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HomeMy WebLinkAboutAnderson, James Michael J.Domino,President ODF SQUjy� Town Hall Annex John M. Bredemeyer III,Vice-President V� ! 54375 Route 25 O P.O.Box 1179 Glenn Goldsmith l�[ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 oly000% BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 27, 2019 Thomas J. McCarthy McCarthy Management, Inc. 46520 CR 48 Southold, NY 11971 RE: JAMES J. ANDERSON 2465 BAY SHORE ROAD, GREENPORT SCTM#: 1000-53-4-18 Dear Mr. McCarthy: The Southold Town Board of Trustees reviewed your request dated June 24, 2019 and the survey prepared by Kenneth M. Woychuk, Land Surveying, PLLC, last dated June 21, 2019, and determined that the installation of the sanitary system is out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no clearing, no removal of vegetation, no cut or fill of land or removal of sod, no construction, sedimentation, or disturbance of any kind may take place within 100' landward from the top of the bluff, or seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without further application to, and written authorization from, the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area 2 between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Michael J. Domino, President Board of Trustees MJD:dd S.C.T.M. NO. DISTRICT: 1000 SECTION: 53 BLOCK: 4 LOT(S): 18 PROPOSED SEPTIC SYSTEM DETAIL (8 BEDROOM) (NOT TO SCALE) PROPOSED 1,750 GALLON SEPTIC TANK 10'0x3.5' EFF. DEPTH PROPOSED (8) 8.5' X 4.75' X 2' DEEP LEACHING GALLEY HOUSE FUTURE EXP (4) 8.5' X 4.75' X 2' DEEP LEACHING GALLEY ELEV. 10.5' CLEAN-OUT FINISHED GRADE -FINISH 0)GRADE EL 8.5 EL 8.5 / TOP (7.5) -1' MIN. TOP (6.7) 1' MIN. MIN. 4" DIA j -�6" APPROVED PIPE SEPTIC APPROVED PIP LEACHING LEACHING T, 3' CLEAN INV'82' SAND min. PITCH 1/4"/1' TANK min. PITCH 1/8"/1' (5.9)LLEY °; GALLEY c COLLAR (6.5) INV. EL ' 10=� (6.0) n 8.5'-gip /80T. EL (2.2) BOT. EL.(4.2) HIGHEST EXPECTED GROUND WATER ELEV. 2.0' �A ' SEPTIC TANK (1) !L ' nN 1. MINIMUM SEPTIC TANK CAPACITIES FOR A 6 BEDROOM HOUSE IS 1,750 GALLONS. Q 1 TANK; 10' DIA. 3.5' UQUID DEPTH �� 2. CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 psi AT 28 DAYS. LANDWARD EDGE OF V AL ��• \N 3. WALL THICKNESS SHALL BE A MINIMUM OF 3', A TOP THICKNESS OF 6"AND A BOTTOM THICKNESS OF 4'. ALL WALLS, BOTTOM AND TOP SHALL CONTAIN REINFORCING TO RESIST AN APPLIED FORCE OF 300 ps1. WETLANDS AS DEIERMI 4. ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT. 81 SUFFOLK ENVIRONN CONSULTING INC. Q,o I W 5.THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WRH A MAX. TOLERANCE OF 11/47 MAY 14, 2019 �+ Lr, ON A MINIMUM 3"THICK BED OF COMPACTED SAND OR PEA GRAVEL N 01 Q 6. A 10' min. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED. jp ; J 0 e LEACHING GALLEYS (6) LOT 41 01 y` ��-� 1. MINIMUM LEACHING SYSTEM FOR A 5-6 BEDROOM HOUSE IS 400 sq ft SIDEWALL AREA, y� 8 GALLEYS; 8.5' LONG X 4.75' WIDE X 2' HIGH (53 eq ft per galley) J 2 LFACHNG POOLS ARE LEACHING STRUCTURESSOE CONSTRUCTED OOF R SPRECLABSAST REINFORCED CONCRETE (OR EQUAL) �J 3. ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL). �; J 10' min. DISTANCE BETWEEN LEACHING NGD WATER LINE SHALL ' min. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MAINTAINED. =, X. 5. AN LOT 42 ��,6 ELEV. 8.5 FRM. 1.3' OL DR BROWN 0.6' SHEDI SANDY LOAM 0 ' 1 , BROWN SM LOAMY SAND 1.9' 'lyd MEALE IUD �/ `t ZONE AE EL 6 TO SW COARSE 4.7' MON. 5 `� / 14 11� SAND a // o,V e �` LOT 43 F -WATER EL 1.3 OLIN q N HIGHEST EXPECTED GROUND WATER 774E X ELEV. 2.0' // \ G� SW WATER IN / O 6 O� MED M 6.0' ` TO COARJD DWELLINGS -D - - W/PUBLIC_WATER_ ---- 150, 05-20-19 PROPOSED !� gs +•':: O ''::.:�. / O. K. WOYCHUK LS SANITARY SYSTEM TYPICAL CLEAN OUT (6 BEDROOM) S.T. X0/8 o�p�'L '= '''•:: / SLATE OR ,M�t' ;.. °�......;.;:::' STOPPER END 0 g s m c+o :. •; ;;. e SUITABLE COVE - o y �i ;_�o OR PLUG G. 19 d' 30' ELBOW �Q\ MON. p� �O' " P �� i� ++� EXISTING SANITARY 60' WYE de !� ,3O TO BE ABANDONED G AND BACKFILLED P. WITH CLEAN COURSE SAND. DWELLINGS FLOW-! £a,P I OQ ♦ IN/PUBLIC WATER '�•.` oy 3p� $ QQ` j 150 yam• css M i ���RN�.. •� / PIPE 78 W/PUBLIC WATER IL, ` a V"' E 150' � O�� JUN 2 6 2019 ZONED R-40 NON-CONFORMING FRONT - 35'MIN Southold Town SIDE - IOWIN (25' TOTAL) REAR - 35'MIN 0 rd o Trustees REVISED 06-21-19 ISLAND VIEW LANE 174E WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL FIRM PANEL 36103CO159H LOCAnoNS SHOWN ARE FROM FIELD OBSERVAnoNS AND OR DATA OBTAINED FROM OTHERS. AREA: 15,015.88 SQ.FT. or 0.34 ACRES ELEVATION DATUM. NAVD88 UNAUTHORIZED AL7ERAT10N OR ADDITION TO THIS SURVEY IS A WOLA77ON OF SECTION 7209 OF THE NEW YORK STATE EDUCA77ON LAW. COPIES OF 7HIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO 7HE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON LISTED HEREON, AND TO 7HE ASSIGNEES OF 774E LENDING INS7777)7/0N, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM 774E PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADD177ONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE S7RUC-TURES RECORDED OR UNRECORDED ARE NOT-GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY SURVEY OF: LOT 42 CERTIFIED T0: JAMES J. ANDERSON; MAP OR PECONIC BAY ESTATES AMENDED MAP A FILED: MAP 19, 1933 N o.1124 SITUATED AT: ARSHAMOMAQUE TOWN OF: SOUTHOLD - KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design P.O. Boz 153 Aquebogue, New York 11931 FILE # 16-202 SCALE: 1"=30' DATE: NOV. 18, 2016 PHONE (631)298-1588 FAX (631) 298-1588 N.Y.S. LISC. NO. 050882 maintaining the records of Roberti. Hennessy k Kenneth M. lloychuk Michael J. Domino,President O�*zF SOU�yOI Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski • Telephone (631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NON-JURISDICTION INSPECTION DATE OF INSPECTION: , INSPECTED BY: �� /%/ Ch. 275 Ch. 111 COMMENTS: /5_t�f� hIL904 IF w l� � � `` 1 2465 Bay Shore Road, Greenport, NY 11971 - 6/17/2019 nom' Ik.:. North East North East r. w> J �!Y r+ }ii •r"� y$s v dot y�y { C i rT.► Y rt � �. i ►', t sem• s *,, tit. ` s �.# � 'at 4 w • '�.�.`' ~'`;.;y 7S �►»� k y• ����.f��� + � �'m South West South West 2465 Bay Shore Road, Greenport, NY 11971 - 6/17/2019 4 .4 - ,, MW'.: '... North East North East 4 IA, A s• u =p. .�e� 5 -nt - - .`�' ^. �j�'- _f �"-+� ' isw '✓� rte. �ti. �. • mow{. .'/C.�L rr..�� � `�,�.a ��I"i• > .��. T.t►��YY� r�"�rlr`�� . South West South West � 1 t Jill M.Doherty,President �VAF Spry Town Hall Annex James F.King,Vice-President �o� �� 54375 Main Road Dave Bergen -P.O.Box 1179 Southold,New York 11971-0959 Bob Ghosio,Jr. G John Bredemeyer Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 4, 2010 Mr. Frank Uellendahl, Architect P.O. Box 316 Greenport, NY 11944 RE: GINO $ CAROL MENCHINI 2355 BAY SHORE ROAD SCTM#53-4-16 Dear Mr. Uellendahl: The Southold Town Board of Trustees reviewed the site plan prepared by Frank Uellendahl, Architect, last dated October 29, 2010, and received on October 29, 2010, and determined that the construction of a proposed deck extension with a hot tub is out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code(Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of,any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff,without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. J I ( } 2 This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, III M. Doherty, President Board of Trustees JMD:eac r } Frank Wolfgang Uellendahl Architect 123 Central Ave POB 316 Greenport, NY 11944 t: 631.477.8624 e: frank@frankueliendahl.com October 29,2010 Submitted to: BOARD OF TOWN TRUSTEES ' Town of Southold r E l n �;t 53095 Main Road t Southold,NY 11971 L �^•:,��,-" fw Owners: i+,:�re T Gino and Carol Menchinl 2355 Bay Shore Road Greenport, NY 11944 SCTM#1000-53-04-16 Project: Deck Extension at the Menchini Residence on 2355 Bay Shore Rd in Greenport Dear Members of the Southold Town Board of Trustees, Attached please find an application regarding the request for a Letter of Non-Jurisdiction by your Board for the above referenced deck extension seaward of the existing residence. My clients wish to extend their existing deck in width and length and incorporate a hot tub on the lower level of the deck. The total width of the two-leveled deck is 25 feet and the total length is 28'-9". The current deck measures 17 feet wide and 14 feet long. The distance from the proposed deck to the high water mark measures ca. 177.5 feet and to the grass line ca.145 feet. I believe that the proposed deck extension does not require an administrative wetland permit and qualifies for the issuance of a Letter of Nan-Jurisdiction because it exceeds the 100 feet distance requirement. 'Thank you for your attention to this matter. Best regards, Frank Uellendahl,RA K 4 a 1 Y . Fgo la suy, � � '�•!c aceta+� q�NF,k �F��"i%�.w �'�.�! —r.,,., ��' 'per' "`��,'�}�X e, ,�Iw`t_a y riY"e I '� r .s .•�. ' s. � �,� �`'.� .;.a:.. -v�-n`�' ' >rw �>,(,� �_,_c3t,h rircc, �,rz, y _ r. t{ 20;7 ~� s`C.,U4 i3 7 I_,3.e5p ✓J r'ot.. <.fi.(_ _" ...P�`_.�+k2a 'cye.al; :373 f t f t � l e�eva'rtoa � C I;E,4T lee' k 2 9 ` I • ,39; ScutF.hold ZIP— 'Tow ,d-,, .s , Board of Trustees - ti vu.U4Ct OS'" 3 N.f51=.s44- W re: `.. .,... '°•f • - �' ' °/�•, 9a' WN6LL 00rob' e • ;x IJ / 10 •% `+ 1 r y�� _-�•�__��-•�e�---•-:amu"=—=�-•�_•:_�..x}-••!�-'•'-=_�--'��.:: • � c' %�� . qV' ��845d7'Zn W.. - mv� ncc3 o.ss , 1252 A •i== µ ••i RE7E'WALL •5 �I'1'Y- /• I IYL� Ai1EP.0.33 AC. 1$ 17 ANTHONY 4 PT'Z!CiA A. °°TS, • mdam — A7 aeA£tJDEL 5EV-T-..,L 1992. rows �U� .+ re •IT.)1n�td •aT`LiGU i N';LL'+ *�Y'. sucv.ey �u�v zl,le9z C 4'Z Cen3 AME_Nfit C MAPA'Pk,.0 NIC.5Ati' :.e.CL)t4'T-05*UCLF.I24= OrF)C.E A. TAX MRPpATF !WQ'S��r•,!C�- - %1�. �`••••— �' - �. .. - • - - -- ONS AMC CONTOUR.5 j2OPOU. i+: MEAN SEA LHyCt._N6VD. ,;� ,��„•�:•,.�,..�rnl+� - rwava,pnrirNY I - / AREA SUMMARY Z DECK A ,� L T IAT AREA =co 14,780 SF = 10000% r TO THE 1 i EASTG BLDG COVERAGE=cc 1,678 SF = 1135R e ,I�, 1"T 2 9 ADDED BLDG COVERAGE = 480 SF ` TOTAL BLDG COVERAGE =cc 2,158 SF = 14 fi0R l! L, MAXMAXBLDG COVERAGE =m cc 2,956 SF = 2000R Z W i seameaid Tawe PROPOSED DECK EXTENSION BoaBoa-__d olTrvstees EXISTING STRUCTURE RESIDENCE SURVEY BY RODERICK VAN L;PC GREENPORT,NY PROPOSED DATED SEPTELMDER 4 1992 2355 BAY SHORE RD DECK EXTENSION g ARCHITECT 23 Oft PR PER N 296 00' m a316 16 POBD 944 O c Of TEL 631 47 11914 177.5E ' m BT1-m 0624 FE�'G OWNERS , GMO A GAOL LUMN EXISTING sm RDRESIDENCE o� A1.1111141EL 60-24-28% - I --- — -- - a r 2Q-6_' --{ t —� PROPERTY UNE CIA 282 00' 2355 BAY SHORE ROAD .. 3 2 i2 e� 1dn9reo� � PROPOSED SITE PLAN SITE PIAN TM# = 1000-53-04 TRUSTEES APPLICATION SC HOL-l' a TOWN OF SOUTOLD A_I REQUEST FOR LETTER OF NON-JURISDICTION SUFFOLK COUNTY, NEW YORK e c 1 • 4 10 6' z CK EXTENSION TO THE HOT TUB BEYOND — 61 RESIDENCE SECTION GREENPORT,NY 2355 DAY MORE RD PROPERTY LINEuuuuu- "' ARCHTECT UP o r POJDK 316 wo gg GRTMM.In 1194! N t2 RL 63hq!6524 OWNERS 3'HIGH RAILING z3ss a4r au c�TEL 140x,34 M � TEL 6l6-591-2666 NOT TUB 1 , I WITH SR M COVER MBR �I a UPPER + LOWER LR 4 6 SF,. 2204 SF. i a UP UP 1 non. 10MI201 Al 5u 6. ins=r-6 EFTDECK EXTENSION 3'HIGH RAILINGFLOOR PLAN FLOOR PLANS &SECTION UP 24'-0' 14'-0' 2X' 5-0' A-2 _9• o . 'ted' 9�09L 90 o ` y - --- --------- MATLH SEESEC NO M O SEE SEC NO MATCH UNE FOR PCL 1B 17' � A(c) SEE SEC NO CA TO—OF SCERIHOLD ;A V .=CE1.NO 4 SEE No 2 1044A OF SOUrtO. J7 13$A(.) CCuNW OF SUFFOLK '2? VT tMN of 2 ell 70 111A(. TOMOFwunict-o 441 El 7 TOM 0FS -- a ;"CM PIPES CREEK o 7- & 67' BA CS CA(,) V 7- 7 7 EA 7M FOR EnNO E NO ——— ———————z--————— E SEE SEC.NO 007 SEESEC NO 057 SEE SEC.NO CTION NO NOTICEOF SUFFOLK ©COUNTYSOUTHOLD SE Real Property Tax Service Agency EY 053 _,NYII- M A —CT.. +000 PROPERTY MAP P W 777T7 RTN'TR WICARTHY M WE 9 MT, INC. 46520 COUNTY ROAu-48 SOUTHOM NY 11971 ; DAT& 1 JOB NO Iz, ATTENTIONIL (01) 765-5815 FAX (631) 765-5816 ; ITO �O .1 RE: y h >o 1 loob WEARIES ENDING YOU ❑ Attached ❑ Under separate cover via the following items: ; ❑ Shop drawings ❑ Prints ❑ -Plans ❑ Samples, ❑ Specifications ; ❑ Copy of,letter ❑ Change order-l' ❑ •• • s fY1 i N 15 c-O 1 V QrIer a t e nne Df t tNq. ` o t PS ufve- ho THESE ARE TRANSMITTED as checked b w: ❑ For approval ❑ Approved as s bmitted ❑ Resubmit copies-for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For review and comment ❑ ❑ FORBIDS DUE ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS i So y 4..,a'e�» BQ r DI ;USi�;°S COPY TO SIGNED: If enclosures are not as noted,kindly notify us at once. Michael J.Domino,President Town Hall Annex AN (j� g ' 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn GoldsmithJ Southold,New York 11971 c!� F.-. A.Nicholas Kru ski '' P C� ,gyp.' Telephone(631)765-1892 Greg Williams �(f�-�,� Fax(631)765-6641 i i BOARD OF TOWN TRUSTEES i TOWN OF SOUTHOLD -- - -- This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application _ Administrative Permit Amendment/Transfer/Extension Received Application:_ Received Fee: Completed Application: Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: jUH 26 2019 Receipt of CAC Report: _Technical Review: Public Hearing Held: _ _- soukflold loom _Resolution: Boars of Trn°ares ; Owner(s)Legal Name of Property(as shown on Deed): James J. Anderson _ Mailing Address: 98 Pearsall Drive Apt 1A, Mount Vernon, NY 10552 Phone Number: 914-260-6665 Suffolk County Tax Map Number: 1000 - 53-4-18 Property Location: 2465 Bay Shore Road, Greenport, NY 11944 (If necessary,provide LILCO Pole#, distance to cross streets, and location) McCarthy Management, Inc. AGENT(If applicable): � s Mailing Address: 46520 County Road 48,_Southold NY 11971__ Phone Number:- 631-765-5815 _ Board of Trustees AppLxcation GENERAL DATA Land Area(in square feet):_15,015.88 SQ. FT_ Area Zoning: R 40 Previous use of property: Single Family Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? Yes _X_ _ No If"Yes",please provide a copy. f 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 X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation:= -- Project Description(use attachments if necessary); Existing sanitary to be abandoned and_ backfilled with clean course sand. Installation of new 6 bedroom sanitary system Board of Trustees ApI,�ujcation WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To install_a new 6 bedroom sanitary system Area of wetlands on lot:. _179.0 approx square feet Percent coverage of lot: 8 approx % Closest distance between nearest existing structure and upland edge of wetlands: 110 - ,feet r Closest distance between nearest proposed structure and upland edge of wetlands: 190 feet Does the project involve excavation or filling? __No X__ _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: 4 approx feet Proposed slope throughout the area of operations: none Manner in which material will be removed or deposited:; Backhoe Statement of the effect, if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): NA 61 Z20 Appendix B Short Environmental Assessment Form Instructions far Comt letinQ. 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 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: James J. Anderson Project Location(describe,and attach a location map): 2465 Bay Side Road, Greenport, NY 11944 Brief Description of Proposed Actioq Name of Applicant or Sponsor: Telephone: 914-260-6665 James J. Anderson E-Mail: tmccarthy.tmccarthy@gmail.com Address: 98 Pearsall Drive, Apt 1A City/PO: J State: Zip Code: Mount Vernon_ _ _ _ NY 1055.2 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 Fid; 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: Suffolk County Health Department,Waste Water Mgmt. NYS DEC ❑ X❑ 3.a.Total acreage of the site of the proposed action? .34 acres b.Total acreage to be physically disturbed? .10 - acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •34 acres 4. Check all land uses that occur on,adjoining and near the proposed action. - -- ❑Urban ®Rural(non-agriculture) [:]Industrial ❑Commercial LE Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A_ a.A permitted use under the zoning regulations? ❑ a b.Consistent with the adopted comprehensive plan? El El- 6. 6. is the proposed action consistent with the predominant character of the existing built or natural NO -YES landscape? 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: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? -- - - NO YES .0 ❑_ b.Are public transportation service(s)available at or near the site of the proposed action? 51 E:I c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X] a 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? i NO YES If No,describe method for providing potable water:_ _ _ __ a X o 11.Will the proposed action connect to existing wastewater utilities? __NO _ YES_ If No,describe method for providing wastewater treatment: Septic System - ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic _NO YES Places? FT b.Is the proposed action located in an archeological sensitive area? a ' 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? ,0; 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: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑AgriculturaI/grasslands ❑Early mid-successional [A Wetland ❑Urban ®Suburban I5.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? ❑X 16.Is 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 E]YES ® 0 b.Willstori_n water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ONO 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: 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:_ _ a I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY' KNOWLEDGE ss Applicant/sponsorname:---10me5 An-de Son Date:_ - - —� Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all ofthe.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?" No,or- - Moderate small to large impact impact may may _ occur occur L Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? F ❑ 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)? EJ- 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 E ❑ 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? S. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? EJ EJ 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? El 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 drainageElproblems? _ 11. Will the proposed action create a hazard to environmental resources or human health? _EI 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. r 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. 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 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 Preparei(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Apl' 'cation AUTHORIZATION (Where the applicant is not the owner) I/We, James Anderson owners of the property identified as SCTM# 1000- 53-4-18 -___ __ —in the town of Greenport ;New York,hereby authorizes _ --McCarthy-Management,--Inc. -- _ 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. aProa wne 's Signature Property Owner's Signature SWORN TO BEFORE ME THIS 13 DAY OF `-z— ,,20_ Notary Public ANDREA RIVE Notary Public,State of New York No.01 814768970 Qualified in Suffolk County Commission Expires Nov.30,20-1 i Board of Trustees Apj�,.cation 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 WELL 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' n e of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS _ 3___�DAY OF,-- 0 ±5t- Notary Public ANDREA RIVE Notary Public,State of New York No.01 814768970 Qualified in Suffolk County Commission Expires Nov.30,20 APPLICANT/AGENT/REPRESENtAIM TRANSACTIONAL DISCLOSURE,FORM Thelown of Sotitb6ld's Code of Ethics prohibit"§conflicts of interest on the part-6f town officers and cmployees.The ifurnose of -,tBis'form is'to provide-infotinntioa-which can alert the town of possr6lc conflicts A tntorest and allow it-to take whafever.action is riecessary.to avoid same. ; YOURNAME: Anderson, James-i. _ ——(Last name,first name,§piddle initial,unless you are applying is 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"Other`,name the activity.). Do you personally(or through your company,'spouse,sibling,parent,or child)have a relationsl»p with.,any office roc;employee< of the Town of Southold? "Relationship"includes by blood,rq�iage,or business interest "Business intbre§t"means a liiisincss; including a partnership,in-which the town officer or employee has even a paitial owneiship of(or emgloyment,by,),4 corporation', in which the town officero"r employee b:kds 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. z Name of person employed by the Town of Southold_ Title or position of that person Describe the relationship between yourself(the applicant/agendrepresentative)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 o(greater than SOio of,the.shares of the cogioratd stock of the appficlnt (when the applicant is a coipdtz0d4); ' B)the legal or•beneficial owner of any interest in a non-corporate entity-(when the ' applicant is not a corporation); C)an office%director,partner;or employee of the applicant;or D)the actuaf applicant. DESCRIPTION OF RELATIONSHIP Submitted this 14t dayof June 2012 Signature Print Name _ _ James Anderson Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Towri of Sonthold's Code o£Ethics prohibits conflicts of interest on the part oftown officers and emaloyeos The purpose"of w 'this form is to provide-inforination wliich can alertthe'towh-0 Doss, bie`conflicts of mterstand allow rt to'take whatever action is neceMa to avoid,same. YOUR NAME: McCarthy, Thomas (Last name,first name,guddle initial,apless-you are applying iii,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"Other,name the activity.) Do you personil"y,`(or through y'_oiir company;spouse,sibling,,parent,or child)have Ielatfonsfiip with auyoffic:i--Q 'employee ; of the Town of,Southbld? "Relationship'°includes by blood,me-riiage,or 6- mess interest:"13osriess interest"-means a business, including a partnersiip,in which the town officer of em`ployce,fias gven a partial ownership of(or,emgloyment by)it corporation in which the town officer�oremployee owns more tfian 5°/aof 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 applicantfagent/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): the;owner ofgreater than 5°l0 of the*hies of the-coirporate stock of the applicant , (•when'the applicant is ii c6i�itiiation) _ B)the legal,o'r,beneficial owner of any interest in,a non_-corporate entity(when the 400 iicdnt is not a corporation); _ __ Clan officer,director,:partner,,orernployee"ofttic_'applicant,or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this da June 2ojk ly Signature - Print Name.- Tho as . cCa y ' Fotm TS l J 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,teyatuated' as ,to: :its:s__ _''icanC :beneficial aiid.adverse effects,upori'the coastal.area(wliich'includes'aIlaSouthold:Towril. ~ 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 r review law. Thus,,:each-,answer-,.must;=lbe-ernlainei In_dAt loth,,sunnort ne and non ,sappoi tiny•facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,;'it:shallA6 be undertaken: f 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# PROJECT NAME James Anderson The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees I 1. Category of Town of Southold agency action(check appropriate response): o =❑(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: ; X Nature and extent of action: Existing sanitary to be abandoned and backfilled with clean course sand. Install-new 6 bedroom sanitary ..system Location of action:_ 2465 Bay_Shore_Road, Greenport, NY 11944 Site acreage: 34 acres 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: k James J. Anderson (a) Name of.applicant;, _ _ _ _ ,- _ -- -- (b) Mailing address: 98 Pearsall Drive,'Apt 1A Mount Vernon, NY 10552- (c) Telephone number:Area Code( )_ 91.4-260-6665 (d) Application number,if any Will the action be directly undertaken,require funding,or approval by a state or federal agency? Suffolk County Health Services Yes.0 No 0 If yes,which state or federal agency?'' NYS DEC 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. 0 Yes 0 No © Not Applicable Attach additional sheets 1f necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LNW Section III—Policies Pages 3 through 6 for evaluation criteria tl Yes O No 0 Not Applicable Attacfi 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 r 7 l Yes.0 No QX Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Y 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 °0 Yes.0 No 'Lv2J 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, 0 Not Applicable - Attach additional sheets if necessary- Policy ecessaryPolicy 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. Cl ❑ 0 Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LVVRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes (❑No❑x Not Applicable Attach additional sheets if necessary Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes o 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 LVVRP Section III—Policies; Pages 38 through 46 for evaluation criteria. WE] 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 LVVRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes '❑ No F—X] 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 LVVRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes ❑ No 0 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 .E• No 0 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LVVRP Section III—Policies; Pages 65 through 68 for evaluation criteria. Yes ❑ No R1 Not Applicable PREPARED BY TITLE ` _ DATE