HomeMy WebLinkAboutTR-9864 Glenn Goldsmith, President QF so Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ,`®� ®�®
P.O. Box 1179
Eric Sepenoski Southold, New York 11971
Liz Gillooly Telephone(631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
2033C Date: May 20, 2023
THIS CERTIFIES that the raising in-place of existing(1 2710sq ft footprint)two-story, single family
dwelling by approximately 18 inches over new foundation with new egress three new window wells,
two new sets of steps in place of existing and a new chimney in place of existing,• and for the installation
of a drainage system of leaders gutters and d!ywells• establish and perpetually maintain a 10' wide non-
turf buffer along the landward edge of the top of the bluff slope;
At 1285 Fleetwood Road,Cutchogue
Suffolk County Tax Map#1000-137-4-29.1
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated March 5, 2021 pursuant to which Trustees Wetland Permit#9864
Dated April 14, 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 raising in-place of existing(1 2710sq.ft. footprint)two-story,
single family dwelling by approximately 18 inches over new foundation with new egress,three new
window wells two new sets of steps in place of existing and a new chimneyplace of existing; and for
the installation of a drainage system of leaders gutters and drvwells• establish and perpetually maintain a
10' wide non-turf buffer along the landward edge of the top of the bluff slope.
The certificate is issued to Laurie M. Helgans owner of
the afores 'd property.
I
Authorized Signature
�F� At
EN-CONSULTANTS
June 14, 2021
Board of Trustees
Town of Southold
P.O. Box 1179
Southold, NY 11971
Attn.: Elizabeth Cantrell
Re: Laurie M.Helgans- Wetland Permit#9864
Dear Ms. Cantrell:
In satisfaction of the Special Conditions of the above captioned permit, the required Declaration
of Covenant was recorded in the Office of the Suffolk County Clerk on June 10, 2021. A copy of
the recorded document is enclosed for your file.
Respec fully yours,
S teens
Enclosure
cc: Laurie M. Helgans
1319 North Sea Road I Southampton,New York 11968 1 p 631.283.6360 1 f 631.283.6136 www.enconsultants.com
environmental consulting
o CC# : C21-13432
COUNTY CLERK'S OFFICE
STATE OF NEW YORK
COUNTY OF'SUFFOLK
I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court
of Record thereof do hereby certify that I have compared the annexed with the original
DECLARATION
recorded in my office on 06/10/2021 under Liber D00013108 and Page 071 and,
that the same is a true copy.thereof, and of the whole of such original.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County
and Court this 06/10/2021
SUFFOLK COUNTY CLERK
��cLcx-.L Q. �aJdcQe_r�
JUDITH A.PASCALE
SEAL
IIIIIIIIIIIIVIIIVIIIVIIIIIIIIVIIIVIIIVIIIIIIIIIII
I
IIIIIillllllllllllllllll '
i
SUFFOLK COUNTY 'CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DECLARATION Recorded: 06/10/2021
Number of Pages : 12 At: 11 : 47 :_44 AM
Receipt Number 21-0108822
LIBER: D00013108
PAGE : 071
District: Section: Block: Lot.:
1000 137 . 00 04 . 00 1 029 . 001
EXAMINED' AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $60 . 00 NO Handling $20 .00 NO
COE $5 . 00 NO NYS SRCHG $15 . 00 NO
TP-584 $0 . 00 NO Notation $0 .00 NO
Cert.Copies $7 . 80 NO RPT $200. 00 NO
Fees Paid $307 .80
THIS PAGE IS, A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
RECORCED
Number of pages 2021. jun alta' 11-47:44- AM
_SUE S M A. i`ASCALE
CLERK I F'
This document will be public SUFFOILY( COUNTY
L C,0,-i01-,1108
record. Please remove all P 071
Social Security Numbers
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee Mortgage Amt.
1.Basic Tax
Handling 20. 00 2. Additional Tax
TP-584 Sub Total
Notation Spec./Assit.
or
EA-52 17 (County) Sub Total Spec./Add.
EA-5217(State) TOT. MTG.TAX
Dual Town Dual County
R.P.T.S.A. ®�� � Held for Appointment
Comm.of Ed. 5. 00 Transfer Tax
Affidavit
Mansion Tax
�� The property covered by this mortgage is
Certified Copy . ® goor will be improved by a one or two
family dwelling only.
NYS Surcharge 15. 00 � � � •—�
Sub Total YES or NO
Other � /%� /� ��
Grand Total 11 ! If NO, see appropriate tax clause on
page# of this instrument..
- C)3`
4 1 Dist. 1000 4526280 1000 13700 0400 029001 1 5 Community Preservation Fund
Real Property RP SMI11111111111111111111111111111111111Consideration Amount
Tax Service 09-JUN-21 Agency CPF Tax Due $
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
TD
En-Consultants
1319 North Sea Road TD
Southampton,NY 11968 TD
Mail to:Judith A. Pascale,Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name
www.suffolkcountyny.gov/clerk Title#
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached Declaration of Covenants made
by: (SPECIFY TYPE OF INSTRUMENT)
Laurie A Helgans The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of Southold
Town of Southold In the VILLAGE
Board of Trustees or HAMLET of Cutchogue
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
DECLARATION OF COVENANTS
THIS DECLARATION made this
day of JtA,►n ,2021,by Laurie M. Helgans,
residing at 1285 Fleetwood Road,Cutchogue,NY 11935,hereinafter referred to as"DECLARANT":
WITNESSETH:
WHEREAS, DECLARANT is the owner of certain real property located at 1285 Fleetwood
Road, Cutehogue,Town of Southold;County of Suffolk, State of New York, described in the Suffolk
County Tax Map as District 1000, Section 137, Block 4, Lot 29.1, which is more particularly bounded
and described as set forth in Schedule"A" annexed hereto,hereinafter referred to as the Property; and
WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of
the Town of Southold(hereinafter the"Trustees")pursuant to Chapter 275 of the Town Code of the Town
of Southold or its successor, and various activities conducted upon the property may thus be subject to the
regulation and approval of the Trustees prior to being conducted; and
WHEREAS,the DECLARANT therefore made application to the Trustees for a permit pursuant to
the Wetlands Law of the Town of Southold to undertake certain regulated activities; and
WHEREAS, on April14,2021,the Trustees approved the application and issued a permit with terms
and conditions; and
WHEREAS,the issued permit,terms acid conditions of the permit, as well as the survey prepared by
Peconic Surveyors,P.C. last dated April 13,2021, and stamped approved on April 14,2021,upon which the
permit is based,are annexed hereto as Schedule"B;"and
WHEREAS,as a condition of the granting of a Wetlands Permit to undertake such regulated
activities,the Trustees required that a ten-foot wide"non-turf buffer"be established and maintained along
the landward edge of the top of bluff, and
WHEREAS, the DECLARANT has considered the foregoing and has determined that the same
will be for the best interests of the DECLARANT and subsequent owners of the Property.
NOW, THEREFORE, the DECLARANT does hereby covenant and agree as follows:
1) Upon the substantial completion of the aforementioned permitted activities there shall be
established and perpetually maintained along the landward edge of the top of bluff,a ten-
foot wide"non-turf buffer"as defined by Chapter 275 of the Town Code, as depicted on
the survey prepared by Peconic Surveyors,P.C. last dated April 13,2021,and stamped
approved on April 14,2021.
2) The DECLARANT shall at all times comply with the Terms and Conditions of the permit,
a copy of which is attached hereto in Schedule`B"annexed hereto.
3) These covenants shall run with the land and shall be binding on the.DECLARANT, her
heirs, assigns,purchasers,or successors in interest and may be modified only upon resolution
of the Board of Trustees.
r
(THIS SPACE LEFT BLANK INTENTIONALY)
2
IN WITNESS WHEREOF, the owner has duly executed this instrument this day of
2021.
Laurie M. Fielgans
STATE OFw
J
ss.
COUNTY OF
On the 8 day of �Tj CQ ,in the year 2021, before me the undersigned, a Notary Public in
and for said State,personally appeared Laurie M.ff ggA: s personally known to me or proved to me on the
basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and
acknowledged to me that she executed the same'in-her capacity, and that by her signature on the instrument,
the individual or the person on behalf of which the individual acted,executed the instrument.
�< " LYNNE K.BURNS
Notary Public NOTARY PUBLIC,STATE OF NEW YORK
Registration No.4796041
Qualified in Suffolk County
My COMMissiOn EXpires
3
SCHEDULE A
ALL that certain plot,piece or parcel of land, with the buildings and improvements thereon erected,
situate, lying and being at Fleet's Neck, Cutchogue,Town of Southold, County of Suffolk and State of
New York,bounded and described as follows:
BEGINNING at a point on the easterly side of Fleetwood Road distant 490.50 feet-to the northerly side of
East Road and also where same is intersected by the northwesterly side of land now or formerly of Greer
and premises about to the described with the easterly side of Fleetwood Road;
RUNNING THENCE along the easterly side the following two courses and distances:
1. North 05 degrees 31 minutes 40 seconds West 2.60 feet;
2. North 63 degrees 14 minutes 00 seconds West 106.90 feet to land now or formerly of Pastors and
Campbell;
THENCE along said last mentioned land,North 41 degrees 36 minutes 00 seconds east 334.24 feet to the
tie line of East Creek(Eugene's Creek);
THENCE along said high water mark,the following two courses and distances;
1) South 51degrees 56 minutes 00 seconds East 61.82 feet;,
2) South,33degrees 20 minutes 53 seconds East 125.20 feet,to land now or formerly of\Fohrkolb;
THENCE along said last mentioned land South 57 degrees 02 minutes 50 seconds West,290.43 feet to
the easterly side of Fleetwood Road,the point or place of BEGINNING.
4
5(Yi1;llULE B (7 Pages)
f
s
BOARD OF SOUTHOLD TOWN TRUSTEES I
SOUTHOLD,NEW YORK
I
i -
I PERMIT NO.9864 DATE: APRIL 14,2021 I
ISSUED TO: LAURIE M.HELGANS
i
PROPERTY ADDRESS: 1285 FLEETWOOD ROAD,CUTCHOGUE
SCTM#1000-137-4-29.1
AUTHORIZATION
iPursuant 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 April 14,2021,and in-
consideration of application fee in the sum of$250.00 paid by Laurie M.Helsans and subject to the Terms and
Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the
i following:
t
Wetland Permit to raise in-place existing(1,2710sq.ft.footprint)two-story,single family
dwelling by approximately 18 inches over new foundation,with new egress,three new window
wells,two new sets of steps in place of existing,a4a new chimney in place of existing; and for
the installation of a drainage system of leaders,gutters,and drywells;establish and perpetually
maintain a 10'wide non-turf buffer along the landward edge of the top of the bluff slope; and
as depicted on the survey prepared by Peconic Surveyors,P.C.,received on April 14,2021 and
stamped approved on April 14,2021.
J I
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Sea]to be affixed,and these
presents to be subscribed by a majority of the said Board as of the 14th day of April,2021.
t
Ntw
2
TERMS AND CONDITICONS
The Permittee Laurie M Help- s,residing at 1285 Fleetwood Road Cutchogue New York as
part of the consideration for the issuance of the Permit does understand and prescribe to the
following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit,and the said Permittee will,at his or her own
expense, defend any and all such suits initiated by third parties,and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees
of the Town of Southold.
2. . That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved,.but should circumstances warrant,request for
an extension may be made to the Board at a later date.
3. That this IPermit 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 because
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work herein
authorized.
6. That thefie shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in the
location of the work herein authorized,'or if,in the opinion of the Board of Trustees,the work
shall cause unreasonable obstruction to free navigation,the said Permittee will be required,
upon due notice,to remove or alter this work project herein stated without expenses to the
Town of Southold.
8. The Permittee is required to provide evidence that a copy of this 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.
9. That the said Board will be notified by_the Permittee of the completion of the work
authorized.
10. 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.
11. No right to trespass or interfere with riparian rights. This permit does not convey to the
permittee any right to trespass upon the lands or interfere with the riparian rights of others in
order to perform the permitted work nor does it authorize the impairment of any rights,title,
or interest in real or personal property held or vested in a person not a party to the permit.
i
SOUTHO
. .S-TEES
Issued TotE M. 1i�+t�kNS Date -
aaaress
1295 F�,�,� m, �, ,,�.
THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION
;TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD
SOUTHOLD; N.Y. 17971
TEL.: 765.1892'
u
SURVEY OF PROPERTY
AT CUTCHWUE
N N- APR 1 2021 TOWN OF SOUTHOLD-
FLJOrA
N N DOCKTING SUFFOLK COUNTY
Southold Town N. Y
Board 1000-137-04-29.1
RAMP SCALE. 1'=30
SEPTEMBER 28, 2020
Atovasam j. 2020 (Lor COVERAGE, LAW LINE)
s78?D0yNOVEMBER 24, 2020 (REVISIONS)
MARCH 1,-2021 (WNOOW VELLS,--LIMIT FENCE)
APRIL 7, 2021 (REVISIONS)
APRIL 13, 2021 (NON-TURF BUFFER)
WOOD
CATWALK -Y
X Ir
APPROVED By
MARSH
0 BOARD OF 1 RUSTEES
WLF N,
# 6 'N' Zip TOWN OF SOUTHOLD
EL=4.3' N DATE
STEPS N \�\Gk- 14,264
# 5
'WOOD LANDING.______ WLF* \A.
'-TIMBER EDGE
-DIRT .7' # 4 IN N
-STEPS EL=3.
-WOOD LANDING
EL--25.6'
NN WL
EL=30.8' 3 "N
PRO EL=32.6' N N
-,EL=3.9'
4. WLFO,
WXY5' 11
-pOA- NN 2
DW EL=330'
,;71�ROPOSED . "N
4.83'x3.67' % N
WINDOW-WELL �N
CHIMNEY To BE
AND REPLACED/ EL=33.1' =4.7' WLF
I CHIMNEY / c # 1
REMOVED EL ma, TIDAL WETLANDS BOUNDARY AS
NELL
4.8yX13.671 WOOD DELINEATED 13Y EN—CONSULTANTS,
RAMP 119P
SEPTEMBER 18, 2020
CMF
EDGE OF LAWN 7.9'
`i
_ J
�a 1
WLF WLF WLF
# 9_�- # $
WLF
EL=3,1' EL
N/O/'F
ANNETTE M. CAMPBELL STEPS
wooD LANDING
EXISTING EL=23.0' TIMBER EDGE
BASEMENT DIRT
ENTRANCE STEPS
' CONC. WOOD LANDING
BLOCK EL=25.6'
EXISTING 2-STORY DWELLING` STEPS
(FF EL32.2') TO BE RAISED 26
TO FF EL33.7' (IN-PLACE,
WITH NO INTERIOR CHANGES 1j
OR INCREASE IN BEDROOMS)
OVER NEW FOUNDATION'(WITH - h 2 PRO
NEW EGRESS AND WINDOW BLOCK °ry F� 4.O'x3!5,
WELLS) STEPS DW
_FIROPOSED
9• l <C �' 4.83'x3.67'
PROPOSED k2� WINDOW WELL
5.83'x11.87' DOSTING CHIMNEY TO BE /
WINDOW WELL !/y0 6� REMOVED AND REPLACED/
WITH NEW CHIMNEY
_ $ TIMBER RET. �• CE TO BE REMOVED /
+0� WALL/EDGING PROPOSED 4.83'x3.67'
BRIC•A16 WALK FEN.LATTICE WINDOW WELL
CP PROPOSED � /
TIMBER R Ln
h 3"5'x1.5WALL/EDGING /
'3• �� STEPS
EDGE OF
ca'.c `�2,CP WELL T^FOR ` '
DW
-.
—feROPOSED
PROPOSED '28^J s r- '/ �
a 4.83'x3.67'
y0 WINDOW WELL
WINDOW WELL O O EXISTING CHIMNEY TO BE
/� 6 REMOVED AND REPLACED/
WITH NEW CHIMNEY /
TIMBER RET. CE TO BE REMOVED /
Q3 WALL/EDGING
�FO BRICK LATTICEPROPOSED 4.83X3.67'•`
FEN. WINDOW WELL
CP PROPOSED TIMBER RET /
Ary _ STgpS 5' WALL/EDGING ¢/
CP wEu\FOR_--,de
EDGE, OF LAw
IRRIGATION ONLY
RAIN RUNOFF CONTAINMENT.
HOUSE: 1.270 Sq. Ft.
1 1,270 x 0 17 x = 216 Cu.Ft PIPE FND�� 3 /� PROJECT LIMITS \�
216142.2 = Jr 1 VF ` 2� r / FENCING. AREA OF
Provide 1 DW 8'o x 6' Deep= 6 VF � 0 / DISTURBANCE 13,115
o`
FDG / '• O"`6�
Connected by Gutters 8r Leaders SQ.FT.e OF - � �
�s�r4 pQ��vr
LOT COVERAGE
BUILDABLE LAND (LOT AREA BETHEEN
/
ROAD AND TOP OF BLUFF) 22355 sq.ft
EVS77NG JOYO
HOUSE �
1270 sq.ft.GARA �
SHED GE 329 sq.t. N� 0„VV UTILITY BOX
96 sq.ft 2.60
T03 sq.ff. oy 1
1695/22355 = 7.6x
-----------------
_n
t
KEY
m
Q = REBAR m 41
® = WELL y
O = STAKE� ® j
I= TEST HOLE � I
• = PIPE
I
■ = MONUMENT ® I
= WETLAND FLAG �
= U77LITY POLE ROAD
ELEVAUONS REFERENCED TO NAND 88
ANY ALTERA7E01V OR ADD17701V TO THIS SURVEY IS A KOLA77ON OF SEC770N 7209 OF 7ME NEW
YORK STATE EDUGA77ON LAW. EXCEPT AS PER SECTION AREA= Jr���7
72G►9-SUED/ R7
HEREON ARE VALID FOR THIS'MAP AND COPIES 7HEREOF:ONLY EF`SAID MAP OR COPIESVlS/0N 2. ALL CER7 BEAR NS
IMPRESSED SEAL OF THE SURVEYOR WHOSE SlGNA7URE APPEARS.HEREON. THE
TO TIE Lij
�--KROPOSED / -,L(/, EL=33.0• T
4.83'x3.67 0
WINDOW WELL \ MO.I
CHIMNEY TO BE �RF
AND REPLACED/ eL EL=33.7' =4.7' �WLF
W CHIMNEY / \� I
3E REMOVED / - - -30.6 TIDAL WETLANDS BOUNDARY AS
DWELL 83'x3.6Ywood °,�\ �9DELINEATED BY EN—CONSULTANTS,
RAMP N o \ SEPTEMBER 18, 2020
CMF
EDGE OF LAWN \
\
VLY \ ,
\ r
\ CONC.
\ RETAINING --
\ WALT
o�y
N/O/F
ANDREW THOMAS FOHRKOLB
OF NEyV
Z®A® f ca N'-'sTZ��
R'EA=-45,372 Sl. FT PION 49618
TO TIE LINE' fs 1) 765— tF�&X 765-1797
P.O. BOX 909
SOUTHOLD, M R T 2®20_0551 971
Glenn Goldsmith,President ®� S®(/j� Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President .y®� ®��
P.O. Box 1179
Eric Sepenoski Southold, New York 11971
Liz Gillooly Telephone(631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
Court
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION:
INSPECTED BY:
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, haybale line/silt boom/silt curtain
1St day of construction
1/2 constructed
Project complete, compliance inspection
COMMENTS:_ Jy( L ck(
r C)k -}-o J SSv e,
CERTIFICATE OF COMPLIANCE:
Glenn Goldsmith, President �QF SO(/ly 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
G Q Telephone(631) 765-1892
Greg Williams Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
SOUTHOLD TOWN BOARD OF TRUSTEES
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
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-
% constructed
k When project complete, call for compliance inspection;
' �ti�•sii�..wN."
"_ � .:e Ci Ti'i SS'o�••y-_ eC4i'i 5eii•. _ - Sidi'ii�•;�=_ ,e•dli eii•'�.: - oJi'si•�:;."_ - �¢oa fi•�-.•��-_
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3
q BOARD OF SOUTHOLD TOWN TRUSTEES
r SOUTHOLD,NEW YORK
vi '•Oed `� � °•ben;,
PERMIT NO. 9864 DATE: APRIL 14,2021
ISSUED TO: LAURIE M.HELGANS
I PROPERTY ADDRESS: 1285 FLEETWOOD ROAD, CUTCHOGUEZEN r•' ,
.i `J>
yr '0•f 4 SCTM# 1000-137-4-29.1 ,°••r s
j AUTHORIZATION .
qe' Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in
av & accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 14, 2021, and in `
consideration of application fee in the sum of$250.00 paid by Laurie M. Helgans and subject to the Terms and
s Conditions as stated in the Resolution the Southold Town Board of Trustees authorizes and permits the f
following: '
- Wetland Permit to raise in-place existing(1,2710sq.ft.footprint)two-story,single family
dwelling by approximately 18 inches over new foundation,with new egress,three new window
wells,two new sets of steps in place of existing,and a new chimney in place of existing; and for
r_ the installation of a drainage system of leaders,gutters,and drywells; establish and perpetually
maintain a 10' wide non-turf buffer along the landward edge of the top of the bluff slope; and
wE.a, as depicted on the survey prepared by Peconic Surveyors,P.C., received on April 14,2021 and
- stamped approved on April 14,2021.
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these
presents to be subscribed by a majority of the said Board as of the 14th day of April,2021.
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TERMS AND CONDITIONS
The Permittee,Laurie M.Helgans, residing at 1285 Fleetwood Road, Cutchogue,New York as
part of the consideration for the issuance of the Permit does understand and prescribe to the
following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will,at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees
of the Town of Southold.
2. That this Permit is valid for a period of 24 months,which is considered to be the estimated
time required to complete the work involved,but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved,to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work herein
authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in the
location of the work herein authorized, or if, in the opinion of the Board of Trustees,the work
shall cause unreasonable obstruction to free navigation,the said Permittee will be required,
upon due notice,to remove or alter this work project herein stated without expenses to the
Town of Southold.
8. The Permittee is required to provide evidence that a copy of this 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 pen-nit.
9. That the said Board will be notified by the Permittee of the completion of the work
authorized.
10. 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.
11. No right to trespass or interfere with riparian rights. This permit does not convey to the
permittee any right to trespass upon the lands or interfere with the riparian rights of others in
order to perform the permitted work nor does it authorize the impairment of any rights,title,
or interest in teal or personal property held or vested in a person not a party to the permit.
Glenn Goldsmith,President �q SO(/lTown Hall Annex
A.Nicholas Krupski,Vice President ,`O ��� 54375 Route 25
P.O. Box 1179
John M.Bredemeyer III Southold,New York
11971
Michael J. Domino
G Q Telephone(631) 765-1892
Greg Williams �� Fax(631) 765-6641
CUUNT
- " BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
April 19, 2021
Robert E. Herrmann
En-Consultants
1319 North Sea Road
Southampton, NY 11968
RE: LAURIE M:HELGANS
1285 FLEETWOOD ROAD, CUTCHOGUE
SCTM# 1000-137-4-29.1
Dear Mr. Herrmann:
The Board of Town Trustees took the,following action during its regular meeting held on
Wednesday, April 14, 2021, regarding-the above matter:
WHEREAS, En-Consultants on behalf of LAURIE M. HELGANS 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 March 5, 2021, 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, in accordance with Chapter 268, said application was found to be Exempt
from the Local Waterfront Revitalization Program policy standards, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on April 14, 2021, 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 approve the application of LAURIE M.
HELGANS to raise in-place existing (1,2710sq.ft. footprint) two-story, single family
dwelling by approximately 18 inches over new foundation, with new egress, three new
window wells, two new sets of steps in place of existing, and a new chimney in place of
existing; and for the installation of a drainage system of leaders, gutters, and drywells;
establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of
the top of the bluff slope; and as depicted on the survey prepared by Peconic
Surveyors, P.C., received on April 14, 2021 and stamped approved on April 14, 2021.
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,
4 -
lenn Gol smith
President, Board of Trustees
GG/dd
tiSURVEY OF PROPERTY
N _
D om_L'7 �4� A T CUTCHOG UE
` FL �.F R 14 2021 TOWN OF SOUTHOLD
FLOATING
�_ SUFFOLK COUNTY, N. Y.
DOCK 1000-137-04-29.1
:�el�ttlold Thum
' Ftoard of Trustees _j SCALE. 1�=30
RAMP SEPTEMBER 28, 2020
' SS NOVEMBER 3, 2020 (LOT COVERAGE, LAWN LINE)
NO"✓EMBER 24, 2020 (REVISIONS)
MARCH 1, 2021 (WINDOW WELLS, LIMIT FENCE)
APRIL
APRIL1 J, 2021 (NON-TURF BUFFER)
0,
s�3 s F
CATWALK \\� C �� APPROVED BY
_ BOARDOF1IRU
c � STEES
_ _ _ _ _ _ _ _
MARSH ]\\�O TOWN OF SOUTHOLD
WL9 #L8 — WLF
# -0- # DATE
�— WLF \ �� 9,p�
# 6
EL=3.1' EL=4.3' 'WLF
N/O/F _ # 5 _ q
ANNETTE M. CAMPBELL STEPS L=3,8'
WOOD LANDING WLF \
EDGE •����� # 4
TIMBER \ \ \® \
EXISTING EL=23.0'
BASEMENT DIRT 1��EL=3.7'
ENTRANCE STEPS \ F 0 \0�0,
WOOD LANDING ��EL=4.5' \ �F \
CONC.
BLOCK EL=25.6' ��L=3.7' \ �q�
EXISTING 2-STORY DWELLING STEPS �� e0JT0 WLF \ Z�y
(FF EL.32.2') TO BE RAISED `Z6 �� f Qr 3
TO FF EL.33.7' (IN-PLACE, ?, EL--30.8' �\ CUFF \ SS
WITH NO INTERIOR CHANGES 9• EL=32.6'
OR INCREASE IN BEDROOMS) _——'L6 y 28 PROP ',,EL 3 9 WL�
OVER NEW FOUNDATION (WITH CONC. a`1 !�F 4.0'x3!5' P TOO OF ��� 2 \
NEW EGRESS AND WINDOW BLOCK
WELLS) STEPS \ 9 �� ,-O DW 70• e<(i EL=33.0' 70 \ \
OJ n��L' AOPOSED hi0 �
`� // i��4.83'x3.67' S� ��0 `� y
k�a WINDOW WELL 4.7'
\ �� WL
PROPOSED F
EXISTING CHIMNEY TO BE // glop #
EL=33.1'
L= 1
5.83'x 11.87' F
WINDOW WELL 50 REMOVED AND REPLACED/ R WITH NEW CHIMNEY 30.8
= ' TIDAL WETLANDS BOUNDARY AS
/ EL p��J
– j CE TO BE REMOVED / �g0• DELINEATED BY EN–CONSULTANTS,
Oe
3� TIMBER RET.. i
WALL/EDGING PROPOSED 4.83'x3.67' WOOD cn�� SEPTEMBER 8, 2020
BRICK LATTICE WINDOW WELL RAMP N m \
ADWALK FEN. ^?0 \ CMF
� CP PROPOSED TIMBER R / I 7.9' \\
3.5'x1.5' WALL/EDGING\
ti --STEPS '__4 EDGE OF LAWN \
�•� `^c p / `�2 CP WELL - FOR
�3Q �\ IRRIGATION ONLY \\
' CONC. I (� I ?�'•
/ I o.
/ 1
RAIN RUNOFF CONTAINMENT-* l RETAINING
CONTAINMENT-* \\ I � / \ WALL
HOUSE: 1,270 Sq. Ft. � < / PROJECT LIMITS \
PIPE FND\ �`32� � / FENCING. AREA OF
1,270 X 0.17 X 1 = 216 Cu.Ft. DISTURBANCE 13,115
\ / SQ.FT.
21642.2 = 5.1 VF FOCF \ �
Provide 1 DW 8'0 x 6' Deep= 6 VF
Connected by Gutters & Leaders 14%DeNT \ / Cg,�p`L
0
-- N 0 F
CF � y wgTF M � ANDREW THOMAS FOHRKOLB
LOT COVERAGE 11/0 �F
OQ \ ,yo
BUILDABLE LAND (LOT AREA BETWEEN
ROAD AND TOP OF BLUFF) 22355 sq.ft. 04 oy
EXISTING
\N5'31 0"W UTILITY Box
HOUSE 1270 sq.ft. 2.6
GARAGE 329 sq.ft. O
SHED 96 sq.ft. x
T6 \
1695/22355 = 7.69 \
1
-----------------
r I
m
rn
KEY
0 = REBAR O
® = WELL O I
A = STAKE j � .OF N Cc- J,
_ TEST I
® = PIPE HOLErr
® = MONUMENT
WETLAND FLAG ROA
E
= UTILITY POLE
:�',S Ll NO. 49618
P CONI C SENE OR '# p.ELEVATIONS REFERENCED TO NAVD 88 (631) 765- 2 - X-(631) 765-1797
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW AREA= 45,372 SQ. FT. P.O. BOX 909
YORK STATE EDUCATION LAW. EXCEPT AS PER SECTION 7209–SUBDIVISION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THISMAP AND COPIES YOR WHOSE SIGNTHEREOF ONLY F SAID
ATURE APPEARS HEREONAP OR COPIES BEAR THE TO TIE LINE 1230 TRAVELER STREET 20_055
IMPRESSED SEAL OF 774E SUR SOUTHOLD, N.Y. 11971
Maim Diane
From: Robert Herrmann <rerrmann@enconsultants.com>
Sent: Wednesday, April 14, 2021 2:39 PM
To: DiSalvo, Diane
Subject: Laurie Helgans
Diane,
By now you should have received three(3)copies of a revised survey/site plan prepared by Peconic Surveyors,last dated
April 13,2021,which has been updated to depict a proposed 10'wide non-turf buffer along the landward edge of the top
of the bluff slope,as requested by the Trustees after their site inspection.
Please confirm receipt of the plans and this email.
Thanks,
Rob
Robert E.Herrmann,MEM
Coastal Management Specialist
En-Consultants
1319 North Sea Road
Southampton,NY 11968
Phone:631-283-6360
Fax: 631-283-6136
Email:rherrmann@enconsultants.com
www.enconsultants.com
ATTENTION: This email came from an external source. Do not open attachments or click on links from
unknown senders or unexpected emails.
i
N SURVEY OF PROPERTY
D A T CUTCHOG UE
TOWN OF SOUTHOLD
FLOATING 4 2021 SUFFOLK COUNTY N. Y.
�
DOCK
Southold lbwn 1000-137-04-29.1
Board of Trustees SCALE- 1�=30
\ RAMP SEPTEMBER 28, 2020
NOVEMBER 3, 2020 (LOT COVERAGE, LAWN LINE)
T\ 6'�S6'0 NOVEMBER 24, 2020 (REVISIONS)
�•B�,OF MARCH 1, 2021 (WINDOW WELLS, LIMIT FENCE)
APRIL 7, 2021 (REVISIONS)
�S APRIL 13, 2021 (NON—TURF BUFFER)
0,
WOOD
A,��• CATWALK \\ C)
WLF WLF WLF \ MARSH \\ O�
# 9 �' - - -�-- WLF I
# 6 F sy
EL=3.1' EL-4.3'
N/O/F
ANNETTE M. CAMPBELL STEPS L=3.8' .
WOOD LANDING WLF^ \ \�
EXISTING EL=23.0' TIMBER EDGE ��� # 4
BASEMENT DIRT EL=3.7'
ENTRANCE SPS
CONC. WOOD LANDING �70`-'\4.5' \ GN, of
BLOCK EL=25.6' EL=3.7'
EXISTING 2-STORY DWELLING STEPS 6 �N,
(FF EL.32.2') TO BE RAISED WLF)K,., �S/y
TO FF EL.33.7' (IN-PLACE, Z EL=30.8' \ M op 3
WITH NO INTERIOR CHANGES
OR INCREASE IN BEDROOMS) _26 9. 8 EL=32.6' \\ `F \ `S
OVER NEW FOUNDATION (WITH - ^? 2 PROP \ �-,EL=3.9'CONC. WLF
NEW EGRESS AND WINDOW BLOCK �� �� 4.0'x3:5' '
WELLS) STEPS 0A_ 2
CIV x j�� KR POSED 1p �/ e�L'F EL=33.0' ` 70 \ \
_2B_ 9 4.83'x3.67'
OF \
PROPOSED �y" �0k WINDOW WELL \,\pN�r� \N, y
5.83'x11.87' EXISTING CHIMNEY TO BE // Rye EL=33.1' L=4.7' WLF
WINDOW WELL tij� �� , REMOVED AND REPLACED/ �� #
WITH NEW CHIMNEY / EL=30.8' TIDAL WETLANDS BOUNDARY AS
TIMBER RET. CE TO BE REMOVED / O�` DELINEATED BY EN—CONSULTANTS,
WALL/EDGING / ��
,O PROPOSED 4.83'x3.67'
BRICK LATTICE RWOODAMP � � SEPTEMBER 18 2020
WALK FEN. yy WINDOW WELL RAMP r :r: \
CP PROPOSED TIMBER RET` / N \ CMF '
3.5'x1.5' WALL/EDGING\ / I 7.9' \
STS \
3 � EDGE OF LAWN \
c�,• � CP WELL - FOR I
IRRIGATION ONLY \ W
/ CONC.
RAIN RUNOFF CONTAINMENT I pe / GONG.
/ \ RETAINING
HOUSE. 1,270 Sq. Ft. \\ // PROJECT LIMITS \ WALL
1,270 X 0.17 X 1 = 216 Cu.Ft. PIPE FND.\� 32�\ / FENCING. AREA OF
/ DISTURBANCE 13,115 f1
216/42.2 = 5.1 IIF �� SQ.FT. / O
Provide 1 DW 8'0 x 6' Deep= 6 IIF cF of a \
Connected by Gutters & Leaders Fi 6`3'�4O�FNr \ ` / �,�0�
114
LOT COVERAGE FF ti �qrF M �' /�'— N/O/F
�
BUILDABLE LAND (LOT AREA BETWEEN 0 ANDREW THOMAS FOHRKOLB\ \ 6
ROAD AND TOP OF BLUFF) 22355 sq.ft. /QO 0y •90. i
EXIS77NG qO \\
HOUSE 1270 sq.ft. \N5'31 �O"W UTILITY BOX
GARAGE 329 sq.ft. 2.6�(? \
SHED 96 sq.ft. 0y
Tom. \\
1695/22355 = 7.69. \
1
-----------------
-n 11
KEY m
Q = REBAR
® = WELL 0 I
® = STAKE 0
O
& = TEST HOLE I
I
® = PIPE I
0 I
® = MONUMENT )>
_OF NFpy
o = WETLAND FLAG � I T ROAD G����T. P�ET�'CQ�i-
cQ, = UTILITY POLE EAS Ry0 t.
ELEVA 77ONS REFERENCED TO NA VD 88 J . '' ' Y. 1C. NO. 49618
ANY AL7ERA77ON OR ADD177ON TO 7HIS SURVEY IS A WOLA77ON OF SEC77ON 7209 OF 7HE NEW NIC 40R,VEY�ORS, .Cl
YORK STATE" EDUCA77ON LAW. EXCEPT AS PER SEC770N 7209-SUBDIVISION 2. ALL CER7IFICA170NS AREA= 45,372 SO. FT. (631 � b`5-,5020r,FA x'631) 765-1797
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THETO TIE LINE P.O.
IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON.
1230 TINA LER T
SOUTHOLD, N.Y. 11971 20-055
Glenn Goldsmith, Pre Itogt]fF�L��Gt Town Hall Annex
A.Nicholas Krupski,Vice I-resident y��} 54375 Route 25
John M. Bredemeyer III w P.O.Box 1179
Michael J. Domino Southold,NY 11971
Greg Williams , r ��y� Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: V-2/21 2-�o Completed in field by: C. G-0 IISM.J
En-Consultants on behalf of LAURIE M. HELGANS requests a Wetland Permit to raise in-place
existing (1,2710sq.ft. footprint) two-story, single family dwelling by approximately 18 inches over new
foundation, with new egress, three new window wells, two new sets of steps in place of existing, and
a new chimney in place of existing; and for the installation of a drainage system of leaders, gutters,
and drywells. Located: 1285 Fleetwood Road, Cutchogue. SCTM# 1000-137-4-29.1
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
-7G. Williams Other
_ ;� rr"^'��� iR�!' - __ -. ti..yam;:` - n � �� -�• � f
•".� � u . � I 6 xvi-TsAM
4F _k
79
4=W - -
JWM
r � �t � . - ;• � �`�_L� t',1�r rte.
itk-
Ica
� F w
t
F v G
�� 4I 7I2 13 , 43
Glenn Goldsmith, Pr(' it aSUFFo��` Town Hall Annex
�• O
A.Nicholas Krupski,Vice-rr sident ��� G� q 54375 Route 25
John M. Bredemeyer III y P.O.Box 1179
Michael J. Domino Southold,NY 11971
Greg Williams 4,- �ao�� Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: Completed in field by:
En-Consultants on behalf of LAURIE M. HELGANS requests a Wetland Permit to raise in-place
existing (1,2710sq.ft. footprint) two-story, single family dwelling by approximately 18 inches over new
foundation, with new egress, three new window wells, two new sets of steps in place of existing, and
a new chimney in place of existing; and for the installation of a drainage system of leaders, gutters,
and drywells. Located: 1285 Fleetwood Road, Cutchogue. SCTM# 1000-137-4-29.1
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
N SURVEY OF PROPERTY
A T CUTCHOG UE
TOWN OF SO UTHOLD
'
FLOATING SUFFOLK COUNTY, MY
�
' ' \
DOCK
1000-137-04-29.1
' SCALE: 1'=30
R""'p SEPTEMBER 28, 2020
NOVEMBER 3, 2020 (LOT COVERAGE, LAWN LINE)
Ti� Ss� NOVEMBER 24, 2020 (REVISIONS)
\•82,OF MARCH 1, 2021 (WINDOW WELLS, LIMIT FENCE)
L
s� GQ 9s�x
moo. �ti 0,
%KsLAWOOD
CATWALK \ �.• ��
WLF WLF WLF \ MARSH \\0�
# 91- - # 8 # � -� F \
'� - - -� WLF
9
# 6
EL=3.1' EL=3
WLF � � N. \ G�
N/O/F # 5 \\�9
ANNETTE M. CAMPBELLL=3.8'
\sem
WOOD LANDING EF* \ \ \ My\M \ J
EXISTING EL-23.0'I TIMBER EDGE D
BASEMENT DIRT SEL=3.7'
ENTRANCE STEPS �� \ F� \
CONC. WOOD LANDING �/O\�L=4.5' \ \ cF OFBLOCK 1 \\?O' MAR - 5
EXISTING 2—STORY DWELLING STEPS EL=25.6' ��\3.7' 6 t<ql 5 ' 2 21
(FF EL32.2') TO BE RAISED 26 � 07TO WLF Z '7
TO FF EL33.7' (IN—PLACE, EL=30.8' \ M or 3 QR
WITH NO INTERIOR CHANGES _ 9 �� �� � SSS —L Southold Town
OR INCREASE IN BEDROOMS) _26 / EL=32.6' \ FF
OVER NEW FOUNDATION (WITH CONC. �y� Q' Z PROPOSED ��EL=3.9' NIL ROard of Trustees
NEW EGRESS AND WINDOW �c
BLOCK 4.0'x305' 7EL-33.0'
/ TOp '�� Z '
WELLS) STEPSX41 O< \ J \
�Z8� 9e ^>>APfZOPOSED
4.83'x3.67'
PROPOSED �`�� WINDOW WELL /' '� L=4.7' WLF
5.83'x11.87' EXISTING CHIMNEY TO BE / EL=33.1'
WINDOW WELL tij� 69 r' REMOVED AND REPLACED/ #
WITH NEW CHIMNEY / EL=30.8' TIDAL WETLANDS BOUNDARY AS
# 3' CE TO BE REMOVED �/ Off` DELINEATED BY EN—CONSULTANTS,
y� TIMBER RET. nIC R
WALL/EDGING PROPOSED 4.83'x3.67' WOOD min�\ �g SEPTEMBER 8, 2020
WALK FBRICK EN.CE y_ WINDOW WELL RAMP w m \
�� CP PROPOSED TIMBER REI'" / 7.9 \\ \ CMF
3.5'x1.5' WALL/EDGING\ / \
STEP
c� •
O CP WELL — FOR EDGE OF LAWN \
IRRIGATION ONLY
4+
/ CONC.
RAIN RUNOFF CONTAINMENT \ I ; •� CONC.REINNG
HOUSE. 1,270 Sq. Ft. \\
// PROJECT LIMITS �� WALL
1,270 X 0.17 X 1 = 216 Cu.Ft. PIPE FND.\� 32�\ / FENCING. AREA OF
/ DISTURBANCE 13,347
216/42.2 = 5.1 VF e -Z / SQ.FT.
Provide 1 DW 8'0 x 6' Deep= 6 VF ^j of o�
op
Connected by Gutters & Leaders F s•�`r4 o MFN \ AA 11 dti
O T
LOT COVERAGE C�F 41 �' �� N/O/F
"v0 �� MSF o/ ANDREW THOMAS FOHRKOLB
BUILDABLE LAND (LOT AREA BETWEEN 0,
ROAD AND TOP OF BLUFF) 22355 sq.ft. /QO Oy •90. /
EXIS77NG ^IO \
HOUSE 1270 sq.ft. \1N 56 O"W UTILITY Box
GARAGE 329 sq.ft. 2.6 \
SHED 96 sq.ft. O \
Esq. f{. S' \\
1695/22355 = 7.6X \ \
1
----------------- \1
KEY rn
m
Q = REBAR FI-:
® = WELL 0 I
A = STAKE 0 I
= TEST HOLE OF N.--c
PIPE �0
f �U
= MONUMENT
I
= WETLAND FLAG I "
C-0.3 = U77LITY POLE EAsT ROAD
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IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. 1230 TRAVELER STREET
SOUTHOLD, N.Y. 11971 20--055
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OFFICE LOCATION:
MAILING ADDRESS:
Town Hall Annex � ��� �� "r P.O. Box 1179
54375 State Route 25 Southold, NY 11971
(cor. Main Rd. &Youngs Ave.)
Southold, NY 11971 ��� Telephone: 631765-1938
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To: Glenn Goldsmith, President
Town of Southold Board of Trustees
From: Heather Lanza, AICP, Town Planning Director
on behalf of Mark Terry, LWRP Coordinator&Assistant Town Planning Director
Date: April 13, 2021
Re: Local Waterfront Coastal Consistency Review
Helgans SCTM# 1000-137-4-29.1
The application referenced above is for a Wetland Permit to raise an existing two-story single
family dwelling by 18" over a new foundation and includes installing a new chimney and
drainage system of gutters, leaders and drywells.
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, the proposed action is
EXEMPT from LWRP review pursuant to:
§ 268-3. Definitions. MINOR ACTIONS item "BB" which state:
BB. Additions to an existing dwelling constituting less than 25% of the existing structure
where the addition is greater than 75 feet from a natural protective feature, except where
the parcel is located in a coastal erosion hazard area;
Note that although the action is technically exempt, it is recommended that to mitigate impacts
to the groundwater and nearby surface water, the cesspools should be replaced with an I/A
septic system or at least a traditional septic system. Cesspools provide no treatment of the
nitrogen from wastewater. The action includes extensive rebuilding of the foundation of this
home, and as such, the replacement of the antiquated cesspools with a new septic system is
appropriate.
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 Town Hall,53095 Main Rd.
Lauren Standish,Secretary P.O.Box 1179
" Southold,NY 11971
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 April 7, 2021 the
following recommendation was made:
Moved by Caroline Burghardt, seconded by Peter Young, it was
RESOLVED to SUPPORT the application of LAURIE M. HELGANS to raise (in-place)
existing two-story, single-family dwelling by approx. 18" over new foundation, with new
egress, three new window wells, two new sets of steps in place of existing, and a new
chimney in place of existing; and installation of a drainage system consisting of leaders,
gutters and drywells.
Located: 1285 Fleetwood Rd., Cutchogue. SCTM#137-4-29.1
Inspected by: Peter Young, Caroline Burghardt
The CAC Supports the application with the recommendation of an I/A septic system, a
drainage plan, and a non-disturbance buffer along the slope between the top of the bluff
and the bottom.
Vote of Council: Ayes: All
Motion Carried
Glenn Goldsmith, President Q� (](� Town Hall Annex
Michael J.Domino,Vice-President �b 'as_ 54375 Route 25
P.O.Box 1179
John M.Bredemeyer IIY Southold,New York 11971
A.Nicholas Krupski cep s�
cr; Telephone(631)765-1892
Greg Williams %�� ly® Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
This Section For Office Use Only
Coastal Erosion Permit Application E
Wetland Permit Application
Administrative Permit
:Amendment/Transfer/Extension AR — 5 2021
Received Application: f-6,24
✓ Received Fee: $ 26x.00
Completed Application: 3.10.2 Southold Town
Incomplete: Board of Trustees
SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date:
/Coordination:(date sent):
�LWRP Consistency Asse s` �tlForm Sent: a�
CAC Referral Sent:
Date of Inspection: •7•Z
Receipt of CAC Report:
Technical Review:
Public Hearing Held: .l •Z1
Resolution:
Name of Applicant Laurie M.Helgans
1285 Fleetwood Road
Address Cutchogue,NY 11935
Phone Number: 51 662-6320
Suffolk County Tax Map Number: 1000 - 137-4-29.1
Property Location: 1285 Fleetwood Road,Cutchogue
(property is located on north side of Fleetwood Road,+/-250' east of Betts Street)
(provide LILCO Pole #, distance to cross streets, and location)
AGENT:, En-Consultants
(If applicable)
Address: 1319 North Sea Road, Southampton,NY 11968
Phone:631-283-6360
C'a 3,)dA
31
Board of Trustees Ap _. ��atiori
GENERAL DATA
Land Area(in square feet): 45,372 sf
Area Zoning: R-40
Previous use of property: Residential,single-family dwelling
Intended use of property: No change
Covenants and Restrictions: Yes X No
If"Yes", please provide copy.
Will this project require a Building Permit as per Town Code? X Yes No
If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review
and Elevation Plans will be required.
Does this project require a variance from the Zoning Board of Appeals Yes X No
If"Yes",please provide copy of decision.
Will this project require any demolition as per Town Code or as determined by Building
Dept. Yes X No
Does the structure(s)on property have a valid Certificate of Occupancy X Yes No
Prior permits/approvals for site improvements:
Agency Date
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
X No Yes
If yes, provide explanation:
Project Description(use attachments if necessary):
Raise(in-place)existing two-story,single-family dwelling by approximately 18 inches over new foundation,with new egress,three
new window wells,two new sets of steps in place of existing,and a new chimney in place of existing;and installation of a drainage
system consiting of leaders,gutters,and drywells,all as depicted on the survey/site plan prepared by Peconic Surveyors,P.C.,last
dated March 1,2021.
Board of Trustees Applic, tion
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
To replace existing foundation and raise existing dwelling thereover by approximately 18 inches.
Area of wetlands on lot: +/-14,141 square feet
Percent coverage of lot: +/-31 oio
Closest distance between nearest existing structure and upland
edge of wetlands: +/-49 feet
Closest distance between nearest proposed structure and upland
edge of wetlands: N/A feet
Does the project involve excavation or filling?
No X Yes
If yes, how much material will be excavated? TBD cubic yards
How much material will be filled? N/A cubic yards
Depth of which material will be removed o iWd: +/-3 feet
Proposed slope throughout the area of operations: N/A
Manner in which material will be removed or deposited:
Standard construction practices.
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
reason of such proposed operations (use attachments if appropriate):
The project consists of the proposed in-place raising of an existing 2-story dwelling over a new foundation with minor
associated maintenance activities,including replacement(in the same locations)of a chimney and two sets of stairs;
removal of an existing cellar entrance;and installation of three new window wells. There is associated with the project no
proposed change to the dwelling's existing interior or bedroom count;no clearing or re-grading;and no change in lot
coverage. The existmg site conditions will thus remain unchanged except for the property's increased ability to capture
and retain potential runoff resulting from the proposed installation of a new drainge system consisting of leaders,gutters,
and drywells. Therefore,the project will not have any significant adverse impacts on the adjacent well-vegetated bluff,
vegetated tidal marsh,or todal waters of East Creek.
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part I based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1 You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item
Part I-Project and Sponsor Information
Name of Action or Project.
Helgans Renovation
Project Location(describe,and attach a location map):
1285 Fleetwood Road,Cutchogue,Town of Southold,Suffolk County,NY; SCTM#1000-137-4-29.1;property is
located on north side of Fleetwood Road,+/-250'east of Betts Street,maps provided.
Brief Description of Proposed Action:
Raise(in-place)existing two-story,single-family dwelling by approximately 18 inches over new foundation,with new
egress,three new window wells,two new sets of steps in place of existing,and a new chimney in place of existing;and
installation of a drainage system consiting of leaders,gutters,and drywells,all as depicted on the survey/site plan
prepared by Peconic Surveyors,P.C.,last dated March 1,2021.
Name of Applicant or Sponsor: Telephone: 516-662-6320
Laurie M.Helgans E-Mail. fletwood@optonline.net
Address:
1285 Fleetwood Road
City/PO: State. Zip Code:
Cutchogue NY 11935
1. Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2. If no,continue to question 2 X
2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES
If Yes, list agency(s)name and permit or approval:
NYS DEC X
3.a.Total acreage of the site of the proposed action? 45,372 sf
b.Total acreage to be physically disturbed? 13,347 sf
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 45,372 sf
4. Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑Commercial ®Residential(suburban)
❑ Forest ❑Agriculture ®Aquatic ❑ Other(specify):
❑Parkland
Page 1 of 4
e
5. Is the proposed action, NO YES N/A
a.A permitted use under the zoning regulations? X
b. Consistent with the adopted comprehensive plan? X
6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape
X
7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? NO YES
If Yes,identify: Name-Cutchogue Harbor,Pecomc Bay&Environs,Reasons Significant coastal fish&wildlife habitat,
Protect public health,water,vegetation&scenic beauty,Agency Southold Town,Suffolk County,Date 3-24-99,7-12-88 X
8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES
X
b.Are public transportation service(s)available at or near the site of the proposed action? X
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action9 X
9.Does the proposed action meet or exceed the state energy code requirements9 NO YES
If the proposed action will exceed requirements,describe design features and technologies.
X
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: X
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: X
12.a Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places?
b.Is the proposed action located in an archeological sensitive area X
X
13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal, state or local agency? X
b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
14. Identify the typical habitat types that occur on,or are likely to be found on the project site Check all that apply.
® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
® Wetland ❑Urban ® Suburban
15. Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? X
16. Is the project site located in the 100 year flood plain? NO YES
X
17 Will the proposed action create storm water discharge,either from point or non-point sources? YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO❑YES
b Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: ❑NO❑YES
Page 2 of 4
18. Does thero os _. ... ............_._.._ .._... _
p p ed action include construction or other activities that result in the impoundment of NO YES
water or other liquids(e.g.retention pond,waste lagoon, dam)?
If Yes,explain purpose and size: X
19. Has the site of the proposed action or an adjoining property been .. ......
the location of an active
or closed NO YES
solid waste management facility?
If Yes, describe: X
20. Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,dcscribc;
w........ _.. ...... _-
. ---mm - - X
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: Robert E.Hemnann,Coastal Mgmt. lista
S eci
.....1? � Date:_....
March 2,2021-------.--
Signature:
021 „.. ..ww_w_w_w...Signature:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?”
No,or Moderate
small to large
impact impact
may may
occur occur
1 Willthe proposed action create a material conflict with an adopted land use 1
p P p p�� .........
an or zoning
regulations?
2. Will the proposed action result in a change an the use or intensity of use of land? ITmmm W W�
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 mm
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 "
reasonabl availableenergy conservation or renewable energy opportunities?
7. Will the proposed action impact existing: r
a. public/private water supplies?
b.public/private wastewater treatment utilities?
8 tproposed
action
impair
t character or qualityof important historic archaeological,
or aesthetice es
9 Wwaterb dies, groundwater,air quality,flora and fauna)?
natural resources( g.,
ill the wetlands
e.
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur
10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
Part 3-Determination of significance.The Lead Agency is responsible for the completion of Part 3.For every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part I
Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts.Part 3 should also explain how the lead agency determined that the impact
may or will not be significant. Each potential impact should be assessed considering its setting,probability of occurring,
duration, irreversibility, geographic scope and magnitude.Also consider the potential for short-term, long-term and
cumulative impacts.
0 Check this box ifou have determined based on the information and d a mmmmmnalysis 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 theproposedaction will not result in any significant adverse environmental impacts.
.. pµIF I'll
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Dame of Lead agency Date
�P
Print or1 e N�iilc
� yp +E„Nieslions able Officer in Lead Agency Title of Responsible Officer
.... - r ... a.
............ ...........
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
Page 4 of 4
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\ NEW SUFFOLK
Board of Trustees Appl_,_�tion
AITTHORIZATION
(Where the applicant is not the owner)
I/We, Laurie M. Helgans ,
owners of the property identified as SCTM4 1000- 137-4-29.1 in the town of
Southold New York,hereby authorizes
En-Consultants 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.
N/A
Property Owner's Signature Q Property Owner's Signature
Laurie M. Helgans
SWORN TO BEFORE ME THIS C� � DAY OF 20
O.
cNh.
4y
No Public , ro�
loll-
" Board of Trustees Appli�a_,-:ion
AFFIDAVIT
Laurie M. Helgans BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF HIS/HER lCiOWLEDGE 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.
sz. M . N/A
Signature of Property Own Signature of Property Owner
Laurie M. Helgans
SWORN TO BEFORE ME THIS � DAY OF����5-� ,20 'a-0
DaeielT.Pinfo
NOfary fupdc,Sfafe of New York
N.010464ffolkroonly
' Notary Public
i
F
}
AP PLICANWAGENUREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The ToWn of So
y1hold'sCode thics 9MMU&S axrnflicts of' on thef and ees.The 6MAGS"of
tthisTorm is trs=vide infoririation+which can alert the town of�Ossbtee conflicts ofb testand aliour itta iake whaiever action is
iteeessary to
avoid sante.
YOUR NAME: Helgans,�Laurie M.
(Last name,first name,griddle initial,unless you are applying to 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,pqmts or child have u rdationihip with any officer or employ
of the Town-ref Southold? "Relatignship"includes by blood,'marriageV or business hitcrem"lusinm imea�est�mean4 a business,
including a partnership,in-which the to%ra officer or employee bw even a parthd ownership of'(or employment by)•a corporation
in which the town officer or employee a wtA more than 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 oftreater than5%of the shares ofthe 6orp6rate stock ofthe applicant
(when,the applicant is a cotpotatiolty,
13}tilt legal or =ficial owner of arty interest in a non-corporate entity(when the
applicant is riot a r�rporation};
C)an of er,'director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this /U day of Q.ca W124L 20,2L
Signattne uw�>L - a✓J
Print Name Laurie M. laanc
Form TS 1
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of
this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME: Herrniann,
(Last name,first name,middle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION. (Check all that apply)
Tax grievance Building
Variance Trustee X
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(If"Other",name the activity.)
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business,
including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES NO X
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
A)the owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
S)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
42jinid '
Submitted this March 20 21
SignaturePrint Nameo Herniram
Form TS 1
r
Glenn Goldsmith,PresidentFOj,4-
�0 CCG, Town Hall Annex
A.Nicholas Krupski,Vice President �� y� 54375 Route 25
John M.Bredemeyer III w P.O.Box 1179
Michael J.Domino o �y Southold,NY 11971
Greg Williams y,�ol �apl ry' Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
March 31, 2021
Robert Herrmann
En-Consultants
1319 North Sea Road
Southampton, NY 11968
Re: Board of Trustees Application of Laurie M. Helgans
1285 Fleetwood Road, Cutchogue
SCTM# 1000-137-4-29.1
To Whom It May Concern:
You are receiving this letter as notice that, in accordance with the Governor's Executive Order
202.1, this application is now scheduled to be heard by the Southold Town Board of Trustees,
via videoconferencing on Wednesday, April 14, 2021 beginning at 5:30 P.M. Please continue to
check the Town's website as the meeting date approaches for the latest meeting agenda and
videoconferencing information.
Also enclosed is an informational notice regarding the videoconferencing meeting and how to
access the online meeting. Please mail a copy of the informational notice along with all other
required paperwork to each of the adjacent property owners. Please keep a copy of said
informational notice for your records so that you can access the meeting in order to have a
conversation with the Board during your application review.
Very Truly Yours,
4� Aa�,�X
Glenn Goldsmith, President
Board of Trustees
NOTICE TO ADJACENT PROPERTY OWNER
BOARD OF TRUSTEES TOWN OF SOUTHOLD
In the matter of applicant:
Laurie M.Helgans SCTM# 1000-137-4-29.1
YOU ARE HEREBY GIVEN NOTICE:
1. That it is the intention of the undersigned to request a Permit from the Board of
Trustees to:
Raise(in-place)existing two-story,single-family dwelling by approximately 18 inches over new
foundation,with new egress,three new window wells,two new sets of steps in place of existing,and a new
chimney in place of existing;and installation of a drainage system consiting of leaders,gutters,and
drywells,all as depicted on the survey/site plan prepared by Peconic Surveyors,P.C.,last dated March 1,
2021.
2. That the property which is the subject of Environmental Review is located
adjacent to your property and is described as follows:
1285 Fleetwood Road,Cutchogue
3. That the project which is subject to Environmental Review under Chapters
96,111 and/or 275 of the Town Code is open to public comment on:
DATE: Wed, April 14, 2021 @ 5:30 PM via Zoom(meeting access info attached)
You may contact the Trustees Office at 765-1892 or in writing.
The above-referenced proposal is under review of the Board of Trustees of the Town of
Southold and does not reference any other agency that might have to review same
proposal.
Laurie M.Helgans
PROPERTY OWNERS NAME: 185 Fleetwood Road
MAILING ADDRESS: Cutchogue,NY 11935
PHONE #: 516-662-6320
AGENT: En-Consultants
MAILING ADDRESS: 1319 North Sea Road, Southampton,NY 11968
PHONE #: 631-283-6360
Enc: Copy of sketch or plan showing proposal for your convenience.
�.
Glenn Goldsmith, President ,jr��0 �4G s Town Hall Annex
A.Nicholas Kru ski Vice President '�� .r ,' ��'�t 54375 Route 25
John M.Bredemeyer III '} z P.O.Box 1179
n, 3
Michael J.Domino =ol,- Q '�{ !��`r' Southold,NY 11971
Greg Williams � �Ol �`a ,' Telephone(631)765-1892
r Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
WORK SESSION & PUBLIC HEARINGS
WEDNESDAY, APRIL 14, 2021
5•.00PM & 5:30PM
A Regular Work Session and Public Board Hearings of the SOUTHOLD TOWN BOARD OF
TRUSTEES will be held on Wednesday, April 14, 2021 with the Work Session beginning at
5:OOPM and Public Hearings beginning at 5:30PM.
Pursuant to Executive Order 202.1 of New York Governor Andrew Cuomo in-person
access by the public will not be permitted. Town residents are invited to attend the public
meetings virtually via the Zoom online platform.
Written comments may also be submitted via email to the Trustees Clerks at
elizabethc@southoldtownny.gov and diane.disalvo@town.southold.ny.us. Said comments will
be considered at the public hearing provided that they are submitted no later than 12:00 P.M.
(Prevailing Time) on the day of the public hearing.
The public,will have access to view and listen to the meeting as it is happening via Zoom. If you
do not have access to a computer or smartphone, there is an option to listen in via telephone.
Further details about how to tune in to the meeting are on the Town's website at
https://www.south oldtownny.Aov/calendar or call the Board of Trustees office at (631) 765-1892
Monday through Friday between the hours of 8:OOAM —4:OOPM.
Options for public attendance:
• Online at the website zoom.us, click on "join a meeting" and enter the information
below.
Zoom Meeting ID: 915 7791 6135
Password: 553396
• Telephone:
Call 1(646) 558-8656
Enter Meeting ID and Password when prompted (same as above).
In order to "request to speak" when the application you are interested in has begun,
please press *9 on your phone and wait for someone to acknowledge your request.
When prompted to unmute your phone press *6.
To view the application files please visit https://www.sodth6ldtownny.gov At the bottom of the
picture on the main screen click on the second button from the right"Town Records,
Weblink/Laserfiche"; go to bottom of page and click on "pg. 2"; click on "Trustees" folder; click
on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on
the name of the application to view the file.
R
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
Name: Address:
SCTM#1000-137-4-27 153 Violet Avenue
Annette Campbell Floral Park,NY 11001
SCTM#1000-137-4-30 PO Box 645
Andrew Fohrkolb Mattituck,NY 11952
SCTM#1000-137-5-9 1330 Fleetwood Road
Clifford&Jill Ohi Cutchogue,NY 11935
STATE OF NEW YORK
COUNTY OF SUFFOLK
Robert E.Herrmann doing business at En-Consultants
1319 North Sea Road
Southampton,NY 11968 , being duly sworn, deposes and says that on the
1st day of April '2021 , deponent mailed a true copy of the Notice
set forth in the Board of Trustees Application, directed to each of the above named
persons at the addresses set opposite their respective names; that the addresses set
opposite the names of said persons are the address of said persons as shown on the current
assessment roll of the Town of Southold; that said Notices were mailed at the United States Post
Office at Southampton , that said Notices were Mailed to each of said persons by
(certified) mail.
x
Robert E.Hemn
Coastal Managment Specialist
Sworn to before me this 5th
TEPHENS
day of APS PUBLIC,2021 NIM H . S
NOTARY PUBLIC
STATE OF NEW YORK
COMMISSION NO . 5015931
QUALIFIED IN SUFFOLK COUNTY
\,_�:N—otarly 15UCft6 EXPIRES AIiGUST g�to' Os?1
U.S.:Postaf Service'
CERTIFIED o RECEIPT
DomesticEr
�
I ,
OFFCL U
p Certified Mail Fee
rU Extra Services&Fees(checkbm;add fee as appropdatal
❑Return Receipt(hardoopy) $ru J
❑ReturnReceipt(electronic) $ s -• �y
C3 ❑Certified Mall Restricted Delivery $ i
0 ❑AduftSignature Required $ _
❑Adult Signature Restricted Delivery$ ,
O Postage . ;
e0 $
tiTotal P `} i
Er Sent Tc Annette Campbell 0S'
a
E3 SveeN 153 Violet Avenue L________�
Floral Park,NY 11001 i
■ ®
CERTIFIED o ■
T.
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ti
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C3 Certified Mail Fee TO
$
Extra SBN(Ce9&Fees(checkbox,eddfeees appropriate) �T_ •��' �',
i ❑
Return Receipt(hardcopy)
4 O ❑Return Receipt(electronic) z)
O ❑Certiiled Mall Restricted Delivery $ 0
I3 []Adult Signature Required $- 1J1
[]Adult Signature Restricted Delivery$ `
p Postage
ru re
ru
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$e, Andrew Fohrkolb
o PO Box 645 -
�`
L
Mattituck,NY 11952
--------------
PostalTM
o
rRECEIPT
I Domestic, Only
ru W.3.1ini
E
E=lCertified Mall Fee
$
rU Extra Services&Fees(check bar,add fee as appropriate 4iL,
❑Retum Receipt(hardcopy) $
rU ❑Retum Receipt(electronic) $ Postmark
C3 ❑CertigedMail ResWclad Delivery $ i
O ❑Adult Signature Required $ t
❑Adult Slgnature Restricted Delivery$ -
O Postageru
ru $ru
$
Er sen, Clifford&Jill Ohi ;
1330 Fleetwood Road
der:
sve Cutchogue,NY 11935 . `l'rid
ciy -------
[1(0)
Glenn Goldsmith,President { O S FF04
�0 C� Town Hall Annex
A.Nicholas Krupski,Vice President b1�� Gym 54375 Route 25
John M.Bredemeyer III y P.O.Box l 179
Michael J.Domino ry� Southold,NY 11971
Greg Williams p! (Y Telephone(631)765-1892
HCl Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application of
LAURIE M. HELGANS
COUNTY OF SUFFOLK
STATE OF NEW YORK
AFFIDAVIT OF POSTING
DO NOT COMPLETE THIS FORM UNTIL AFTER POSTING REMAINS IN PLACE FOR
AT LEAST SEVEN DA YS PRIOR TO THE PUBLIC HEARING DATE
I, Robert E. Herrmann , residing at/dba En-Consultants,
1319 North Sea Road, Southampton, NY 11968
being duly sworn, depose and say:
That on the 6th day of April , 2021 , I personally posted the property known as
-1285-Fleetwood-Road-, Cutchogue, SCIM #1000-137-4-29.1
by placing the Board of Trustees official noticing poster where it can easily be seen from the
street, and that I have checked to be sure the noticing poster has remained in place for a full
seven days immediately preceding the date of the public hearing. Date of hearing noted thereon
to be held Wednesday,April 14, 2021.
Dated:
(signa ure
Sworn to before me this
day of20 o'ti/
KIM H . STEPHENS
NOTARY PUBLIC
4Notaryyylic STATE OF NEW YORK
COMMISSION N0 . 5015931
QUALIFIED IN SUFFOLK CO NTY
EXPIRES AUGUST 2 , 20 `q
EN-CONSULTANTS
April 14,2021
APR 2 1 2021 I
Town of Southold Southold Town
T
Board of Trustees oard a rustee
54375 Main Road
Post Office Box 1179
Southold,New York 11971
Re: Laurie M.Helgans
1285 Fleetwood Road, Cutchogue
SCTM#1000-137-4-29.1
Dear Board of Trustees:
In accordance with the memo regarding Chapter 55 Notice of Public Hearings, attached for your files are green
signatures cards received related to the April 14, 2021 hearing for the above referenced application
Sincerel ,
m St ens
Enc.
1319 North Sea Road Southampton,New York 11968 1 p 631.283.6360 1 f 631.283.6136 www.enconsultants.com
environmental consulting
SECTION
XFTE . . DELIVERY
COMPLETE
- - -- g Si
■ Complete items 1,2,and 3. 13 Agent
■ Print your name and address on the reverse X 0 Addressee
so that we can return the card to you.
C�
■ Attach this card to the back of the mallpiece, B. eceived by(Prig dName), �of Del'v _
or on the front if space permits. 1
1. Article Addressed to: D. Is delivery ?cress different from item 1? Okyes
if YES,a ter deJfiry address below: ❑No
Annette Campbell �` r
i 153 Violet Avenue 3. Servide Type ❑'Priority Mad Express&
❑Adult Signature +• - Q Registered Mail-
--
ail-
-doral Park,NY 11001 ❑ It Signature Restdcted De very ❑Registered
elliivery d Mail Restricted
ertified WHO
❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery ,Merchandise rm
G _•__ ______ ----- — eiivery,Restricted Delivery,;❑Signature Confirmation
2, ^-••-•-'- ��❑,SlgnatureConfirmation
0 0 2 210 4 12 6 q d Delivery
7 p 19 -2 2 8 0 Restricted Delive -tRestrlcte
ry a
1 { (over$500) 4,..,,.. ..±_
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt ;
••�
■ Complete items 1,2,and 3. A. Signature
■ Print your name and address on the reverse E3 Agent
so that we can return the card to you. X ❑Addressee
B. Received by(Printed Name) C. Date of Delivery
■ Attach this card to the back of the,mailpiece, �—, �� -q—LD– � l
or on the front if space permits. ��1�0� 1 t
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
If YES,enter delivery address below. p No
Andrew Fohrkolb
PO Box 645 3. Service Type ❑Priority Mail Express&
Mattituck NY, 11952 ❑Adult Signature ❑Registered Mail*m
❑Ault Signature Restricted Delivery ❑Renlstered Mail Restricted
•alive ed WHO Delivery
! _ ❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
_ _ __ _ , c^'^^•^^i Delivery Restricted Delivery .❑Signature ConfirmationTm
❑Signature Confirmation
?019' 2280; -00'02 2114 1283: -Restricted affil Restricted Delivery Delivery i
i
t I h'n Receipt t
R
Domestic eurp
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domesr
■ Complete items 1,2,and 3. A. Signature
E3 Agent '
k ■ Print your name and address on the reverse X V� ❑Addressee
so that we can return the card to you.
■ Attach-this card to the back of the mallpiece, l iB. Received (Printed Name) C. Date of pelivery
or on the front if space permits. ®jpq -2j
1. Article Addressed to: D. Is delivery address different from item 1? 13Yes
If YES,enter delivery address below: 0 No
}
Clifford&Jill Ohi ;
If i 1330 Fleetwood Road 3. Service Type ❑Priority Mail Express&"•$
❑Adult Signature ❑Registered Mailm
Cutchogue,NY 11935 ❑Adult Signature Restricted Delivery QRegistered Mall Restricted,
ertified Mail& Delivery
❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
— —L---- -- ^- --�eiivery Restricted De`2104
,❑Signature Confirmatlon7m
<- ❑Slgi�ature Confirmation
7.01.`9 .22-811 ! 0 0 0 2_ 21 4 127 6 ' _IIIf Restricted tiellvery"` Restricted Delivery
o
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
r-
it
I
Glenn Goldsmith,President }0�0 COGy�, Town Hall Annex
A.Nicholas Krupski,Vice President 54375 Route 25
John M. Bredemeyer IIIA, P.O. Box 1179
Michael J.Domino oy �� Southold,NY 11971
Greg Williams Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
WORK SESSION & PUBLIC HEARINGS
WEDNESDAY, APRIL 14, 2021
6:OOPM & 5:30PM
A Regular Work Session and Public Board Hearings of the SOUTHOLD TOWN BOARD OF
TRUSTEES will be held on Wednesday, April 14, 2021 with the Work Session beginning at
5:OOPM and Public Hearings beginning at 5:30PM.
Pursuant to Executive Order 202.1 of New York Governor Andrew Cuomo in-person
access by the public will not be permitted. Town residents are invited to attend the public
meetings virtually via the Zoom online platform.
Written comments may also be submitted via email to the Trustees Clerks at
elizabethc@southoldtownny.gov and diane.disalvo@town.southold.ny.us. Said comments will
be considered at the public hearing provided that they are submitted no later than 12:00 P.M.
(Prevailing Time) on the day of the public hearing.
The public,will have access to view and listen to the meeting as it is happening via Zoom. If you
do not have access to a computer or smartphone, there is an option to listen in via telephone.
Further details about how to tune in to the meeting are on the Town's website at
https://www.southoldtownnV.gov/calendar or call the Board of Trustees office at (631) 765-1892
Monday through Friday between the hours of 8:OOAM —4:OOPM.
Options for public attendance:
• Online at the website zoom.us, click on "join a meeting" and enter the information
below.,_
Zoom Meeting ID: 915 7791 6135
Password: 553396
• Telephone:
Call 1(646) 558-8656
Enter Meeting ID and Password when prompted (same as above).
In order to "request to speak" when the application you are interested in has begun,
please press *9 on your phone and wait for someone to acknowledge your request.
When prompted to unmute your phone press *6.
To view the application files please visit: https://www.southoldtownnV.gov At the bottom of the
picture on the main screen click on the second button from the right"Town Records,
Weblink/Laserfiche"; go to bottom of page and click on "pg. 2"; click on "Trustees" folder; click
on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on
the name of the application to view the file.
NOTICE F HEARING
NOTICE IS HEREBY GIVEN that a Public Hearing concerning this property will be held by the Southold Town Board of Trustees
via the online Zoom platform.
OWNERS) OF RECORD: LAURIE M. HELGANS
SUBJECT OF PUBLIC HEARING: For a Wetland Permit to raise in-place existing
(1,2710sq.ft. footprint) two-story, single family dwelling by approximately 18 inches over new
foundation, with new egress, three new window wells, two new sets of steps in place of
existing, and a new chimney in place of existing; and for the installation of a drainage system
of leaders, gutters, and drywells. Located: 1285 Fleetwood Road, Cutchogue. SCTM# 1000-
137-4-29.1
TIME & DATE OF PUBLIC HEARING:
Wednesday, April 14, 2021 — at or about 5:30P.M. — To access the Zoom meeting please
see the meeting agenda located in the Trustees section of the Town website. If you have an interest
in this project, you are invited to view the Town file(s) through the Southold Town website. To view
the application files please visit: https://www.southoldtownny.gov At the bottom of the picture on
the main screen click on the second button from the right "Town Records, Weblink/Laserfiche"; go to
bottom of page and click on "pg. 2"; click on `;Trustees" folder; click on "Applications"; click on
"Pending"; all files are listed by name in alphabetical order. Click on the name of the application to
view the file.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
Q� 1000 137 4 29.1 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN
rsU trrcT Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No
a What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off
(include Total Area of all Parcels located within 45,372 sf Generated by a Two(2")Inch Ramfall on Site?
the Scope of work for Proposed Construction) (S.F./Acres)) (This item will include all run-off created by site X
b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all
El
and/or Ground Disturbance for the proposed S f Site improvements and the permanent creation of
construction activity? (5 F/Acres) impervious surfaces.)
2 Does the Site Plan and Survey Show All Proposed X PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indidi cating Size&Locations This
item shall include all proposed Grade Changes and
Raise(in-place)existing two-story,single-family dwelling by Slopes Controlling Surface Water Flow,
approximately 18 inches over new foundation,with new egress, 3 Does the Site Plan and/or Survey describe the erosion / ❑
three new window wells,two new sets of steps in place of and sediment control practices that will be used to LX,
existing,and a new chimney in place of existing;and installation control site erosion and storm water discharger.This
of a drainage system consitmg of leaders,gutters,and drywells, Item must be maintained throughout the Entire
all as depicted on the survey/site plan prepared by Peconic Construction Period
Surveyors,P.C.,last dated March 1,2021. 4 Will this Project Require any Land FillinGrading or ❑
Excavation where(here is a change tot ,a Natural
Existing Grade involving more than 200 Cubic Yards
of Material within any Parcell
5 Will this Application Require Land Disturbing Activities ❑ \/
Encompassing an Area in Excess of Five Tousand LXX
(5,000 S.F.)Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site?Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements or within One Hundred(100')feet of a Wetland or ix
Submission of a SWPPP is required for all Construction activities involving soil Beach?
disturbances of one(1)or more acres-including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes Elare part of a larger common plan that will ultimately disturb one or more acres of lands, which Exceed Fifteen(15)feet of Vertical Rise to
Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance
the DEC has determined that a SPDES permit is required for storm water discharges_ Q
8(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit Will Driveways,Parking Areas or other impervious
for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X
1.The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way?
submitted to the Department prior to the commencement of construction activity
2 The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ❑
required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliance with the terms and conditions of this permit In addition,the SWPPP shall Areas(This item will NOT include the installation of Dnveway Aprons)
identify potential sources of pollution which may reasonably be expected to affect the
quality of storm water discharges NOTE:If Any Answer to Questions One through Nine is Answered with a Check Mark
3 All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S F &1 Acre in area,
component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of
that is knowledgeable in theprinciples and radices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit
g P g (NOTE. A Check Mark(X)and/or Answer for each Question is Required for a Completed Application)
STATE OF NEW YORK,
CouNTY OF Suffolk SS
That I, Robert E.Herrmarm ______ being duty sworn,deposes and says that he/she is the applicant for Permit,
(Name of individual signing Document)
And that he/she is the Agent
- ---------------------------- -----------------------------------------------------------------------------------------------------
(Owner,Contractor,Agent,Corporate Officer,etc
Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to
make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and
that the work will be performed.in the manners set forth in the application filed herewith.
Sworn to before me this,
----------- 2nd----- - - - --------- of,_March ---------------------- ,20 21--- 1
Notary P is - --- ---- -- ----- --- ----------------Kim----------H --S T E P H_- N S-------------------- P��
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NOTARY
------
NOTARY PUBLIC (signator of pphcant)
FORM - 06/10 STATE OF NEW YURK
COMMISSION NO . 5015931
QUALIFIED IN SUFFOLK COUNTY
EXPIRES AUGUST 2 , 2041
Town of Southold F
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).
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# 137 - 4 _ 29.1
PROJECT NAME Laurie M.Helgans
The Application has been submitted to (check appropriate response):
Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees VN
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:
Raise(in-place)existing two-story,single-family dwelling by approximately 18 inches over new foundation,with new egress,three new
window wells,two new sets of steps in place of existing,and a new chimney in place-of existing;and installation of a drainage system
consiting of leaders,gutters,and drywells,all as depicted on the survey/site plan prepared by Peconic Surveyors,P.C.,last dated March
1,2021.•
Pursuant to Southold Town Code§268-5("Review of Actions")and the corresponding definitions of"action" and"minor action"by
§286-3 ("Definitions"),the proposed work meets the following definition of a minor action and should thus be determined to be exempt
from waterfront consistency review pursuant to chapter 268: 'B.Replacement,rehabilitation or reconstruction of a structure or facility,
in kind,'on the same site(in place),including upgrading buildings to meet building or fire codes,except for structures in areas
designated by the Coastal Erosion Hazard Area(CEHA)law...".
Location of action: 1285 Fleetwood Road, Cutchogue
Site acreage: 45,372 sf
Present land use: Residential,one-family dwelling
Present zoning classification: R-40
2. If an application for the proposed action has been filed with the Town of Southold agency, the following
information shall be provided:
(a) Name of applicant:' Laune M.Helgans
(b) Mailing address: 1285 Fleetwood Road
Cutchogue,NY 11935
(c) Telephone number: Area Code 516-662-6320
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
Yes 11No® If yes, which state or federal agency?
C. Evaluate the project to the following policies by analyzing how the project will further support-or not
support the policies. Provide all proposed Best Management Practices that will further each policy.
Incomplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy 1. Foster a pattern of development in the Town of Southold that enhances community character,
preserves open_space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and
minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation
criteria.
❑Yes ❑ No ® 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
❑ Yes 11 No ® Not Applicable
\I
1
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.
❑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.
❑ Yes ❑ No® Not Applicable
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria.
❑ Yes ❑ No ® Not Applicable
PUBLIC COAST POLICIES
Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public
resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation
criteria.
❑ Yes ❑ No® Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses and promoLU siting of new water-dependent uses in
suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria.
❑ Yes ❑ No ® Not Applicable
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary
and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria.
❑ Yes ❑ No ® Not Applicable
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62
through 65 for evaluation criteria.
❑ Yes 1:1 No ® Not Applicable
Attach additional sheets if necessary
Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP
Section III - Policies; Pages 65 through 68 for evaluation criteria.
❑ Yes ❑ No ® Not Applicable
4-
PREPARED BY TITLECoastal Management Specialist DATE March 2,2021
Robert E. He ann
Amended on 811105
EN-CONSULTANTS
March 9, 2021
F � � QV ED
f
Town of Southold MAR 1 0 2021
Board of Trustees
54375 Main Road Sour: fd Torn
r3oard cf Trustees
Post Office Box 1179
Southold,New York 11971
Attn.: Diane DiSalvo
Re: Laurie M. Helgans
1285 Fleetwood Road, Cutchogue
SCTM#1000-137-4-29.1
Dear Ms.DiSalvo:
As per our discussion regarding the above referenced,because the project does not qualify for an
Administrative Permit attached is the additional $150 application fee for a full Wetlands Permit and the
$50 inspection fee. Should anything additional be required,please contact our office.
S' e. y,
Kim Stephe
Enc.
e
1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631283 6136 www.enconsultants.com
environmental consulting
EN-CONSULTANTS
March 2, 2021
Town of Southold D E C E 9 V
E- 0
Board of Trustees
54375 Main Road MAR5 2021
Post Office Box 1179
10
Southold,New York 11971
Southold Town
Re: Laurie M. Helgans Eto?rd of Trustees
1285 Fleetwood Road, Cutchogue
SCTM#1000-137-4-29.1
Dear Board of Trustees:
In regard to the above referenced property, enclosed are the following for the Board of Trustees review:
1. Four(4)Wetland Permit Applications including:
a) Authorization&Disclosure Forms;
b) Short Environmental Assessment Form;
c) Erosion, Sedimentation& Storm-Water Run-off Assessment Form.
d) LWRP Consistency Assessment Form.
2. Two(2) Sets of Photographs.
3. Four(4) surveys prepared by Peconic Surveyors,P.C.,last dated March 1,2021.
4. Application fee of$'100.00.
I trust this information shall allow you to process our permit request. Should any additional information
be required,please do not hesitate to contact our office.
Sincere ,
Robert E. emnann
Coastal Management Specialist
/khs
Enc.
1319 North Sea Road I Southampton,New York 11968 p 631.283 6360 f 631.283.6136 www.enconsultants com
environmental consulting