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HomeMy WebLinkAboutTR-9690A Glenn Goldsmith,President �QF sorry Town Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 - -�ohn-M.-Bredemey�L- P.O.Box 1179 -- - - - ----- ---- --- - - — - -- -- ._---�outhold3 Nevv-Y-ark=1-1:g7-1------- - --A.Nicholas Krupski G Q Telephone(631)765-1892 Greg Williams %�� �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF- TRUSTEES 7'i.H4OUfRS_ORId T COMMENCEMENT OF THE ACTIVITIES CI��P,,-;OFF :BLOW INSPECTION SCHEDULE Pre-constrUdIH6 Ii lie fe i r stft loon Ise i `rtairi 1St day-of construction % constructed X When project complete, call for compliance inspection; - _ . Glenn Goldsmith,President Qf sorry Town Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 - -- ------- --- ------- — - -- -------P.O.Box 1179-- ----------------- - - John re emeyer III Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9690A Date of Receipt of Application: August 18, 2020 Applicant: David.& Barbara Hazard SCTM#: 1000-103-2-1.1 -Project,Location:-1465 Harbor Lane, Cutchogue ' Date of Resolution/Issuance: September 16, 2020 -,,Date of Expiration: September-16, 2022 Reviewed by: A. Nicholas Krupski, Trustee Project Description: Abandon and fill in the_existing sanitary system and install a new Innovative/Alternative Onsite,Wastewater Treatment System (I/A OWTS). Findings:. The project meets all the-requirements for issuance of an Administrative, Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Daniel R. Falasco, P.E., P.C., dated June 30, 2020 and stamped approved on September 16, 2020. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is notva determination from any other agency. m __ .,. ...__.,,.,..w.._:". ....h......_.._,...-ti....w....__.,...W_......�, ....,.�,M._.._._e,.._.-,:.w,......... Glenn Goldsmith, President Board of Trustees NGLE FAMILY SURVEY OF LOT 1 ONE RESIDENCE (41 BEDROOMS) gog MAP OF S� �� ''�IDAL S 35'16'26" E F.F. ELEV. 13.5 10_ ` -/ WETLAND 19.75' F.F. 1,094 SF ,LINE 3 EAST CREEK ESTATES PARTIAL FINISHED BASEMENT 1,094 SF �S / I i GROSS FLOOR AREA 2,188 SF �\ FILE No. 12120 FILED MAY 16, 2018 INSTALL CLEANOUT SITUATE AT FINISHED GRADE CUTCHOGUE ABANDON EXISTING �\ �� W TOWN OF SOUTHOLD SANITARY SYSTEM / I +� S 03'0 ' 2" r� SUFFOLK COUNTY, NEW YORK ''� ; / 54.30' w S.C. TAX No. 1000-103-02-1 .1 0�o��. PEER �/' ,__-' _moi W 1 i1 DOCK U CO c � W DATUM — NAVD88 e�gL� ,-�\� a 10 M,1�R IME i 3Q S 07.50'13" W W TOTAL LOT AREA = 107,944 SF -/ z ��� �° wP 21'28' W /------ /- 1 T\\1-, �N°R.ON / S 30'36'26" W w c (F1 �` 16.06' p pS 38.45'55" W (F E p �l1_ — 75' M 10.46' / _ GF. 100' S 18'11138" W (5) 8'0 x 3' TO ELEC. 0 40.22' EFF. DEPTH 5' MINLINE I �F, LEACHING POOLS LOT 1 /P _— -------_fir_ 02 ELECTRIC FOR I/A UNIT 11A / err 6�g. AL HYDRO ACTION AN500 10' WIDE / TIDAL TREATMENT UNIT W/ INTEGRAL TEST HOLE �� ��-'� �'�ELECTRIC �= WETLAND VENT & CONTROL PANEL �p(E /- ELEV = 6.0 /-' ��S ® \ EASEMENT ,� LINE, rol LOT AREA — -- -i� `moo / 107,944 SF x ti o1� OR 2.478 AC. ,r,f' _ a _�_-- APPROVE® BY -BOARD OF I RUSTEES 0 .OF ,SOUTHOLD LOT 2 7 DRNEtiVgy TEST HOLE DATA DA sbPlSA�d �6� Zo2U I � o� /r McDONALD GEOSCIENCE ;l' D E E VE JANUARY 17, 2017 i L� ELEV. = 6.0 20 2.0' MIXED SAND & LOAM (OL) AUG 18 2020 OAD CE R 2.9' BROWN CLAYEY SAND (SC) -PIES „_G ._-. - Southold Town GROUNDWATER 1.1' WATER IN BROWN CLAYEY Board of Tru-toes ELEV. = 1.1 SAND (SC) HIGHEST EXPECTED = 1.8 17.0' oFNEW�0 DANIEL R . FALASCO , P .E . , P . C . 11.0' WATER IN BROWN FINE Gj�P�F\ R• Fq��s�J� To MEDIUM SAND (SP) Q `o * CONSULTING ENGINEER 1 Q 94 STEUBEN BLVD., NESCONSET, NY 11767 (516) 317-7209 O. 056g9� =cv DATE SCALE DRAWING NO. pR�FESSIONP�' TEST HOLE DATA 6-30-20 1"=60' 1 OF 2 FINISHED GRADE 054,2500 924.5010 066 � 0000 0248750 =ECONCRETE COVER 03�� 024875 �N MIN 4° DIA SDR 35PVC PIPE OR EQUIVALENT N 20' ' 78 PITCHED 1/8"-1' MIN MIN ` 20' MAX ®®®®®®® 02 0 R9®®®® PRECAST SANITARY 951.2500 9760000 0700000 ®EN ®®® RINGS TYP 9 ®®®® 0572500 132• PROVIDE SECONDARD m PROVIDE SECONDARD G C-HIR-PANEL SAFETY COVER ®® - SAFETY COVER /HPeO COMPRESSOR Z 3' MIN COLLAR MATERIAL TO E _ ®®®®® CONSIST OF CLEAN H D—D ®®®® SAND AND GRAVEL ®®® INLET n N„ OUTLET 3' MIN. ABOVE HIGHEST J B 104 BACKFILL MATERIAL TO BE CLEAN SAND & GRAVEL K F 6' MIN PENETRATION INTO VIRGIN STRATA OF SAND & GRAVEL c-c 82 S.C.D.H.S. SANITARY LEACHING POOL DETAIL A N.T.S. 24' 8 7.j 66 J .5 4]5000 BILL OF MATERIALS EXIST. RES n'EM PIN DESCRIPTION QTY. F.F. EL. 13.5 HA-180056 TANK,AN500 245 NITROGEN REDUCTION 1 C/Q INV. EL. 9.0 INV. EL. 8.4 A 180055 TANK,AN500 245 PRETREATMENT 1 B 100118 COUPLING, 4- SCH 35 PVC SXS 1 BASEMENT 1 11 C 240018 FG CONNECTING PANEL 24X19 2 INV. EL. 9.5 I 19' AN500 2$' 0000 0000 Cl 160028 ADHESIVE, CARTRIDGE 1 --------- TREATMENT TANK 0000 C2 240031 SCREW, 1 #10 SELF TAP PPH ZINC 2 0_00_0 D 760066 FASTENER, 3/8-16 X 3 3/4' AT HHCS 1 INV. EL. 9 1 8'0 X 3' DEEP DI 200013 NUT, 3/8-16 SS 3 LEACHING POOL (5) o / !� D2 200006 WASHER, 3/8-16 SS 4 D 1 l D3 200034 WASHER, SS 3/8' LOCKWASHER 1 5.4 E 100110 ASSEMBLY,RE-CIRCULATION 245 COMPLETE 1 F AP600-P AP600 ATU W/PLATFORM COMPLETE 1 HIGHEST EXPECTED GROUNDWATER EL. 1.80 3' MIN G ECSO-30-LIOD-PLC EC50.30-L-100-PLC 1 -------------___________________ —_____ H 100023 PIPE, 4' PVC SCH35 (1) 16' LONG AUG 1 8 202 ' I 100023 PIPE, 4' PVC SCH35 (1) 28' LONG i 180111 TEE, STRAIGHT 4- SCH35 1 SANITARY SYSTEM PROFILE I K 100023 PIPE, 4- PVC SCH35 (1) 10' LONG vVLLL'r T_ N.T.S. L Inr.1 Board TYPICAL HYDRO ACTION AN500 DETAIL NTS OF NEW R Fq4 0 DANIEL R . F'AL.ASCO , P .E . , P . C . 9 CONSULTING ENGINEER 94 STEUBEN BLVD., NESCONSET, NY 11767 _ (516) 317-7209 0569 9 �C� ���FDpNO � DATE SCALEDRAWING NO. R�FESsm\MP' 6-30-20 N.T.S. 2 OF 2 Glenn Goldsmith, Pre;4 °nt ��4SUFF�(�CpG Town Hall Annex Michael J. Domino, Vice-Prca,cIent ,� yam, _- 54375 Route 25 John M. Bredemeyer III o ` P.O. Box 1179 A. Nicholas Krupski O Southold, NY 11971 Greg Williams y ®'t- Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OO t Date/Time: b�° Completed in field by: / y DAVID & BARBARA HAZARD request an Administrative Permit to abandon and fill in the existing sanitary system and install a new Innovative/Alternative Onsite Wastewater Treatment System (I/A OWTS). Located: 1465 Harbor Lane, Cutchogue. SCTM#: 1000-103-2-1.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q 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 Ch. 111 SEQRA Type: 1 II Unlisted Action. Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: r�p�a(6-4 t,J P(a cP W c/'Pof � �d✓'� I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other SURVEY OF LOT 1 METES AND BOUNDS METES AND BOUNDS TEST HOLE DATA MAP OF 25' WIDE RIGHT OF WAY (TEST HOLE DUG BY McDONALD GEOSCIENCE ON JANUARY 17, 2017) 1 > ELECTRIC EASEMENT ® N 25:15'00" W 25.20' AO N 02'18'11" E 30.15' EL. 6.0 0. C0,111 EAST CREEK ESTATES ® N 71 54 19 E 153.39 e N 17'54'18" E 45.85' MIXED SAND & LOAM S` � �$g• © R=50.00' =47.47' \\ °? M \\ F FILE No. 12120 FILED MAY 16, 2018 , „ , © N 08-11-24" W 73.95 BROWN CLAYEY SAND SC © N 17'30 33 E 112.75' �L. 1 1 4.9' 10— it N 29.11'25" W 40.52' \ SITUATE © N 67'46'00" E 32.51' WATER IN \ \ ? e'y ,. , BROWN CLAYEY SAND SC S CUTCHOGUE S 17'30'33" W 133.54' ® N 71'5419 E 10.21 /S l © S 29'111'25" E 40.21 © R=75.00' =71.20' , WATER IN \\ 1 Al-- „ , Q S 08-11'24" E 78.13' BROWN FINE TO MEDIUM SAND SP TOWN OF SOUTHOLD ® S 71'5419 W 35.1 0 S 17.54'18" W 46.80' 17' `\ ► ► / �o°•40 N SUFFOLK COUNTY, NEW YORK m S 07'08'22" W 25.00' o S 02.18-11" W 25.39 20 ® N 82'51'38" W 68.22' 0 S 73 35 30 W 10.56' S.C. TAX No. 1000- 103-02- 1 . 1 Q S 71'54'19" W 56.20' I �s /"" /i� `co HGHI'N'I MARK SCALE 1 "=40' ® N 71'54'19" E 58.64' 1 r S 03'04 22 E /C3 a t� o�� 54.30 JULY 23, 2018 _— 592 5 ,1 `\ 3 1136.5 — MAY 22, 2019 MAP FOR LOT 1 0� SK w �� / GL R R I 53.0• FIXED WOOD DOCK CER TIFIED TO: N I T01� �c , �-G �No I } T _ v, 27.3 DAVID HAZARD NgY FSEs Q // .4-9v��'0\ oa- OE �P----- —i/ /' 38• g0 ° 1 4 WOOD FLOATING DOCK TOTAL LOT AREA = 107,944 sq. ft. BARBARA HAZARD ��No I c 1 25/' �-- / CHIMN 94� N o I m 2.478 ac. 0 %' w CELLA Z�3 " / S 07'50'13" W /ENTRgNCE .,_ a 4 o `.... WOOD U o DRIVEWAY RIGHT OF WAY = 8,357 sq. ft. �\\\Se/ �- m\ / s�. - W�!-, :;/; S EPS $ 21 .28' e� 0.192 ac. WETLANDS = " ` w 23.5 _::" / a� a, EDCE OF MARSH GRASS 1 ,219 sq. ft. ---_\� � \ ' s. _ / 3g S 30'36'26" W 0.028 a C. / \\ \ /""/' /- I \ 510NE DRNA C WALK %,: q3/ \°\O \ 1 CON / 16.06' LOT AREA LESS WETLANDS = 98, / G _ �� 368 sq. ft. \ \ °y // i S 38'45 55 W & DRIVEWAY RIGHT OF WAY 2.258 ac. 10.46 NOTES: LOT 1 _ / S 18711 '38" W 1. ZONING USE DISTRICT: R-80 \ I / a� 40.22' 2. LOT CLEARING AREA = 27,600 sq. ft. or 25% OF UPLAND LOT AREA. Q I h9` 3. CONTOUR LINES AS SCALED FROM TOPOGRAPHICAL MAP OF FIVE EASTERN TOWN /�1 �l ��G�P j coNc•M°N o EXISTING CONTOUR LINES ARE SHOWN THUS: -----XX------ EXISTING SPOT GRADES ARE SHOWN THUS: xx.x o �3Q 1 / A\ i� FUG ---� 2 -----------— 6 1g 0 FLAG x2 \ / N 4, o �� 0c, NSISI ENP��R� �coi — FUG g �o ON w Dav SUSAV E Pv Op' ----- �l /3 ,i j i- 00 ` /� rno pG DRRECHARGER AREA \i I (NATURAL DEPRES ION AREA) :J 1 PEO >,\ �I`\ ; � ° ; oPy �' 'z 365 n �• � •\ \\ ` � �-�°6 j-j/�� � / to I rQ 25GN GOOF 00JS�oN�P� R� co LOT 2 ri'/w j AUG 1 8 2020 I cul CP r'O , cm yo 'CPO. G° 9 —Kf- 12' WIDE DRIVEWAY �p 1 5 25' WIDE 2 5 RIGHT OF WAY N( NOU �pO�o 93 9A CONC.M Inn PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED Z BY THE L.I.A.L.S. AND APPROVED AND ADOPTED FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATION. y o > o: � s �O- 00. N.Y.S. Lic. No. 50467 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF �D�ND M°N SECTION 72 Nathan -raft Corwin 11 THELAND SURVEYOR'S INKED SEAL R EDUCATION LAA OF THE NEW YORK STATE W. C. GON N T3225a IFTHIS EIMAP NOT RING EMBOSSED SEAL SHALL NOT BE CONSIDERED Land Surveyor V u r v e y®r TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE Successor To: Stanley J. Isaksen, Jr. L.S. TITLE NMENTAL AGENCY c10 LENDING nPANYINSTITUTONELISTED HEREON, ANDND Joseph A. Ingegno L.S. ,r TO THE ASSIGNEES OF THE LENDING INSTI— Title Surveys — Subdivisions — Site Plans — Construction Lay TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. Y Y g,0 yy PHONE (631)727-2090 Fax (631)727-1727 C THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS P ��R AND/OR EASEMENTS OF RECORD, IF 1586 ?,.da'n Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jarn:'Spo:", Iden: 1"01!, ! Jamesport, New York 11947 39-139 ONE STORY SINGLE FAMILY SURVEY OF . LOT 1 RESIDENCE (4 BEDROOMS) S`� �8 ''NIDAL S 35.16'26" E MAP OF F.F. ELEV. 13.5 10_ �/ VETLAND 19.75' EAST CREEK ESTATES PARTIAL FINISHED IBA EMENT 1,094 SF �S\,094 SF �\\ MINE , o GROSS FLOOR AREA 2,188 SF FILE No. 12120 FILED MAY 16, 2018 INSTALL CLEANOUT -r ► h�� SITUATE AT FINISHED GRADE CUTCHOGUE ABANDON EXISTING TOWN OF SOUTHOLD SANITARY SYSTEM / I �� S 03.0422" E w SUFFOLK COUNTY, NEW YORKI lug -� / 54.30' W S.C. TAX No. 1000-103-02-1 . 1 0���\,wP�Ea /�' ,;�-'� \ _— —�� o DOCK � ,� � w DATUM — NAVD88 Q�e /�'\ a 10 M\N HIM E I TOTAL LOT AREA = 107,944 SF SER / 3� s 07 .28'" w W .�® �� m\ PSL ZO WF \ / 21.28' W S 30°3626" W 16.06' P P S 38'45'55" W \� \ / �\ / (F1 P — 75' M 10.46' \ \ — \ \\ G F. P / 100' / O S 18'11'38" (5) 8'0 x 3' 0 40.22' I/ EFF. DEPTH 5' MIN. TO ELEC. �•/ j �Fe LEACHING POOLS & PROP. LINA LOT 1 ELECTRIC FOR I/A UNIT HYDRO ACTION AN500 10' WIDE ^TIDAL TREATMENT UNIT W/ INTEGRAL /' v� TEST HOLE ��—,�' °'ELECTRIC '' WEFLAND VENT & CONTROL PANEL 1 /'' // ELEV = 6.0� /-' EASEMENT AL LINE,t, S. LOT AREA 107,944 SF ti �\ OR 2.478 AC. 0000, / ? `` // DRNEyygy LOT 2 TEST HOLE DATA McDONALD GEOSCIENCE , {{; JANUARY 17, 2017 l_ AUG 8 2020 5 1 ELEV. 6.0 ?0 2.0' MIXED SAND & LOAM (OL) ` ssliis.oro 'u;n �D�,D Board of T,i;tn PIERCER 2.9' BROWN CLAYEY SAND (SC) GROUNDWATER 1.1' WATER IN BROWN CLAYEY ELEV. = 1.1 SAND (SC) HIGHEST EXPECTED = 1 8 T c( � 17.0' P��O NEW 0 DANIEL R . FALASCOy P .E . 9 P . C . 11.0' WATER IN BROWN FINE C�TO MEDIUM SAND (SP) a� `� * CONSULTING ENGINEER 94 STEUBEN BLVD., NESCONSET, NY 11767 (516) 317-7209 05699 DATE SCALE DRAWING NO TEST HOLE DATA pR�FESSIO6-30-20 1"=60' 1 OF 2 FINISHED GRADE 054. o0 0245010 066 0000 0248756 CONCRETE COVER 0'3� • 024 8]5 Ing V / MIN 4" DIA SDR 35 PVC PIPE OR EQUIVALENT IN � '6 PITCHED 1/8"-1' MIN MIN' '• 2.0' MAX ME ®®®®®®® 024 010 ®®® d PRECAST SANITARY 051 2500 0760000 0700000 _ N _ ®®®®®®® RINGS TYP ! ®®®REMO 4" 0s7zsoo 172, PROVIDE SECONDARD m ®® PROVIDE SECONDARD C] PLC CONTROL PANEL SAFETY COVER ®® - /HP80 COMPRESSOR SAFETY COVER z 3' MIN. COLLAR MATERIAL TO E _ 09 COILAR CONSIST OF CLEAN H D—D ®®®® SAND AND GRAVEL 1F INLET „ OUTLET 3' MIN ABOVE HIGHEST U B 104 BACKFILL MATERIAL TO BE 891 CLEAN SAND & GRAVEL K I F 6' MIN. PENETRATION INTO VIRGIN STRATA OF SAND & GRAVEL c-c 6Z S.C.D.H.S. SANITARY LEACHING POOL DETAIL A N.T.S. 24• 6 7ji 66 az buw5 47 DODO BILL OF MATERIALS EXIST. RES. ITEM PIN DESCRIPTION QTY F.F. EL. 13.5 HA-180056 TANK,AN500 245 NITROGEN REDUCTION 1 c 0 INV. EL. 9.0 INV EL. 8 4 A 180055 TANK,AN500 245 PRETREATMENT 1 B 100118 COUPLING, 4' SCH 35 PVC SXS 1 BASEMENT C 240018 FG CONNECTING PANEL 24X19 2 INV. EL. 9.5 I 19' AN500 28' o000 0000 c1 16002e ADHESIVE, CARTRIDGE 1 TREATMENT TANK C2 240031 SCREW, 1' #10 SELF TAP PPH ZINC 2 --------- D 760066 FASTENER, 3/8-16 X 3 3/4' AT HHCS 1 INV. EL. 9.1 8 0 X 3' DEEP o 0 0 DI 200013 NUT, 3/8-16 SS 3 LEACHING POOL (5) D2 200006 WASHER, 3/8-16 SS 4 0 00 E,: � D3 200034 WASHER, SS 3/8' LOCKWASHER 1 0�= 5.4 D E �? jl�, E 100110 ASSEMBLY,RECIRCULATION 245 COMPLETE 1 F AP600-P AP600 ATU WI PLATFORM COMPLETE 1 3' MIN G ECSD30-LIOD-PLC EC50.30.4 _100-PLC 1 _____________ HIG_HEST_EXPE_CTED_ GROUNDWATER EL._1.80_ _________ H 10OD23 PIPE, 4' PVC SCH35 (1) 16' LONG AUG 1 8 2020 I 100023 PIPE, 4' PVC SCH35 (1) 28' LONG 160111 TEE, STRAIGHT 4' SCH35 I SANITARY SYSTEM PROFILE K 100023 PIPE, 4' PVC SCH35 (1) 10' LONG N.T.S. Southold To4m Boar!I of Tru tees TYPICAL HYDRO ACTION AN500 DETAIL NTS pFNEbyy0, DANIEL R . FALASCO , P .E . , P . C . o * CONSULTING ENGINEER 94 STEUBEN BLVD., NESCONSET, NY 11767 (516) 317-7209 NO. 056998 � DATE SCALE DRAWING NO. pR�FESSION�� 6-30-20 N.T.S. 2 OF 2 COUNTY OF SUFFOLK h z 6 STEVEN BELLONE SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES GREGSON H. PIGOTT, MD, MPH Commissioner DAVID HAZZARD August 1, 2020 1465 HARBOR LN Notice#: 1 CUTCHOGUE, NY 11935 1465 HARBOR LN, CUTCHOGUE Tax Map: 1000103000200001001 Record ID: R-20-1013 Notice of Incomplete Application DAVID HAZZARD, This office has reviewed your application for existing or proposed sewage disposal and water supply systems for the above reference project. The following will be required prior to any further processing of the application for approval to construct: File appears acceptable pending receipt of DEC and Town Wetlands permits. Please note that a review of the additional information requested may result in the need to modify the proposed sewage disposal and/or water supply systems. Please do not hesitate to call (631) 852-5700 with any questions. Regards, Nicolas Meyers Public Health Sanitarian 1 E CC: DANIEL FALASCO AUG 1 8 2020 Town Board of Tr f'"" IV DIVISION OF ENVIRONMENTAL QUALITY-OFFICE OF WASTEWATER MANAGEMENT 360 Yaphank Avenue,Suite 2C,Yaphank, NY 11980 (631)852-5700 1 Fax(631)852-5755 Page 1 of 1 Lill a , ?.� - , i~ 'i is �f-��:. r'-`.G -_ ,� �'`�r.A{ =XQ ia�c�.�•s r: � .' yr.� . - eF � - tl ''. SEE SEL\N tJ rv� p.E9i • i arE EGHe.on , _ , sa _ w4... M4TCH IINE w I GH - �.. 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) ha- Southold, NY 11971 Telephone: 631765-1938 r LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: September 9, 2020 Re: LWRP Coastal Consistency Review of HAZARD SCTM# 1000-103-2-1.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. 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 Glenn Goldsmith,President $®F S (fT Town Hall Annex 1 Michael J.Domino,Vice-President ;�Q`� � 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A Nicholas Krupski G Q Telephone(631)765-1892 Greg Williams �o • a� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD , [ This Section For Office Use Only U UpUG 1 8 2020 Coastal Erosion Permit Application Wetland Permit Application Southold TOM i X Administrative Permit Board of Tru5tns Amendment/Transfer/Extension - J __Received Applicaf}on:_ _ Received Fee:$ _ 100 Completed Application: T�Z$LO _- Incomplete: SEQRA Classification: TypeI Type IIUnlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): �LWRP Consistency Assessment Form Sent: CAC Referral Sent: bate of Inspection: _ Receipt of CAC Report:. Technical Review: Public Hearing Held: :l •20 Resolution: _ Owner(s)Legal Name of Property(as shown on Deed): D Bi 0 ; 9 An Mailing Address:. 7 lJg, o f— L^4 4 CA 4 02yC, -i'��/ Phone Number: - ---- -- -- -- Suffolk County Tax Map Number: 1000- Property Location: (If necessary,provide LILCO Pole#, distance to cross streets,and location) AGENT(If applicable): Mailing Address: - Phone Number: Board of Trustees Applic, .on GENERAL DATA Land Area(in square feet): Area Zoning: �® - Previous use of property: Intended use of property: ��" �� 4/Mr/71 eels( Covenants and Restrictions on property? ',*'- Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes ZNo 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 k--' 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 i/ No / Does the structure(s)on property have a valid Certificate of Occupancy? y Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency? �/ No Yes If yes,provide explanation: Project Description(use attachments if necessary): Re m, e O1 a fC, c, fYfPfe-7r f/' �6��n T J�S�L s✓1 r Board of Trustees lApplic--;Aon WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: U- 0`, square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: -7 r feet Does the project involve excavation or filling? y' No Yes If yes,how much material will be excavated? �� cubic yards How much material will be filled? IU/4 cubic yards Depth of which material will be removed or deposited:�� feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: PV� 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): � f `'tiP-C. G�/%�� �C no //�7 Jt�C l'� �O F�nS/ -✓�T�G�n �,S 6I Z20 Appendix B Sliort Environmental Assessment Form bstruetio►is7for Contnletinz Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 oBr/Pro"ect: [[ ��/// _! ] <o�icTeon /Ar)gJ :Ve- W, -kr, T e_ JC Project Location(describe,and attach a location map): I N6 AIL, J, e 11117r _ Brief D9escription of Propose//d Action: l L f Name of Applicant or Sponsor: Telephone: ` E-Mail: f Address: City/PO: State: Zip Code: J?J__ 1.Does the propo d 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 a may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 3.a.Total-acreage of t1k site of the proposed action? , $ acres b.Total acreage to be physically disturbed? ®• 01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial EfResidential(suburban) El Forest ElAgriculture ❑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? ❑ 1 2 ❑ b.Consistent with the adopted comprehensive plan? ❑ FW1 ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ IA_;T 7. Is the site of the proposed action located in,or doe adjoin,a state listed Critical Environmental Area? NO VES If Yes,identify: C 4eG O tea- �a! Or 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? - ❑ ; c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? -NO YES If No,describe method for providing potable water: (;/( ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:- ___ "_ ❑, 12. a.Does the 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? Z ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO., YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 5 ❑ 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 El Early mid-successional EdWetland ❑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? ®' ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ 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: EJ 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: R1 FI 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: �I a 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO, YES completed)for hazardous waste? If Yes,describe: (; ❑ _ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE-TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name:/ - Date: Signature:. T-�— Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 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 EJregulations? 2. Will the proposed action result in a change in the use or intensity of use of lands ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the El El of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. •Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 f No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El :E:1 problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. t 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 Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Appli(.-iion AFFIDAVIT DGVIyaZU G�� DG�4�c, �Z�CCJ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS I DAY OF V S7 ,200 4 jtP blic o v,,J 9c,zcv-J S � N( JONATHAN D. FOGARTY PI Notary Public•State�of New York No.01F06241421 el I Qualifed in Suffolk county 20 3 My Commission Expires May APPLICANT/AGENT/REPRESENTATWE TRANSACTIONAL DISCLOSURE FORINT The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emplovecs.The numose bf 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_sa/m�e. I �J / ,1 YOUR NAME: f/4'a d Gt�s(,� De�►f�jtz-'<t 1 (Last name,fust name,Viiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other i 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 l/ 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 of 200_ Signature ri Print Name Form TS I Town of Southold / LWRP CONSISTENCY ASSESSMENT FORINT A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed. action will_be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or"no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus. each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shaft-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# PROJECT NAME Mje0<0t on 14 MV 00 1i".c 9n04 /s'ea e, ���C The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of'Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ 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: r �n � /(��(�,../� In �}n e�-►�f+ e� �f►n,a v I Location of action: �► oi- n u G�a Site acreage: Present land use: S L^y Je, i e Present zoning classification: leo 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: I / �/ 1 (a) Name of applicant:, Dgv j J 4,+d �.I'Ig! 'ei & (b) Mailing address: r�� J`/�ti-Gam,' e, C-��/ - �����S (c) Telephone number:Area Code( (d) Application number,if any: 1� Will the action be directly undertaken,require funding,or approval//by a state or federal agency? Yes E� No❑ If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy A. ]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. ZYes ❑ No ❑ Not Applicable ®l.�Cr' f'r I r ,Z I n - D G�of tc/et Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LR'RP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes 1:1No [3 Not Applicable I f Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No D Not Applicable Of, L'I t n4 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—PoliciesPages8 through 16 for evaluation criteria F-1Yes ❑ No u Not Applicable = /'0 �Gt. c✓.� ,�Q �t�l't,0 riv ✓/cL fv vO•cZ',S 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 YNot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evalg�ation criteria. F1 ❑ ro;f-6� .wy�l n ®4 -46� All 4•r/G Yes Not Applicable i Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See 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. ' 1:1 (� Wo No u Not Applicable Attach additional sheets if necessary WORIINNG COAST]�1,ICIES J 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 0 No 10 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. ElYes ❑ No [A"'Not Applicable PREPARED BY di TITLE 4�n�'� DATE ��� z