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HomeMy WebLinkAboutTR-9829A Glenn Goldsmith, President SO Town Hall Annex A. Nicholas Krupski,Vice President ® ®�� 54375 Route 25 P.O. Box 1179 Liz Gillillool Eric S ki 3 Southold,New York 11971 ool y � ' Elizabeth Peeples Telephone(631) 765.1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1920 C Date: June 10, 2022 THIS CERTIFIES that the replacement in kind of 1258sq ft pool patio with marble stone; construct 108sq.ft. sun shelf 138sq ftpatio; 286sq ftpatio and "L" shaped 39sq ftwater feature; At 57908 Main Road, Southold Suffolk County Tax Map #111-66-2-2.2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated February 17, 2021 pursuant to which Trustees Administrative Permit #9829A Dated March 18, 2021 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 the replacement in kind 1258sq ftpool patio with marble stone,• construct 108sa.ft. sun shelf,• 138sq ft patio; 286sq ft patio and "L" shaped 39sq ft water feature The certificate is issued to Russell & Julianne Karsten ow of the a re 'd pr ty. Authorized Signature u� Glenn Goldsmith,President Zv SID Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ��� � P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly CA, Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: (�V/O 2 INSPECTED BY: G. • c ���1 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction % constructed X Project complete, compliance inspection (ViA --q 2 CERTIFICATE OF COMPLIANCE: O L S�- Glenn Goldsmith,President Qf SUUlTown Hall Annex A. Nicholas Krupski,Vice President ,`O� Ol0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III J�t [ Southold,New York 11971 Michael J. Domino G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 lyc4UM`I,� BOARD-OF TOWN TRUSTEES TOWN OF,SOUTHOLD SOUTHOLD TOMN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE"OPFICE OF THE BOARD OF TRUSTEES 72"'HOUIRS PRIOR-TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction',14Y bale"line/silf boom/silt curtain rt 1St day of construction '/ constructed When project complete,-call for compliance inspection; Glenn Goldsmith,President �Qf SoUry Town Hall Annex A.Nicholas Krupski,Vice President ,`O� Ol0 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J 7 [ Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9829A Date of Receipt of Application: February 17, 2021 Applicant: Russell & Julianne Karsten SCTM#: 1000-66-2-2.2 .Project Location: 57908 Main Road, Southold Date of Resolution/Issuance: March 18, 2021 Date of Expiration: March 18, 2023 Reviewed by:. John M. Bredemeyer, III, Trustee Project Description: Replace-in kind 1258sq.ft. pool patio with marble stone; construct - 108sq.ft. sun shelf;,138sq-.ft, patio; 286sq.ft. patio and "L" shaped 39sq.ft. water feature. Findings: The project meets_all the requirenients'.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 survey prepared by , Howard W. Young, Licensed Land Surveyor, dated January 29, 2021 and stamped approved on March 1-8, 2021. 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 wiil be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees -- -- (I)UNAUTHOOZED ALTERATION OR ADDITION TO TH?S SURVEY IS A VIOLATION OF SECTION 7207 OF WE NEW YORK STATE EDUCATION LAM(2)OSTANCES 9IORN HEREON FROM PROPERTY LINES TO EVSTINO STRICTURES ARE FOR A 5PECWC PURPOSE VINO ARE IOT TO BE USED TO ESTAVIISH PROPERTY LINES OR FOR ERECTION GE nW=.(J)CWIES OF THIS"VEY MAP NOT BEARINC TME LAND 9JRVEAVR'S INKED SEAL OR EMBOSIM SEAL SHALL NOT RE CONSIDERED TO BE A VALID TRUE COPT.(4)COIE111FlCAT10N INDICATED HEREON SHALL RUN ONLY TO 111E PIRSON FOR WH1. THE SURVEY 15 PRCPARED AND ON Ml RDALF TO IH` TITLE COM°4NY,GCYTWNMC4TAL A.I`NCY AND LENCING INSTITUTION LM11ED HEREON,AND TO THE ASS04MS CF THE LCNDINO INSTINTION (ERTW.AnORS ARE NOT TRANSTERAFILE 70 ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (S)THE LOCATION OF WELLS(TI')•SEPOC TANKS(ST)t CESSPOOLS(('P)SHOW HEREON ARE FROM EIELD OBSERVATIONS NTD OR DATA OBTAINED FROM OTHERS 400 Ostrander Avenue, Riverhead, New York 11401 tel. 631.727.2305 fax. 631,727.0144 adminayoungongineerfng.com Howard W. Yovng, Land 5vrveyor 4S Thomas G. Nolpert, Professional Engineer / Douglas E. Adams, Professlonal Engineer / F Robert G. East, Architect Robert 5trom5kl, Architect SITE DATA wRg AI bra In qQ / AREA = 1.8601 ACRES OR 81,024 SQ. FT. �O ^ 7° / DELOT UCAUMBERS REFER TO MI ��8¢I+��N� ,N.CHARL �,„,JJ``��ll ee � r A ti J Gss °�'/ ' " VERTICAL DA M BOARD OF I RUSTEESNAVD 19850 114 ( ) "Q o^ \ \ ` Q11�e�NO-, / * AREA OF WE -ANDS 8,067 OF SOUTI-60LD =8,067 SQ.FT. s Q^�KP�¢ Lot 1 ,/ DATE rnkkc& 18 ZOz( S1-0\-ql s20o ro\ o s �o 3 F � �h \\ R9�\ ormerlY sono �` / nota or{ RQad 1,1,6 _ -�` ac �Q. 4. 1>0 22 (� \ojc 5786 Main __ - Geo t� \�Q1- 44425' mor for ~Karsten '". Lot 2 �-" - \,W 3Ulionme 00' - �� , . D �O� 1210 °^ ell Karste W - FEB 202 0 2 \ Russ tate49 v°F'P - 7 ND Ep? � F Southold Town Wq4 \ Board of Trustees wRA 2049,50ME � 11 tl'�y'C� mLy� sazKE s°moo Lot 4 a: SURVEYOR'S CERTIFICATION q \ FOUND X11 �Y' *WE HEREBY CERTIFY TO RUSSELL KARSTEN & NIULIANNE KARSTEN THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE 4110 o,3 ,} CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE C100 1 t ' PROPOSED PATIO I 81 00, } o t (138 SF) `90/°+- ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. n O\. s o o \` IPF Lot 3 0y II�PJ Q��O of (86 55ED PATIO �'A ^F) f Al PROPOSED SUN SHELF (108 SF) oh r r. $ \9� S 0 0. '. (_) . �� ` 3>rp -I�foP� l QO tiA n RAaa� � n1 O HOWARD W.YOUNG,N.Y.S.L.S.NO,45893 �LOT COVERAGE CO.ePROPOSED� OyO d FF *cp�0 �0' FRAME HOUSE&GARAGE = 3,548 SQ.FT. =4.4% Ns cG2 y° :�,�o Q a� f tit REPLACE SURVEY FOR FRAME SHED = 84 S FT. =0.1% ` 73 RO = 360 SQ.FT. =0.4% prop Ar� �� 5.a' ��� PATTO o e°i �� y e IN KIND 1 �pO*1 Y` 6 POOL =790 SQ.FT. = 1.0% �o� N= NAh F��,� y. ��, RUSSELL KARSTEN HOT TUB = 52 SQ.FT. =0.1% �/2 i� 1� WOOD DECK = 599 SQ.FT. =0.7% JULIANNE KARSTEN TOTAL=5,433 SQ.FT. =6.7% --� � ^i �� at Southold, Town of Southold --'`•.,\ Suffolk County, New York , - r BUILDING PERMIT SURVEY @� O^� County Tax Map District 1000 Section 66 Block 02 Lot 2.2 o s � LEGEND r7C 16 IU 106 04 _ __ MAP PREPAR4' FIELD ED COMPLETED JAN.29,2021 FEB,08,2021 1`1 N47 2T I LINE SHOWN ON JOHN C.EHLERS LAND SURVEYOR1 �1�3•, TIE LINE ALONG 17 13.659L'W Record of Revisions BBA =BELGIAN BLOCK APRON SURVEY LAST DATED 08/01/2011 LABELED AS JJJ o0 APPROXIMATE HIGH J-1031,1591% -1 31 REVISION DATE CC =CONCRETE CURB "WETLANDS LINE FLAGGED ON 11/13/01" y�3 WATER MARK CMF =CONCRETE MONUMENT FOUND CMS =CONCRETE MONUMENT SET DI =DRAIN INLET / EOP =EDGE OF PAVEMENT H IPF =IRON PIPE FOUND g OL =ON PROPERTY LINE HIPPODROME CREEK PRF =POST&RAIL FENCE CI I WDF =WOOD FENCE CI WSF =WOOD STAKE FOUND 50 0 25 50 100 150 WSS =WOOD STAKE SET =END OF DIRECTION/DISTANCE —� Scale: 1" = 50' JOB NO.2021-0005 DWG.2021_0005_bp 1 OF 1 Glenn Goldsmith, Pig Jent �O�OS rup UFF���C0� Town Hall Annex A. Nicholas K ,.,.r, Vice-President yam, a . 54375 Route 25 John M. Bredemeyer, III o '` P.O. Box 1179 Michael J. Domino O Southold, NY 11971 Greg Williams y �o� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ] Date/Time: 26 �� ��1:? Completed in field by: a�c�J John Tortorella on behalf of RUSSELL & JULIANNE KARSTEN requests an Administrative Permit to replace in kind 1258sq.ft. pool patio with marble stone; construct 108sq.ft. sun shelf; 138sq.ft. patio; 286sq.ft. patio and "L" shaped 39sq.ft. water feature. Located: 57908 Main Road, Southold. SCTM#: 1000-66-2-2.2 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: 11_/ J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other (1)UNAUTNF0?FO ALTFRARON OR AWTKXN TO THIS SURVEY,S A WTLAT"OF SECO-N M9 OF THE NEW YORK STALE EDUCATION UM (7)MTANCES SHORN HEREON FROM PROPERTY URM TO EXISTING SMUCTURFS ARE FOR A SPECIRC PURPO$AN ARE NOT TO RE USED TO EST49US1 PROPERTY ONES OR FOR ORCTMN or FfA m.(J)cwn or THHS"VEY MAP NOT BEMNC UNE LAND SURVEYORS INKED SEAN.OR EYROSSEO SEAL SHALL NOT BE L'ON90ERED TO 9E A VALK)""COPY.(s)CERTFCATION NDICATED WPCI.IN SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY R PREPARED AND CN NS BEHALF 10 INF TITLE(YNAPANT,CCVENNV-NTAL ADEN••^.Y AND LENDNG NSTITUTION USTLU HEREON.AND TO THE ASSIGNEES OF THE L04DNr NSRRTION CERRF#:ADONS ARE NOT TRANSFERABLE TO ADDIDONAL NSTITUTIrNS OR SUBSEQUENT OWNERS. (S)THE LOCATNN GE WELLS(W).SEPRC TANKS(ST)t C'ESSPCCLS(rP)SHORN HEREON ARE FROM FIELD OBSEAVATKWS AM OR DATA OBTRUNED FROM OTHERS 400 Ostrander Avenue, Riverhead, New York 11401 �'� tel. 631.727.2303 Fax. 631.727.0144 admin®youngonglneering.com / 'e Howard W. Young, Land Surveyor Thomas 6. Wolpert, Professional Engineer LW Douglas E. Adams, Professional Engineer AZ / r �,T) a Robert 0. Tost, Architect r^ / Robert 5tromski, Architect / SITE DATA CJ .NPO d)N,Nn ��„ / AREA = 1.8601 ACRES OR 81,024 SQ. FT. C) /' *LOT NUMBERS REFER TO MINOR SUBDIVISION FOR N.CHARLES o h*0 DELUCA. F4 �O� �vS n �h (L El`X,se�� �c0 * VERTICAL DATUM =NAVD(1988) / \ ` ,oh�E' of,Q"S�LPe^/� AREA OF WETLANDS =8,067 SQ.FT. / \ �ZIP! / e7 Lot 1 \ \ Ir / \ ` Ali OF\ 57b56 tS l � 0 V oy A.25' e 1Y ~ ��r �' Lot 2 l _ " ^aW °r{ori io^^e y°relevI - - OL o o„ • �� _ �- - R,,SSQtar 5o''w _ \ 'SEB 17 2021 eO/x10 e�� \\ \ �r _/ . �D , ,�, So� es d of Trus e ,04VROADWAY 255.21 w"� \ A54 NDS° 572°49'5011E P Q 11' � SO�Q Lot 4 g SURVEYOR'S CERTIFICATION \ FOUND �r o4f�F >?, o� "WE HEREBY CERTIFY TO RUSSELL KARSTEN & jULIANNE KARSTEN THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE ` TO CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE Q( \ 20o pn i 1 ' PROPOSEb PATIO o ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. o Qj. O°t (138 SF) 0� 4-, po� �101, ' pO\ � PROPOSED PATIO ILot 3 7'o^ PF , o� (286 SF) �P Q ,J PROPOSED SUN SHELF (108 SF) A Vo �. �0s. 01- elk ma LOT COVERAGE 6b° 41 Ire, 4 p3n1 i \?, ; HOWARD W.YOUNG,N.Y.S.L.S.NO.45893 y �� '` J5 g6 o o �y PROPOSED WATER FEATURE FRAME HOUSE&GARAGE = 3,54$SQ.FT. =4.4% �O�('c2 pm. ' o Q FRAME SHED =84 SQ.FT. =0.1% �Q'�o��sq �ti\ 5.8 \�0 7.3' REPLACE , ° 0e SURVEY FOR RO = 360 SQ.FT. =0.4% to POOL =790 SQ.FT. =1.0% Q { IN KIND i ��� �p Cf' HOT TUB = 52 SQ.FT. =O.ly, ti �F ; .0 Fra ��. RUSSELL KARSTEN do WOOD DECK = 599 SQ.FT. =0.7% �Z °o , %' . w°� JULIANNE KARSTEN �p TOTAL= 5,433 SQ.FT. =6.7% at Southold, Town of Southold �a -.� Suffolk County, New York . BUILDING PERMIT SURVEY N � � erg ..._....... - eif,,s J' County Tax Map District 1000 Section 66 B)oek 02 Lot 2.2 LEGEND X82, 715?0 1610 IQ6 _ ^ __ FIELD SURVEY COMPLETED JAN.29,2021 ' • 'LW � -- MAP PREPARED FEB,08,2021 ipb ,,y.1 N 47 27`17 1,, ' 04 LINE SHOWN ON JOHN C.EHLERSLAND SURVEYCR DL •3� FN�'V 13.65 nW Record of Revisions BBA = BELGIAN BLOCK APRON SURVEY LAST DATED 08/01/2011 LABELED 05 oOb APPRoiQMATE ALONG °6H 7031 59 CC =CONCRETE CURB "WETLANDS LINE FLAGGED ON 11/13/@" h�3 WATER MARK REVISION DATE CMF =CONCRETE MONUMENT FOUND CM5 =CONCRETE MONUMENT SET DI =DRAIN INLET EOP =EDGE OF PAVEMENT IPF =IRON PIPE FOUND HIPPODROME CREEK g OL =ON PROPERTY LINE PRF =POST&RAIL FENCE o WDF =WOOD FENCE Do WSF =WOOD STAKE FOUND 50 0 25 50 100 150 WSS =WOOD STAKE SET =END OF DIRECTION/DISTANCE Scale: 1" = 50' JOB NO.2021-0005 DWG.2021_0005 by 1 OF 1 (1)UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW.(2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO EMSTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO BE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES.(J)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY.(4)CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUDON LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING IN;TITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (5)THE LOCATION OF WELLS(W),SEPTIC TANKS(ST)&CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS 400 Ostrander Avenue, Riverhead, New York IlaOl tel. 631.727.2303 fax. 631.72.1.0144 odminayoungengineering.com SIU O Howard W. Young, Land Surveyor Thomas 0. Wolpert, Professional Engineer Douglas E. Adams, Professional Engineer Robert 0. Tost, Architect t^ / Robert Stromski, Architect / SITE DATA Q / AREA = 1.8601 ACRES OR 81,024 SQ. FT. 7 Q o *LOT NUMBERS REFER TO MINOR SUBDIVISION FOR N.CHARLES Q� DELUCA. ao �° ti rVb. `\ �`S *0 r. °h / * VERTICAL DATUM =NAVD(1988) s/ AREA OF WETLANDS = 8,067 SQ.FT. Lot 1 Oo \ \ Fl,\ \ Oo l0' \ O LQ o merll � ' now anRoadVC ojc, 57856M - 0 �o�°`Ls 1 9 444.25 -- mor fora e Kar Lot z sten - fi pp 32 i now &Juliann 2i__ II S u ° °^� \3��29 \ _ Russ N�Z°4i- \ ° SOME ' FEB v� HALjROAdWAy 255.217 P 1 WMR O� \ F'�O(�Cif ltvs�tees g0 IlG \ 572°49750 11 A SPIKE tJ° Lot 4 a. SURVEYOR'S CERTIFICATION TT \ FOUND 1 O,P 0 *WE HEREBY CERTIFY TO RUSSELL KARSTEN SE jULIANNE KARSTEN THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE o CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE 0 1 10' PROPOSED PATIO ° ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. N O OOQ. 1 t (138 SF) °/ 7 \\ l011 Pte° 0, .•J'y i \ y� 1 O� IR OV PROPOSED PATIO S ^ U) DF o \ IPF Lot 3 o (286 SF) 2 11 J e �P �o �q �°., 6,y�' ✓t ..,-ti r r PROPOSED SUN SHELF (108 SF) -y �e O O,\'S °� d/�t../L O�AF�P�p 9O 1�0 i PX00 LOT COVERAGE a 5� `��' `'� O`�O o 3"��' HOWARD W.YOUNG,N.Y.S.L.S.NO.45893 �`�' ` J`' 6 O o cO O i PROPOSED WATER FEATURE x ~- ^ FRAME HOUSE&GARAGE = 3,548 SQ.FT. =4.4% FRAME SHED =84 SQ.FT. =O.lo% ��9�0��`rb ti�1 5'g � �.3 REP LACE I o 6° "� SURVEY FOR PO = 360 SQ.FT. = 1.4/° �'a OOH RUSSELL KARSTEN & POOL =790 SQ.FT. =1.0% �OF 6 00 IN KIND i ��� HOT TUB = 52 SQ.FT. =0.1% �/ i/ ;, Frc� �' WOOD DECK = 599 SQ.FT. =0.7% 2�°� , C) I� WDF JULIANNE KARSTEN 2l00 I ,o E TOTAL=5,433 SQ.FT. =6.7% ` •�_ h"h/ � �� at Southold, Town of Southold Co •�•.\ I Suffolk County, New York I I I N0 I BUILDING PERMIT SURVEY N 0/1, x G�S J' County Tax Map District 1000 Section 66 Block 02 Lot 2.2 0 S2 54' ` FIELD SURVEY COMPLETED JAN.29,2021 it 710'7\1/ 10 _ MAP PREPARED FEB,08,2021 LEGEND - - — � b A�� N70°16 N4�° 6.Ip4 � , LINE SHOWN ON JOHN C.EHLERS LAND SURVE✓OR K%611 � 2,17"W 13.65 TT Record of Revisions BBA =BELGIAN BLOCK APRON SURVEY LAST DATED 08/01/2011 LABELED AS oOb APPROXIMATE HITIE LINE GH 70°31'59 W "WETLANDS LINE FLAGGED ON 11/13/01" '� N REVISION DATE CC =CONCRETE CURB hQ� WATER MARK CMF =CONCRETE MONUMENT FOUND CMS =CONCRETE MONUMENT SET DI =DRAIN INLET \ EOP =EDGE OF PAVEMENT IPF =IRON PIPE FOUND HIPPODROME CREEK g OL =ON PROPERTY LINE PRF =POST&RAIL FENCE 0 WDF =WOOD FENCE WSF =WOOD STAKE FOUND 50 0 25 50 100 150 WSS =WOOD STAKE SET Q =END OF DIRECTION/DISTANCE a Scale: 1° - 50' JOB NO.2021-0005 DWG.2021_0005-bp 1 OF 1 J.TORTORELLA -- -"" CUSTOM GUNITE POOLS 1764 COUNTY ROAD 39 \ SOUTHAMPTON, NY 11968 Tel: 631-283-7373 Fah: 631-283-4697 ENGINEERING e e T b s*. I, a `t\'''.. , ' i, Sj,cw� rrk Y i , 18/" 4b✓f �y v w;,✓,. pr 4 r+ '°}.�d` ir^•$1� i'.;. _,.��, . .. 'f ,K{.r, - , _� ', . 4 �'!! �� . °�O�Ma^A.'• ,05.`f �►' f v `tea• _ .g `5v s m..a4.s'/•,i.,^, 1 S'..' . a.;:.y iw >ai 9' / i. ^1'.r-'i ' ' x ( ;. f"-g,,;k `4•r•R ;a�". Y«.� `!, � .' i.. n PPz� -REP L CE PATIO IN KIND ,,d ,P°• - t,. r" !.,"yr f' �•...' , � EXISTI MATERIAL ( INDIAN PEACH) « PROPOS MATERIAL (CREMA EDA) GENERAL NOTES 71 101. WATER FEATURE CONCEPT / <' X\ I i jhz. j I N. i I ,. I I 7 I ! cQ• t j 77" I , I I I I I II i I ' I i I ♦♦ � I O ' I I ' I ♦♦ � � � I II I i i i i I f e O I j I I I � I I s i I J I i � i I I t I � PROPOSED PATIO i • PROPOSED MATERIAL I i I I NATURAL. STONE - CREMA EDA it i I I i I i � j I I i I I nn I I i I I i i I j ♦ V I i I n- I I , I � V I I I I I II I 7 � I I 9 I I + i ♦� � I i I I %" � � � l i I PROPOSED 9X12 SUN SHELF I 1 I I 1 i s 1 ORIGINAL ♦ ►� 02/16/21 III I 1 NO. REVISION/ISSUE DATE / PROJECT NAME: f e KARSTEN RESIDENCE .70,, 57908 MAIN RD, / ' SOUTHOLD,NY / / DRAWING NAME: / / / PROPOSED WATER FEATURE PROPOSED MATERIAL SITE PLAN / NATURAL STONE - CREMA EDA / / / / / o / ' SHEET: / DATE: 2/16/21 / / GENERAL SITE PLAN FOR THE PROPOSED WORK FEB 17 �02I SCALE: 1/4"=1'-0" 1 - ' SCALE: 1/4" = 1'-0" / Southold Town DRAWN BY: MA A� 1 "_,.,._., )f Tn_tstee5 CHECKED BY: AR / / / f J.TORTORELLA a CUSTOM GUNITE POOLS 1764 COUNTY ROAD 39 \ SOUTHAMPTON, NY 11968 Tel: 631-283-7373 Fax: 631-283-4697 ENGINEERING e s. e f'"F,Z ` ®„ q'1 k G3 1�` A /�„aa°'' - #m ..,d t i y`• �fir` ' i ' �.' ° ..,. *r' •,i; i•'S �''� � �nl�r`Iy�` ,, g' `+�v,,:yi'ea` ;ic►i •` �'iiJ'"v t°�: '.w'r..• •'?^`' ,'i. _ .` \'., r / ♦ ., `lC"'" - d e 1*e”♦, y.3_'4F'd�..•r —•e;t.t'�9t'` •r^ ' .., - "'' k.."`( V'r.t p•.r�• " rl,t'f'Y .y,,.,. -&- k. �E�,.I, L r.`s " ';a. ,. '+,A/"!;. d ' 4 iS., .w p..,'r'°• ,r'I F• r;: {: ��=p ,y.<, i1 ' °e4';j.,,lr ..- <usv""f-' , 4 yk``,! ,•dF` i`}',.,�, w, t• .r,•`ti ' ' , +P'"°"'::tea. ' . �; k' F ! a • �::.. -' .. .. � ,. _ ¢ ,.e. �/ REP L CE PATIO IN KIND ;:" ,�' „• -- `� .. e � A � .� �',r �.Y�� EXISTI MATERIAL ( INDIAN PEACH) PROPOS MATERIAL (CREMA EDA) 777 GENERAL NOTES -+ems ..,.. µ7p' .• { f' ' r, w ,♦ ly i WATER FEATURE CONCEPT \<f I I r I I J / j 1 / I I I I 1 i ♦;b / I I I 9 0 fe r I t I % I lS I i I I I i' i I I I , Q ' I cb I ♦� G I PROPOSED PATIO I PROPOSED MATERIAL I , / j ! co* NATURAL STONE - CREMA EDA i i I l , I t r i i I I i I i ! I I PROPOSED 9X12 SUN SHELF I I ! I � I I I i ! f I i i I 1 ORIGINAL 02/16/21 I i i i 1 NO.O REVISION/ISSUE DATE k,F / PROJECT NAME: f e �b KARSTEN RESIDENCE gyp,, / , f 57908 MAIN RD, / SOUTHOLD,NY / / DRAWING NAME: PROPOSED WATER FEATURE / PROPOSED MATERIAL SITE PLAN / NATURAL STONE - CREMA EDA / / / / / o � (� IN E DATE: 2/16/21 SHEET: D GENERAL SITE PLAN FOR THE PROPOSED WORK z z FEB 17 2021 SCALE: 1/4"=1'-0" SCALE: 1/4" = V-0° / DRAWN BY: MA / Southoid Town p '.-'-� of Trustees / A� 1 / CHECKED BY: AR / / Aj Tr a uu' .t; ^- ct E b y. J 1 aY u SAMS �.t • -.............. z : - ��. �.. d`. re '�� �.l x'tl � '�s ti,:,� 4�. °• wV2' •r', art m � .yti.,..A;,;:. �. �.t y _ P + ". yti �tiW'rvr. .,t t k "p`'�1I L1 �F i '�� �f ,�'� �.. #T F• �w � t. t , 7,71 Op JA _ �.—iJ�.1 3�• �` f — � M 7 , L T i a 1 `- F a e 7 . CP Poll' MEMO& t 711 tiY � �� 4:38 PM MI? w r - � .. ..yf ifs .� 'r'A E 1.,yt .. ` f -•� A - +� +'" r.r�. .1 7i .,,{�'� -:) � b: aiL •«.•� _ -. 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A. l 'Nu / _ ------ ` _ _ x - 4 64 i — SECTUN NO COUNTY OF SUFFOLK © N NOTICE E ' o00 L a...ro _�-- o..._ v�xw>t2U hwNrpavr�..Lrpwnn sue an r ..>,of Ey wn:•�@ —•—— O �"" __. „� 2t NSI Real Property Tax Service Agency W E oarrsl�,oN6 rx.n•POR.roN OF FINED �OTNap 066 G __ _ — -- _ _ w,r,. ___— a 300 cent,Pl.e.l hmi NY 11901 SIiFIX%00.MV rN[xMPa Rt xEO q w uewN6 _ _ _ x.vnnrrt wu E __ _ _ _—.— w u�. ,p wIx110llr vsuna PHA65W RTtE p ••_--_ a N MaLv. D —___— OFFICE LOCATION:LOCATION: � `; MAILING ADDRESS: � Town Hall Annex � P.O. Box 1179 54375 State Route 25 b �" Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold NY 11971 Telephone: 631 765-1938 X � �1 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To; Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: March 15, 2021 Re: LWRP Coastal Consistency Review for RUSSELL & JULIANNE KARSTEN SCTM #1000-66-2-2.2 John Tortorella on behalf of RUSSELL & JULIANNE KARSTEN requests`an Administrative Permit to replace in kind 1258sq.ft. pool patio with marble stone; .construct 108sq.ft. sun shelf; 138sq.ft. patio; 286sq.ft. patio and "L" shaped 39sq.ft. water feature. Located: 57908 Main Road, Southold, SCTM#: 1000-66-2-2.2 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 action is 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 I Glenn Goldsmith,Pr,� int QF soyo Town Hall Annex A.Nicholas Krupski,Vice President ,`O �� 54375 Route 25 John M. Bredemeyer III [ P.O.Box 1179 Southold,New York 11971 Michael J. Domino co • Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 ly�4UNT i l I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: SOUTHOLD TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS SCTM#: ��— 2 2, 2 J i Property;Owner•NameFEB 1 2 2021 Date Sent to Bldg: Dept: The•Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Departments permitting requirements stated below: YES 'NO Will the proposed project require a Building Permit? V Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition. as described under Town Code? COMMENTS: C( All LIE Signature of Reviewer Date i �x Glenn Goldsmith,President �dp S®U'� Town Hall Annex Michael J.Domino,Vice-President 54375 Route 25 John M.Bredemeyer III P.O.Box 1179 Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �® -��® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application ® r �n E C E P v E Wetland Permit Application Administrative Permit FEB 17 Mt Amendment/Transfer/Extension 2.17 2( Received Application:,_ Z Received Fee: $.__�Q�BD-_-__.__ _ -__-_ Southold Town Completed Application:_ 2.17.24 Board of Trustees Incomplete:__ SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: /Coordination:(date sent):. LWRP Consistency Assessment Form Sent: .__ CAC Referral Sent: Date of Inspection: Receipt of CAC Report:. � -Technical Review: ✓ Public Hearing Held.,- 3474,( Resolution: OwnerJulianne Karstens)Legal Name of Property(as shown on Deed):. Mailing Address: . 57908 Main][fid, Southold Phone Number: -, _ 631-278-2283 Suffolk County Tax Map Number: 1000 - 66-2-2.2 Property Location: 57908 Main Rd, Southold (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): John Tortorella Mailing Address: 1764 County Rd 39, Southampton, NY 11968 Phone Number: , 631-283-737.3 __ DiSalvo, Diane From: Michael Abdo <mabdo@tortorella.com> Sent: Wednesday, February 17, 2021 2:20 PM To: DiSalvo, Diane Subject: RE: 57908 Main Rd, Southold- Karsten Residence Hi Diane, As requested, please see below Replace patio in kind =1258 sgft Proposed sun shelf = 108 sqft Proposed patio 138 SQFT Proposed patio 286 SQFT Water feature dimension : L shape 3'x5' each side total of 39 sgft The material for the above is deep blue Marble stone 2" thk for the coling 1.5" thk for the Patio Kindly let us know if you have any questions. Thank you Michael Abdo Drafting& Estimating Associate 7526 I- ­11MON-0101-111 1764 County Road 39, Southampton,NY 11968 P:(631)283-7373 F:(631)283-4697 W:hgp://www.Tortorella.com f6 From: DiSalvo, Diane<diane.disalvo@town.southold.ny.us>~m Sent:Wednesday, February 17, 20212:12 PM To: Michael Abdo<mabdo@tortorella.com> Subject: RE: 57908 Main Rd,Southold- Karsten Residence So all of these structures are already there? Diane From: Michael Abdo [mailto:mabdo@tortorella.com] Sent: Wednesday, February 17, 20212:11 PM i /""3oard of Trustees Applicat n GENERAL DATA Land Area(in square feet): 81,881 sqft Area Zoning:_ R-80 Previous use of property: _ residential_-- Intended use of property: residential Covenants and Restrictions on property? Yes e9 No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes", be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ,=_V No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? --Yes No Does the structure (s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?__V No Yes If yes, provide explanation: Project Description(use attachments if necessary): 1- Replace patio in kind 4.-_prop®sed,patio_286 SQ I' 2-proposed water feature 5-proposed patio 138.SBFT_ _ 3-proposed sun shelf 108 sqft /�"3oard of Trustees Applicat a f WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:.- I- perations: _I-Replace patio in kind 4-proposed patio 286 SQFT 2-proposed water feature 5-proposed patio 138 SQFT 3-proposed sun shelf 108 sgft Area of wetlands on lot: 8,067 square feet Percent coverage of lot: 9.95 % Closest distance between nearest existing structure and upland edge of wetlands: 89 feet Closest distance between nearest proposed structure and upland edge of wetlands:_ 102 feet Does the project involve excavation or filling? _ -No Yes If yes, how much material will be excavated? cubic yards How much material will be filled?" cubic yards Depth of which material will be removed or deposited: _ feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): -Replace patio in kind 4-12ro oIs sed patio 286 SOFT 2-proposed water feature -pr®posed patio 138 SQFT 3-proposed sun shelf 108 sgft APPLICANUAGENUREPRESENTATIVR TRANSACTIONAL DISCLOSURE FORM 'The Town of Southold's Code of EthicsRrohi' its codflicis of ntereston the pate oPtown ofl7ceis and employees'Tile nual sdiot this form is to provide i forinati6n which cuo alert thetown of possi}ale conthcts of iiiteresfand allow�it•to fake whtite"ver action�is` °necessary_to avoid same: µ YOUR NAME::._ John Torto"ells (Last name,fust name,aliiddle initial,`unless you are appiyingl fhe name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring =- --- Exemption from plat or official map : _..;_ Planning - Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSI41P `- Submitted this day of V—,�\YVtU20@�A ,S'igty"atiir81 Print Name - t'�t ev►� Form TS I oard of Trustees Applica din -AFFIDAVIT �IjSS KCAr Sif I'1 BEING DULY SWORN f DEPOSES AND AFFIRMS HAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE 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 ignature of Prope y Owner SWORN TO BEFORE ME THIS DAY OF C e 3'^ '5202-0 f p0aaon1upngoo®+°°°j . - tary Public STATEN �'OF NEW YORK .N NOTARY PUBLIC' Qualified in Suffolk County;' ``Com'•, 01MI6338152 ' °0jueeeu+cess►°`° 3oard of Trustees Applicai n AUTHORIZATION (Where the applicant is not the owner) I/We, cl r� �� 4Nr� �`4�5 of q41 SS ��✓`syl owners of the property identified as SCTM# 1000- 66 -, �; r 2, a in the town of New York,hereby authorizes.-3—, T-by +-o G to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS S DAY OF (0 c,\-ob 2 r , 20-,�Q ��Oo�Q�,,09aoy919M1 ppepejD�oss�' . STATE N6&ry Public :'OF NEW YORK LIC puOalfiedR cuff kBOA o' C) 01M{6336152 o, ®!'ee ee epe e e ap eeeosa APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employecs.Tire ouroose of this form is to-provide,inforinat ion which can alert the town of possible conflicts,of interest and allow-it to=take whatever-action,is- necessary to avoid-same. _ �✓ �. YOUR NAME: - (Last name,first name,spiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning - 9 �] Q Of"Other",name the activity.) we't'tJ�gnf 491 ftn t.SlL�9 �I/Ve- 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,rqarriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi O © 44,6 200 0-"C> `Signattire Print Name_ Form TS 1 APPLICANT/AGENT/REPRFSENTATIVIE TRANSACTIONAL DISCLOSURE FORM The Town o'f:Southold'-s Code of Ethics prohibits.coriflicts of interest on the part Lf-t6wri officers and employees:The pin6kof this form istumvide,.in£orniaii6h tivhicti-tan aleft the town of pdssi6le 6hfIicts�of_interest and allow it-o take whateyer-_actiari is hecessar�to-avoid same. YOUR NAME: (Last name,fust narrle, riddle initial,unless you are applying;in-the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map .- _ Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of th 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/agcnt/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 2002rOZO Signature. Print Name- ZZs/t c ,n r SS Form TS l r-� 61 Z20 Appendix B Short Environmental Assessment Form 'Instruction`s:'for=Com pletiri' Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 1 -Project and Sponsor Information Name of Action or Project: -- - Karsten Residence Project Location(describe,and-attach a locatia6map): 57908 Main Rd, Southold,NY Brief Description of Proposed Action: 1-Replace patio in kind 4-proposed patio 286 SQl~r 2-proposed water feature 5-proposed patio 138 SQFT 3-proposed sun shelf 108 sgft Name of Applicant or Sponsor:----'—- —"" — -- - Telephone: 631-283-7373" John Tortorela E-Mail:- - Mabdo@tortorella.com Address: 1764 County road 39 --- -- ---- --- -- - - City7PO: .. _ 'State: . Zip Code: SouthamptonNew Fork 11968 I.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. ,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 the site of the proposed action? 1.88 acres - b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned - or controlled by the applicant or project sponsor? 1.88 acres 4. "Check all land uses that occur on,adjoining and near the proposed action. - ' - ❑Urban ❑Rural(non-agriculture) ❑Industrial []Commercial Residential(suburban) ❑Forest ElAgriculture ❑Aquatic 0Other(specify):. . ❑Parkland Page 1 of 4 S. Is the proposed-action;"- - - NO YES N/A a. A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? ❑ :❑ s 6. Is the proposed action consistent with the predominant character of the existing built or natural N9_- _YES landscape? ❑' , T"Is the site of the proposed-action located in,or does it adjoin,a state listed Critical Environmental Area? NO _;,.YES- If Yes,identify _ - 01, ❑ 8.'-a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES_ '.M . ❑ 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? Y ❑ 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: r 10. Will the proposed action connect to an existing public/private water supply? N0- YES If No,describe method for providing potable water: FT 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:, -There is no wastewater ® F-1, 12.'a:Does-the site contain a structure that is tisted on either the State or National Register of Historic - 'NO_' YES Places? b.Is the proposed action located in an archeological sensitive area? r EJ, 13.a.Does any portion of the site ofthe proposed action,or lands adjoining the proposed action,contain -NO YES wetlands or other waterbodies regulated by a federal,state or local agency? J ❑� 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: _ JV El I 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply - _ ❑Shoreline [3 Forest ❑Agricultural/grasslands El Early mid-successional V Wetland ❑Urban ❑Suburban I5.Does the site of the'proposed action contam'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-pointsources?T 'NO YES; If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO ❑YES a ❑ b.Will<std ti'water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefIydescribe: 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: _ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed .NO _.YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or-'a'n 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 ii II ` Applicant/sponsor nam �(�14 �ll4— Date: - [Signature: Li 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 l: Will the proposed action-create a material conflict with an adopted land use plan or zoning " regulations? EJ 12 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4._.Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? ;❑- 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? EJ b.public/private wastewater treatment utilities? �. 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? (_J Page 3 of 4 r ' •-- - - -= _ - •--- - -- -- --- -- ---- - - - - -- - -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 problems? El 11. W ill 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. QCheck 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 Signdiure-of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1,_ All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2 , Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A,.nronosed__action�w ll--be--evaluated, as to its significant beneficial and adverse effects upon the coastal=area-(which,includes all of Southold Town). 11 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- -9u0uoftihk=facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,=it shall.not;be.undertalcen. 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#_ 1000_-- -_ 66 PROJECT NAME Karsten Residence The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. 12 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: I-l[�epla' e pati®in kind - 4-proposed patio 286 SQFT 2-propose water feature - 3-proposed sun shelf 108 sgft l Location of action: 57908 Main lid, Southold Site,acreage: 1.88 _ Present land use: residential Present zoning classification: R_8®_ 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant:: John.Tortorella (b) Mailing address: 1764 County Rd 39, Southampton,NY 11968 (c) Telephone number: Area Code( ) 631-283-7373 (d) Application number,if any: _N1A, Will three action be directly undertaken,require funding,or approval by a state or federal agency? Yes Cl No PJ' If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED_COAST-POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes U No ® Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria D Yes O No D"'Not Applicable Attach additional sheets if necessary "- -- - - Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes .❑ No Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes No ® Not Applicable Attach additional sheets if necessary — -- -- -- - Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes ❑ No ®Not Applicable 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. � 1 Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. E j Yes Ej No"M 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. '1 l Yes No FLI 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. a Ye� No® Not Applicable Attach additional sheets if necessary / y \ f r WORKING COAST POLI6k3 Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LVVRP Section III•-Policies; Pages 47 through 56 for evaluation criteria. Oyes :.Q 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 LNVRP Section III-Policies; Pages 57 through 62 for evaluation criteria. Yes Not Applicable ,0 No 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. `0 Yes 0- No[q Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies; Pages 65 through 68 for evaluation criteria. Yes ❑ No Not Applicable John Tortoaella PREPARED BY__ _ TITLE. ��® ®f J. Tortorella - DATE 2-16-21 - - _CU st®in-G-niteLL oo s - - -