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HomeMy WebLinkAboutTR-9772A Glenn Goldsmith,President ®� so Town Hall Annex ®� ®� 54375 Route 25 A. Nicholas Krupski,Vice President P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 C®UN°i,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1965C Date: October 10, 2022 THIS CERTIFIES that for the existing residence. All work will be done to existing exterior walls, nothing proposed is outside of the existing footprint: Removal of the following: (2) 3'-10"wX3'-2"h existing windows (1) 1'-10"wX3'-2"h existing window (2)3'-9"wXl'-10"h existing windows (1)2'-8"wX6'-8"h wood exterior door (1) 6'-0"wX6'-8"h 2 panel sliding glass door unit Installation of the following: (1) 9'-0"wX6'-8"h 3 panel sliding glass unit (1)4'-0"wX3'-0"h window (1) 7'-1"wX3'-0"h window (1)2'-0"wX3'-0"h window (3)2'-8"wX3'-0"h windows (1)2'-0"wX3'-0"h skylight (1)4'-0"wX2'-0"h basement awning window. New wall framing_ and siding to match existing will be installed as necessary to fill areas of removed windows; At 801 Maple Lane, Southold Suffolk County Tax Map 41000-64-1-30.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 2, 2020 pursuant to which Trustees Administrative Permit#9772A Dated December 21, 2020,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for Removal of the following: (1) 1'-10"wX3'-2"h existing window 2) 3'-10"wX3'-2"h existing windows (2)3'-9"wXl'-10"h existing windows (1)2'-8"wX6'-8"h wood exterior door (1)6'-0"wX6'-8"h 2 panel sliding glass door unit Installation of the following: (1) 9'-0"wX6'-8"h 3 panel sliding glass unit (1)4'-0"wX3'-0"h window (1)7'-1"wX3'-0"h window (1)2'-0"wX3'-0"h window (3)2'-8"wX3'-0"h windows (1Z2'-0"wX3'-0"h skylight (1)4'-0"wX2'-0"h basement awning window. New wall framing and siding to match existing will be installed as necessary to fill areas of removed windows; The certificate is issued to Benjamin& Siobhan Morden owner of the aforesaid property. Authorized Signature Glenn Goldsmith, President � i Town Hall Annex ,�"�j ��,,, 54375 Route 25 A. Nicholas Krupski, Vice President P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly i Telephone (631) 765-1892 Elizabeth Peeples , .® �� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: (U 2� INSPECTED BY: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1st day of construction '/2 constructed Project complete, compliance inspection COMMENTS: � Ap CERTIFICATE OF COMPLIANCE: (`��C +) 1-5 �v-� Glenn Goldsmith,President QF SU(/rTown Hall Annex Michael J.Domino,Vice-President ,`O� �l� 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 �� �� Fax(631) 765-6641 C4UN(`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YQ_U ARE REQUIRED TO CONTACT THE OFFICE OF THE BO;ARD,OF TRUSTEES 72 HO'URS'PRIOR TO'C0MMENCEMENT OF THE"ACTIVITIES CH'qq Ep�t(TF ."13 ; _ INSPECTION SCHEDULE Pre-constructf6h;*I ba bal'eYiin&/silt-d6in/gilt+6urtain 1St day of construction,u - %2 Cd.hstruci6d X fWhert project complete, callfor coenPlianoe inspection; Glenn Goldsmith,President *0f SO(/�yO Town Hall Annex Michael J.Domino ,`O l0 54375 Route 25 P.O.Box 1 John M.Bredemeyer III , Southold,New York 11971 A.Nicholas Krupski G • O Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 �y�4UNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9772A Date of Receipt of Application: December 2, 2020 Applicant: Benjamin & Siobhan Morden SCTM#: 1000-64-1-30.2 Project Location:-801 Maple Lane, Southold - Date:of Resolution/issuance: December 21, 2020 Date of-Expirafion: December 21; 2022 Reviewed by: Michael J. Domino, Trustee Project Description: Administrative Permit to the existing residence. All work will be done to existing exterior walls, nothing proposed is outside of the existing footprint: Removal of the following: (2) 3'-10"wX3'-2"h existing Windows (1) 1'-10"wX3'-2"h existing window (2) 3'-9"wX1-'-10"h existing windows (1) 2'-8"wX6'-8"h wood exterior door (1) 6'-0"wX6'-8"h 2 panel sliding glass door unit Installation of the following: (1) 9'-0"wX6'-8"h 3 panel sliding glass unit (1) 4'-0"wX3'-0"h window (1) 7'-1"wX3'-0°'h window (1) 2'-0"wX3'-0"h window (3) 2'-8"wX3'-Q"h windows (1) 2'-0"wX3'-0"h skylight (1) 4'-0"wX2'-0"h basement awning window. New wall framing and siding to match existing will be installed as necessary to fill areas of removed windows 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 AMP Architecture LLC, dated December 2, 2020 and stamped approved on December 21, 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 not a determination from any other agency. ,�&� 419411 � Glenn Goldsmith, President Board of Trustees ASN -q® GENERAL 51'MBOL KEY: �'®��G Q �� oat UE- I PWWnNS TO REMAIN F'�--'=-1 NEW FOUNDATION KA{.L LL WN MOOD FRAM. Q=0 �-�a'1 "c�aa� I I7 qq p gf �IO EXIST. Lli f' ¢o paxl3 DN. DEC 2 2020 ; i W2gg-31 EXIST. WOOD _ DECK , ��—: EXIST. WINDOWS TO BE EXIST. DOOR REMOVED WINDOWS TO BE EXISTING (2) SLIDERS TO ALL KITCHEN CABINETS, I I \\ REMOVED BE REMOVED AND COUNTERTOP5 4 I I \ REPLACED W/5 PANEL APPLIANCES TO BE SLIDERS REMOVED I I \ II � --_�---- ----- _7.._�_T— ---�--_ \ I I \ I I I I \ REMOVE PORTION OF \\ WALL FOR NEW SLIDERS I I \� �/ I I 1 1 _ I I � I � 1 I - EX15T. / /ol of � EXIST. �) I I I MUDROOM / 1 EXIST. STAIRS TO BE I I I KITCHEN f ——1—— REMOVED EXIST.ROOREAT EXIST. ING I ILL —— I I `�)��%I I I ROOM \ I 11 L_`_y 1 jj I I I EX15T. 11 I II —I GARAGE L�-----� �_ I I I I I - ---H I I I I A��9�OC® I I I I EXIST. \�\ I I BY � 1111 ISI I SKY W � g � BOAR® OF -TRUSTEES _ N ___ � �1i1���= =-, ��___� TOVViV OF SOUTHOL I-- - - -------- Z a� I lul I L J II I 1 I EXIST. ® O O ¢ p L LJ I I I I--=-41 = I I CL ®ATE `z" - 0EWW 2l 20 2p o o � J � EXIST. DOOR5 o EXIST. WINDOW TO BE CLOSETS TO BE a. REMOVED REMOVED;EXIST. a WASHER $ DRYER TO BE REMOVED - �- -- -- Y N PROP05ED FIRST FLOOR DEMOLITION PLAN inin SCALE, 1/41IL 0 a • ®��® ®��, GENERAL SYMBOL KEY: �a v o� so a� EXIST049 TO REMAIN �2NEN FOWDATION WALL '3�E g 93 v NEN WOOD FRAte 0 3 u a Zao35am r �Waaa@ • rV 2a O W WlQ� Z y� DEC 2 2020 �oaN BUILD NEW WALL AT w��o z 3 a EDGE OF EXISTING X X HVAC DUCTS S 'u3icsi�ocz.+� jEc°i�daa�dx EXISTING $. - 3'X6'8" NEW 1 CL. NEW Io S.F. BATHROOM O 60 S.F. 07 I PROV. NEW 08 DROPPED CEILING NEW GREAT 1 0 ROOM 400 S.F. w F � } I EXIST. BOILER PROVIDE NEW OA5 GLASS CONNECTION TO EXIST. WALLS 1 FIREPLACE EXIST. BASEMENT - - EXIST. EXIST. 04 UP CRAWLSPACE ti OS Z C z NEW 06 EXIST. WATER Gi EXIST. ELECTRIC WINE CELLAR HEATER ~ w PANEL 25 S.F. EXIST. > i z CL EXIST. OAS LINE O C 4:x o EXIST. U-TRAP _ _ -0 2 W _ 0 BASEMENT 00= N N O a 0 X EXIST. EXIST. a WASTE PIPE GAS METER N ■ N QO PROPOSED 5A5EMENT PLAN ui iil SCALE, 1/4'.V O o a 01- c o��® ,� OENERAL SYMBOL KEY: U ?aC NEW Wood FRAre c wo 3 w 5 a dE zasY,{gm _ W O�COi ei 0 O >o sr oit - 1 R x O I y� -aSIO 1,L_ O W�N �U DEC 2 2020 J a QQ mZ WO(JJ W y HosFa4aW Lp �Fcoi�d¢a3x I I I I I CONTRACTOR TO GUT I I THROUGH EXIST. 5LAB I I FOR NEW BATHROOM I I PLUMBING. EXACT 51ZE & I I DEPTH T.B.D. IN FIELD I I 2------------ ---� I I I I I I I EXIST. I r--------- I BASEMENT I EXIST. COLUMNS d I 1 ————————— HEADER TO BE REMOVED r— I I � I I l L ----------------�. -- -------------0--� — 1 1 71 DEMOLITION NOTE: PROVIDE SHORING AND SUPPORT TO ALL AFFECTED I EXIST. PVC VENT STRUCTURAL MEMBERS PRIOR TO THE COMMENCEMENT EXIST. BOILER OF ANY DEMOLITION OR CONSTRUCTION. I I I I I I I I 4'-0"W I DEX2'-O"H I6H I PORTION OF EXISTING ti I I BASEMENT WALL TO BE Z z Z I I REMOVED FOR NEW AWNING WINDOW EXIST. EXIST. QZ 1 GRAWLSPAGE > EXIST. WATER Z EXIST. ELECTRIC PANEL HEATER W _ EXIST. 0 EXIST. U-TRAP 6AS LINE LL N �- — — �— 0 N 0 0- 0 a EXIST. Rt6A5 METER N t N Q PROP05ED BASEMENT DEMOLITION PLAN W SCALE, IAV a I'-0" c7 o a S1`spp�� zl® �a v sr (P m 3 3 0 ly _ a M a DEC 2 2020 �o�oo 0 — — — — — — f Engird__-''--- --• $-—.o W o�z 1y� 2 O O O O ❑❑ �Fo�dQo °dx .. . . . . . . . . . . PROP05ED PARTIAL REAR ELEVATION SCALE.I/8••P-O" U Q W Q1 -- - - - -- Z O Z eI -i z 00 -- — — z 0 O LL co O J V1 Q 0 a PROP05ED PARTIAL FRONT ELEVATION PROP05ED PARTIAL LEFT ELEVATION LO SCALE,1/8'o I'-0• 5GALE, 1/8••V-O' Q N O a o Qa �® ^ Z1111,41 GREEK�f GTOWN GREEK x a a 3 �` r �OMin a>a^" _ fp C r, 0�3W JO 't v _� 2ysy�QOf a . �dry AO ,i' g - -- V.i aw % eCj �J \� aye 103 72 {{ W 6.0 RZ R E =' - �/ DEC 2 2020 ° EXISTING STEPS 1 I c 3 2 log, a°U r9 9L It / - LU 4 I A' I 111 z b' ` e/-v'/ I / JU EXIST.WOOD I Q DECK 1 Lu / EXIST. TE / p BASEMENT >:S 1 r` ENTRANCE EAST. 2 STORY 5 K_ I } N DWELLING W gZ I 1 — FULL BASEMENT s 14.4 uJ / _. Q� Z EXI /% / STORY FRAM •-SPARASE UPON I I 0 11 DWELLING PVCOW-.SLAB ,! /. W 22ND STO I i �- GRAWLSPAGE F jABOVE I xd \00= i 7 % EXIST.GRAVQ Q DRIVEWAY 1 % ' /' �/' Z O z J z CL Z 0 / w O ' • w 0 1Z- .� o ao % �/ LL 0 % N �/- a / o a .� V, /'/ C % � CL /PROPOSED SITE PLAN l OdO COLE - CA - 3D.2v Np9° SCALE.1'-O° 50'-W LU cU o a r• N :1® ® c�y[� GENERAL SYMBOL KEY: o Ww= LL so (� tz� ewsntas r0 R2MAIN �"-�� ?MH FOUNDAnON WALL N Z y>Q mwmmm-m ooWs� rr e.-� o `^adC.a A �--- 1 l C W O O r2 �'U I i . L` DEC 2 2020Ems_ M E O' � o�aoa N LLW4��oF EXIST. EXI DECK T. OD D D p pard l;it Z-5y� N yS S NN co)Q HE S OINEN OI MUDROOM`r c N NEW X 6o S.F. BATHROOM 12 8Y2„ I I to -: NEW B G • GL. � � O UP ® F PROVIDE NEW (5) PANEL SLIDERS; I f O ACTIVE 2 PASSIVE OO11 PEN BEL11L,14 NEW NEW LANDING UP W IIIGERANGE I I I PROVIDE OBUILT-IN I I I I I I III I I I I I I UNDER STAIR EXIST. DINING I I X � ROOM I I II II II II NEW \ II I I II MODIFIED I I I I UP PROV. DENSE PACK I' KI PROV. NEW NATURALI I I 2�0 .F. I INSULATION IN EXIST. CEILING WOOD FLOORING I I I I I I I II EXIST. I I I OF GARAGE;FILL CAVITIES THROUGHOUT FIRST FLOOR I I NEW ISO L. III I I SKYL, Oq DN � I I I I I I I III EXIST. Z uw INEW GEIYJING�LII/ II II I GARAGE ( Q O g Q -jz G. 00 < d o NEW NEW W 0 rl = REF. TY• GL. o coo SO RELOCATE ALARM 4 rn A GABLE CONNECTION X X TO NEW CLOSET 0 IL � a X EXIST. DOOR TO REMAIN N N Q PROP05ED PARTIAL FIRST FLOOR PLAN W 500 S.F. INTERIOR RENOVATION sca,LE, va•a r-o° a � o a Glenn Goldsmith I" ',ident �gUFFOL,�C Town Hall Annex Michael J. Domino ,� �G�A 54375 Route 25 John M. Bredemeyer III o =` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Greg Williams y ® pl� Telephone (631) 76-1892 Fax 3 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 1'v 7°y'' Completed infield by: JL4 OL,J AMP Architecture on behalf of BENJAMIN & SIOBHAN MORDEN requests an Administrative Permit to the existing residence. All work will be done to existing exterior walls, nothing proposed is outside of the existing footprint: Removal of the following: (2) 3'-10"wX3'-2"h existing windows (1) 1'-10"wX3'-2"h existing window (2) 3'-9"wX1'-10"h existing windows (1) 2'-8"wX6'-8"h wood exterior door (1) 6'-0"wX6'-8"h 2 panel sliding glass door unit Installation of the following: (1) 9'-0"wX6'-8"h 3 panel sliding glass unit (1) 4'-0'°wX3'-0"h window (1) 7'-1"wX3'-0"h window (1) 2'-0"wX3'-0"h window (3) 2'-8"wX3'-0"h windows (1) 2'-0"wX3'-0"h skylight (1) 4'-0"wX2'-0"h basement awning window New wall framing and siding to match existing will be installed as necessary to fill areas of removed windows. Located: 801 Maple Lane, Southold. SCTM#: 1000-64-1-30.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I 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: Ij u. I have read & acknowledged the foregoing Trustees comments: XNA 00000' \� / /'� o i � looe i / -> 1000, X. \ \ 1\0a-/ y \ ♦ '� \ Ssol,, \ c% -Q ♦ `\ �X A ``y� �544°3844W Z N \ 2152' mii v \ \ 243' 1 �A IE ♦ � Jl N ♦ \ T1 I. F- N 4m� Ti. di \ �$p�t� \ '� �� �% ♦ �TryTx �sIIN � N C1 D� \ �9 �$ 101E ♦ o N� --------� ��.����r.-a�-----��-�� 20421' N6593130°W PRI V A T S D R I V E (GONNEGT5 TO MAPLE AVENUE) _ t ® ..... rT cn" n a O R r , PROPOSALFOR: MARK UP DATE COMMENTS DATE: 12/02/20 MOR D EN THESE PLANS ARE FOR DESIGN PURPOSES ONLYAND SHALL NOT BE USED FOR ARENOVATION ARCHITECTURE CONSTRUCTION.THE DESIGNS PRESENTED HEREIN ARE THE PROPERTY OF AMP PAGE: ARCHITECTURE,LLC AND SHALL NOT BE DUPLICATED WITHOUT WRITTEN AUTHORIZATION FROM ANTHONY PORTILLO,RA,LEED AP.THESE PLANS ARE _ S01 MAPLE LANE PROTECTED AGAINST ANY UNAUTHORIZED USE UNDER FEDERAL LAW BY THE lAvr— ARCHITECTURAL WORKS COPYRIGHT PROTECTION ACT OF 1990(AWCPA),WHICH SOUTHOLD,N.Y.11971 HAS SEVERE PENALTIES. Y' N d® �® SoNe GENERAL SYMBOL <EY: o p�LL 4,S 3 ` MW O Q F- (� 1:=1 EXI9TINB TO REMAIN ��•��•� NEW FOUNDATION WALL o-� ��Z N m r� maiWgs NEW WOOD FRAME o 0- �+W�o ® aero•se D = CCa�� W W Gkk oda. W n�aS°x urn � a zQ� I �' z-z t`I DEC 2 2020 " •g �-}Z.0�j G K G Q W EXIST. I W �LL3 DN. EX15T. WOOD DECK x tL x m o �a� Fx0�daax ONEPqOI MUD ROOM`r EW X605.F. 5A ROOM 12 55 S.F. 82 1. I I 10 NEN O 02 PROVIDE NEW (5) D �° I — PANEL SLIDERS; I — I — 5' S" ACTIVE 2 PASSIVE °O 0° PEN BEL W LANEK ND HG NSP 6� RANGE I I I PROVIDE NEW BUILT-IN IIII I I I I III I I N I I I I 1 G UNDERSTTAIR EX15T. DINING I i X ROOM IIII II II II NEH 1 II II II MOD IED I I II UP PROV. DENSE PACK PROV. NEW NATURAL KITEN 210 .F I INSULATION IN EXIST. CEILING WOOD FLOORING IIII NEW I I I I I I I �I I I OF GARAGE;FILL CAVITIES THROUGHOUT FIRST FLOOR FEXIS II SKYL. II I I SKYL. I I NEPS IIIA III I II II III IIII Oa DN I I I I I I INEW C DING RAL I I III GARAGE 1 w o_ g 0 Q J Z Y 0 > G. NEW W E 0 NEW O TY. GL. & � o 1- REF. 1 0 00 =) U. 0 RELOCATE ALARM # A GABLE CONNECTION X o X TO NEW CLOSET p 1 a X EXIST. DOOR TO REMAIN N 1 N Q PROPOSED PARTIAL FIRST FLOOR PLAN W 500 S.F. INTERIOR RENOVATION WALE. 1/4•o I.-0° a C7 c a • ®��3 ®� GENERAL SYMBOL KEY: o Q W W= � �=j E%15nris TO REMAIN r19+FAJNDAnON WALL o-� W� z m g EB W HEN NO=FRAME m c ga g I �Wo�WN ® I W�" EXIST. DEC 2 2020 DN. $ '.FEV3� EXIST. WOOD DECK _______ p WtEo = — - - - - --- - - ------- _—_—_=_-- _ o y - -- - EXIST. WINDOW5 TO BE EXIST. DOOR d REMOVED _ WINDOW5 TO BE EXI5TING (2) SLIDERS TO ALL KITCHEN CABINETS, REMOVED BE REMOVED AND COUNTERTOPS 8 I I REPLACED 16V 5 PANELAPPLIANCES TO BE I I 5LIDER5�— REMOVED I I I I I I I a II REMOVE PORTION OF WALL FOR NEW SLIDERS I i I I I l I I I I I I ��� I I I I EXIST. I`����) 1 I I MUDROOM ——1 —��EXIST. STAIRS TO BE I K►TGHEN I I `a)�`>) REMOVED EX19T. ROOREAT EXIST, DI INC ) I I I �) I I I II I I I EX15T. it II I II GARAGE I I --- I I 1 1 ISI I I EXIST. IRI x LSKY /c�� � I I Z w Z O Z u-------------- ---=fir=== r�---� in > -i z r I l u l EX15T. 0 0 a C L A° J i t i - ==�-ii I l i CL. w m 0 oo N EXIST. DOORS c a EXIST. WINDOW CLOSETS TO BE TO BE o REMOVED REMOVED;EXIST. a WA5HER d DRYER TO BE REMOVED o N N O PROPOSED FIRST FLOOR DEMOLITION PLANAn W SCALE, 1/4's 1'-0° o a N do� GENERAL SYMBOL KEY: og LLa mw EX19TINS TO REMAIN NBA!FOUNDATION WALL �O Farcaga NEN WOD OFRAME Y mow,i ,^,, % is°u9 L) aOR dz=28xt� IL oZ=oZ 2020 1__ 2 � 1�„ BUILD NEW WALL AT LL W o.o F EDGE OF EXISTING p a m z 3 a X X;iav J. X HVAC, DUCTS ---- Q g= S a W ° -- ml UP IF EXISTING = w, 3 8° NEW NEN ix 10 S.F. BATHROOM O X 60 S.F. n 07 PROV. NEW 08 DROPPED CEILING NEW GREAT O ROOM 400 S.F. w �d F � � I EXIST. BOILER PROVIDE NEW GA5 GLASS CONNECTION TO EXIST, WALLS FIREPLACE EXIST. BASEMENT EXIST. EXIST. O4 ; UP GRAWL51FAGE ti NEW OS ch Z ZO z O6 EXIST. WATER W F- :5 EXIST. ELECTRIC, WINE CELLAR HEATER 0 J z PANEL 25 S.F. EXIST. it > a EXIST. 6AS LINE C Z 0 EXIST. U-TRAP =. _ W BASEMENT �— 6c c 77777-77, 7777777=777777 711111 (n 0 a 0 X EXIST. EXIST. ° WASTE PIPE GAS METER M o ' ;cs Q PROPOSED BASEMENT PLAN ao 0 0�. ®A�ObL�® �� 5ENERAL 5YMBOL KEY: WW= LL �F3 � EXISTING TO REMAIN F"-•"'-=y NEV!FOUNDATION HALL o-� -z f l m NEW MOOD FRAME ��W 5 g �qy , �ade � aLLLL L) ^Y, ayZ-j�JS o lz `t ' DEC o ' L {/''�/�LVLO ice` 1y O J I W FE�LL 2a 3 4 f �O a: < YC W LpI 1 I I I CONTRACTOR TO GUT I I THROUGH EXIST. SLAB I I FOR NEW BATHROOM i I PLUMBIN6. EXACT 51ZE E i I 1 DEPTH T.B.D. IN FIELD I I I I I I I' I I EXIST. 1 F ------ I BASEMENT I I EXIST. COLUMNS 8 L--------- I HEADER TO BE REMOVED I I I I � l L ---------------� -- -------------0---- — 1 1 DEMOLITION NOTE: EX15T. PVC VENT PROVIDE 5HORIN6 AND SUPPORT TO ALL AFFECTED STRUCTURAL MEMBERS PRIOR TO THE COMMENCEMENT EXIST. BOILER OF ANY DEMOLITION OR CONSTRUCTION. . . . A I I I i i I 4'-O"WIDEX2'-O"HI6H I IPORTION OF EXISTING I I BASEMENT WALL TO BEPR z 0 z I I REMOVED FOR NEW EXIST. Lu H g AWNING WINDOW UP IEXIST. in Q J z 1 GRAWL5PAGE > p p 0 a dKATEREXIST. ELECTRIC EXIST.HEATER W 2 0 PANEL EXIST. Ir 0 GAS LINE LLN EXIST. U-TRAP -- —$— �- 0 0 0 s a EXIST. 6A5 METER N N Q PROP05ED BASEMENT DEMOLITION PLAN W SCALE, 1/4°-I'-0° 112 o a �a � yy��,, 7 � ZaRma _ 0 3 qty O �'•I }E t zW�QW� DEC 2 2020o�o Y1ww W 0 A W r '=401 WtSR m mo Board c;_: ZE W z O 0 U N �c�i°d¢a°ds PROPOSED PARTIAL REAR ELEVATION SCALE. I/8"_V-O" W W rl Z O g rl _ — W p C ac La ® O F A 11 co tOi O N N O a 0 E a PROPOSED PARTIAL FRONT ELEVATION PROPOSED PARTIAL LEFT ELEVATION Lo SGALE,1/8.0 1'-0° SCALE, 1/8• V-0• cm c Q N O N LLl W o a Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other t, MAIN ROAD(IV r.s. SURVEY OF PROPERTY 9,\ SITUA TE V101F q gos UjIySSrS CA1,1^4 SOUPHOLD11 TUG TOWN OF SOUTHOLD F�\F r �t J) 84-21'50" E J�i 9643, ''1 DEC 2 0 �L, \ ,2, 0 SUFFOLK COUNTY, NEW YORK T 01 12 S.C. TAX No. 1000-64-01 -30.2 -110,4.5 AL • ENCE 07, ," .1 1 SCALE 1"=30' '01 0 F 0, P, c 7 SEPTEMBER 17, 2013 ;0 C14 AREA = 70,093 sq. it, (TO TIC LINES) 1.609 ac. 'I AL 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM A4. EXISTING ELEVATIONS ARE SHOWN THUS-JPQ To AIL O O. AL Vj ALL f _l3 4 4ie `0 kJ% Ll 452.40 Ly, 'I-TI, t Amb 36,42' cP LA FTAC 1\ --j-, W Q�I 2Q GO DECK LU 8 STEPS �,LAQ _§L_—Y' 4 0' 0/ OC) -,1,.11.11ARD TOO Cr' LAG r"G Y)a) CO V A) 6a.13 246.47' 30vJ 62-39,57 N ECG!or PA EWNT c� Z2 J, -jLj 04. --.Lo rY 0) UNAUTHORIZED At ICA On APDRION v5 tl:f PlINIARFI)114 ACLOADANC�17n.71lE XINOXIM 10 TMG SUNNEY VI A VO (IF S, Nathan Taft Corwin Ill I5TAIJIDAROV.WR TITLE SURVEYS AS ESTABLISHED TO PON 1200 01 THE NEW TORN STATE Of 11F L.LAI14 AND APPROVED AND ADOPTED EDUCATION LAW ELEVATION HIGH WATER MARI<OR 17/2014 FOR SUCH ka BY iHc NEW YORK STATE;AND A TITLE ASSOCIATION COP IS Of 11 IS qIJAKY MAP Not VEARING FLILVATION I OWER LOW WATER MARK ft/17/P014 -0 W Land Surveyor TITLAI4D SURI YOR'S INKED SEAL OR WATER DEPTHS SHOWN 114 INLIICS ARC REIFICkENCILD TO 19, EUBOSSEO'W'SHAIL N01 BE CONSIDEREDI OWER LOW WATER BEING Al c' 9 TO Or A VAIID 7017 COPY. ELEVATION ALONG WETLA40 BOUNDARY 05/17/2014 u 32' SLICm%.,To-SI.Plw J.156w,J,.I,S CETITfICNTIONS INDCAILD llFnco4 THAL4 RUN Jowph A hqqno LS ONLY TO 7111.PVNSON IOR IMOM In.SURYTY is PR&PARED;•AND,ON iNISuElm-Ir TO THE VILE COMg GOVrRNMLNTAL AGENCY AND1,11i,su­ys– S,bd.,S,04. – 5,10 cm— tbo.L.yQL( LLNONO IN141ILPON LISILD HLRLON,AND To Till:ASSIGNEES or THE LCNDNC INS11- PHONE (631)727-2090 [oA (631)727-1727 UTION CeRTIFICAPONS ARE NO,IRANSFERAD,C. OFFICE:'I OCIATO) IF 5(AILING ADDRCSS 1586 ,14m Roud P.0 Bo, Ic, THE EXISTENCE or RIGHTS or WAY JIme,port.NawYo,k 11947 J�P,�Spbrt,No,York Ilq,17 AND/CR CASEMENTS OF RECORD. IF N.Y.S Lm No. 50467 ANY. NOT SHOWN ARE NOT GUARANTEED. TWIT 777" IL m 14i� s w �•,t, r/ �,F a �// F// F s n ^ M G2 165O 4,�}. e/ + F /T aP `V a // S Q 9/ 14.9M2 A 1 Ni E 9.1 2'2+ ' ///F �9 �/' dy F F 'L V. _ _ \ y / q 001)k it o ,l / ,TA(cY 13 / �N rdarice K � � z� ��� 1000 - sec?irn+raO 2. COUNTY OF SUFFOLK © M µ EQ Y SOUT OI �64 Real Property Tax Service Agency W E us,rsia.rticr+cF rw PORTroR or,laE M wR or G 300C—LYive.Idxnhm{NY 11 01 51FfOL1(C0.N1Y TNf MV s PRQIBRF➢ A __. Wi1RIXff NRYRBI F9A69W 611E P w.ti Or (21) aee..r " S. RFOln'TNI SITYVI0=MB4Y. OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex ��w rv �, P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971v `� Telephone: 631 765-1938 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: December 9, 2020 Re: LWRP Coastal Consistency Review of BENJAMIN & SIOBHAN MORDEN SCTM# 1000-64-1-30.2. AMP Architecture on behalf of BENJAMIN & SIOBHAN MORDEN requests an Administrative Permit to the existing residence. All work will be done to existing exterior walls, nothing proposed is outside of the existing footprint; Located: 801 Maple Lane, Southold. SCTM#: 1000-64-1-30.2. The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "B" which states: B. Replacement, rehabilitation or reconstruction of a structure or facility, in kind, on the same site (inplace), including upgrading buildings to meet building or fire codes, except for structures in areas designated by the Coastal Erosion Hazard Area (CEHA) law where structures may not be replaced, rehabilitated or reconstructed without a permit and shoreline erosion control structures (including, but not limited to, groins, jetties, bulkheads, filled piers) located within Great Peconic Bay, Cutchogue Harbor, Little Peconic Bay, Hog Neck Bay, Noyack Bay, Southold Bay, Shelter Island Sound, Pipes Cove, Orient Harbor, Gardiners Bay, Long Island Sound, Fishers Island Sound and Block Island Sound (excluding all creeks). 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 1 Glenn Goldsmith,President I so(/ly Town Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III 1 Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williamsi0 Fax(631) 765-6641 olyIrou BOARD OF TOWN TRUSTEES j ` � V TOWN OF SOUTHOLD TO: SOUTHOLD TOWN BUILDING DEPARTMENT DEC - 2 2020 RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIRIIENTS E�_ S t.tilWi'Zii{dE t.kitxa�t� 'Property Owner Name: •l._ a, ._ i_a3i_. f'. e:. =1i_a.l_Z. `;f !'_:. 11.•tA Date''Sentto`-Bid g:'Dept: l2.220 ::,.• _::« �;_.- :h=� The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Departmepts,permitting requifements stated below: YES NO Will the proposed project require a Building Permit? _J t/ Will the proposed project require a variance determination = from the Zoning Board of Appeals? Will any part of this application be considered,a,perholition as described under Town Code? COMMENTS: v �O Signature o Revie er Date Glenn Goldsmith,President q so Town Hall Annex Michael J.Domino,Vice-President �� �{� 54375 Route 25 P.O.Bog 1179 John M.Bredeme er III Y Southold,New York 11971 , A.Nicholas Krupsld 4 Telephone(631)765-1892 Greg Williams Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension E Received Application:_ 17-1 lot DEC 2 2020 Received Fee: $ 100.60 ' CompletedApplication: Incomplete: ,.;,,;, SEQRA Classification: Type I Type H Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: s _____,,Coordinahon:(date sent): V LWRP Consistency Assessment Form Sent: _ CAC Referral Sent: Date of Inspection: Receipt of CAC Report: ; Technical Review: Public Hearing Held: 17--10 Resolution: Owner(s)Legal Name of Property(as shown on Deed): Benjamin &Siobhan Morden Mailing Address: 801 Maple Lane, Southold, NY 11971 Phone Number: 917-945-5236 Suffolk County Tax Map Number: 1000- 64-01-30.2 Property Location: 801 Maple Lane, Southold, NY 11971 (If necessary,provide LILCO Pole#, distance to cross streets,and location) AGENT(If applicable): AMP Architecture Mailing Address: 1075 Franklinville Road, Laurel, N.Y. Phone Number: 516-214-0160 Board of Trustees Application GENERAL DATA Land Area(in square feet): - 70,093 SF Area Zoning: R-40 Conforming Previous use of property: Single Family Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? Yes x No If"Yes",please provide a copy. 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? Yes x No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes x No Does the structure(s)on property have a valid Certificate of Occupancy? x Yes No Prior permits/approvals for site improvements: Agency Date Southold Building Department January 1977 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): Please See Attached 4RCHffECTURE Operating Business Address:1075 Franklinville Road,Laurel,N.Y.11948 Brooklyn Office:204 25th Street,Suite 203,Brooklyn,NY 11232 C Business Phone:(516)2140160 Date: December 2,2020 Southold Town Trustees 54375 Route 25 PO Box 1179 Southold, NY 11971 RE: 801 Maple Lane,Southold, NY 11971 SCTM#1000-64-01-30.2 To Whom it May'Concern, The following is the proposed work to the existing residence at the above address. Please note all work will be done to existing exterior walls,nothing proposed is outside of the existing footprint: Removal of the following: (2)3'-10"wX3'-2"h existing windows (1) 1'-10"wX3'-2"h existing window _ (2)3'-9"wX1'-10"h existing windows (1)2'-8"wX6'-8"h wood exterior door (1)6'-0"wX6'-8"h 2 panel sliding glass door unit Installation of the following: (1)9'-0"wX6'-8"h 3 panel sliding glass unit (1)4'-0"wX3'-0"h window (1)7'-1"wX3'-0"h window (1)2'-0"wX3'-0"h window (3)2'-8"wX3'-0"h windows (1)2'-0"wX3'-0"h skylight (1)4'-0"wX2'-0"h basement awning window New wall framing and siding to match existing will be installed as necessary to fill areas of removed windows. Thank You, Brooke Epperson AMP Architecture,PLLC Senior Architect E: bepperson@amparchitect.com O: 516-214-0160 www.amnarchitect.com • 4 ALL NEW WINDOWS SHALL BE ANDERSEN 400 SERIES WITH THE EXCEPTION OF THE 5KYLIC7HT, INSTALL AS PER MANU. SPEC.s. SEE PACE "6-005" FOR NAILING 5TRAPMN6 DETAILS. ALL FINISHES TO MATCH EX15TIN6 vn a. CLEAR <, _ROUGH OPE P41NOON DIMENSION TAO TYPE MODEL# OPENING WIDTH Rr=0'D: 20" HF-16HT REGV:24- D HEI6HTE1,11". WIDTH HEIGHT OPEN REQ D: A CASEMENT 025 5 11 CASEMENT1 C065 I 11 C, C7LASS oAsa��aNTF I TEMPERED F D 11 CASEMENT15 E SKYLIGHT MATCH EXISTING F AWNING A41 40 4'-0" DOOR MATERIAL TAGS DESCRIPTION NOTES WIDTH E� HEI&HT 0 77-7 7, 7, FR '10 01 SINGLE 02 5 PANEL "!X 2' b (0.- .e, 05 51NOLE 04 SINGLE 05 51NOLE or. DOUBLE 5IN(5LE v 05 5INC7LE Oq SINGLE IF 1 10 1[- DOUBLE IF-77'_7111,� 71 II- 5INC7LE Z-0" IE I Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Please See Attached Area of wetlands on lot: 18,950 square feet Percent coverage of lot: 27 % Closest distance between nearest existing structure and upland edge of wetlands: 43.6 feet Closest distance between nearest proposed structure and upland edge of wetlands:_ 43.6 feet Does the project involve excavation or filling? x No Yes If yes,how much material will be excavated? N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet ; Proposed slope throughout the area of operations: - N/A Manner in which material will be removed or deposited: N/A Statement of the effect, if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): Proposed work is within existing structure and construction will be in a controlled setting. 61 Z20 Appendix B Short Environmental Assessment Form Instructibns fof'Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part l based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: Morden Renovation Project Location(describe,and attach a location map): 801 Maple Lane, Southold, NY 11971 Brief Description of Proposed Action: Please See Attached Name of Applicant or Sponsor. _ Telephone: 516-214-0160 AMP Architecture E-Mail: bepperson@amparchitect.com Address: 1075 Franklinville Road City/PO: State: Zip Code: Laurel NY 11948 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 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: a ❑ Southold Town Building Department 3.a.Total-acreage of the site of the proposed action? 1.6 acres b.Total acreage to be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.6 acres 4. Check all land uses that occur on,adjoining and near the proposed action. E]Urban ®Rural(non-agriculture) []Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic []Other(specify): ❑Parkland Page I of 4 ` J 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ ❑ b_Consistent with the adopted comprehensive plan? ❑ M ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: nx EJ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO 1 YES b.Are public transportation service(s)available at or near the site of the proposed action? El ❑ ❑ ❑ 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: ❑ X 10. Will the proposed action connect to an existing publiclprivate water supply? NO YES If No,describe method for providing potable water: 0 ❑ 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? ❑ 1:1b.Is the proposed action located in an archeological sensitive area? o F, 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline El Forest ❑Agricultural/grasslands ❑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? ❑ ❑ 16.Is the project site located in the 100 year flood plain? NO YES X 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? D NO DYES ❑ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: El NO DYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of -Na YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO - YES solid waste management facility? If Yes,describe:, 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: a I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: AMP Architecture Date: 12/02/20 Signature Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 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 F] ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impairthe character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? El F S. Will the proposed action result in an adverse change in the existing level of traffic or F1 F1affect 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 Elreasonably available energy conservation or renewable energy opportunities? EL 7. Will the proposed action impact existing: Ela.public/private water supplies? EL b.public/private wastewater treatment utilities? E 11 8. Will the proposed action impair the character or quality of important historic,archaeological, a ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, F]waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El 1:1problems? -7 IL Will the proposed action create a hazard to environmental resources or human health? o 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-tern,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. 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 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SCTM# 1000- CP ^_� " ��' in the town of New York,hereby authorizes - -- AMP Architecture to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town . S Board of Trustees for this property., Yioperiy6wnres Signature Property is Signature s t , i SWORN TO BEFORE ME THIS,.. _ n __DAY-OF._._� 'C e �e'� .. ",20 Lori T McBride NOTARY PUBLIC,STATE OF NEH'YORK Registration No.OIMC6368447 Notary Public Commission Expires December 11,2021 APPLICANT/OWNER 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• oum d c'� A Yl •(Last first uAne,middle initial,unless you are applying in the name meone else or other entity,such as a company.Lf so,indicate the other person's or company's name.) TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest.`Business interest" means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this day of��C, .2C 2� • _yy Lori T McBride Signature NOTARY PUBLIC,STATE OFNEW YORK � s Registration No.OIMC6368447 Print Name- Lt:rt- ---t-- tA CJ VJ6-jz -—Qualified-in-SuffolkC-ounty- Commission Expires December 11,2021 Board of Trustees Application AFFIDAVIT _BEING DULY SWORN f Ijl9P6Sn AND AFFIRMS THAT HE/SHE -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. Slgnil&of Property Owner SignAture Property Owner SWORN TO BEFORE ME THIS, �Z',d'_ '. ._DAY OF. .1�Cew��j No Pubic f- Lori T McBride N0T.M'Pl'BL1C,ST%TE 0FNP'y0RK �. kiegj•%raatonNo.U1MC6368447 ouafgied in Suffolk County Commission Expires December 11,2021 APPLICANUAGENT/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: _ Brooke Epperson (Last name,fust name,griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ Planning Other (If"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,rnarriage,or business interest"Business interest"means a business, i 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(wheir 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 thi 2nd a of December 20020 Signature Print Name rD • r- Form TS 1 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 R onosed 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- sunportink facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shallnot 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#. 64 _ 01 30.2 PROJECT NAME Morden Renovation 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: Please See Attached A Location of action: 801 Maple Lane, Southold, NY 11971 Site acreage: 1.6 Present land use: "Single Family Residence ° Present zoning classification: _R-40 Conforming 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. AMP Architecture (b) Mailing address: 1075 Franklinville Road, Laurel, N.Y. (c) Telephone number:Area Code( ) 516-214-0160 (d) Application number,if any: _ " 1A Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes 1 No Fx] If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑x Yes ❑ No n Not Applicable Proposed work is within the footprint of an existing residence Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Section III—Policies Pages 3 through 6 for evaluation criteria Yes ❑ No 0 Not Applicable Site is not located within historical or archaeological areas 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 x❑ Yes ❑ No ❑ Not Applicable Proposed work does not encroach into the Wetlands area or go beyond the existing house footprint Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRF Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable There is no proposed work to the site 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 ❑x Not Applicable There is no proposed site work or new water connections 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. Q ❑ ❑ Yes No Not Applicable The proposed work is within the existing house footprint,work will not affect the wetlands Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LNVRP Section III — Policies Pages 32 through 34 for evaluation criteria. 0 Yes No FX-j 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 m No Not Applicable f 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. El YeT:1 No FX] Not Applicable There is no access to the property via the waterway Attach additional sheets if necessary I r , WORE NG 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 x❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 2 Yes ❑ No ❑ Not Applicable The proposed work does not affect the site 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. X Not Applicable El Yes El No Attach additional sheets if necessary Policy 13. • Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. 0 Yes ❑ No ❑ Not Applicable All work to be done will be up to the latest code standards for energy efficient construction PREPARED BY AMP Architecture TITLE Agent DATE 12/02/20