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TR-9627
Glenn Goldsmith,President �QF SO�jTown Hall Annex 54375 Route 25 A.Nicholas Krupski,Vice President P.O. Box 1179 Eric Sepenoski '. � � Southold, New York 11971 Liz Gillooly �n G Q Telephone(631) 765-1892 Elizabeth Peeples • �� Fax(631) 765-6641 COUNT`1,� BOARD OF TOWN TRUSTEES. - TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1900C Date: March 8,2022 THIS CERTIFIES that the,construct onto existing 1.5 story, single family dwelling with approximately 30'x27'. second story addition and.roof alteration, an'ap�iroximately 286sq_ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4.'x15' cellar entrance; maintain existing structures constructed prior to 1988, including an 18'x36' swimrning pool,a 1 570sq.ft. deck, and a.3-.3'.x1.2'. stair leading to a 12.3.'x-17' on-grade:deck;.remove existing septic system and.instaitnew"UA OWTS" sanitary system and cristal .drainage_system.of.;. .leaders, �dfters and dr wells At 11`70 Willow:Terrace._Lane-Orient uffolkCounty Tax Map,#1.000=26 2=23 Conforms to:the,application fora Trustees Perritt heretofore filed in tfiis . office Dated December 9;201.9'pursuarit.to which Trustees Wetland'Permif.#9627 Dated J`puIM y 15,2020,was issued and-conforms.: o all the;requirements and conditions of the applicable provisions of laW. Th`e project for which, this certificate is being issued is for the.construct onto existing'1.5.story, single family.dwelling with4proxiinately 30',x27' second story addition and roof alteration; an approximately 286sq ft covered porch in _.. . s tructures cobscorfs7u sci. onto 1 n an approximately 4'x15' cellar entrance maintain existing Lace o£existin 75sQ 'ft orch ari p ' 8, iricludin .an 18'x36'.swimriiing�o1. ol a 1,570sgA deck and a 3.3'x12' stair leading to a`12.3'.x17' on-rade deck; remove existing septic system and install new"I/A OWTS"•sanifary systein; and install drainage system of leaders, butters and drywells: The.certificate is issued to John P..& Kimberly.G. Keiserman owners.of the aforesaid Xe"* - Authorized Signature Glenn Goldsmith,President QF SUUjy Town Hall Annex A. Nicholas Krupski,Vice President �Q� 0l0 54375 Route 25 P.O. Box 1179 Eric Se,penoski l [ Southold,New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Elizabeth Peeples �l� �� Fax_(631) 765-6641 COUNT`I,N ...'BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD. , DATE OF INSPECTION: . INSPECTED BY Ch. 275 Ch. 111 INSPECTION.SCHEDULE Pre--construction, haybale line/silt boom/silt curtain . 1st day of construction '/2 constructed X .- Project complete,:compliance inspection COMMENTS: oik CERTIFICATE OF COMPLIANCE: t I Glenn Goldsmith, President *QF S10 Town Hall Annex Michael J.Domino,Vice-President ,`O� Ol0 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III 1 Southold,New York 11971 A.Nicholas Krupski G Telephone (631) 765-1892 Greg Williams �� Fax(631) 765-6641 co BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 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-construciloh,"May bale-line%sift'boord/silt curtain 1St day of construction constructed When project complete, call for compliance inspection; ei%........... BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT N0. 9627 DATE: JANUARY 15,2020 ISSUED TO: JOHN P. & KIMBERLY G. KEISERMAN PROPERTY ADDRESS: 1170 WILLOW TERRACE LANE, ORIENT SCTM# 1000-26-2-23 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on January 15,2020, and in consideration of application fee in the sum of$250.00 paid by John P. &Kimberly G. Keiserman and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct onto existing 1.5 story, single family dwelling with approximately 301x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; maintain existing structures constructed prior to 1988, including an 18'x36' swimming pool, a 1,570sq.ft. deck, and a 3.31x12' stair leading to a 12.3'x17' on-grade deck; remove existing septic system and install new "I/A OWTS" sanitary system; and install drainage system of leaders, gutters and drywells; all as depicted on the site plan prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated January 8,2020 and stamped approved on January 15, 2020 I 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 15th day of January,2020. 'irk I F TERMS AND CONDITIONS The Permittee John P &Kimberly G Keiserman residing at 1170 Willow Terrace Lane, Orient, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. 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. Glenn Goldsmith,President �QF S (/r Town Hall Annex Michael J.Domino,Vice-President ,`O� yOIO 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J�( Southold,New York 11971 A.Nicholas Krupski G Q Telephone (631) 765-1892 Greg'Williams �0 �� Fax(631) 765-6641 �yCOUNT'1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 17, 2020 Robert E. Herrmann En-Consultants' 1319 North Sea Road Southampton_, NY 11968. RE: JOHN P:=& KIMBERLY G. KEISERMAN 1170:WIL•LOW TERRACE LANE, ORIENT SCTM#1000-26-2-23 Dear Mr. Herrmann:, The Board of Town Trustees#ookxthe.following•action.during its .regular meeting held on Wednesday, January 15, 2020-regarding the above matter WHEREAS, En-Consultants-on behalf of JOHN P. & KIMBERLY G. KEISERMAN 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 December 9, 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 issued a recommendation that the application to construct onto existing 1.5 story, single family dwelling with approximately 30'x27' second' story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; and install new"I/A OWTS" sanitary system be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, the LWRP Coordinator recommended that the proposed application for the as-built 18'x36' swimming pool, a 1,570sq.ft. deck, and a 3.3'x12' stair leading to'a 12.3'x17' on-grade deck, be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered the Local Waterfront Revitalization Program policies 4 and 6.3 to the greatest extent possible through the imposition of the following Best Management,Practice requirements: the issuance of a permit for the structures and the submission of a revised plan; and, 2 WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on January 15, 2020, 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 of the Southold Town Code, and, RESOLVED, that the Board of Trustees APPROVES the application of the JOHN P. & KIMBERLY G. KEISERMAN to construct onto existing 1.5 story, single family dwelling with approximately 30'x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; maintain existing structures constructed prior to 1988, including an 18'x36' swimming pool, a 1,570sq.ft. deck;and a 3.3'x12' stair leading to a 12.3'x17' on-grade deck; remove existing septic system and install new"I/A OWTS" sanitary system; and install drainage system of leaders, gutters and drywalls; all as depicted on the site plan prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated January 8, 2020 and stamped approved on January 15, 2020. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, 4C Glenn Goldsmith, President Board of Trustees GG/dd (,� Michael J.Domino,P nt QS�FFDC' 1 Town Hall Annex John M. Bredemeyer III,Vice-r esident �� OPV_ 54375 Route 25 Glenn Goldsmith y x P.O.Box 1179 A.Nicholas Krupski d Southold,NY 11971 Greg Williams p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: ` Completed in field by: En-Consultants on behalf of JOHN P. & KIMBERLY G. KEISERMAN requests a Wetland Permit to construct onto existing 1.5 story, single family dwelling with approximately 30'x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; maintain existing structures constructed prior to 1988, including an 18'x36' swimming pool, a 1,570sq.ft. deck, and a 3.3'x12' stair leading to a 12.3'x17' on-grade deck; remove existing septic system and install new "I/A OWTS" sanitary system; and install drainage system of leaders, gutters and drywells. Located: 1170 Willow Terrace Lane, Orient. SCTM# 1000-26-2-23 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� 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 k-ofCh. 111 SEQRA Type: 1 II Unlisted Action . Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey :5 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 4'�G. Goldsmith N. Krupski l G. Williams Other S.C.T.M.# DISTRICT: 1000 SECTION: 26 BLOCK: 2 LOT: 23 /- NO SANITARYOR J WELLS VISIBLE IN THIS AREA APPROVED BY BOARD OF I RL STEES DWELLING TOWN OF SO HOLD \ w/WELL LP. ATE q-AWdAf 1 2020 O '^ WELL LP LP. � DWELLING W/WELL L.P. HIGH WATER -4 N \ ORDINARY HIGH WATER-- MARK AT TIME OF SURYK \ MARK AS INDICATED / ON FILED MAP. �—� �� � � PROPOSED WATER LINE 0.5S 1 549'12'00"W L07 3 \ I TDb om1 + o.5'N 185.80' P/0 LOT 4 \ } S IK : POLE EL 16.1U P. W I RL. : 1 ( EXISTING WELL '� I I 1 TO BE :X I N ABAN42:2 PROPOSED '_0 .-0 'N z trj IN ' D ' N2423 + � y rf EL16.0 a m x -" \ \ \ POSED VACANT2 D SMRY g. O EXisTirci:jsrr: `\ Ine 1.� • ' w.•.•.. FRM. • 0 DWELLING 11170z o10 1 _ 60 m 1 1 1+ PRO 6 of I I I , WOOD DECK �`�`�`��`�`�``� P/0 LOT 4 1 / •�,� I I I ' EL 17.3 v'�``�` `�`` *0 EkISR 6D I I I `�`�`�;`�`;o ED FCC 0 , WELL ,r- O� , Wppp ":':: ..............:: 4.1'��`�`�` �3iP 0 PROPOSED 4 BEDROOM SANITARY SYSTEM r HYDRO ACTION AN400 TREATMENT TANK(44WO) ' 13.5' `, (2) 6'DEEP LEACNMG GAIlEYS (STACKED!GALLEYS, GRADE �i DWELLING ap : : ;:;::::: :;;: z ROOM IT7R(1) 6'DEEP LEAcllmnc GAILE, FUNRE EXPI W�LI- DRAINAGE CALCULATIONS aa....,. :+ 16.3':.` ENT 10 ip jl - 31 100' m SEE DETAILS PREPAREd BY S L A1ARE4G COMIM ERS CK 4� 071 (12 S.FI) iro I:t:;:?::�•:��:;t2�:�:; n LP. E%P EL 15.8 MON. O cO I I P ..: I PROPOSED 2ND FLR ADDITION & COVERED PORCH=944 SQ.FT. Tk. ±� I N d 2+.sU.P. 944 x 0.166=156.70 < 157cf REQUIRED I I o.2N 1$0.91p (1) B'D1A x 4' DEEP DRYWELL=169cf PROVIDED I.3N 4 VINYL PICKET 151.8'S38-17'(b"W ExLS m SANITARY SYSTEM L.P. L.P. PROJECT UNITING FENCE ' I AND eIACKKFILLBE�ED�CLEAN LOT 5 LP' BUILDABLE LOT AREA: 13,065 S.F. I PROPOSED 1 , POOL WASTE LL !� (AREA LANDWARD OF THE WATER ar,r+BEEP 6. AS SHOWN ON MAP x`26 COASTAL EROSION HAZARD UNE.) COASTAL EROSION HAZARD BOUNDARY \ � EXISTING LOT COVERAGE: DWELLING: 1,890 S.F. or 14.46% �• FRONT PORCH: 75 S.F. or 0.57% POOL DECK(EXCLUDING OVERHANG): 1,442 S.F. or 11.03% / POOL DECK OVERHANG: 128 S.F. or 0.98% WELL / SWIMMING POOL W/STEPS: 665 S.F. or 5.09% DWELLING / TOTAL: 4,200 S.F or 32.15% _. - .... . W/WELL / / PROPOSED LOT COVERAGE: / DWELLING: 1,890 S.F. or 14.46% FRONT PORCH: 286 S.F. or 2.19% JAN 1 3 2020wELL DWELLING POOL DECK(EXCLUDING OVERHANG): 1,442 S.F. or 11.03% POOL DECK OVERHANG: 128 S.F. or 0.98% / ELEV. 15.8 W/WELL LP SWIMMING POOL W/STEPS: 665 S.F. or 5.09% DR BROWN CELLAR ENTRANCE: N/A OL LOAM IN, -0.5' TOTAL: 4,411 S.F or 33.76% WELL ADD POOL DRYWELL 01-08-20 TYPICAL SILT \\\ /// ML BROWN REVISED 06-17-19 7HE WATER SUPPLY, WELLS, DRYWFLLS AND CESSPOOL SCREEN SECTION / —3.0 LOCA77ONS SHOWN ARE FROM FIELD OBSERVA770NS PALEAND OR DATA OBTAINED FROM OTHERS. GEOTEXTILE FABRIC BROWN 21,435.79 SQ.FT. or 0.49 ACRES FIRM MAP #36103C0068H NAVD88 - _ FINE AREA: ELEVATION DATUM: SUPPORT POSTS '—------_ SW TO UNAUTHORIZED ALTERA71ON OR ADD17701V 70 774/S SURVEY IS A VIOLATION OF SEC7701V 7209 OF THE NEW YORK STATE EDUCAIION LAW. COPIES OF THIS SURREY WOOD OR METAL COARSE MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN SAND ONLY TO 774E PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF 70 774E TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON FLOW DIRECTION WATER _14.8' LISTED HEREON, AND TO 774E ASSIGNEES OF THE LENDING INSTTTU770N, GUARANTEES ARE NOT TRANSFERABLE. (EL 1.0) THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE EXCAVATED AND DWELLING NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS BACKFILLED TRENCH W/WLLL PALE BROWN AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 71ME OF SURVEY EXISTING GROUND SW ITO N SURVEY OF: P/0 LOT 4 CERTIFIED TO: KIMBERLY G. KEISERMAN; COARSE MAP OF: WILLOW TERRACE SECTION ONE JOHN P. KEISERMAN; SAND I I(=1 I I= I I-I�=11 LI-1 I I=I I(_ -- 17• FILED: NOV. 28, 1969 No.5407 CHICAGO TITLE INSURANCE COMPANY; -III-III-III=III-�-III=II III=11 =III-III-III-III= = NOV. 03, 2016 SITUATED AT: ORIENT CITI MORTGAGE; - i- McDONALD GEOSCIENCE I-1TI_IIII-I i 1=1 1111-11141 1 11-1 1 _I 1 1_I 1 1=1 I I_I 11 11 1— TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC a' 2' MINIMUM SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design LP. g �� �,f P.O. Bog 153 Aquebogue, New York 11931 LP. PHONE (631)298-1588 FAX (631) 298-1588 FILE 15-64 SCALE: 1"=30r DATE: MAY 26, 2015 N.Y.S. LISC. NO. 050882 maintaining the records of Robert J. aennesq a renneth M. Woychuk Avg I Bohn P.&Kimberly G.Keiserman ' '1170 Willow Terrace Lane,Orient SCTM#.- 1000-26-2-23 1/8/20 ' Rj 1- 7 r �r t t JOHN A&MBERLY KEISERMAN, 1170 WH. W TERRACE LANE,ORIENT t� f ' • , '-f Ln ... Figure 1. Aerial view of subject dwelling,swimming pool,and decking in October 2017. Image by Google Earth. �r Figure 2. Looking east at front of existing dwelling and staked locations of proposed porch and cellar entrance, and at location of proposed second-story addition over center portion of dwelling. JOHN AAWBERLY KEISERMAN, 1170 WIL TERRACE LANE,ORIENT 40 � T 11MIII�IIIA ^ 'A on n, Figure 3. Looking southeast at existing swimming pool,deck, and stnirwar down bank. - fr 1. t Figure 4. Looking northwest at seaward edge of existing deck, stainval,down bank, and grade level deck adjacent to bulkhead. 5 r� � �.n 5- �� ' � y ,� .� r y �' '� L vY � �_ Y { .*`, � r # � �y � - !' - x,� ., t �: -.. � � �~�* ' � r �� ��� - .L- i - �_ ,rte ,�,,. � '3,. ��� ,� �� A x � i,t. - �� !�_ _ ;�. '- t �� AIR# &/off D 3 EXP# SCALE Kr c f-- DATE 2—z5—1 Q 1�Ct aeroimage@optonline.ne 631.467.4087 fax631.467.4f,� - � r au ::., � • ,. -s �'' �.m� r,v+'1'ea�iat p t � �Lr.��-..< t rsat+ara�^xz� eaatc.'_ �suaa're ) a .r _ .,`"_ __. ._'tY'",�s-"-.,-,�. .,. _._ ..._.r,n .Qr�u�4b':.�.. �Fa♦7cat.�e� �+ a 3-21-01 % fi 0 w 0 y t•,T " - ... +22x2a r As r 1 3A t9-0Tc y ', 3 +2505 ��y 1t 4_1' m lit I�,fv S2L19 • Y1 ♦ 101 1 9 ) T 1 1 sy, .I 4 .an * n 10.1 ri 122 12.t — A. � •« 321 i q 10 31 23 35 ; 36 r M C m t.GA 1 Yl U T/N 0 40 301543.0 1\ to j 11 � vx LIM q 3 " m 1.OA a10 1lA(1A10_ e a w t0 a• � 12 wz a3.10 `rT 10 38.17 na O 43.11 3614 m t.an 6. 3 � 1'ah 1.aA� pR w V J Ql i t 361 , 0 t3A(C) w Tt .� , a 23 324 4 1aW 1 0 � 9 2 25 /r '•+ (9Sy i m ti 271 1 12 i w.ss�w..,�o�axwrss.u�„:.ax�ss a,m�,,, �„.:,. �w NOTICE E " E,a,,„a" rs a — oa COUNTY OF SUFFOLK © h lova secrla No E O o... --�— o..vv til A:.'eu N ori _—.—— —— — u. z amu. __ b___ ...� 2-w.) Real Property Taz Service Agency nwMe"T+�ti'�AT�+ a'+ M elsmleurloKa arc roRTlon or'tHc aourtw�o 026 306 Cmre!>ne.l3."/heat M L90] W E s1iTOLK e0.3RV TA%naw a Eo 0 --.—_ __.w__ w —__ .v w. (21) roar + 9' WfOgtrt WRfrtBl PQA65Ot6TIE P ___-- S REIL PR6S•HIY TAK a3'NKf M.B<Y. EN-CONSULTANTS January 10, 2020 Glenn Goldsmith, Chairman Board of Trustees Town of Southold P.O. Box 1179 JAN 1 3 2020 Southold, NY 11971 Re: John and Kimberly Keiserman Dear Mr. Goldsmith: In response to the Board's request during field inspection of the captioned property on January 8, 2020, please find enclosed three (3) copies of a site plan prepared Kenneth M. Woychuk Land Surveying, PLLC, last dated January 8, 2020, which has been revised to depict the addition of a proposed pool drywell for the pre existing swimming pool. Should you have any questions or require any additional information, please let me know. Res ec fully yours, ! Robes . He=ann Coastal Management Specialist Enclosures j 1319 North Sea Road Southampton,New York 11968 p 631283.6360 f 631.283.6136 www.enconsultants.com environmental consulting I OFFICE LOCATION: �®f ® �® MAILING ADDRESS: j Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) b '- 4„ Southold,NY 11971 t Telephone: 631 765-1938 { Fax: 631765-3136 couffmf LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM I To: Michael Domino, President 'Town of Southold Board of Trustees I From: Mark Terry, AICP LWRP Coordinator Date: Januay6, 2020 I Re: LWRP Coastal Consistency Review JOHN P. & KIMBERLY G. KEISERMAN SCTM# 1000-26-2-23 En-Consultants on behalf of JOHN P. & KIMBERLY G. KEISERMAN requests a Wetland Permit to construct onto existing 1.5 story, single family dwelling with approximately 30'x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; maintain existing structures,constructed prior to 1988, including an 18'x36' swimming pool, a 1,570sq.ft. deck, and a 3.3'x12' stair leading to a 12.3'x17' on-grade deck; remove existing septic system and install new "I/A OWTS" sanitary system; and install drainage system of leaders, gutters and drywells. Located: 1170 Willow Terrace Lane, Orient. SCTM# 1000-26-2-23 - I The proposal to construct an approximately 30'x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, install a I/A OWTS and an i approximately 4'x15' cellar entrance is recommended as CONSISTENT with the LWRP. The proposal to permit the as built 18'x36' swimming pool, a 1,570 sq. ft. deck, and a 3.3'x12' stair leading to a 12.3'x17' on-grade deck; is recommended as INCONSISTENT with policies 4'and 6.3 and the LWRP. ! Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. 4.1. Minimize losses of human life and structures from flooding and erosion hazards. The following management measures to minimize losses of human life and structures from flooding and erosion hazards are suggested.- Portions uggested.Portions of the pool and wood decks are located within the Coastal Erosion Hazard Area j (Figure fl. . f a� HIGH WATER MARK AT TIME OF SURVEY. COT 3 ORDINARY HIGH WATER MARK AS INDICATED ON'FILED MAP. ,54,5_` LS49'12'00"W - I 185.80' _ r✓ ,.� ass �,N _.._ _Z , �, �� I 4 P/O LOT4 ` m WELL AU.P. 2 Q r� ' '•- 1 i ui ae.r;;.42.2::,'u{':7.w x„. A O AA Ct Z ..''S' „•x;, P/0 LOT 4 0 :i'it,,,..e',,..ri..i; 0 i'. ' t IS cl+ #,:'"i t.s. »,y'i/�sTMsr}'e.o 63.6' r*i • ;.Y FRa. of h I WOCD DECK ✓ D_. CI C rv'd 1 bYrhM1,- o R p n ON EL O.6 o {. Z r (Ire sFJ mom aa o ct r --' a K 180.91' 4 wKrL PDKEr 538'17'00"w 151.8' I LOT 5 COASTAL EROSION HAZARD BOUNDARY J AS SHOWN ON MAP 926 Figure 1. Portions of the pool and deck seaward of the•CEHA Line. It is recommended that as built structures located seaward of the coastal erosion hazard area be removed or moved as far away from flooding and erosion hazards as practical. Policy 6.3. Protect and restore tidal and freshwater wetlands. r A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. According to Town records, the 18'x36' swimming, pool, a 1,670 ' sq. ft. deck, and a 3.3'x12' stair leading to a 12.3'x17' on- grade deck; were constructed without obtaining Board of Trustee review or a regulatory permit. In the event the action is approved, the following is recommended to further Policy 6. 1. Require a de-watering well for the pool. 2. Verify that the storm water is controlled pursuant to Chapter 236 Stormwater Management of the Southold Town Code. 3. Formally recognize the vegetated, non-turf buffer in future permits. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney ���g�yFFO�►k�d Peter Young,Chairman ti - Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 i Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 I Conservation Advisory Council Town of Southold i At the meeting of the Southold Town Conservation Advisory Council held Wed., January 8, 2020 the following recommendation was made: Moved by Carol Brown, seconded by John Stein, it was RESOLVED to SUPPORT the application of JOHN P. & KIMBERLY G. KEISERMAN to construct onto existing 1.5 story, single-family dwelling an approx. 30'X 27' second-story addition and roof alternation, an approx. 286 sf. covered porch in place of existing 75 sf. porch, and a 4'X15' cellar entrance; maintain existing structures constructed prior to 1988, including an in-ground swimming pool, deck, stairs leading to an on-grade deck; remove existing septic system and install new I/A OWTS sanitary system; an install drainage system of leaders, gutters and drywell. Located: 1170 Willow Terrace Lane, Orient. SCTM#26-2-23 j Inspected by: John Stein, Carol Brown The CAC Supports the application using best management practices and the installation of a 10' non-turf native vegetated buffer. Vote of Council: Ayes: All Motion Carried I, BOARD MEMBERS �*OF $O(/Tyo Southold Town Hall Leslie Kanes Weisman,Chairperson �� 1p 53095 Main Road •P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora Office Location: Eric DantesRAI �p Town Annex/First Floor, Robert Lehnert,Jr. ,�teaa 54375 Main Road(at Youngs Avenue) Nicholas Planamento OI�COO ,��`" Southold,NY 11971 http://southoldtownny.gov R E C"E I VE D ZONING BOARD OF APPEALS �, _" to:q9 AIM TOWN OF SOUTHOLD t Tel.(631)765-1809•Fax(631)765-9064 N 0 V U 2 2 6/2019'/ LG I'l2". FINDINGS, DELIBERATIONS AND DETERMINA ftU ®Id Town Clerk MEETING OF NOVEMBER 21, 2019 ZBA FILE: 7334 NAME OF APPLICANT: John & Kimberly Keiserman PROPERTY LOCATION: 1170 Willow Terrace Lane, Orient,NY SCTM No. 1000-26-2-23 SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated July 2, 2019 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated November 4, 2019. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records it is recommended that the proposed action is CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. PROPERTY FACTS/DESCRIPTION: The subject property is a 21, 435 sq. ft. non-conforming lot in an R-40 Zoning District. The property has a road frontage of 100.00 feet along Willow Terrace Lane, where the southerly line runs west 180. 91 feet to Orient Harbor, then the rear yard runs north 135.00 feet along Orient Harbor before returning 185.80 feet back to Willow Terrace Lane. The property is improved with an existing one-and one-half story dwelling, and an accessory swimming pool surrounded by a wood deck. All shown on the survey prepared by Kenneth M. Woychuk, L.S. last revised June 17,2019. BASIS OF APPLICATION: Request for a Variance from Article XXIII, Section 280-124 and the Building Inspector's June 19, 2019, Notice of Disapproval based on an application for a permit to make additions and alterations to an existing single family dwelling; at, 1) more than the code permitted maximum lot coverage of 20%; located; at: 1170 Willow Terrace Lane, (Adj.to Orient Harbor), Orient,NY. SCTM No. 1000-26-2-23. RELIEF REQUESTED: The applicant requests a variance to construct a covered porch on the east side of the house with a proposed 33.76% lot coverage where a maximum of 20% is allowed by Town Code. r ` Page 2,November 21, 201_ #7334, Keiserman SCTM No. 1000-26-2-23 ADDITIONAL INFORMATION: In both written and oral testimony, the agent for the applicant stated that the subject property was improved before the development of the NYS Coastal Erosion Hazard Areas Act of 1998, and therefore falls outside the allowable limits of development. Since the passage of this law, the definition of "Buildable Land" was changed to exclude land seaward of the Coastal Erosion Hazard line, delineated by New York State. The as built pool was granted a permit prior to 1988. Since the proposed improvements also include the construction of a second story addition, the applicant is proposing a new Advanced IA Sanitary system for the property. On August 1, 2017, the applicant was granted a letter of non jurisdiction by the NYS Department of Environmental Conservation which determined that landward of the top of bluff, as depicted on the survey last revised July 25, 2019,was beyond their jurisdiction. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on November 7,2019 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law 4267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The proposed covered porch on the landward side of the existing dwelling conforms to all required setbacks and will remain open, non-habitable space. The proposed construction is in keeping with other properties in the surrounding area and will replace an existing covered porch that is to be demolished. 2. Town Law $267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The proposed small porch addition complies with all the setback requirements, but due to the location of the Costal Erosions Hazard Line on the subject property, the allowable buildable area is considerably less than the actual size of the entire property. Therefore, any addition on the property at ground level will require variance relief. 3. Town Law §267-b(3)(b)(3). The variance granted herein is mathematically substantial, representing 68.8% relief from the code. However, the relief is not substantial due to the fact that the increase relative to what has existed for more than 30 years is limited to 211 sq. ft. If the applicant were allowed to include the land located seaward of the Coastal Erosion Hazard Area in the calculation of lot coverage, the substantiality would be reduced to 19.6%. Additionally, if the applicant created a small physical separation between the pool-surround, and the portions of the existing deck that overhang the bluff, the lot coverage would decrease to 2, 613 sq. ft. or 22.7% which would be far more consistent with other properties that have received variance relief for excessive lot coverage. 4. Town Law t 267-b(3)(b)(4). No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code and conditions of this Board. 5. Town Law $267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law $267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a proposed covered porch while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. A Page 3,November 21, 201 #7334,Keiserman SCTM No. 1000-26-2-23 RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Lehnert, seconded by Member Planamento, and duly carried,to GRANT the variance as applied for, and shown on the survey prepared by Kenneth M Woychuk, Land Surveying, last revised June 17, 2019. t SUBJECT TO THE FOLLOWING CONDITIONS: 1. The proposed covered porch shall remain unenclosed, and not be made into habitable space. 2. The applicant shall install an Innovative/Alternative Waste Water Treatment System as approved by Suffolk County Department of Health. 3. The applicant shall receive the approval of the Town of Southold Board of Trustees. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s)granted herein as shown on the architectural drawings, site plkn and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. In the event that an approval is granted subject' to conditions, the approval shall not be deemed effective until the required conditions have been met; and failure to comply therewith will render this approval null and void. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured, and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3)years from the date such variance was granted. The Board of Appeals may, upon written request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one (1)year terms. Vote the Board: Ayes: Members Weisman (Chairperson),Dantes,Acampora, Planamento and Lehnert. (5-0) :— &7-4-�J A'I V,4r�\ � Leslie K nes Weisman, Chairperson Approved for filing /,14,� /2019 omi 1Z Plug OFFICE LOCATION: �`�%Z�SOUT�O MAILING ADDRESS: �(�lV►l'tP/� Town Hall Annex P.O Box 1179 j 54375 State Route 25 ' Southold,NY 11971 l (cor Main Rd. &Youngs Ave.) CA, � Southold, NY 11971 i5k ® Telephone: 631 765-1938 Fax: 631 765-3136 couffN LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD RECEIVED MEMORANDUM DBoard To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry,AICP Assistant Town Planning Director LWRP Coordinator Date November 4,2019 Re: LWRP Coastal Consistency Review for ZBA File JOHN AND KIMBERLY KEISERMAN #7334 SCTM# 1000-26-2-23 JOHN AND KIMBERLY KEISERMAN #7334 - Request for a Variance from Article XXIII, Section 280-124 and the Building Inspector's June 19, 2019, Notice of Disapproval based on an application for a permit to make additions and alterations to an existing single family dwelling; at, 1) more than the code permitted maximum lot coverage of 20%; located; at: 1170 Willow Terrace Lane, (Adj. to Orient Harbor), Orient,NY. SCTM No. 1000- 26-2-23. 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 action is CONSISTENT with the Policy Standards and therefore is CONSISTIENT with the LWRP. This recommendation is made considering the following: 1. The proposed 211 s. f. area porch expansion is located landward of the dwelling. 2. The action would not result in significant conflict with community character. 3. The applicant is installing a I/A OWTS at least 100' from surface waters. 4 A storm water drainage system will be installed. Pursuant to Chapter 268,the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: William Duffy, Town Attorney i Michael J. Domin< esident Town Hall Annex John M. BredemP.O.yer III,Vice-President Route 25 o$V�F��,f' P.O.Box 1179 Glenn Goldsmith �~ �O� Southold, New York 11971 A.Nicholas Krupski _2 Telephone(631) 765-1892 Greg Williams w Fax(631) 765-6641 'BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only ,Coastal Erosion Permit Application _ d/ Wetland Permit Application Administrative Permit Amendment/Transfer/Extensio Received Application. ��'�' ®EC 9 2019 Received Fee: $1.S 0.00 Completed Application: 12 R •I Incomplete: / _ Boarcln __, SEQRA Classification: Type I Type II �1 Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: �Coordination:(date sent): LWRP Consistency Assessment Form Sent: ICAC Referral Sent: 12- •13- ' Date of Inspection: I .8 Receipt of.CAC Report: Technical Review: _ Public Hearing Held: Resolution: Name of Applicant John P.&Kimberly G.Keiserman 114 Mackey Avenue Address Port Washington,NY 11050 Phone Number: eL21 940-6385 Suffolk County Tax Map Number: 1000 - 26-2-23 Property Location: 1170 Willow Terrace Lane,Onent (property is located on south side of Willow Terrace Lane,+/-330'west of Majors Pond Path) (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road,Southampton,NY 11968 Phone:631-283-6360 ''1 Board of Trustees A Licatiori GENERAL DATA Land Area(in square feet): 13,065 sf Area Zoning: R-40 Previous use of property: 1.5-story,single-family residence with pool and decks Intended use of property: Same with second-story addition,reconstructed porch,and new cellar entrance Covenants and Restrictions: Yes X No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals X Yes No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by 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 Southold Wetlands Permit#5279& 2-23-01;Amended 7-30-01 &6-17-15; Coastal Erosion Management Permit#5279C Transferred 10-21-15 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): Construct onto existing 1.5-story,single-family dwelling an approximately 30'x 27'second-story addition and roof alteration,an approximately 286 sf covered porch in place of existing 75 sf porch,and an approximately 4'x 15'cellar entrance;maintain existing structures constructed prior to 1988,including an 18'x 36'swimming pool,a 1,570 sf deck,and a 3.3'x 12'stair leading to a 12.3'x 17'on-grade deck;remove existing septic system and install new"I/A OWTS" sanitary system;and install drainage system of leaders, gutters,and drywell,all as depicted on the survey/site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 17,2019. Board of Trustees Appl. tiori WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To renovate the existing dwelling with a second floor expansion and new porch,which will increase the habitable space of the dwelling without increasing its habitable footprint. Area of wetlands on lot: 3,972 square feet Percent coverage of lot: 30.4 *io Closest distance between nearest existing structure and upland edge of wetlands: 0 feet (grade level deck) Closest distance between nearest proposed structure and upland edge of wetlands: +/-58 feet (second-story addition) Does the project involve excavation or filling? No X Yes (as required for proposed I/A OWTS,drywell,and If yes, how much material will be excavated? TBD cubic yards cellar entrance) How much material will be filled? N/A cubic yards Depth of which material will be removed o i&iW: +/- 10 feet (as required for proposed I/A OWTS) Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Standard construction practices. Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): The proposed renovation,which will result in a minimal increase in structural footprint(211 sf),will have beneficial effects on the environmental condition of the site and adjacent tidal waters because the existing sanitary system,which is located as close as 60 feet from the surface waters of Orient Harbor,is to be removed and replaced with an"innovative and alternative onsite wastewater treatment system" (I/A OWTS)to be located at least 100 feet from surface waters. Unlike conventional systems,which are not designed or equipped to treat nutrients such as nitrogen,these systems are designed to significantly reduce nitrogen loading into the groundwater and ultimately surface waters by using aerobic and anaerobic bacteria to convert organic nitrogen to nitrite and nitrate and then gaseous nitrogen into the atmosphere Additionally,a drainage system consisting of leaders,gutters,and drywells will be added to the property to capture and recharge roof runoff from the renovated dwelling. I 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 I- Project and Sponsor Information Name of Action or Project: Keiserman Renovations Project Location(describe,and attach a location map): 117 Willow Terrace Lane,Orient,Town of Southold,Suffolk County,NY; SCTM#1000-26-2-23; property is located on south side of Willow Terrace Lane,+/-330'west of Majors Pond Path,maps provided. Brief Description of Proposed Action: Construct onto existing 1.5-story,single-family dwelling an approximately 30'x 27'second-story addition and roof alteration,an approximately 286 sf covered porch in place of existing 75 sf porch,and an approximately 4'x 15'cellar entrance;maintain existing structures constructed prior to 1988,including an 18'x 36'swunming pool,a 1,570 sf deck, and a 3.3'x 12'stair leading to a 12.3'x 17'on-grade deck;remove existing septic system and install new"I/A OWTS" sanitary system; and install drainage system of leaders,gutters,and drywell,all as depicted on the survey/site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 17,2019 Name of Applicant or Sponsor: Telephone 212-940-6385 John P &Kimberly G.Keiserman E-Mail: john.keiserman@kattenlaw.com Address: 114 Mackey Avenue City/PO: State: Zip Code: Port Washington NY 11050 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 may be affected in the municipality and proceed to Part 2. If no,continue to question 2. X 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: NYS DEC Letter of Non-Jurisiction,SCDH,Town of Southold ZBA&Building X 3 a.Total acreage of the site of the proposed action? 21,435 sf' b. Total acreage to be physically disturbed? +/-6,000 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 21,435 sf 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑Rural(non-agriculture) ❑ Industrial ❑ Commercial ® Residential(suburban) ❑ Forest ❑Agriculture ®Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 t � 5. Is the proposed action, NO YES N/A a A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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: Name:Peconic Bay&Environs;Reasons:Protect public heath,water,vegetation& scenic beauty;Agency: Suffolk County;Date:7-12-8 X 8 a Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 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: X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: Connection to a new well is proposed for X potable water. 11 Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment. A new SCDHS approved sanitary X is proposed. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b Is the proposed action located in an archeological sensitive area? X X 13.a Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X b. Would the proposed action physically alter, or encroach into,any existing wetland or waterbody? X 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 ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ® Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 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? YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES Page 2 of 4 18 Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: X 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: X 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: X I AFFIRM THAT THE INF RMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Herrmann,Coastal Mgmt. Specialist Date: December 5,2019 Signature: Part 2-Impact Assessment.The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? I/ 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)? 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? 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? t/ b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g., wetlands, / waterbodies,groundwater,air quality,flora and fauna)? V Page 3 of 4 No,or Moderate small to large impact impact may may occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance.The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part I 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. ❑ 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. Southold Bard of Trustees G 21"eo Name of Lead Agency Date Michael J. Do Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 rsore: ` .T3- r,saa U3 V3 W3 r-p„ s --- -- - - ---- - r I I II I ( I i i S TerrOt Cam ®d9EYV3 90 a o PS i n� East ManIt? i , - 'I--• _ - cg a s z i ! � Onent Park S"PPER Central -�' StPPs 92 r�Um r I �¢l e � ORCHARD ,pyp t' P PpW 9f a4 ( One A p o� c -- gaa°h :' YC Soci Nlus i e 9 — EAS WIN! Ai MAPLE P a�I 25 - Site C Access Via °9 S ° o 5ubject Properf�) '9l I I ,r s i 59A County Haastran Map#49 a 1" +2,000' Rd EW p ° NOPtH � F9Jf .F`\ppP I ' I' 99 p j\ 1 t 1 I I 1 -7• 1t I� i, L j I —L_ Pt Aj Gloves Pt J r Long Bea ch s} � 0 LH Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) j, John Keiserman' residing at 114 Mackey Avenue (print owner of property) (mailing address) Port Washington,NY 11050 do hereby authorize (Agent) En-Consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature),John Keiserman Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Kimberly Keiserman residing at 114 Mackey Avenue (print owner of property) (mailing address) Port Washington,NY 11050 do hereby authorize (Agent) En-Consultants to apply for permit(s) from the Southold Board of Town Trustees on my behalf. ( wner's a re ,Kimberly Keiserman Board of Trustees Application County of Suffolk State of New York .john Keiserman BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature,John Keiserman SWORN TO BEFORE ME THIS DAY OF ,20 �(o Notary Public NANNE I SUMRA" Notary Public,Stag of Nowftk No.01Sueas M7 MOW In Khp tbsrrtlf► CammWWW En"�21 CMV 2019 s Board of Trustees Application County of Suffolk State of New York Kimberly Keiserman BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH VIEW OF THIS APPL ATION. e, imbe ly Keiserman SWORN TO BEFORE ME THIS f�`DAY OF x,20 *- otary P is LY J MOESSNER Notary Public,State of New York No.01 M04970982 Qualified in Nassau County My Commission Expires 8/20/20_L V APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Keiserman,John (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) 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 5%of the shares. 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 or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this eqY" (day of Signature Print NamJohn Keiserman ` Form TS 3 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Keiserman,Kimberly (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) 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 5%of the shares. 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 or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day f 200 Signature Print Nam Kim rl dijerman Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The ouroose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same YOUR NAME: Herrman, $obeit P (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION (Check all that apply.) Tax grievance Building Variance Trustee xx 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 5%of the shares YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person^_ Describe the relationship between yourself(the applicant/agent(representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 5th t December 20 19 Signature Print Name E. Herrmann Form TS 1 ik NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: John P. &Kimberly G.Keiserman SCTM# 1000-26-2-23 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct onto existing 1.5-story,single-family dwelling an approximately 30'x 27'second-story addition and roof alteration,an approximately 286 sf covered porch in place of existing 75 sf porch,and an approximately 4'x 15'cellar entrance;maintain existing structures constructed prior to 1988,including an 18'x 36'swimmmg pool,a 1,570 sf deck,and a 3.3'x 12'stair leading to a 12.3'x 17'on-grade deck; remove existing septic system and install new"UA OWTS"sanitary system; and install drainage system of leaders,gutters,and drywell,all as depicted on the survey/site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 17,2019. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1170 Willow Terrace Lane,Orient 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: Wednesday,January 15,2020 at or about 5:30 P.M. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. John P. &Kimberly G.Keiserman PROPERTY OWNERS NAME: 114 Mackey Avenue MAILING ADDRESS: Port Washington,NY 11050 PHONE #: 212-940-6385 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road, Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. ZZr7 1 gUFFQ(k Michael J.Domino,President �Q, �'O � Town Hall Annex John M.Bredemeyer IIl,Vice-President bY,��O li��,� 54375 Route 25 Glenn Goldsmith ro �� P.O.Box 1179 A.Nicholas Krupski u- "T Southold,NY 11971 O � Greg Williams 'y� �p��:�'r Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of JOHN P. & KIMBERLY G. KEISERMAN 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 1, Robert E. Herrnann , residing at/dba En-Consultants 1319 North Sea Road, Southampton, NY 11968 being duly sworn, depose and say: That on the 6th day of January , 20 20, 1 personally posted the property known as 1170 Willow Terrace Lane, Orient; SCIM #1000-26-2-23 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, January 15, 2020. Dated: (signature) Sworn to before me this 15th day of Jan 20 20 KIM H. STEPHENS ar ublic NOTARY PUBLIC STATE OF NEW YORK COMMISSION N0 . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 , 20_6r E' PROOF OF MAILIING OF b ICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: SCTM#1000-26-2-22 1060 Willow Terrace Lane Bushell Family Trust Orient,NY 11957 SCTM#1000-26-2-24 P.O.Box 188 - Robert N.Hulsmann Trust&Ann V.HulsmannTrust Orient,NY 11957 SCTM#1000-26-2-30 80-15 Main Street,Apt.C Marie-Lise Gazarian Jamaica,NY 11435-1253 e( xt,-rnc2n CIOMpLETETHISiSECTIONON DELIVERY COMPLETE i Complete items 1,2,and 3. ,tA ;Signature X \� r [I Agent ' ■ Print your name and address on the reverse"- ' \ J— ❑Addressee so that we can return the card to you. a eived by(Printed Name) C. ate df Delivery ■ Attach this card to the back of the mailpiece, V or on the front if space permits. 1. Article Addressed to: D. Is delivery add different from dem 1? es if YES,enter delivery address below: Wo Robert N. Hulsmann Trust Ann V. Hulsmann Trust 3. Service Type ❑Priority Mall Express® P.O. Box 188 ;,,', ❑Adult signature ❑Registered MadrM v ❑ydult signature Restricted Delivery ❑Registered Mall Restricted Orient, NY 11957 Certified Mail® ❑Certified Mad Restricted Delivery ❑Return MerchandisReceipt for ❑Collect on Delivery - --^-'ivery Restricted Delivery ❑Signature Confirmation- 2 - ❑Signature Confirmation 7 019 1640 0001 4119 2 5 2 3 iestrlcted Delivery Restricted Delivery over PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt STATE OF NEW YORK COUNTY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 being duly sworn, deposes and says that on the 6th day of January ,2020 , , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their 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 Southampton , that said Notices were Maed to each of said persons by (certified)( edz wec) mail. Robert E.Herrmann Coastal Managment Specialist Sworn to before me this 6th KIM H . STEPHENS day of January ,20 20 NOTARY PUBLIC STATE OF NEW YORK COMMISSION ND . 5015931 QUALIFIED IN SUFFOLK COWY Notary lic EXPIRES AUGUST 2 , 20_1 KIM f ■ i Er ■• O ' � l,y � 9�v� i,.^^..w5 �•� E�� �{..I �f� Il �S� "'> ',�..:4 _ Q � Certified Mali Fee $I ro nate Extra Services&Fees(check box,add fee as app p ) []Return Receipt(hardcopy) $ .��- = Retum Receipt(electronic) $ OStrtlBrk �' Certified Mall Restricted Delivery $ C H+9re C3 C ❑Adult signature Required $ Adult Signature Restricted Delivery$ p Postage 17-1Total Pot -- — - os `f Er $enrro Bushell Family Trust ra 1060 Willow Terrace Lane C3 Sireef ar N Orient NY 11957 Crty,Stai r e 1 r r rr�•r- - - - _ ' e I ru Ln ru Certified Mad Fee - $Xtra Services&Fees(checkbox,add fee as appropnate) ❑Return Receipt(hardcopy) $ /� OSt Q ❑Return Receipt(electronic) $ o ❑Certified Mail Restricted Delivery $ C3c C-3 ❑Adult Signature Required $ +s51pA V) l Adult Signature Restricted Delivery$ f O Postage Tota Robert N.Hulsmann Trust n- sen Ann V.Hulsmann Trust r-q ( i------------ C=3 P.O.Box 188 I Orient,NY 11957 , :,r r r, rr •r. ) `C3 .. M s LPI _ - � � • 1' S �^! �'^:: ;.:' rl•I fat 's-� >'� �I Ef��, ��':;: g`;., it.;i ����} t'.x Certified Mad Fee P\ $ � Extra services&Fees(check box,add fee as appropriate)' ❑Retum Receipt(hardcopy) $ $ :C P Return Receipt(electronic) _ 0��`• tc C ❑Certified Mall Restricted Delivery $ '�: S C-3 ❑Adult Signature Required $ Adult Signature Restricted Delivery$ pPostage ______ .ATotal i � I $ ' ' Marie-Lise Gazarian Er sera r-9 1 80-15 Main Street, Apt. C C3 sr`Be Jamaica,NY 11435-1253 C3 NUTILL UF Ht: AKINUO" 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 P. & KIMBERLY G . KEISERMAN SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct onto existing 1 .5 story, single family dwelling with approximately 30'x27' second story addition and roof alteration, an approximately 286sq.ft. covered porch in place of existing 75sq.ft. porch, and an approximately 4'x15' cellar entrance; maintain existing structures constructed prior to 1988, including an 18'x36' swimming pool, a 1 ,570sq.ft. deck, and a 3.3'x12' stair leading to a 12.3'x17' on-grade deck; remove existing septic system and install new "I/A OWTS" sanitary system; and install drainage system of leaders, gutters and drywells. Located: 1170 Willow Terrace Lane, Orient. SCTM# 1000-26-2-23 TIME & DATE OF PUBLIC HEARING : Wednesday, January 15, 2020 o at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 aIg"' 4 Town of Southold Erosion, Sedimentation & Storm-Nater Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.MA THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1000 26 2 23 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN i13 sfrrcT Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No a.What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within ❑ the Scope of work for Proposed Construction) 21,435 Sf Generated by a Two(2")Inch Rainfall on Site? (S.F/Acres)) (This item will include all run-off created by site b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed +/-6,000 sf Site improvements and the permanent creation of _ construction activity? (S F/Acres) impervious surfaces.) 2 Does the Site Plan and Survey Show All Proposed X PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indidi cating Size&Location?This item shall include all proposed Grade Changes and Construct onto existing 1.5-story,single-family dwelling an Slopes Controlling Surface Water Flow, approximately 30'x 27'second-story addition and roof 3 Does the Site Plan and/or Survey describe the erosion ❑ alteration,an approximately 286 sf covered porch in place of and sediment control practices that will be used to existing 75 sf porch,and an approximately 4'x 15'cellar control site erosion and storm water discharger.This entrance;maintain existing structures constructed prior to 1988, Item must be maintained throughout the Entire including an 18'x 36'swimming pool,a 1,570 sf deck,and a 3.3' Construction Period x 12'stair leading to a 12.3'x 17'on-grade deck;remove existing 4 Will this Project Require any Land Filling,Grading or ❑ septic stem and install new"I/A OWTS"sanitary Excavation where ere is a change to the Natuna p y tary system;and Existing Grade involving more than 200 Cubic Yards install drainage system of leaders,gutters,and drywell,all as of Material within anv Parcel? depicted on the survey/site plan prepared by Kenneth M. 5 Will this Application Require Land Disturbing Activities Woychuk Land Surveying,PLLC,last dated June 17,2019. Encompassing an Area in Excess of Five Thousand (5,000 S.F)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site?Is this Project within the Trustees jurisdiction General DEC SWPPP Reourrements or within One Hundred(100)feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres-including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of lands, which Exceed Fifteen(15)feet of Vertical Rise to EllX � Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges, (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off9 F \ / 1 The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? /X� submitted to the Department prior to the commencement of construction activity n 2 The SWPPP shall describe the erosion and sediment control practices and where Will this Proj Removal of ect Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Vegetation and/or the Construction of any ❑ Xconstructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit In addition,the SWPPP shall Area?(This item will NOT include the installation of Driveway Aprons.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges NOTE If Any Answer to Questions One through Nine is Answered with a Check Mark 3 All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S F &1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit g (NOTE A Check Mark(X)and/or Answer for each Question is Required for a Completed Application) STATE OF NEW YORK, COUNTY OF Suffolk SS ---------------------------------- - That I, Robert E.Herrmann(Name of individual signing Document) being duty sworn,deposes and says that he/she is the applicant for Permit, And that he/she is the Agent - ---------------------------------------------------------------------------------------------------------------------------------- (Owner,Contractor,Agent,Corporate Officer,etc Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief,and that the work will be performed in the manners set forth in the application filed herewith. Sworn to before me this-- --------- his-- ------444December 2019 Notary Pu �-�*A --1 E P N E N ---------------- ---- -------- ---- ----- (sign ure of Applicant) FORM - 06/10 STATE OF NEW YORK COMMISSION N0 . 5015931 OUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 . 20_9/ 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 si nig ficant beneficial and adverse effects.upon the coastal area (which includes all of Southold Town). 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# 26 - 2 _ 23 PROJECT NAME John and Kimberly Keisennan The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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: Construct onto existing 1.5-story,single-family dwelling an approximately 30'x 27'second-story addition and roof alteration,an approximately 286 sf covered porch in place of existing 75 sf porch,and an approximately 4'x 15'cellar entrance;maintain existing structures constructed prior to 1988,including an 18'x 36'swimming pool,a 1,570 sf deck,and a 3.3'x 12' stair leadmg to a 12.3'x 17' on-grade deck;remove existing septic system and install new"UA OWTS" sanitary system; and install drainage system of leaders, gutters,and drywell,all as depicted on the survey/site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 17,2019. Location of action: 1170 Willow Terrace Lane Site acreage: 13,065 sf Present land use: Residential, 1.5-story dwelling with swimming pool Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: John and Kimberly Keiserman (b) Mailing address: 114 Mackey Avenue Port Washington,NY 11050 (c) Telephone number: Area Code 212-940-6385 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No N If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. ❑Yes ❑ No N Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III- Policies Pages 3 through 6 for evaluation criteria E] Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ® Yes ❑ No ❑ Not Applicable The propsed additions and alterations to the existing dwelling will be situated over or to the landward side of the existing dwelling; outside the Coastal Erosion Hazard Area;and landward of an existing bulkhead,which provides protection from flood and erosion damage. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Associated with the proposed dwelling renovation is the proposed replacement of the existing sanitary system,which is located as close as 60 feet from the surface waters of Orient Harbor,with an"innovative and alternative onsite wastewater treatment system" (UA OWTS)to be located at least 100 feet from surface waters. Unlike conventional systems,which are not designed or equipped to treat nutrients such as nitrogen,these systems are designed to significantly reduce nitrogen loading into the groundwater and ultimately surface waters by using aerobic and anaerobic bacteria to convert organic nitrogen to nitrite and nitrate and then gaseous nitrogen into the atmosphere. Additionally,a drainage system consisting of leaders,gutters,and drywells will be added to the property to capture and recharge roof runoff from the renovated dwelling. Therefore,the project will be consistent with the Policy 5 goals of protecting and improving water quality through improved groundwater quality and runoff control. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. ®Yes ❑ No ❑ Not Applicable The proposed additions and alterations will result in a minimal increase in lot coverage(211 sf);and the proposed mitigation measures will have the effect of protecting and restoring the function and quality of the surrounding Orient Harbor ecosystem. Specifically,as described above in connection with Policy 5,the existing sanitary system,which is located as close as 60 feet from the surface waters of Orient Harbor,will be removed and replaced with an"innovative and alternative onsite wastewater treatment system" (UA OWTS) located at least 100 feet from surfacewaters. Additionally,a drainage system consisting of leaders,gutters,and drywell will be added to the property to capture and recharge roof runoff from the renovated dwelling. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [—] NON Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ❑ Yes FIN o® Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PREPARED BY TITLECoastal Management Specialist DATEDecember5,2019 Robert E. IVrjmann Amended on 811105 EN-CONSULTANTS ' December 5, 2019 Mike Domino, Chairman Board of Trustees DEC 9 2019 E Town of Southold i P.O Box 1179 Southold,NY 11971 Re: John&Kimberly Keiserman, 1170 Willow Terrace Lane, Orient, SCTM 1000-26-2-23 Dear Mr.Domino: Enclosed is a Wetland Permit application for proposed renovations at the above referenced property, including construction of a second-story addition and cellar entrance,replacement of an existing porch with a new porch; and installation of an "UA OWTS" sanitary system in place of the existing septic system to be removed. Also included in our application is a request that the permit authorize several existing structures, including a swimming pool, pool deck, bank stairway, and deck adjacent to the bulkhead, all of which were constructed prior to February 25, 1988, as depicted on the copy of an aerial photograph taken on that date. You may recall that the Board met me at the property to discuss the eventual submission of this application on June 15, 2016, at which time I reviewed the site and permit history with you and the need for the Board's authorization of the existing pool and deck. Specifically, I relayed that the swimming pool was issued Certificate of Occupancy #Z15201 on January 14, 1987, and that the surrounding deck, which appears to have been constructed shortly thereafter, was believed to be a grade level structure not requiring a Building Permit. However, after they purchased the property with the belief that all structures were properly permitted and submitted a Building Permit application for the proposed renovations, the current owners learned of the Building Department's interpretation that the deck is a"raised"structure that should have been granted a Building Permit prior to its construction. The owners were thus directed to submit applications for the variance relief necessary for the proposed and existing structures, which has been obtained (ZBA Decision No. 7334); and a Wetlands Permit for same,the application for which is enclosed, as noted above. Please note that while the existing structures are located partially or wholly within the Coastal Erosion Hazard Area, the above noted Certificate of Occupancy issued in 1987 and aerial photograph dated February 25, 1988, clearly document that the structures pre-date the adoption of the Town of Southold Coastal Erosion Hazard Area Law in 1991 and therefore did not require a Coastal Erosion Management Permit(CEMP)at the time of their construction. Therefore, no CEMP is requested or required, as maintaining an existing structure constructed prior to the effective date of Chapter 111 does not constitute a regulated activity requiring a CEMP pursuant to Section 111-6 of the Town Code; and even the "normal maintenance" of an existing functioning structure does not require a CEMP pursuant to Section 111-6. Respe tfully yours, Robert . Herrmann Coastal Management Specialist Enclosures 1319 North Sea Road Southampton,New York 11968 1 p 631.283.6360 1 f 631.283.6136 wwwenconsultants com environmental consulting EN-CONSULTANTS December 5,2019 Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 t t •i+ �1r Southold,New York 11971 DEC 9 2019 9 Re: John&Kimberley Keiserman --.-- - 1170 Willow Terrace Lane, Orient SCTM#1000-26-2-23 f Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Authorization&Disclosure Forms; b) Erosion, Sedimentation&Storm-Water Run-off Assessment Form; c) Short Environmental Assessment Form; d) LWRP Consistency Assessment Form and November 4, 2019 Memorandum issued for ZBA. 2. Cover letter addressing site history and basis for application. 3. Survey/site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC, last dated June 17,2019. 4. Copy of ZBA Findings,Deliberation and Determination for file#7334. 5. One(1)set of site photographs, including copy of aerial photograph Air#6104-03, Exp#544 by Aerial Image Resources,dated February 25, 1988. 6. Application fee of$250.00. I hope this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sinc lly, Robe Herrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting