees Wetland Permit#9508 - Dated July 17, 20193 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing 20'x42' in-ground swimming pool; and to remove and replace existing+/-54'x36' pool patio with new brick pavers in same location and elevation as existing-, and for the existing shed; and to install a line of silt fencing seaward of the work during construction. The certificate is issued to John&Ellen Bellando owners of the aforesaid property. Authorized Signature I Michael J.Domino, President ��OF SO!/j�o 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 WilliamsyCOU O Fax(631) 765-6641 � NTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 10/x'3/ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: At Krep k., COMMENTS: Oyu � 155v� CERTIFICATE OF COMPLIANCE: 1 ' 0• sk Michael J. Dome President �� Tjf/O Town Hall Annex John M.Bredemeyer III,Vice-President �� l® ' 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G � O Telephone(631) 765-1892 Greg Williams �COU O Fax(631) 765-6641 � NT`I,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 9,y o _ZoCh. 275 Ch. 111 INSPECTION SCHEDULE 5i If FeAcAKC� /11�Pre-construction, hay bale line/silt bodm/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED BY: N (ZLWS1/ COMMENTS: r �" S��r /-eyice od- Jy` t-0 LoceV(. CERTIFICATE OF COMPLIANCE: ✓,r/2--z} Michael J. Domino; rresident y4S�yfFQ( Town Hall Annex John M. Bredemeyer, III Vice-President "za y� 54375 Route 25 Glenn Goldsmith N ,? P.O. Box 1179 A Nicholas Krupski y • ol�,�,r Southold, NY 11971 Greg Williams �ov 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 i� When project complete, call for compliance inspection; FRI %0. BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK J, I PERMITNO. 9508 DATE: JULY 17,2019 ISSUED TO: JOHN &ELLEN BELLANDO PROPERTY ADDRESS: 1370 JACKSON STREET,NEW SUFFOLK SCTM# 1000-117-10-10 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in q accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 17, 2019 and in consideration of application fee in the sum of$250.00 paid by John&Ellen Bellando and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit for the existing 20'x42' in-ground swimming pool; and to remove and replace existing+/-54'x36' pool patio with new brick pavers in same location and elevation as existing; and for the existing shed; and to install a line of silt fencing seaward of the work during construction; and as depicted on the site plan prepared by Jeffrey Patanjo dated April 29,2019, and stamped approved on July 17,2019. 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 17th day of July,2019. COD F 4 a Inc ARE F UN DIMENSIONS SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY G 72D9UNAUTHORIZED ALTERATION TA ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION [RNES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT'YTECtDEO TO GUIDE 7209 OF THE NEW YORK SPATE EDUCATION LAW. THE ERECTION OF FENCES. RETAINING WALLS.POOLS.PATIOS.PLANTING AREAS. VJDITION TO COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S CONSIDERED IINKED SEAL BUILDINGS OR ANY OTHER CONSTRUCTION OR EMBOSSED SEAL SHALL NOT BE EO TO BE A VALID TFVE COPY, I 11 ZIP C � L 1 _ ' aI,;L N 06° 08' 20" E 46552 G s { HEIYSE 2'*Wtl HEDGE ON LINE n i.n••-_-- o HEDGE 2'&:W ..EDGE 3'fW eV�.. VVYv� WOOD 't:ETTN p N !- . CHAIN LINK FE> . - - - - - - - - - - - - - - -DO FRAME SHEDFRAME (POOLHOUSE) WOOD DECK—SHED OBRICK PATIO2nd STY WOOD DECK Z OOOVER BRICK PATIOO OY.2om AC> O m eDRICK r E N N 1 S C O U R T F p ED ti po y � W� I .�i 0Gp n 'L 16.00 �m Z x ei °z C) 41 m Op T1 N y p m �•I[+I m I __ I = I- 1 IO ZO OL+1S.1 u ROOFOVER N 16.00 o SLATE CHAIN LINK FE PORCO LBRICK PATIO: BRICK n O PATIO 15.70 OOBRICKWALPOLE O. H WIBEO 3.9W• .� I [e o ?p 233-poO .. p CO bi HEDGE B'tW Ni ,\ O A V L R I V E A VIGOp.IET<Y HEDGE 2•sW ` lI i t `� \ D S 06° 08' 20" Fr N w�� 458.88 I-Io.00 N0 I t p Rr R.1pul o S.Lm E 4"E.M(t L•1'( £ \ dl N w JA . e I ' J , F I F T H S T R ' E E T FEY OF. DESCRIBED PROPERTY .TED: NEW SUFFOLK, TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE OF NEW YORK JACK ALLISON HALL � FEYED: OCTOBER 2,_4 2• 0a0a59 PCFIPP_ =z-�T LIC. LAND - -0 ZP. 6t5yV E NO.: vsc� :ocT.zD ? IINYS. LI t 979 DESK.: 1000 — 117 — f0 — 10 995 S ° Y,, BAB YLO 4 TO: JOHN W BELLANDO & ELLEN BELLANDO (6^1) 6 6 Ie 6363 FIRST A&BRICAN TITLE 19SURANCE COMPAQ Y p. NEE' YORK LAt10 SCALE: 25' B NO: 48025 I I JACKSO mN STREET 0E OF PAVEyp� S 84'00'00" E 10_I HEDGE ROW QI'00' Iti••` Y =I 331.57' w 1w CIO 00 00 to Iw 2 r IW ❑2I ,: �1 rc ` ,BRAVE! Dffft1 ` W \ROPL 1 sroRy -- - - - --- - - - - - -- R%Dea 2nd Srr.WOOD DMK BRICK PATIO 54' REMOVE AND REPLACE EXISTING BRICK PATIO TO SAME DIMENSIONS AND ELEVATION AS 20142' EXISTING ON EXISTING W TDaft O ROMt n=DlMa CONCRETE BASE MATERIAL EXISTING POOL TO REMAIN o UN-DISTURBED ' N 3 O O i0 O O N � co Z "'�y"B+teS'1]-i � O m®®®® y PROPOSED SILT FENCE SEAWARD ow.BUUGM OF WORK LIMITS DURING 9' CONSTRUCTION 'APPROVE® BY ,,;'•BOARD.OF 1RUSTEES TOWN_OFSOUTHOLD 4 DATE, �J MAY 2 2 2019 % N 84'13'40" w ��' 100.00' SC1LIVitol �Cl`e3iF6� /ti DOW WOOD JET1Y 007ING WOOD JfT1Y i --- REAT PECONIC BAY NOTES: 1. ELEVATIONS REFER TO N.A.V.D. PROPERTY OWNER: JOHN W. & ELLEN BELLANDO POOL PATIO PERMIT PLANS SCALE: 2. LOT AREA: 46,532 S.F. / 1.07 ACRES 25 WELLESLEY ROAD 1"=40' 3. PORTIONS OF SITE PLAN FROM SURVEY PREPARED BY: ROCKVILLE CENTER, NY 11570 DATE: JACK ALLISON HALL PREPARED BY: PROPOSED PLAN 4-29-19 995 SUNRISE HIGHWAY, BABYLON, NY 11704 JEFFREY PATANJO DATE SURVEYED: OCT. 2, 2009 P.O. BOX 582 1370 JACKSON STREET BOHEMIA, NY 11716 NEW SUFFOLK, TOWN OF SOUTHOLD JJPATANJO@GMAIL.COM SUFFOLK COUNTY, NY SHEET: 631-484-9332 TAX MAP N0. 1000-117-10-10 1 OF 1 TERMS AND CONDITIONS The Permittee John &Ellen Bellando residing at 1370 Jackson Street New Suffolk,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,bf any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant,'request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass;along the beach between high and low water marks. , 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. ' 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. 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,____ident �QF S�Ury Town Hall Annex John M. Bredemeyer III,Vice-President ,`O`� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631)',765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 17, 2019 i Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: JOHN & ELLEN BELLANDO 1370 JACKSON STREET, NEW SUFFOLK SCTM# 1000-117-10-10 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, July 17, 2019 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of JOHN & ELLEN BELLANDO 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 May 22, 2019, 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 issuance of a permiffor the structures; and WHEREAS, a Public Hearing,was held by the Town Trustees with respect to said application on July 17, 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, 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 JOHN & ELLEN BELLANDO for the existing 20'x42' in-ground swimming pool; and to remove and replace existing +/-54'x36' pool patio with new brick pavers in same location and elevation as existing; and for the existing shed; and to install a line of silt fencing seaward of the work during construction; and as depicted on the site plan prepared by Jeffrey Patanjo dated April 29, 2019, and stamped approved on July 17, 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: $100.00 Very truly yours, d Michael J. Domino President, Board of Trustees MJ D/dd X�+'b �suFFoc/�e Michael J. Domino, r-resident tr�o� �K__ Town Hall Annex John M. Bredemeyer, III, Vice-President y 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A Nicholas Krupski y�Sj Southold, NY 11971 Greg Williams " `Y Telephone (631) 765-1892, Fax (631) 765-6641 BOARD OF TOWN TRUSTEESg TOWN OF SOUTHOLD -70 °s i TO: JOHN & ELLEN BELLANDO c/o JEFFREY PATANJO Please be advised that your application dated May 22, 2019 has been reviewed by this Board at the regular meeting of July 17, 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) 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) 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: TOTAL FEES DUE: $ 100.00 ` BY: Michael J. Domino, President Board of Trustees SVFFfl(� Town Hall Annex Michael J. Domino, Presi' �® C �, John M. Bredemeyer III, Vice-President 54375 Route 25 Glenn Goldsmith y } P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971 Greg Williams A Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES I TOWN OF SOUTHOLD l Date/Time: -7 /� Completed in field by: ��, ��N���`'I Jeffrey Pata'njo on behalf of JOHN & ELLEN BELLANDO request a Wetland Permit for the existing 20'x42' in-ground swimming pool; and to remove and replace existing +/-54'x36' pool patio with new brick pavers in same location and elevation as existing; and to install a line of silt fencing seaward of the work during construction. Located: 1370 Jackson Street, New Suffolk. SCTM# 1000-117-10-10 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: _ J. Bredemeyer M Domino ` G. Goldsmith N. Krupski G. Williams Other Photo 1 t _ g --- --- - I �v . >e ♦ / ' e 3y ]e Al x.5 MATCH___ . /�I ��-- / ��•• $ Am w. "8 FOR PCE.NO 1 / SEE SEC NO e e4 CJ-/� - TUTHILL RD. (sq f I t yah ] 10 a m.1 m2 \ 4.2 O Ad, 15 ,Z»Y •� iiNcl a 3 '� I I r » s o 1217.4 N FOR PCL.NO. G1.•" '] ,w=) ,tA(c) g 1 SEE SEC.,w. )• 6 O / EE SE �+ tUISA d 18� 1Z0 '1T.5 6 T zT ycEORCE wit ,m. rm ,• „� O••,r � e.e, ' •. { 12 ] 1e.7 'A ue to ( ♦ Wu_8 z.sA x ; ,x CUTCHOCUE tea q.1 18.6 N �e • - 1x.t ♦ '+- 5♦r y1A . 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Box 1179 54375 State Route 25 Ar Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Telephone: 631765-1938 Southold, NY 11971 P ® Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: July 16, 2019 Re. LWRP Coastal Consistency Review for JOHN & ELLEN BELLANDO SCTM# 1000-117-10-10 Jeffrey Patanjo on behalf of JOHN & ELLEN BELLANDO request a Wetland Permit for the existing 20'x42' in-ground swimming pool; and to remove and replace existing +/-54'x36' pool patio with new brick pavers in same location and elevation as existing; and to install a line of silt fencing seaward of the work during construction. Located: 1370 Jackson Street, New Suffolk. SCTM# 1000-117-10- 10 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 INCONSISTENT with LWRP Policies 4 And 6, specifically 6.3 (below) and therefore, INCONSISTENT with the LWRP. 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 asset forth in Trustee permit conditions. The structures were constructed without Southold Town Board of Trustees review or permit. Note that Town records indicate that the pool and patio existed in 1994. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman y Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179; Southold,NY 11971 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., July 10, 2019 the following recommendation was made: Moved by Peter Young, seconded by James Abbott, it was RESOLVED to SUPPORT the application of JOHN W. & ELLEN BELLANDO,for an existing 20'X 42' in-ground swimming pool, remove and replace existing pool patio with new brick pavers in same location and elevation as existing. Install silt fence seaward of work during construction. Located: 1370 Jackson Street,)New Suffolk. SCTM#117-10-10 Inspected by: Peter Young, James Abbott, Caroline Burhgardt The CAC Supports the application; however the work has been completed. There was a question concerning the legality of the existing staircase and consistency with,best management practices, and whether the pool house is in compliance with the town code. Vote of Council: Ayes: All Motion Carried Michael J. Domino, Pre$itlent opo cow = Town Hall Annex John M. Bredemeyer, III, Vice-Presidento� y� 54375 Route 25 Glenn Goldsmith N = P.O. Box 1179 A Nicholas Krupski y Southold, NY 11971 Greg Williams mol ,� 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 R a,,)IREMENTS SCTM#: 017-10 -10 MAY 3 1 2019, Property Owner Name: Date Sent to Bldg. Dept: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? L Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition as described under Town Code? ' a COMMENTS: J�x, Plush 6 /10 4Sa4tureo Reviewer Date Michael J.Domino,President,®I S®�l�® Town Hall Annex John M.Bredemeyer III,Vice-President �® �® 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone(631)765-1892 Greg Williams Fax�] �Y�p�p�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application = Y Wetland Permit Application - Administrative'Permit F Amendment/Transfer/Extension MAY 2 2 2019 Received Application: S•ZZ.�Q Received Fee: $ ZSO.00 _ Completed Application: 3�• "`"""'' ��';�n�':vsV Incomplete: / '-- -•�_1 or i�+.;steep �rP� i SEQRA Classification: Type I Type II d Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: VDoordination:(date sent): lo'21./q AC Referral Sent: .2(0'Q ate of Inspection: 7• ®•� Receipt of CAC Report: Technical Review: Public Hearing Held: 7 17-If Resolution: Owner(s)Legal Name of Property (as shown on Deed): a k n V1. ���h e l 14 n a Mailing Address: a-S VJ L e s 1 t� Y`0C'4v'/1'e CC ii+ef IJ 1 1157-70 Phone Number: ` 8 o 91 -3 3 O V Suffolk County Tax Map Number: 1000 - Property 000 -Property Location: 13 '10 -S u a vin ee T- — fi e c.,) S� 121Cd d L 33l I wcbrt' mF V-14:+1ei (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): -;Y e AC-PCt_4 P.'t t a - Mailing Address: D - 0 o 13 o f em l-k-,lJ y 11-711, Phone Number: 6 3 1 • q g y ' 9 3 3o'\- DiSalvo, Diane From: Jeffrey Patanjo <jjpatanjo@gmail.com> Sent: Thursday, May 30, 2019 9:42 PM To: DiSalvo, Diane Subject: RE.Wetland Application - Bellando - 1370 Jackson Street, New Suffolk Diane, Please allow this e-mail to serve as our request to add an existing 20' x 42' in-ground swimming pool to our application description for the above referenced project. Please let me know if you need anything further. Thanks, Jeff _Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 631-484-9332 From: DiSalvo, Diane Sent:Thursday, May 30, 2019 11:00 AM To• 'iipatanio' Subject: RE: Wetland Application - Bellando- 1370 Jackson Street, New Suffolk Then please send me an a mail stating that you would like to add the pool to your project description—giving me the dimensions of the pool. Thanks Diane From: jjpatanjo [mailto:jjpatanjo@gmail.com] Sent: Thursday, May 30, 2019 10:54 AM To: DiSalvo, Diane Subject: Re: Wetland Application - Bellando - 1370 Jackson Street, New Suffolk Sure ! Sent fi-om my T-Mobile 4G LTE Device -------- Original message -------- From: "DiSalvo, Diane" <diane.disalvo@town.southold.ny.us> Date: 5/30/19 9:54 AM (GMT-05:00) To: 'Jeffrey Patanjo' <jjpatanjo@gmail.com> Subject: Wetland Application - Bellando - 1370 Jackson Street,New Suffolk i Board of Trustees Applicai n GENERAL DATA Land Area(in square feet): y 5 Area Zoning: (Lr- Previous cPrevious use of property: ReS Intended use of property: 2e C 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 ✓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 ✓ 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 ✓ No Does the structure(s) on property have a valid Certificate of Occupancy? ✓ Yes No Prior permits/approvals for site improvements: Agency Date 1—tvs-.tel 06 9 A - 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): rLa�n o vc. �ZcPl4ce �Ct gni n y POOL .PoLfl O wI�► MGN �fttG{C- Plil vdLS /r �!n-tG LeLaTto�/ ArtP o-leve- tiotl AS Sr C` - 4�to7c.-_ , --,,Board of Trustees Applica n WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: 4-19 1,ka-e- ax i sfii"'y QaoL pG-b�o wt-t►� new y/LtcIL Pavctij jr, S4/xt Loc4T�o� An qQ Teva -1-Ito A 517r'I . 7-•- S-".L 51 L4' $c4,w4,-,Q e � Woit,V, - Writ n4 itCII&eo . Area of wetlands on lot: o square feet Percent coverage of lot: O % Closest distance between nearest existing structure and upland edge of wetlands: .yv o feet Closest distance between nearest proposed structure and upland edge of wetlands: q o n feet Does the project involve excavation or filling? '� No Yes If yes, how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): -Thcr,e- wttl be no c �fe cj 6tvc +. a F eceleck c 11 l'tS` e)t,S'r-,1..t-e -f—o rvG,+cNS - Short Environmental Assessment Form Part 1 -Project Information Instructions for Completing Part 1—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 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 1—Project and Sponsor Information Name of Action or Project: 1370 Jackson Street-New Suffolk Pool Patio Replacement Project Location(describe,and attach a location map): 1370 Jackson Street-New Suffolk Brief Description of Proposed Action: Remove and replace existing pool patio to same dimensions and elevation as existing.Install silt fence seaward of work limits during construction. Name of Applicant or Sponsor: Telephone: q 1-7 John W.$Ellen Bellando E-Mail: jwilliambell@yahoo.com Address: 25 Wellesley Rd. City/PO: State: Zip Code: Rockville Center NY 11570 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 R1 ❑ 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3. a.Total acreage of the site of the proposed action? 1.07 acres b.Total acreage to be physically disturbed? 0.05 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.07 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial ❑✓ Residential(suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ F&_/� ❑ b. Consistent with the adopted comprehensive plan? ❑ Fv� ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, If Yes,identify: Agency:Suffolk County,Date:7-12-88 ❑ ❑� NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ❑ ❑ b. Are public transportation services available at or near the site of the proposed action? ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed a Elaction? 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: ❑ ❑ 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the El of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 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? ❑ R1 b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? R] ❑ If Yes identify the wetland or waterbody and extent of alterations in square feet or acres: Page 2 of 3 r ' 14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply: 0 Shoreline ❑ Forest ❑Agricultural/grasslands ❑Early mid-successional [:]Wetland ❑ Urban RI Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? Least Tern,Piping Plover ❑ 21 16. Is the project site located in the 100-year flood plan? NO YES ❑ Z 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, v ❑ a. Will storm water discharges flow to adjacent properties? 2 ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑✓ ❑ If Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: ❑ ❑ -.9. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES 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 I YES completed) for hazardous waste? If Yes,describe: ❑ ❑ I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/nam John W ell Date: Signature: Title:Owner PRINT FORM Page 3 of 3 Part 2-Impact Assessmen• The bead Agency is responsible for the completii Part 2. Answer all of the following questions in Part 2 using the oration contained in Part I and other materials su ed by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Flave my responses been reasonable considering the scale and context of the proposed action?" ? No,or Moderate e 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 r-7�j regulations? [V 2. Will the proposed action result in a change in the use or intensity of use of land? o 3. Will the proposed action impair the character or quality of the existing community? 1117 1 4. Will the proposed action have an impact on the environmental characteristics that caused the f establishment of Critical Environmental Area(CEA)? f S. Will the proposed action result in an adverse change in the existing level of traffic or f� affect existing infrastructure for mass transit,biking or walkway? �J 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? r _ b.public/private wastewater treatment utilities? � S. Will the proposed action impair the character or quality of important historic,archaeological, iV LL 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 10 Will the proposed action result in atl 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. DIDI1 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result to one or more potentially large or significant adverse impacts and an nvironmental 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 impacts. Town of Southold-Board of Trustees '71 Name of Lead Agency Dat I M i c h ciPresident �eiPrint orType Name sposr® IrpIAgency Title of Responsible Officer gra ur o Respon- sibleerPL!eaAgency Signature of Prepater(if different from Responsible Officer) EAF Mapper Summa,_,aport -Wednesday, May 01,2019 9:20 PM Disclaimer: The EAF Mapper is a screening tool intended to assist L- t�0 W800 project sponsors and reviewing agencies in preparing an environmental S E f,7t9t7-6t?flrfl66fia f F C`Z434i-613ft- c€/i st,_.�,_ -. i assessment form(EAF).Not all questions asked In the EAF are � ..y_ ='E 17,00-900=2�Ut�Q - tt answered b the EAF Mapper.Additional information on an EAF { '"s , -C' tit74Q question can be obtained by consulting the EAF Workbooks. 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'c a�`- _ aCa[um - ^"�., till _ - _ �, �,',.�• - cry r,ty'p ry5'W'` _ - �-,:-- ESQ-34!J "A3,l - T-�..3 _ :' t`'}S' .4,�.•,'° pg�± j^�R r Hn.,,...nen-.,,! ,e:.,::z,a.� a,<w-:;.s:�.,:.n~n, ...s[.,.;,:.:s_`r`„��:'.i�.:s:.,x.:.r�`S':..."�-. w:,...'iz„�.,,.',su:ih�•.',�<:;:',�.� - �sik�.,aJ,.17�Ti13'Yti.W.a� Part 1 /Questlon 7 Critical Environmental Yes JArea] __ 1Part 1 /Question 7 [Critical Environmental Name:Peconic Bay and Environs, Reason:Protect public health,water, Area= Identify] y.�.,_G �, vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National or State No w ry I Register of Historic Places or State Eligible Part 1 /Question 12b®[Archeological Sites] _ IYes Part—1 /_Qu_est`ion 13a [Wetlands or Other Yes- Digital mapping information on local and federal wetlands and — _ {Regulated Waterbodies] waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15 [Threatened or Yes Endangered Animal] Part 1 /Question 15[Threatened or �.,a"._.....�. Least Tern, Piping Plover Endangered Animal- Name] _ Part 1 /Question 16 [100 Year Flood Plain] Yes Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report , hoard of Trustees ,Applicat, AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED.HEREIN ARE TRUE TO THE.BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 THIS 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 ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. S' afore ofTroperty0 w r Signature of Prope Owner _,e, ljdllla�h_ SWORN ' BEFORE ME THIS DAY OF ,20Iq r Notary Public v, . ' Auna+� �, A:m8N),0 QW, v hoard of Trustees Applicat' AUTHORIZATION (Where the applicant is not the owner) Uwe, o � n W . E 0,e rt t e- 4.4, j- 0 owners of the property identified as SGTM# 1000- 1 7- in the town,of P,ew Sv (-F. Lk- ,New York,hereby authorizes -Te jCq:�-t of Tot �-a 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. Pro Owner's Signature Property Owner"s Signature Pr 0)-3SWORN'T BEFORE ME THIS_2DAY OF V\k& 1 Notary Public E Plota�r Public,-S of New ftk r4893018 ' Qualified in Nassau County irpmmi�sion EzpiMs May 04,20 APPLICANT/AGENT/REPRESENTA9['AT TRANSACTIONAL DISCLOSURE FORM eo 0 of ' ' def tluc ohib' n ' fi to es to v o and erniflAMes.Tile20-MRS f. this o f rnv' a inforinationw ' can alert the town oEaMible confliscIA0111110MMAd allow t to e h ver do ngccmy- to avoid sarrie. 11 iI rl YOUR NAME; G i n r�q q n (Last name,first nante;gaiddle 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 ofplat Mooring Exemption from plat or official map Planning Other (If"O,ther",name the activity.) Do you personally(or through your company,-spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood;Marriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employte t us even a platin!owttcnlrip of(or employment by).a corporation in which the town officer or employee owns more than 501sof the shares. YES NO if you answered"YES",complete the balance ofthis form and date and sign where indicated. Name of person employed by the Town of Southold Title br,position of that person Describe the relationship between yourself(the applicant/agent/representadve)and the town officer or employee,Either check the appropriateline A)through D)atidlor 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 50/6 of the shares ofthe corporate stock of the applicant (when the-applieaht is a corporation), !3)-the legal orbenef cial'owner of any interest in a non-corporate entity(when the applicant is not a corporation), Cj an officer,director,partner,or employee of,the applicant;or D).the actual applicant. DESCRIPTION Oi'RELATIONSHIP Submitted Ithi d f 24 Signature PrintN Form TS I i APPLICAN'!['fAGENT/REPUSENTO E TRANSACTIONAL DISCLOSURE FORM The Town of Southofd's Cnde of Elides prohibits conflicts of interest on the Part oftijwn offici;rs and empllovecs The Parnose of this form,is to provide inforinalion which can alert thetdwn of possible conflic of intemt-and allow it io-take whotever actiom Necessary to avoid same. YOURNAME: 43t l 4 n bin " 4 f Ch (Last name;first name ipiddle initial,unless you are applying in the name of someone else or other entity,such as a�company.If so,indicate the other petson'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 Of"Other',nate the activity.) Do you personally(Orthrough 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 r as even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%-of thes. /share YES _ NO - ✓ if you,ans-svered"YES",complete the balance of thisformand date and sign where indicated. Name of person employed by the Town of Southold Title or position ofthat person Describe the teiationship between yourself(the applicantiagent/repeeseritadve)and the town officer'or employee.Either cheek the appropriate line A)through D)and/or describa bi the space provided The town officer or employee or his or her spouse,sibling,parent,of child is(check all that apply): A),flWowner of,greater than 5,1/a of the shares of the corporate stock of the applicant (when the applicant is a corporation), B)the legal orbeneftcial owner of any interest in a non-corporate entity(Whe 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 az-,day o d 20_L3 Signature Print Name, Form TS t APPLIICANUAGENUREPRESENTATIV E TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The-uuroose of this farm is to provide inforination which can alert the town of possible conflicts of4nterest and allow it to take whatever action is necessarvv to avoid same. YOUR NAME: Pa--r 4.-n I'D (Last name,first name,Middle initial,unless you ar applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee .Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns'more than 501 of th S. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal orbeneficial 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, a1w L 20I Signature Print Name ccFn. 04 A. C; Form TS 1 July 9, 2019 D Town of Southold Trustees JUL 1 5 2019 Town Hall Annex Building ` � 54375 Rte. 25 Southold Town P.O. Box 1179 Boad ofJ Southold, New York 11971 RE: 1370 JACKSON ST.—NEW SOUTHOLD SCTM No. 1000-117-10-10 AFFIDAVITS Dear Trustees: Attached please find affidavits of posting and mailing for above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, 9L Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 ,PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM .2—] SCTM#1000-117-10-11 Marvin, Edgar&Arlene Manning Crdt Shelter Trt Mannview LLC Jackson Street 1470 Jackson Street PO Box 28 PO Box 262 New Suffolk, NY 11956 New Suffolk, NY 11956 SCTM#1000-117-9-10 SCTM#1000-117-9-11 Solution East LLC Carroll, Peter J &Deborah 440 W 44th Street #1 38535 Route 25 New York, NY 10036 II Peconic, NY 11958 STATE OF NEW YORK COUNTY OF SUFFOLK Jeffrey Patanjo .residing at P.O. Box 582,Bohemia,NY 11716 being duly sworn,deposes and says that on the _ 9 _ -day of.July- , 2019 ,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- _,tie m it ,that said Notices were mai to each of said persons by CERTIFIED BUII/RETURN RECEIPT. Sworn to before-me this 9 _ Day ofjuly._.__ . 2019 MARILYN S. HICKS f Notal Public= i NOTARY PUBLIC,STATE OF NEW YORK i Registration No.01 HI63W89 Qualified in Suffolk County commission Expires October 10,2021 4, Michael J.-Domino,President ��sVfFOL,(`,O Town Hall Annex John M.Bredemeyer III,Vice-President ��� Gyp 54375 Route 25 Glenn Goldsmith y z P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-I892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES:TOWN OF SOUTHOLD In the Matter of the Application of JOHN &ELLEN BELLANDO COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Teffrey Patanjo ,residing at/dba PO Box 582 Bohemia,NY 11716 being duly sworn, depose and say: That on the 6 day of July ,2019 , I personally posted the property known as 1370 Jackson Street,New Suffolk SCTM# 1000-117-10-10 by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing.Date of hearing noted thereon to be held Wednesday,July 17,2019. Dated: ' b ) , ' (si nat�•e - Sworn to before me this day of July 2019 MARILYN S. HICKS NOTARY PUBLIC,STATE OF NEW YORK Registration No.01 H1636M89 Notary"'Public Qualified in Suffolk County Commission Expires October 10,2021 U.S. Postal Service" V.S. 0 O�stal S6 S ° ■ ®ly, o ■ ro , COonly , SHO � CertifledM�e ru �,r° �• � U t:.� E3 .�' Ln �� L ,jam CO Ln $ertlfied Mail Fee Extra Service &Fees(check box,add fee as �° ,EMra Services&Fees(check box,add fee as appropdate) ❑Return Receipt(hardcopy) $ aPPropdate) q�, qQ C3 ❑Return Receipt(electronic) $ l4\y O Return Receipt(hardcopy) $ p ® `P`stmt( ❑Return Receipt(electronic) $ 1post I�) dl E3 ❑Certified Mall Restricted Delivery $ \v�ere' � ❑Certified Mail Restricted Delivery $ JUL He�`Ol 9 []Adult Signature Required $ J - O ❑Adult Signature Required $ - ❑Adult Signature Restricted Delivery$ Y []Adult Signature Restricted Delivery$ E:3 Postage 0 Postage r-3 $ 5 m FTo � - - -- C3 Total Postage and - - SCTM#1000-117-9-11 I m $ SCTM#1000-117-10-11 rr-1 Carroll, Peter J & Deborah ! w Sentro Manning Crdt Shelter Trt Mannview LLC o ' 1470 Jackson Street P- 38535 Route 25 O SlreeiendApt No,Peconic, NY 11958 cry,stale;ziP+4a PO Box 262 New Suffolk, NY 11956 .o tb MAIL" ■ ■ 1 /e Opinestic Mail Only r%- Ln `Ln Erru 00 FF IF e e e • e e ..� a Certified Mail Fee IN I CO $ertlfied Mall Fee �® , Cal Ln $ Lr) �• Extra Services&Fees(checkbox,add fee as appropriate) Z' Extra Services&Fees(check box,add fee as appropriate) \� ❑Return Receipt(hardcopy) $ ® (�� 19 []Return Receipt(hardcopy) $ 9��` Imo, ❑Return Receipt(electronic) $ ,`pOStr�r J C3 El Return Receipt(electronic) $ ® SttltarK- 0 []Certified Mall Restricted Delivery $ JSP Here t-3 ❑Certified Mail Restricted Delivery $ - ,I1ere E3 []Adult Signature Required $ O []Adult Signature Required $ C3 F]Adult Signature Restricted Delivery$ []Adult Signature Restricted Delivery$ 0 Postage 9 5p� r3 -Postage Qr U F Q' $ O Total Postage ant — - — ----- o Total Postage ar SCTM#1000-117-10-9.-26 m m $ SCTM#1000-117-9-10 $ CO Sent To Marvin, Edgar&Arlene Sent To I Solution East LLC C3 Jackson Street i o SiieeiandApE"N'"c 440 W 44th Street #1 C3 Street andApt.� � [�- r%- PO Box 28 Ctry-stale 2iP+4 New York, NY 10036 Cary State;ZlP+ , New Suffolk, NY 11956 1 Zitill Orr,111i hk PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 117 STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says 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 MAILIRETURN RECEIPT. Sworn to before me this Day of 120 Notary Public NOTICE OF HEARING 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 : JOHN & ELLEN BELLANDO SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing 20'x42' in-ground swimming pool; and to remove and replace existing +/- 54'x36' pool patio with neve brick pavers in same location and elevation as existing; and to install a line of silt fencing seaward of the work during construction. Located: 1370 Jackson Street, New Suffolk. SCTM# 1000- 117-10-10 TIME & DATE OF PUBLIC HEARING : Wednesday, July 17, 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 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 Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# i to - /V PROJECT NAME 13-7 c, Tm eV,son S i• Pa o C_ PaL-h o Aff laeern trL�- The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of TrusteesI 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: t&M,p" I k t t_ .a° kj-�rrt n q i'n u o C_. 12 b(it�lL -t4 e"k&Ir- Opt onen$10/7S -w rtdo e4ew-L-t[0•R OtS C�K! S-ring . wzrSToo l S--awst l,9 of- �•'� -14 roeft o-) _ I Location of action: 151D Tm c!G s o-% ST - N e L-) S� �F.o LLL i Site acreage: / 0 -7 Present land use: s i Present zoning classification: R4S• 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: n (a) Name of applicant: o 4 n "i E 1 l r n { I` Zen IQ b (b) Mailing address: a-J W1 e I(t S leu 2 P—OC"# l/c Cen 4-,ex, N`Q I! S7 0 i (c) Telephone number: Area Code{ ) °� 7- (d) Application number,if any: I Will the actionbb�edirectly undertaken,require funding,or approval by a state or federal agency? Yes F-1NoUdiIf 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. ❑Yes ❑ No Not Applicable m,p t f-pt Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LMW Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable i I 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 RNot Applicable A,o c r—t 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 Ige-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 L1 ( Yes ❑ No u Not Applicable AJ 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. i f , 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 — PoIicies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable NO C f-F e G* Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWR.P Section III—Policies; Pages 34 through 38 for evaluation criteria. 1:1 Yes ❑ No L� 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. ❑ Ye0 No Not Applicable A/P Attach additional sheets if necessary WORKING COAST POLIOkS Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable ,ve ! f4 e C 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 1:1 No No U 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 ❑ NoNot Applicable PREPARED BY �' PA fig.n 7 TITLE i4 tel+ DATE '� May 14, 2019 � ECE � VVE Town of Southold Trustees MAY 2 2 2019 Town Hall Annex Building 54375 Rte. 25 Southold Town P.O. Box 1179 B ar o Tr ste Southold, New York 11971 RE: 1370 JACKSON STREET, NEW SUFFOLK, NY SCTM No. 1000-117-10-10 APPLICATION FOR PERMIT Dear Sir/Madam: We hereby submit one original and three (3) copies of the proposed plans, application, check, photographs and required data for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very trA yours, effrey Patanjo P.O. Box 582 Bohemia, NY 11716