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HomeMy WebLinkAboutTR-9283 Glenn Goldsmith,President ®f so Town Hall Annex A. Nicholas Krupski,Vice President e`O� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples ® a® Fax(631) 765-6641 COU ,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 2098C Date: October 18, 2023 THIS CERTIFIES that the construction of a 2 400sq ft two-story single-family dwelling; new sanitary system; and proposed driveway' with the condition of the installation of gutters to leaders to drvwells to contain roof run-off existing three 3)story deck each deck being_30' x 8.1'• with 6'x4'6"steps from first floor deck to yard,• pervious 16'6"x30'8"stone patio constructed of 24"x24" 1"thick natural stone squares laid with 6"spacing built on top of compacted sand and stone dust with synthetic turf laid in between the spacing; 3.5'x5.3' outdoor shower against rear of dwelling; At 405 Williamsberg Road, Southold Suffolk County Tax Map#1000-78-5-17 Conforms to the application for a Trustees Permit heretofore filed in this office Dated May 3, 2018 pursuant to which Trustees Wetland Permit#9283 Dated July 18, 2018,was issued and Amended on October 18,2023 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 construction of a 2 400sq ft two-sto[y, single-family dwelling; new sanitary Ustem• and proposed driveway with the condition of the installation of gutters to leaders to drywells to contain roof run-off,• existingthree(3) story deck each deck being 30' x 8.1%with 6'x4'6" steps from first floor deck to yard; 16'6"x30'8" stone patio constructed of 24"x24" 1"thick natural stone squares laid with 6"spacing built on top of compacted sand and stone dust with synthetic turf laid in between the spacing; 3.5'x5.3' outdoor shower against rear of dwelling. The certificate is issued to Anthony&Beatrice Falcone owner of the aforesaid property. 'ei"- 4-"" Authorized Signature ®� soUr Town Hall Annex Glenn Goldsmith,President �� A. Nicholas Krupski,Vice President �® �® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly � Telephone(631) 765-1892 Elizabeth Peeples ® '® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 20, 2023 Anthony & Beatrice Falcone 6 Terrace Drive Port Washington, NY 11050 RE: 405 WILLIAMSBERG ROAD, SOUTHOLD SCTM#: 1000-78-5-17 Dear Mr. and Mrs. Falcone: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 18, 2023. RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#9283 for an as-built three (3) story deck, each deck being 30' x 8.1'; with 6'x4'6" steps from first floor deck to yard; pervious 16'6"x30'8" stone patio constructed of 24"x24" 1" thick natural stone squares laid with 6" spacing, built on top of compacted sand and stone dust with synthetic turf laid in between the spacing; 3.5'x5.3' outdoor shower against rear of dwelling, and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated September 20, 2023, and stamped approved on October 18, 2023. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, eIa sith G nn Go President, Board of Trustees GG/dd HOUSE slate or other SMSRLjF# F.F. EL11.0' $uitaie saver p SURVEY OF PROPERTY topper end plug Locking Cover Cost Iron R10 15—®1001 fIN/SHED GRADE EL.5.3'IIIIERBIIIE�3111 IN 11 0,011F. , AT BA YVIEW 6 6' a �moaoncry ch(mney 12 6MInr TOWN OF SOUTHOLD dean oWIWI- ur 1 I.E. I.E. �•�•� �•• '• •� SUFFOLK COUNTY N Y 4' 1/4° per foot min. pitc s•3� �6' f0 0 5,8 1/8'per.foot min �'�'��,'' '''''' 2� 1 N. ' min. 4' dia. pipe pftch m�. 4'iia pipo class 2400 pipe or equal mn ; doss 2400 pipe or equm 3' SAND COLLAR 10®,1�r-78-05 17 2'mIn.12�PACTANKAST mIn. LEACHINGIPOOLS 8/ SCALE: 1 — 30e 2.5 L/OUID DEPTH GROUND WATER EL.D.7• EL.o 7' DECEMBER 09, 2005 HIGHEST RECORDED GROUNDWATER JANUARY 19, 2006 BACKFILL MATERIAL TO BE CLEAN SAND do GRAVEL MARCH 3, 2006 (ADDI77ONS) 5E?T1G SYSTMM GETAll. REMOVE MAUNIA•L *0 70 U�' 1.3j 2018 .PRD alO SE SPAWLT(SW ee ITAC07C NDfITH s N:-r.s. - � 8'0 SAND (SW) OCTOBER 15, 2018 (HD REVISIONS) CONCRETE STOPPER END SAND NOVEMBER 13, 2018 (HD REVISIONS) COLLAR 24' 'OR PLUG (SP) JANUARY 9, 2019 (REV. DETAIL) C1 , MAY 11, 2021 (FOUNDA 77ON LOCA 770N) RISER&COWN ': FEBRUARY 23, 2023 (FINAL SURVEY) RBER JOINT MARCH 27, 2023 (15' NON VEGETA 77VE BUFFER) PACKING 2 SEPTEMBER 20, 2023 (Dimensions Added) Q CI SEWER PIPE (TYPICAL) Ei 31f 4'SDR 35 f 1 BE W FROM DWELLING OeQ� TO SEPAL TANK Gl. 60• PVC WYE Cl TO PVC • HOUSE ADAPTOR �O SEPTIC, SYSTEM AN OUT DETAIL �,a� fid` L 131 DEDROOM5 N.T.S. .10 TD5 ° TRAFFIC, DEAKIN& 5LA6 • 'VA "ON (1) 1250 GALLON CYLINDRICAL SEPTIC, TANK T65 (6) 6 � LEACHING POOL5 TD5 O® SEP'T1iC LOCA7= Q•��v a• c>D� wQ' •B• 3 4�v o o� 8T 34' 17' co O LPI 25' 26.6' 0 C) Z s�� LP2 33 32.6' �� a,,9 00 �y �y�� �A RAIN RUNOFF CONTAINMENT 4 .- aS , G HOU5E,EARA(,E- 1360 5Q.FT. �z/ L 1360 + 1 * 0.17 ° 231.2 GF DRIVEWAY (PERV I OU5) TEST HOLE DATA 231.2 GF / 42.24 • 5.47 VF NIC-00IGE05GIENCE DW - OVW06 a• � (3) 8 10 DRYWELL5 AT 2' DEEP , 01 O � � Q►.6' �0 ''� "� DRY WELL5 CONNECT TO HOU5E EL 5,8' o' SARK DROWN Loma OI. s0 0, �o .0. WITH GUTTER5 + LEADERS Ai DROWN CLAYEY 5W 56 2S �� ¢Gpq 0 Q-��@ EL 0.7' S.1 •0l77}� y�0 4Y �v0 Q�v WATER IN DROWN CLAYEY sANo 56_ �� Q �'� � ��o��• o�y =��o WATER IN DROWN CLAY GH ZONE AE6 �,��„ 0�P� °� •� 8.0' V\� �p� �� O,h 1 �s �v 'h '� •2• WATER IN DROWN CLAYEYas ?y ��� 6• 41b NT SASG _drA Gyp' 0W R, 3 ZONE X ary 10.0' - �"- 17��•�� VJQJ� `d5�.��j� / WATER IN PALE DROWN FINE 5AO SP ZA 17 3+� LA®y s IY DW a E' SI Ata\ O'y KEY pPROV Y �'O 9C�o -9C,, o'er• Q R RMM ; <y ��/ �0 ® m IM1gIL 90ARD ®E 'f R ES 9 �0 ip 41161 / .� ME AE6 ® e STAKE ` TOWN OF S®Ul• ® 0 �bq ® a TEST HOLE 0. d k E G PIPE DATE to ziza?� v afoNUMENr v SEP 2 6 2023 IIIII RAG M.) _ (/T1,L1T'Y AIC y �c Southold Town ,a HYDRANT �' �/ f / -�- Board of Trustees J FLOOD ZONES (AE EL 6 da X) Ilk FROM FIRM 36103CO166 H 5/25/09 A I ELEVATIONS ARE REFERENCED TO NAVD 1988 s 51 The location of public water, wells and cesspools shown hereon are from field observations and or f•om data obtained from others. 'y.�gracLP�!a, ADDITIONALLY TO GOMFLY WITH SAID LAW THE TERM 'ALTERED DY MUST DE USED DY ANY ANO t '� < ALL SURVEYORS UTILI21NCs A COPY OF ANOTHERS SURVEYORS MAP.TERMS SUCH AS 'INSPECTEANO N.Y.S. UC. NO. 49618 � }�,. 4-,- "OR000HT- TO- GATE" ARE NOT IN COMPLIANCE WITH THE LAW. D' '- .Y.S. LIC. NO. 051132-01 ANY ALTERATION OR ADDITION TO TH15 SURVEY 15 A 'VIOLATION PECONIC SUR S, P.C. OF DEPT TA5 MION R09OF THE NEW YORK 5TATE 5EGT ON 7209-5UDDIV1510N 2�ALLION LAW.GER IFIL ATION5 TOTAL AREA (Emla ll•7peconicsurte�ptonline.n t797 HEREON ARE VALID FOR TH15 MAP AND GOP1E5 THEREOF ONLY IF 14,446 Sq►.ft. P.O. BOX 909 5A1D MAP OR COPIES BEAR THE IMPRE55ED SEAL OF THE 5URVEYOR 1230 7RAVELER STREET nnur�Win.n ►. v wee•.. Pg— wienn Goldsinliri,'President �o�a, COGy Town Hall Annex A.Nicholas Krupski,Vice President Z-3 54375 Route 25 0 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �y • 0`� Southold,NY 11971 Elizabeth Peeples � �� Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time:1011 ol .3 4.50 MCompleted in field by: nt-UbfA� ?ft PA 6 ANTHONY & BEATRICE FALCONE request an Administrative Amendment to Wetland Permit#9283 for an as-built three (3) story deck, each deck being 30' x 8.1'; with 6'x4'6" steps from first floor deck to yard; pervious 16'6"x30'8" stone patio constructed of 24"x24" 1" thick,natural stone squares laid with 6" spacing, built on top of compacted sand and stone dust with synthetic turf laid in between the spacing; 3.5'x5.3' outdoor shower against rear of dwelling. Located: 405 Williamsberg Road, Southold. SCTM#: 1000-78-5-17 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment ✓Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: S1yea&W-6cwaA avid w" abnlrov1X1 fi= +6e goa ey 'Tyus4as , it is okau }o �SSUC C4 C fvc nc I -i— *I?A; Present Were: G. Goldsmith N. 7E. ski E. Sepenoski L. Gillooly Peeples Anthony & Beatrice Falcone 6 Terrace Dr. Port Washington, NY 11050 917-968-4716 / 516-883-0241 davinci874@aol.com September 25, 2023 Board of Town Trustees Town of Southold 54375 Main Rd. PO Box 1179 Southold, NY 11971 RE: Permit#9283 To Whom It May Concern, We would like to request an amendment to Permit#9283 for the following. 1)-As noted by board member"3 story deck" which details and dimensions are on the approved plans prepared by CMT 11/18/2020 , A-1,A-2,A-3 &A-4. ,6azi d" j s 2)-6 steps from first floor deck to yard, dimensions noted on final survey 6' wide x 4'-6" deep 3)- Pervious "Patio" constructed of 24" x 24" x 1" thick natural stone squares laid with 6" spacing on top of compacted sand and stone dust. Synthetic turf laid in between the spacing and the patio size of 16'-6" x 30'-8" as shown on final survey. 4)-Outdoor shower up against the rear of dwelling, constructed of 4- CCA 4" posts with horizontal 2" cedar lumber and a framed hinged door. The size as shown on final survey is 3'-5" wide x 5'-3" deep x 8" tall. 5)-As noted by board member"add existing non turf buffer to plan submission"this was installed under permit#6615 5/16/2007 and received certificate of compliance #0481 C 10/05/2009 by Board of Town Trustees Town of Southold. Sincerely yours, 9 / Anthony&Beatrice Falcone SEP 26 2023 Glenn Goldsmith,President Town Hall Annex A. Nicholas Krupski,Vice President V" 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly G Q Telephone(631) 765-1892 Elizabeth Peeples �® ® �a® Fax(631) 765-6641 c'u NT`11�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPECTED BY: Ellzabel� P�e�n�Ca �✓ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction �c % constructed Project complete, compliance inspection COMMENTS: — ' k azlArj vyl jgve4 CW 0 CERTIFICATE OF COMPLIANCE: F R'. Glenn Goldsmith, President t`,� „ n�� Town Hall Annex A. Nicholas Krupski, Vice President "� t��r 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold, New York 11971 Michael J. Domino Telephone(631) 765-1892 Greg Williams � �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 22, 2021 Anthony & Beatrice Falcone 6 Terrace Drive PortWashington, NY 11050 RE: 405 WILLIAMSBERG ROAD, SOUTHOLD SCTM#: 1000-78-5-17 Dear Mr. and Mrs. Falcone: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Thursday, March 18, 2021: RESOLVED that the Southold Town Board of Trustees grants the Last One (1) Year Extension to Wetland Permit#9283, as issued on July 18, 2018. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office.. Snc rely, Glenn Goldsmith President, Board of Trustees GG:dd Glenn Goldsmith, President s" � Town Hall Annex A. Nicholas Krupski,Vice President 54375 Route 25 1 P.O. Box 1179 John M. Bredeme er III Y Southold, New York 11971 Michael J. Domino Telephone(631) 765-1892 Greg Williams ' � � � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 22, 2021 Anthony & Beatrice Falcone 6 Terrace Drive Port Washington, NY 11050 RE: 405 WILLIAMSBERG ROAD, SOUTHOLD SCTM#: 1000-78-5-17 Dear Mr. and Mrs. Falcone: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Thursday, March 18, 2021: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #9283 from Cheryl L. Hansen Revocable Trust c/o Cheryl L. Hansen to Anthony & Beatrice Falcone, as issued on July 18, 2018. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency, If you have any questions, please contact our office at (631) 765-1892. Sincerely, 4S4, Glenn Goldsmith, President Board of Trustees GG/dd Glenn Goldsmith, Pim dent D�OSUfFQ(�CpG �- Town Hall Annex A. Nicholas Krup�Ki, Vice-President 54375 Route 25 John M. Bredemeyer, III o P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams y p! Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ff 61S Date/Time. � Completed in field by. ANTHONY & BEATRICE FALCONE request the Last One (1) Year Extension of Wetland Permit #9283, as issued on July 18, 2018. Located: 405 Williamsberg Road, Southold. SCTM#: 1000-78- 5-17 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet ' 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitaryleaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 vofCh. 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: ole art , I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other 5 Glenn Goldsmith, Pr Hent �o�OS11FF0(�COG Town Hall Annex A. Nicholas Krupsru Vice-President „ yJ, 54375 Route 25 John M. Bredemeyer, III o '` P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams y �ao� � Telephone Faex 631 (631) -1892 65 6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: ANTHONY & BEATRICE FALCONE request a Transfer of Wetland Permit#9283 from Cheryl L. Hansen Revocable Trust c/o Cheryl L. Hansen, as issued on July 18, 2018. Located: 405 Williamsberg Road, Southold. SCTM#: 1000-78-5-17 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 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: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other thony & Beatrice Falcone FEB 2 2 202f 6 Terrace Dr. Port Washington, NY 11050 Southold Town 917-968-4716/516-883-0241 Board of Trustees Davinci874@aol.com February 16, 2021 Southold Town Board of Trustees 54375 Main Rd. PO Box 1179 Southold, NY 11971 RE: Cheryl L. Hansen Revocable Trust 405 Williamsberg Road, Southold SCTM# 1000-78-5-17 Dear Southold Town Board of Trustees, This letter is to request an extension from the Southold Town Board of Trustees for our property at 405 Williamsberg Road, Southold for the following wetland permit#9283. We would also like to obtain a copy of bulkhead permit#6615. Sincerely yours, A th ny and Beatrice Falcone ga Anthony & Beatrice Falcone 6 Terrace Dr. Port Washington,NY 11050 917-968-4716/516-883-0241 Davinci874@aol.com January 24,2021 Board-of Town Trustees Town of Southold 54375 Main Rd. PO Box 1179 Southold,NY 11971 RE:Cheryl L. Hansen Revocable Trust 405 Williamsberg Road, Southold SCTM#1000-78-5-17 Dear President Glenn Goldsmith, On September 3,2020 we purchased the above lot from Cheryl Hansen with plans to build a single family home.We are writing this letter to request a transfer of ownership and extension on Wetland Permit#9283 providing us adequate time to obtain all necessary building permits and perform construction and completion of the project. Sincerely yours, �t4�" 4#nkthonvy'anl Beatrice Falcone D E C E E FEB "2 321 Southold Town Anthony & Beatrice Falcone 6 Terrace Dr. Port Washington,NY 11050 917-968-4716/516-883-0241 Davinci874@aol.com -- February 9,2021 -�- a Southold-Town Board of Trustees ! FEB 1 2 2021 54375 Main Rd. PO Box 1179 Sautr��id Town Board of Trustees Southold,NY 11971 RE:Cheryl L. Hansen Revocable Trust 405 Williamsberg Road, Southold SCTM#1000-78-5-17 Dear Southold Town Board of Trustees, This letter is to grant the Southold Town Board of Trustees permission to access our property at 405 Williamsberg Road,Southold in order to review for the following permits. Wetland-Permit#9283 - - -- Bulkhead Permit#6615 Sincerely yours, Anth ny and Beatrice Falcone i A' thony & Beatrice Falcone ` , FEB - u 2021 6 Terrace Dr. SoUthoid Town Port Washington,NY 11050 Soca!r, no Trustees 917-968-4716/516-883-0241 Davinci874@aol.com February 5,2021 Southold Town Board of Trustees 54375 Main Rd. PO Box 1179 Southold,NY 11971 RE:Cheryl L.Hansen Revocable Trust 405 Williamsberg Road,Southold SCTM#1000-78-5-17 Dear Southold Town Board of Trustees, As per our conversation with Mrs. Diane DiSalvo,we have provided you with proof of ownership of the property SCTM#1000-78-5-17. Included please find our closing documents from-September 3,2020 as proof of ownership.We are requesting to transfer-the following permits into-our-name. Wetland Permit#9283 Bulkhead Permit#6615 Sincerely yours, FEREo �1C Anthony and Beatrice Falcone - B 2MI Southold Town Board of Trustees Glenn Goldsmith,President QF SU(/rTown Hall Annex Q 54375 Route 25 Michael J.Domino,Vice-President h0 l0 P.O.Box 1179 John M.Bredemeyer III Jx[ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �0 �� Fax(631) 765-6641 COUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 16, 2020 Cheryl L. Hansen 305 S. Windsor Dive- ` Arlington Heights, IL 60004 RE: " CHERYL-,L._HANSEN REVOCABLE TRUST 405 WILLIAMSBERG ROAD, SOUTHOLD ----- _ ----- SCTM# 1000-78-5-17 _ ------ ----- -- --- Dear Ms. Hansen: _ - The folio-wing--action was taken by-the Southold Town-Board of Trustees at their Regular - - - - --- - ------------------- - -- ---- - - Meeting held on Wednesday; July 15, 2020: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland.Permit#9283 as issued on July 18, 2018. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, 441__e4n_nPIdith , President, Board of Trustees GG:dd Glenn Goldsmith I >ident ,,y S1�FF0L, CC p Town Hall Annex �0 Michael J. Domino, Vice=r,'esident �,�� Gy,,,�i 54375 Route 25 John M Bredemeyer III ? �; P.O. Box 1179 A. Nicholas Krupski o .:: Southold, NY 11971 Greg Williams y . � Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: L0 'Xv Completed in field by: CHERYL L. HANSEN REVOCABLE TRUST c/o CHERYL L. HANSEN requests a One (1) Year Extension to Wetland Permit #9283 as issued on July 18, 2018. Located: 405 Williamsberg Road, Southold. SCTM#: 1000-78-5-17 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Noticeof 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: J. Bredemeyer VIM. Domino G. Goldsmith N. Krupski G. Williams Other Cheryl Hansen 305 S Windsor Drive n Arlington Heights IL 60004 D E C EE 847-421-5581 JUN - 1 2020 Southold Tcwn Board of Trustees May 27, 2020 Board of Town Trustees Town of Southold P. O. Box 1179 Southold, NY 11971 To Whom It May Concern: I am writing this letter to request an extension on my Permit No. 9283. The permit is for construction of a single-family dwelling at 405 Williamsburg Drive., Southold, New York. I have enclosed a copy of the original permit and a check for$50 to the Town of Southold. Sincerely, Cheryl ansen Michael J. Domino, PresidentFFO(/.0.9, Town Hall Annex John M. Bredemeyer, III, Vice-President .t 54375 Route 25 Glenn Goldsmith y z P.O. Box 1179 A Nicholas Krupski "may • �� Southold, NY 11971 Greg Williams ��l , '�a� Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction 1/2 constructed Project complete, compliance inspection; BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 9283 DATE: JULY 18,2018 ISSUED TO: CHERYL L. HANSEN REVOCABLE TRUST c/o CHERYL HANSEN PROPERTY ADDRESS: 405 WILLIAMSBERG ROAD, SOUTHOLD SCTM# 1000-78-5-17 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 18, 2018, and in consideration of application fee in the sum of$250.00 paid by Cheryl Hansen and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a 2,400sq.ft.two-story,single-family dwelling; new sanitary I system; and proposed driveway;with the condition of the installation of gutters to leaders to drywells to contain roof run-off; and as depicted on the survey prepared by Peconic Surveyors, P.C., dated July 13,2018, land stamped approved on July 18,2018. IN WITNESS WHEREOF,th6 said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this. ,F` dol � ��° i � , _0 i TERMS AND CONDITIONS The Permittee Cheryl Hansen, residing at 405 Williamsberg Road, Southold, New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: I 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any,and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 1 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 1 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. I 6. That there shall be rio interference with the right of the public to pass and repass along the beach between highi and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if,in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. j 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. i 10. No right to trespassior interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. i I HOUSE slate or other F.F. EL11.0' suitale cover j stopper end plug ///--- Cast Iron SURVEY OF PROPERTY Locking Cover EL. 7.0' / FINISHED GRADE EL.5.3' AT BA YVIEW 5 6' c mosonary chimney 712" 6'"'" TOWN OF SO UTOLD clean ouf ' E' '6" '•E. 7ual =� � = SUFFOLK COUNTYN Y 1/4" per foot min. pitc 5.2' — 10'0— --- 4'7 1/8' per foot ��� "' """" 2'min. 4" dia. pipe pitch min. 4' dia.class 2400 pipe or equal „4�;, ,, ,• ,, ,, , class 2400 pipe or 3' SAND COLLAR 1000-78-05-17 1200 GAL.PRECAST I 2-min. [6J 810 6' I� SCALE: 11= 30' SEP71CTAW, LEACHING POOLS 3'UOUID I DEPTH GROUND WATER ff EL.0.7_--- ------a-----------,---------- -L-- ------------- --- ----- EL.0.7' DECEMBER 09, 2005 HIGHEST RECORDED GROUNDWATER L- –� JANUARY 19, 2006 BACKFILL MATERIAL TO BE CLEAN SAND &'GRAVEL MARCH 3, 2006 (ADDITIONS) SEPT I'G SYSTEM SETA I L I REMOVE MATERIAL 8'0 TO JULY 13, 2018 (PROP. HOUSE) N•T•s• I _ _8'0 SAND (SP) & BACKFILL WITH" SAND (SW) CONCRETE STOPPER END SAN—D COLLAR24' OR PLUG / (SP) RISER&COVER nBER JOINT Z� ��� / 7 CI SEWER PIPE (TYPICAL) \U 4'SDR 35 BEND FROM DWELUNG TO SEP7IC TA Cl. 60" PVC WYE CI-710PVC NK " HOUSE ADAPTOR GLEAN OUT DETAIL / ,�7��.0 PROP05E0 SEPT I G SYSTEM / � (3) DECROOM5 N.T.S. (1) 1200 GALLON GYLINDRIGAL 5EPTIG TANK / (6) 6' 4 LEAGHIN& POOL5 V) .(3) 8' � EX5PAN51 ON POOLS PROPOSED RAIN -RUNOFF CONTAINMENT HOU5E,&ARAGE= 1360 5Q.FT. 1360 * 1 * 0.17 - 231.2 GF e' -DRIVEWAY (PEKVIOU5) -0 231.2 GF / 42.24 = 5.47 VF �X, / U ZONE AE6 TEST U5E (3) 6' DKYWELL5 AT 2' DEEP TEST HOLE DATA Q��U . // �, �� �mJ `ID S, E SBHOLE' Ffss, DRY WELL CONNECT TO HOUSE MC,DONALD C7E05GIENCGE J� �r�k O k LP � WITH GUTTEK5 + LEADER5 01/12/06 / •'� Ex LP LP L O' ,h/m '�i�,tc� /Cs�- - - — DARK DROWN LOAM OL ` 017,4P DIN DROWN CLAYEY SAND 5C \ �0 0' 5T of .0 EL- ---- � iAo,� EL 0.7 - 5.1' 2 4T 0 �/ WATER IN DROWN CLAYEY S 00 �,P `/osb s�/ �m�-� I a �P �P/ SAND 5C, ���°�y' ��9 // 000) / ----- 6.0' \' 9 /moo"ry xis WATER IN DROWN CLAY GHQ�' !) ,,�, o WATER IN DROWN CLAYEY ----- IP ROVEID 1 =® ' j y Dw ZONE X CP , ARDTOFN TF-3INE 5AN 5PTO 4 0� N-OF'SOUTHOLD ��o� sem DIN e - 1110 %21 DATE �d� .«I 2vig ���T dA/ �N 0 ' AN 00, Qj KEY 2G S OS _ ZONE AE6 Q = REVAR ® - tNELL EC0 � �� E / = STAKE ��1 EIl t;� ? U = TEST HOLE i_) ����h`' • = Iq PIPE ■ = MONUMENT I J U L 2018 ��,0 % 14�� h = WEMAND FLAG 0 � , Southold Town � = U71UTY POLE - _ YY — HYDRANT Board of Trustn.o , FLOOD ZONES (AE EL. 6 & X) FROM FIRM 36103CO166 H 5/25/09 r-� oNEW ELEVATIONS ARE REFERENCED TO NAVD 1988 If me The location of public water, wells and cesspools shown hereon are from field observations and or from data obtained from others. fJ ADDITIONALLY TO COMPLY WITH SAID LAW THE TERM "ALTERED BY' MUST DE USED DY ANY AND ALL,SUKVEYOK5 UTILIZING A COPY OF ANOTHER5 SURVEYORS MAP.TERM5 SUCH AS "IN5PECTED" AND i^! "DROUGHT- TO- DATE' ARE NOT IN COMPLIANCE WITH THE LAW. .Y.S. LIC. N0. '4961.8 ANY ALTERATION OR ADDITION TO TH 15 SURVEY 15 A VIOLATION ORS, P.C. OF 5EGTION 7209OF THE NEW YORK STATE EDUCATION LAW. TOTAL AREA EXCEPT A5 PER 5EGT I ON 7209-5UDD I V 151 ON 2. ALL CERT I F I GAT I ON5 020 FAX (631) '765-1797 HEREON ARE VALID FOR TH15 MAP AND 'COPIE5 THEREOF ONLY IF 14,446 Sq.ft. P.O. BOX 909 5AID MAP OR GOPIE5 GEAR THE IMPKE55ED SEAL OF' THE 5URVEYOR 1230 TRAVELER STREET SOUTHOLD, M Y. 11971 85-24- Michael J.Domino,President ��if SUUry� Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G �Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 y00M,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 18, 2018 Cheryl Hansen 305 S. Windsor Drive Arlington Heights, IL 60004 RE: CHERYL L. HANSEN REVOCABLE TRUST c/o CHERYL HANSEN 405 WILLIAMSBERG ROAD, SOUTHOLD SCTM# 1000-78-5-17 Dear Ms. Hansen: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, July 18, 2018 regarding the above matter: WHEREAS, CHERYL L. HANSEN REVOCABLE TRUST c/o CHERYL HANSEN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated May 3, 2018, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on July 18, 2018, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVE the application of CHERYL L. HANSEN REVOCABLE TRUST c/o CHERYL HANSEN to construct a 2,400sq.ft. two- story, single-family dwelling; new sanitary system; and proposed driveway; with the condition of the installation of gutters to leaders to drywells to contain roof run-off ; and as depicted on the survey prepared by Peconic Surveyors, P.C., dated July 13, 2018, and stamped approved on July 18, 2018. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, . 400 Michael J. Do ino President, Board of Trustees MJD/dd Michael J. Domino,. Nresident �;��� G�a� Town•Hall Annex John M. Bredemeyer, III, Vice-President y 54375 Route 25 Glenn Goldsmith �o P.O Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williamsa Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEESaP� TOWN OF SOUTHOLD � TO: CHERYL L. HANSEN REVOCABLE TRUST Please be advised that your application dated May 3, 2018 has been reviewed by this Board at the regular meeting of July 18, 2018 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project— Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) xx Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: 4 qq&18 TOTAL FEES DUE: $50.00 BY: Michael J. Domino, President Board of Trustees ! Town Hall-Annex Michael J. Domino, QSVFF©(� `' Off' �G John M. Bredemeyer III,Vice-President �� yJ 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski y Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN requests a Wetland Permit to construct a 2,400sq.ft. two-story, single-family dwelling; new sanitary system; and proposed driveway. Located: 405 Williamsberg Road, Southold. SCTM# 1000-78-5-17 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 f 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: �d I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: /J. Bredeme er L ZMDomino G. Goldsmith /N. Kru ski Y �.1� p G. Williams Other { goo r moi•-:_ y �:I'.. - �r.ici.. � ��� -' Ar�G♦ A woo :n, �r >w Poo;, :�. �` 7 / 11 /2018 11 : 26 1 / - Michael J. Domino,*d( o� Town Hall Annex John M. Bredemeyer III,Vice-President may` �� 54375 Route 25 Glenn Goldsmith y z P.O.Box`1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �o Completed in field by: -7,k-' w CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN requests a Wetland Permit to construct a 2,400sq.ft. two-story, single-family dwelling; new sanitary system; and proposed driveway. Located: 405 Williamsberg Road, Southold. SCTM# 1000-78-5-17 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: J. Bredemeyer M. Domino -�.XV. Goldsmith N. Krupski ✓ G. Williams Other Aft NEW YORK STATMARTMENT OF ENVIRONM-ENTAL CO*VATION Facility DEC ID 1-4738-03528 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: Facility: CHERYL HANSEN HANSEN PROPERTY 305 SOUTH WINDSOR DR 405 WILLIAMSBURG RD ARLINGTON HEIGHTS, IL 60004-6751 SOUTHOLD,NY 11971 (631) 765-9083 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 716.31 NYTM-N: 4546.39 Latitude: 41°02'24.1" Longitude: 72°25'35.6" Authorized Activity: Construct single family dwelling and pervious driveway. Install sanitary system. All work must be done in strict accordance with the attached plans stamped "NYSDEC Approved" on July 12, 2016. Permit Authorizations Tidal Wetlands -Under Article 25 - Permit ID 1-4738-03528/00005 New Permit Effective Date: 7/1-2/2016 Expiration Date: 7/12/2021 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations,-and all conditions included as part of this permit. Permit Administrator: GEORGE W HAMMARTH, Deputy Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY @ Stony Brook150 Circle Rd Stony Brook,NY 11790 -3409 Authorized Signature: �,G1r Date �i� Distribution List Habitat - TW SHERRI L AICHER Page i of 6 O � fj irr'��► `"` Mit. Aft [ [ W f4 1. k . a 1 yy k w ssem / _,_� 1 " m" s -'- `� . .. _ • SEE sm. m ....., .. I a .a SLEEPY H LLOW S a+C 5�p•.."_�../�; f ,1 %/� 1/\ �; 110. 1 ) t�0.11 L _ TOWN OF • . 1 M �^ • m 6 y �' ry BourAfoAO ✓ � ° � • "� tos ,� 9 tz-t !30'1 y� �^O. .T � ° 111' >s. m ]s e Wq r 3), 4 \16\ r n.~e JO '/ WE WC.NO 0n 15 S, yf .� SUFrOAXI( .1 � 31 ,4 13 M t51 A 143 /k 12 SEE BEC.NO an e`b ,.3A(� t4f0 271. 6 1 \ pJ O ♦ • 4 �-v9�f Si_ 10 a 3 16.1 141 Ms 15 ]• y, w � 32e 2 w m I f°Vc) f'Gfc) �• TM 19 m £ t • Ste' ° .UB � ' �)' � 33.2 9 m �,3. e I 1 a M S)m 32.0 ) PS PP � g't • Y �'" qt��cA+ �' T1 ' a \ ,4 �� € +°yc) w°''1`ls "'ts 'A "� O �° N � .• n Ts o� t � tT N ^", z+me �ii 32." �j fyAl •.. ��wM � :• •� ]1 D� b � t4 �/a )If 3fo - �1j 17>'A� ]] .. '!. N.1 • mi' t] E w ® 4 ; 3'21/ /y w 16 ,z 3 A 1 b dtr pa•' !4{(c b O )1.3 b © !d y tT ti L<Ak) 2c) '�. �' _ a\3 '423 8t Q •' 18 ,4 /1 m 15 e i _ y13_ 0u M ) of Q j B) 110� •1 . �"� w mov3 er SEE SEC NO.04>I1NE r��` tip,"� •S' ,cx 45 AN j NOTICE COUNTY OF SUFFOLK © E s m " � SOUTHOLD SECTION NO E µms— ""'"'°""' Rf) —O �� --~— _�_�_--�,—_—_ Real Property TaxSernceAgency v (^�1 ® pp N a...�w.� _---_- -- — --- wr4yGM+,IenrM.4,NYttb1 N W3 Y OA NLL'�R U7V O ..�.. a ti n,NQ.n+. —'-- s«u. .¢Ncv A .0 1000 P Bee an ab °BR°`T PROPERTY AMP OFFICE LOCATION: ®��OF ®l SLING ADDRESS: Town Hall Annex '` ® P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) cn Southold,NY 11971 ® �Q Tel 631 765-1938 O Fax: 631 765-3136 �yCOUfVT`I,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: June 13, 2018 Re: Local Waterfront Coastal Consistency Review for CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN �SCTM# 1000-78-5-17 CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN requests a Wetland Permit to construct a 2,400 sq.ft. two-story, single-family dwelling; new sanitary system; and proposed driveway. Located: 405 Williamsberg Road, Southold. SCTM# 1000-78-5-17 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the following is considered to further Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. It is recommended that perpetual, landscaped buffer be required landward from the wood bulkhead to protect the water quality of Corey Creek. Further, to further Policy 5, "Protect and improve water quality and supply in the Town of Southold" and protect and improve the water quality and supply in the area; the following is also recommended: 1. Require Chapter 236 compliance: the installation of gutters, leader and drywells. Due to parcel location and size, there is no ability to relocate the single family residence outside of the FEMA Flood Zone'0.2 annual chance of flood hazard. 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 Peter Young,Chairman Q Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 7/ Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 13, 2018 the following recommendation was made: Moved by James Abbott, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of CHERYL HANSEN to construct a single- family dwelling, install new sanitary system and pervious driveway. Located: 405 Williamsburg Rd., Southold. SCTM#78-5-17 Inspected by: James Abbott, Peter Meeker Vote of Council: Ayes: All Motion Carried �SOFFO(,fc Michael J. Domino, President o� oG Town Hall Annex John M. Bredemeyer, III, Vice-Presidenty-A 54375 Route 25 Glenn Goldsmith y ,? P.O. Box 1179 A Nicholas KrupskiSouthold, NY 11971 Greg Williams y�ol , �ao� Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES TO: SOUTHOLD TOWN BUILDING DEPARTMENT O V RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT RE O MAY ® 3 2010 SCTM#: BIDING Dom. Property Owner Name: WN OF SOUTHOLD Date Sent to Bldg. Dept: S'3•�g The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? 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: S � Si nature 6f Revi we Date Michael J.Domino,President �'�'0f soyo Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President h0 l0 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Telephone(631) 765-1892 Greg WilliamsFax(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 r - Amendment/Transfer/Extension Received Application. 53,10 SAY ® 3 2018 I Received Fee: $ ?SU Completed Application: Incomplete: Su rit.old Tc;m SEQRA Classification: Type I_ Type II Unlisted Board c,i ir��te;�5 Y.__, Lead Agency Determination: Coordination:(date sent): 6191/9 /it" Consistency Assessment Form Sent: CAC Referral Sent: 5?64 Date of Inspection: 6-1-5 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Legal Name of Property Owner(s): Mailing Address: S <S., W A)h M6 it 1 l 7 �v Phone Number: �g g q"q a _,S7.SS j Suffolk County Tax Map Number: 1000 - Q s — 0 Property Location: Ocs— o r OE fil-41IJ � (If necessary, provide LILCO Pole#, distAce to cross streets, and location) AGENT (If applicable): Mailing Address: Phone Number: Board of Trustees Appl ' ation 4 � GENERAL DATA Land Area(in square feet): S0016166� Area Zoning: Previous use of property: V lgiut- La JU 6 Intended use of property: /J C)-t6 �� �'11� LU&I-L J/J 6— Covenants and Restrictions on property? Yes V/ 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 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 00 0SeP Vq-T/bA S 0 F)=0b 9� - 46,4cr 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): --L P,4m /LCI LI- �- Board of Trustees Appl ' ition WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: l2y U 6T, 19- N G LF-, 1% �lL L4 iNWE LLING- Area of wetlands on lot: g)()11JF-_ square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: Ah� 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: ,p Manner in which material will be removed or deposited: 6 UL 4- d 021-6 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): 61 Z20 Appendix B Short Environmental Assessment Form Instructions for 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 1 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: Es J Project Location(describe,and attach a location map): 406- Brief Description of Proposed Action: r•�� z�-T/6;4) �t—.- ,P,�-, L ��t ce��4- r-c�ao 57�oeP�v q00 c Ne U) Name of Applicant or Spon or: ] Telephone: gq 7`L�O2'/ E-Mai �frt(15��U Ll q j� Address: . � �; uJ/jU��O� City/PO: TI� L- : Zip Code: {-L1-!NG--'b� ��I� 7`S 10©O 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? ❑ ❑ If Yes,attacha 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?U 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? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban [:]Rural(non-agriculture) [:]Industrial ❑Commercial El Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ 9 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 10 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? ©' ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 0 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ I l l l.Will the proposed action connect to existing wastewater utilities? NO ,YES If No,describe method for providing wastewater treatment:dl/&W S#QTT}-)2,V S1- FSM ❑ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? rte( ❑ b.Is the proposed action located in an archeological sensitive area? u ❑ 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? El ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands El Early mid-successional ❑ 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 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? ,�]NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and star drains)? If Yes,briefly describe: ❑NO E3 r nS 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: Zf ❑ 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: Vf ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon n e: C#. P—VLdkV�AJ Date: Jr�oy"lO 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 I. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 0 ❑ 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? 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)? 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 ❑ problems? / 11. Will the proposed action create a hazard to environmental resources or human health? El 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. ❑ 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. F] 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 imp cts. le- Town of Southold-Board of Trustees (0 � [ Name of Lead Agency Date G ri I Ji 0-1-1.y0 i President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Z_Vzv _PJ t , Signature of Re-spoiistible officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Appl 3tion AFFIDAVIT BEING DULY SWORN DEPOSES AND APIFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signator f Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF , 24 b Notary Public MARINA I(oKKIN®S Notary Public-State of Now York No.01 K®6191941 ®ualMgd In Suffolk Count 2020 My commission Expire Aug. APPLICANT/AGENT/REPRESENTAT" TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics rohibits conflicts of interest on the art of town officers and em Io ees.The se of this form is to rovide information which can alert the town of ssible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: ISS (Last name,first ame,-diddle 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.) f Tax grievance Building V 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 Ifyou answered-"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this d o 20 Signature Print Name Form TS l f } ,HIS SECTION COMPLETE • ON f� Ind 3. A. Signature ddress on the reverse XP(A_gent he card to you. - ❑Ad essee back of the mailpiece, B. Req}ve I y(Pnnted N me) le -t VIM V o4000aoo sm f permits. 1• ���� D. Is delivery address different froitem 17 s If YES,enter delivery addre below: ❑ o II IIIIII IIII VIII I VIII III I IIII III��III II III 3. Service Type ❑Registered Mail Express® ❑Adult Signature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9403 0565 5173 0327 27 ❑Certified Mail® Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM �` ❑Insured Mad ❑Signature Confirmation n❑_n n n i._n 463_8 5�8 \' ` ❑Insured Mail Restricted Delivery Restricted Delivery. Cq.MP�ETg�THIS SECTION ON DELIVERY on the reverse g to ) A. Si E3 Agent .d to you. X 11 Addressee ' 0 of the mailpiece, B. Reb&y d by(Printed me) Date of Delivery oo�00oo400q its. ill D. is delivery re r iyt item 17 11Yes TZ7- C),S f YES nrery ad dr ss�be aw: ❑No II I IIIIII I'II I'I I I I I I II III I II I I O IN I I II I III III El Adult Sign lure Res d Delive Reg steered red MMail aiPRestricted 9590 9 ❑Certified 403 0565 5173 0327 34 elivery ❑Certified Mad trice.9pyg Return Recelpt f,,, ❑Collect on Delive VV ii''' Merchandise _�-9- Artirle Numher{Transfer from service late/1 ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM '7 017 2400 0 0 01 0463 8 5 4 2.—_ °-!2�°ray Mail R«,.; _r_ ❑Signature confirmation � Restricted Delivery ,i COMPLETE •N C6MPLETETHIS SECTIONON ■ Complete items 1,2,and 3. A. Signre ■ Print your name and address on the reverse X 1 13 Agent so that we can return the card to you. [?'Addressee E Attach this card to the back of the mailpiece, Received by(Print d Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is delivery address differ ntfrom item 1? 0 Yes If YES,enter delivery address below: ❑ No bj �fju �f � / O C/ 3. Service Type IIIIlllil I'll IIIIi l llIII III I VIII[III I II II III YP ❑ Mad Expresso ❑Regist ❑Adult Signature Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mad Restricted ❑Certified Mail® Delivery 9590 9403 0565 5173 0327 41 ❑Certified Mail Restricted Delivery ElReturn Receipt for ❑Collect on Delivery Merchandise 9 A.4irio ni.:.,k—fr.,ter._s..,�a�,, 1-k-n _ ❑Cobert on Delivery Restricted Delivery ❑Signature ConfirmatlonT 7 017 2400 0 0 01 0463 8 4 9 8 ail 11 Signature Confirmation I ad Restricted Delivery Restricted DehVery I PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt rz Michael J.Domino,President �QS �'O Town Hall Annex John M.Bredemeyer III,Vice-President �® G2� 54375 Route 25 Glenn Goldsmithy P.O.Box 1179 A.Nicholas Krupski o Pry�A� Southold,NY 11971 Greg Williams '� � �p� Telephone'(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE N/SC-A) , residing at/dba being duly sworn, depose and say: That on the // day ofV AIP, , 2018, I personally posted the property known as by placing the Board of Trustees official postir where it can easiK be ken, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,June 20, 2018. Dated: "(signature Sworn to before me this l l day of J LA Ij 20 18` N tary Public PATS NolG6 R 1btN d� 1�IIPA61 0440-1 Qualified,in;Sufi k,Co.r ,, Coinmiss�ion Expires January30,c PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 26 -� — C, N L c©sem My All � 7) �Vo�� � 1�I �-- AJV // 7 /O STATE OF NEW YORK COUNTY OF-SUFFOLK b-04do �f� residing at being duly sworn, deposes and says that on the 0_Ui_, deponent mailed a true copy of the Notice set forth in the Board of tees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at C h' M& ir.1tthat said Notices were mailed to each of said persons by CERTIFIED MAII,/R + URN RECEIPT. Sworn to bef re me this .3011` Day of ,20) -OFFICIAL SEAV COUN1 tmy P'ulgo.staoa of tf{wls P My CommfeAbtt ExPtras Ja$r�.2� Not L Adjacent Properties: ✓ 1000-78.-5-16 Peter Tagios, Jr. Aletra Monfredo-Tagios 26 Amherst Road Port Washington, NY 11050 ,/1000-78-5-15 Brian Parker Sherri Clarry 305 Williamsberg Road Southold, NY 11971 ,, 1000-78-5-10 Wamsley Family Trust 490 Williamsburg Drive Southold, NY 11971 v--'l 000-78.-5-9 Lester & Ethna Lay 111 Soifer Avenue North Bellmore, NY 11710 `�R f ®. ilt-�n �to ® ' ¢ ° � �-'• t70U:I HLI��M'a •,e '._, E, ttY-a';;�}-a'I .,�`i.;�-.�,.,'ttE�y'e"i ,. ,� J ,, rs,, ec^?: l.s.^.n� ,a. a !"Sl,=�k�-``;'4°w:r3:_'`,:•f'i,?iatyt'.:?�i;:Y'y.irt:':is!?"'ty21,. ,,.Y,s`<_r;. 11y,,,!vl,_a.,,__s',>'•,,tt'Sl..rL,`z`' a n'; RN � >',%2 � t8:"ix=±'�=+.iJi;;?-.a.'+, ,pir{: ,.;,,: 1', ai":=•3,` ' °� ;;,p 'Certlfled tMail Fee` (1[t,,nhe r' Tf 'N' 3 •, 't , •,�+t;lp.%,r'� { #,�', .i':.ss 5�' ,•;..="k..•;;d,r'r*- M _...v ',.:.:r .,t� f.. `: i �_U i Certified Mad Fee �e^SV�Fs�, ` , ".a'?' r a � -� " '•� I- :',a,�a,.:':c�;:.i�,neat',Wit,' - ,tu''e.`....rp ,.,,i'_,�t;�`'.- xtra'Sen(Ices&Fe esfgneck6ox,IBdd•r—WRIP �� 6 I Ektra Services&':FeeSchecktSak,_adc�fe� ` a elr e �Q �'�- ••-"� ' Rel Receipt �, I ' ', O I �"����� Pt t a:nit, �Qy, ) ti o p 1.! ,w„ .F6�NYark o ❑)ietum RecE:IpY�(f,atcbpy7.,—µ,'�";$ I '�ReturnlRece,pt j Iq(;t nIF i,'.e$', CDt f��r -1n Retum Receipt'(gleralrOi{,c •' �.i$"�- LI'i .n � ,Sf o®�I,f O Certlfled Mall A,e fP. 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L'�9- -------------------------------------- ------------------------------- Stre3ei an A No., PD Box No. C3 Streetand Apt.No.,or P ox No. D ----------------- j City t e, IP+46 Ci Stat ZI +4 e --------------- SS�`r� LAtil it I 7 oR�F ��,�L✓nc� C � e 1 1 1 o ee•e — :01 a e e eee•e — — _ NUT1L 't__ U 'i= HLA :KING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: CHERYL L. HANSEN REVOCABLE TRUST, c/o CHERYL HANSEN SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a 2,400sq.ft. two-story, single-family dwelling ; new sanitary system ; and proposed driveway. Located : 405 Williamsberg Road, Southold. SCTM# 1000-78-5-17 TIME & DATE OF PUBLIC HEARING : Wednesday, June 20, 2018 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 r { Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# PROJECT NAME,W ILI l ig- M 0 6- �.� l tj� 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 an exte t of a tion: s r f 'E Location of action: 4JO� Lo /!4 6 4l-S i6 o 6 6- 4,811'V6 Site acreage: /� 4a46 Present land use: IZa(?,-�'� Present zoning classification: r 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: l ( ) Name of f applicant: ( L JV 9�/v (b) Mailing address: �° d� I N1'5dta- A&-1A)r,'t-bkL) C)0 � (c) Telephone number: Area Code( ) I/ J-M J 31—7 5--70 23 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes © No❑ If yes,which state or federal ency? MAWM51J7- AU6w t Pk,)dArio V C�0 ! S C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. .Yes ;❑ No ❑ Not Applica ` Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Po ' ies Pages 3 through 6 for evaluation criteria F-1Yes 1:1No Not Applicable i 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 ONot 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 S2/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. r } Yes No ! '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. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No oNot 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. ❑ Yeo No FZKNot Applicable Attach additional sheets if necessary o is WORKING COAST PtCIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes 1:1 No D Not Applicable ' Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No E(Not Applicable PREPARED BY WM-1VS f) TITLE (9 W A)SIC DATE I I