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HomeMy WebLinkAboutTR-9748A Glenn Goldsmith,President Sy� Town Hall Annex A. Nicholas Krupski,Vice President ,`O l0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold,New York 11971 Michael J.Domino G • Telephone(631) 765-1892 Greg Williams Y Fax(631) 765-6641 �y00UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1848C Date: August 17, 2021 THIS CERTIFIES that the construction of a 341sq.ft. composite deck approximately 30"over an existing patio with two sets of 5'x6' stairs; install a 5'x35' handicap ramp and 285'-trellis above deck; At 8630 Great Peconic Bay Blvd.,Laurel Suffolk County Tax Map #1000-126-5-1 Conforms to the application for a Trustees.Permit heretofore filed in this office Dated October 29, 2020 pursuant to which Trustees Administrative Permit#9748A Dated November 18, 2020,was issued and Amended on April 14, 2021 and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a 341sq.ft. composite deck approximately 30"over an existing patio with two sets of 5'x6' stairs; install a 5'x35' handicap ramp and 285' trellis above deck. The certificate is issued to John Abbottowner of the aforesaid pro erty. e Authorized Signature Glenn Goldsmith,President *QF SO(/ry Town Hall Annex A. Nicholas Krupski,Vice President ,`O� Ol0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III lx[ 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 DATE OF INSPECTION: S/,7/�! INSPECTED BY: G, Go Us,"iA Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale-line/silt boom/silt curtain 1St day of construction '/ constructed Project complete, compliance inspection COMMENTS: �;,y� +n oCG�T�cx�,c,� a,v;7`� �r�+_1 � �I��/� dln� �a��S S�'aw►��� CERTIFICATE OF COMPLIANCE: Glenn Goldsmith,President �QF SOJI& Town Hall Annex A.Nicholas Krupski,Vice President ,`O �1 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III [ J Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES April 15, 2021 TOWN OF SOUTHOLD Gary Fisher P.O. Box 311 Laurel, NY 11948 RE: " JOHN ABBOTT 8630 GREAT.PECONIC BAY BLVD., LAUREL SCTM# 1000-126-5-1 Dear Mr. Fisher: The following action was taken at the Southold Town Board of Trustees regular.meeting held on Wednesday, April 14, 2021: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Administrative Permit#9748A to install a 5'x35' handicap ramp and 285' trellis above deck; and as depicted on the site plan prepared by James J. Deerkoski LPE, dated December 20, 2020 and stamped approved on April 14, 2021. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you-have any questions, please do not hesitate to contact this office. Sincerely, "C� t��/" Glenn Goldsmith President, Board of Trustees GG/dd GONSTRUGTION NC)TES I. ALL ELECTRICAL WORK SHALL BE BOARD OF FIRE UNDERWRITERS APPROVED. :� 42), 11111111oI � 2. ONGRETE FOOTIN65 ARE TO REST ON FIRM VIRGIN SOIL. FOOTINGS ARE DE5I6NED A55UMING A MINIMUM OF (2) TON PER 50. FT. 501L BEARING CAPACITY, SUBJECT TO TESTS, INSPECTION AND VERIFICATION. NEW 12"x60" 3. CONCRETE 15 TO BE 3000 LB5. PER 50. INCH OOMFRE551 VE STRENGTH AT 28 DAYS. ALL WORK TO BE IN ACCORDANCE P. GONG. PIER WITH A.G.I. STANDARDS. 4. STRUCTURAL LUMBER TO 13E MINIMUM 1100 P.5.1. IN BENDING m_ UNDER NORMAL LOADING, HEM-FIR OF DOUGLA5 FIR TO BE `U USED. _ �- 5. ALL HEADERS ARE TO BE (2) 2X65 UNLE55 OTHERWI5E I I I I li - �" INDICATED. HEADERS TO REST ON DOUBLE STUD POSTS, EACH NEw BEARING SIDE. PROVIDE 50LID VERTICAL SUPPORTS UNDER 2x D AGQ POST ; v P. GONG. FT'G ALL BEAMS. 6. TIES; UNLE55 SHOWN OTHE;RWI5E, AUXILIARY RAFTER TIES SHALL (2) 2"x8° d A m BE 2x4's @ 16" O.G. TIED 13ACK TO A MINIMUM Of (3) CEILING ACO GIRDER BEAMS WHEN SUCH BEAMS AND RAFTERS ARE PERPENDICULAR l l w lu i' d v N T TO EACH OTHER. I z z I z I z I' r 1. ALL WOOD OR STEEL POSTS ARE TO BE PROPERLY BRACED 0a e 0�1 1 O AND ANCHORED. I I I Q I (� ly N N N N j TOWN-CITY OR VILLAGE ZONING LAW5 NEw 8. ANY VARIANCE OR SPECIAL EXCEPTION REQUIRED FOR THE (2) 2°x8° I I; L4— CONSTRUCTION ACCORDING TO THESE PLANS 15 THE 50LE ACO GIRDER RESPONSIBILITY OF THE OWNER. ' 5' 'o" GENERAL NOTES ' IIIIII. CONTRACTOR SHALL CHECK AND VERIFY ALL CONDITION5 AT THE CONSTRUCTION 51TE BEFORE BEGINNING ANY PHY51CAL WORK. HE SHALL FAMILIARIZE HIMSELF WITH THE INTENT OFtill THESE PLANS, SPECIFICATIONS AND ALL OTHER INFORMATION LINE OF WALL BELOWINCLUDING GOVERNING CODES, LAW5, ORDINANCES, ZONING AND - _ i------------------------------ -----REGULATIONS. -- - -- -- NEw-- o r- rum --5LD'G c4 A s DOOR � i i z_ (2) 2"x1O"� AGQ 61RDERI --------------------------------------4II II II II2. ALL WORK SHALL CONFORM TO THE 2010 NEWYORK STATE ® ® ; LINE of FLOOR ABOVE ; - ,I 1I iL BUILDING CONSTRUCTION CODE, THE 2010 N.Y.5, ENERGY NEIN 6"x16„ CONSERVATION CONSTRUCTION CODE AND ALL LOCAL CODES, Q GONG. BLOCK PIER ON I Q 20 x30 xl2 DEEP NEW 8"xI6„ I r- EXT'G RULES RE6ULATION5 AND ZONING LAW5. �C P. GONG. FOOTING ' II II II II O ' GONG. BLOCK PIER ON ' � WOOD DECK 14"x5o"x 12" DEEP 3. IF, DURING THE COURSE OF CONSTRUCTION, A CONDITION EX15T5 P. GONG. FOOTING cv �� I N ; —� I I I II L Q WHICH D15AGREE5 OR CONFLICTS WITH WHAT 15 INDICATED ON I ' ' ' c� 1=XT'G ASE 5-1/ " 1 " REM IZE AND W/ — :-�, I I 3 I _� O GQ IGDR I -- (N{-.1^� 5-1/4" X 14" WOMANIZED PARALL,Af•'i O2 xl0 AGQ GDR —� I 3 2 xl0 � s_ -- -- -- THESE PLANS AND SPECIFICATIONS, THE CONTRACTOR SHALL I I , I , ' - ---------J NEW -_� I I L- -J i —1� ------ LINE OF EXT'G DECK ABOVE —Id" STOP WORK AND NOTIFY THE DESIGNER/ARGHITEGT. SHOULD THE #4 REBAR _ _ I , i T lU Y EVERY OTHER GUT EXT'G ' — " 11 I I _ CONTRACTOR FAIL TO FOLLOW TH15 PROCEDURE, AND CONTINUE I — - 18 -II = 1 n n u n II II a 111811-I lil' ,I II n u Q < AND BLOCK P.G. PATIO N N WITH THE WORK, HE SHALL A55UME ALL RESPONSIBILITYV TO ALLOW FOR II I 1 11 11 11 FOOTINGLU,- , z LIABILITY ARISING THERE OF. 1 , A� ® EXT G , I I I 1 I Q I( jII, II II I, III II II I, I„I 11 11 I, II II II II II U II I 4. THESE DRAWIN65 AND SPECIFICATIONS HAVE BEEN PREPARED P. GONG. 0.0PATIOBY THE DE5IGNER/ARGHITEGT AND TO THE BEST OF H15 -'KNOWEDGE AND BELIEF MEET THE REQUIREMENTS OF THE N.Y.5. A F0— O ENERGY CONSERVATION CONSTRUCTION GORE. _ I I I-- — — — _ — — — — — — — — — — —� = I _ u II II II II n II n II II II n II n I �Q Z _ I I I I I I � � I i _ __. -___ _ - II II II II II II II II II II II II II II II II II II II � 5. CONTRACTOR SHALL EXERCISE GOOD JUDGEMENT0 IN ORDER TO MINIMIZE DAMAGE TO ANY EXISTING AREAS AND CONDITIONS. „ I r II II II II II II II II II II I I II II II I I --� I I I I I I (3)2 xl0 AGQ GDR (3)2 xl0 AGQ GDR , NEW (3) 2X10 ACO NEW (3) 2XIO ACO r— II 11 II m Z EXI5TING WORK DAMAGED AS A RESULT OF NEW CONSTRUCTION __ . __ __ __ __ U._J1._.u._JL_u__JL_1L_IL_ _����I_�___ __ -- SHALL BE RESTORED TO THEIR ORIGINAL CONDITION, AT NO - L-1- L-L_1_' ----------------------- '----------------------- -J ADDITIONAL C05T TO THE OWNER. r � a'_I2�� ��_22�� � � ��_I2�� ��_22�� � I 11 IL z 6. DO NOT 50ALE DRAWING5, WRITTEN DIMEN51ON5 SUPERSEDE 50ALED DIMENSIONS. (N.T5.) '-6" Iq'-6" o U m 1. DE5I6NER/ARGHITEGT HAS NOT BEEN RETAINED FOR ON 51TE INSPECTION OR OBSERVATION OF CONSTRUCTION. REVISIONS 8. DRAWIN65 AND SPECIFICATIONS AS IN5TRUMENT5 OF SERVICE ARE AND SHALL OF THE DE5IGNER/ARCHI EETAIN WHETHER THE OEPERTY EPROJECT FOR WHICH THEY FOUNDATI ON FLAN I7 GK FLAN 2ND FLOOR FLAN ARE MADE 15 EXECUTED OR NOT. THEY ARE NOT TO BE USED ON ANY OTHER PROJECTS OR SITES OR EXTENSIONS AND 5GALE: I/4" = I'-O" 5GALE: I/4" = I'-O" 50ALE: I/4" EXPANSIONS TO THI5 PROJECT EXCEPT BY WRITTEN AGREEMENT ALONG WITH APPROPRIATE. COMPENSATION TO THI5 ARCHITECT. DECK DETAILS (NOTE USE TRIPLE ZING CONNECTORS) a. WHERE JOIST HANGER5 OR, STEEL FRAME CARRIERS ARE USED �ERPI. r AND WHERE "TECO" TYPE CONNECTORS OR GUSSETS ARE P RAILING - GALLED FOR ON THESE •® o . �P O 10. DRAWINGS, ONLY FASTENERS RECOMMENDED BY THE •®• ' °• POST MANUFACTURER ARE TO BE USED. m o Z (j) ry r' Z 2-MINIMUM son Strong-Tie Stm ��j J .rAf :. '.•:•. ••• � I. PROVIDE A STORM DRAINAGEoEcovrlt SYSTEM FOR ALL ROOFS AND :. ' . .., p DRIB gTle •o z' °�z oz . ., ..; FSSI P PAVED AREAS. 4. ' APPROVED J "� a '' Simpson Strong-Tie BY Simpson Strong-TIe 12. THIS DESIGNER/ARGHITEGT SHALL NOT BE RE5PON51BLE FOR ABU44 PG BOARD OF i RUSTEES DRAWN BY:BY: J. TURNER CONSTRUCTION MEANS Simpson Strong-Tie TOWN OF SOUTHOLD SCALE: AS NOTED DBTI 13. METHODS, TECHNIQUES, 5EQUENCE5 AND PROCEDURES EMPLOYED DATEAPRGHCD BY: BY CONTRACTORS IN THE PERFORMANCE OF THEIR WORK, AND i� ��+ ZOZ� E c C NI [ DATE: 12/20/20 SHALL NOT BE RE5PON51B1_E FOR THE FAILURE OF ANY o JOIST �,,w, SHEET NUMBER CONTRACTOR TO CARRY OUT WORK IN ACCORDANCE WITH H15 0 — CONTRACT WITH THE OWNER. AND IN ACCORDANCE WITH THESE 3,0 A P 9 - 5 2021 PLANS AND SPECIFICATIONS. "TECO" JOIST HANGER Southold Town LEDGER SECURE TO STRUCTURE w/ 1/25/6 LAG BOLTS ® 16" O.G. Board of Trustees LOB #: DDG-20-0008 � m I- Q m � HOUSENTO REMAIN EXT16 V }- 3' HIGH RAILING � �Q � JjCL ., EXT'6 " to TRELLIS 5/4" DECKING ON -� 2" X 8" AGQ 2X8 ACG D.J. ® I6"O.C. Z 2�L81'SAGQ ® 12" O.G. � Q O O aOa 111 !dl C ---- ® 12' O.G. rO txI OrN (3) 2"x10" AGQ IRDER — N AGQ GIRDER (() �y 51MPSON AGQ GIRDER H � f1 1'1 1"1 " 5052-3/6 -1N COLUMN GAP 6 X6 1: F- ACO POST i i i i i i 8" 50. DECORATIVE i i i i i NEW COLUMN WRAP 3 H16H RAILING W/ GAP AND BASE EXISTING 1 HOUSE TO REMAIN -1,--r TYPICAL L4— °O O 00 00@�� a- NEVi , o0 000°� o o� °oo° �'o o° °0 0 000�J�o�°o°000°00 00 0000°12" DIA. P. GONG. 5ONO TUBE FTG. I TYP. (8 PLACES) I I I I I I I I I �- I — — — — — — — — — — - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - z — — REAR ELEVATION LEFT SIDE ELEVATION � SCALE: 1/4" = 1'-0" SCALE: 1/4" = 1'-0" , LU v A � w 3' HIGH RAILING v A z Lu ILI - LU 5/4" AGQ DECKING Q 2"X6" AGQ D.J. °- z @ 16" O.G. O� O (2)2"x5" Ar-,O ' Q < GIRDER > J ACO 61RDER TO BE HURRICANE GLIP5 Re�loV�AND REPT AGI:v W/ ® EA. RAFTER m LU Q S I MPSON z 3 H16H RAILING P044 POST GAP 411X4" AGQ EXISTING P05T EXT16 HOUSE TO REMAIN O TRELLIS 5/4" DECKING ON .mU 2 X 8 AGQ 2X8 ACO D.J. ® I b"O.C. 0 ® 12" O.G. DETAIL ' REYIs1oNs SCALE: 11/2"=P-011 (5) 2"xl0" C ACO GIRDER SIMPSON HURRICANE CLIPS 51 MP5ON LU5-26 BG52-3/6—� JOIST HANGER ® EA. RAFTER COLUMN GAP EX T'6 ACQ 61RDER AGQ POST TO BE REMOVED AND REPLACED 1^V OeW 5-1/4" X 14" W0MAN12ED PARALLAM EXISTING 8" 50. DECORATIVE— HOUSE TO REMAIN COLUMN WRAP NEW W/ GAP AND BASE 5/4" DECKIN6 ON HURRICANE CLIPS ( 2X8 ACQ D.J. ® I6"O.C. ® EA. RAFTER — _ ,, F_OF _ •,.k. Nr- 2"x10" O(3) ACO 61RDER &RADE 4nX4n AGQ N Q POST (3) 2"x10" POST 4'X4" AGEXT'G GRADE ON 12" DIA P. G. PIER I 14 ACO &IRDER • : P. GONG. PATIO OF A,p ° s o 2 rc�� I I m EXISTING FSSI •" •; ''.'•' BASEMENT SIMPSON NEA 8"x16" PB44 POST BWN ASE z DRABY: J. GONG. BLOCK PIER ON _I — 20"x30"xl2" DEEP (() SCALE: AS NOTED P. GONG. FOOTING 04K'D BY: - - - - - - - - - - - - - - - - - - - 12" DIAc E W E DATE: 12/20/20 P. G. PIER D SHEET NL "SER � APA - 5 2021 SEGTioN A - A _ DETAIL II.2 II Southold Town SCALE: 3/8" = 1'-0" R.oard of Trustees SCALE: I/2"=I'-O" JOB #: DDG20-0008 Glenn Goldsmit residentvOSUFF©��0; Town Hall Annex A. Nicholas I )ski, Vice-President ,��� ���, ` 54375 Route 25 John M. Bredemeyer, III y P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams 0! Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES // TOWN OF SOUTHOLD Date/Time: Le/�/ ���` Completed in field by: _41 Gary Fisher on behalf of JOHN ABBOTT requests an Administrative Amendment to Administrative Permit#9748A to install a 5'x35' handicap ramp and 285' trellis above deck. Located: 8630 Great Peconic Bay Blvd., Laurel. SCTM#: 1000-126-5-1 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: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino /G. Goldsmith N. Krupski G. Williams Other CONSTRUCTION NOTES 5'_o" 5'-6" I. ALL ELECTRICAL WORK 514ALL BE BOARD OF FIRE UNDERWRITER5 APPROVED. I I 2. ONCRETE FOOTIN65 ARE TO REST ON FIRM VIRGIN SOIL. FOOTING5 ARE DE5I6NED A55UMING A MINIMUM OF (2) TON PER I II (� 17- 50. FT. 50IL BEARING CAPACITY, SUBJECT TO TE575, , , , , ,I IN5PEGTION AND VERIFICATION. "x60" 3. CONCRETE 15 TO BE 3000 L65. PER 50. INCH COMPRE551VE NEW 12 , , , 5TREN7TH AT 28 DAY5. ALL WORK TO BE IN ACCORDANCE P. GONG. PIER , , , , if m WITH A.G.I. 5TANDARD5. ,L . I 4. 5TRUGTURAL LUMBER TO BE MINIMUM 1100 P.5.1. IN BENDING UNDER NORMAL LOADING, HEM-FIR OF DOU6LA5 FIR TO BE USED. i i i i i' _ O � u `- 5. ALL HEADERS ARE TO BE (2) 2X8'5 UNLE55 OTHERWISE I I ( I I� tT z }- INDICATED. HEADERS TO REST ON DOUBLE STUD P05T5, EACH NEINi i i i ii — =O IL p BEARING 51DE. PROVIDE 5OLID VERTICAL 5UPPORT5 UNDER 2x DAGa POST IA P. GONG. FT'6 I ( ( I II _-- ALL BEAMS. , , ii = = Q� t z d) a O 6. TIE5; UNLE55 5HOWN OTHERWI5E, AUXILIARY RAFTER TIES 5HALL ()2"x8" BE 2x4's @ 16" O.G. TIED BACK TO A MINIMUM Of (3) CEILING AGQ GIRDER �I m m BEAMS WHEN SUCH BEAMS AND RAFTERS ARE PERPENDICULARw w w t(1 ^ TO EACH OTHER. z z( z I z I' r 1. ALL WOOD OR STEEL POST5 ARE TO BE PROPERLY BRACED AND ANCHORED. N N (V N TOWN-CITY OR VILLAGE ZONING LAWS NEw 8. ANY VARIANCE OR 5PEGIAL EXCEPTION REQUIRED FOR THE (2) 211X881 I II L4_ CONSTRUCTION ACCORDING TO THE5E PLANS 15 THE 50LE ACO GIRDER RE5PON515ILITY OF THE OWNER. GENERAL NOTES IIIII� _ I. CONTRACTOR 5HALL CHECK AND VERIFY ALL GONDITION5 AT THE CONSTRUCTION 51TE BEFORE BEGINNING ANY PHY51CAL WORK. HE 5HALL FAMILIARIZE HIMSELF WITH THE INTENT OF �` __ _ _ _ T' NEIN r' THESE PLANS, 5PECIFICATION5 AND ALL OTHER INFORMATION _ _ _ LINE OF WALL BELOW INCLUDING GOVERNING CODE5, LAWS, ORDINANCES, ZONING AND -- - -- I i------------------------------ ----- II II II II °- O— -- -- -- — I O i _ EXT'6 EXT'6 �'F' i I III ( z '� REGULATIONS. NEw , r - WINDOIN SLDIG GLASS�z ANDOw _ (2) 2"xlO" ----------------------------------- AGQ 61RDER ' - �' II II II II "� 2. ALL WORK SHALL CONFORM TO THE 2010 NEW YORK STATE ® I ® I _ LINE OF FLOOR ABOVE i = - DL BUILDING GON5TRUGTION CODE, THE 2010 N.Y.5. ENERGY A NEw 8"x16" I Q i — ' VID w CONSERVATION CONSTRUCTION CODE AND ALL LOCAL CODE5, GONG. BLOCK PIER ON20"X50" I21' VEEP Q I c0 I O RULES, REGULATIONS AND ZONING LAW5. NEW 8"x16" P. CONGXFOOTING I ; r i ExTG a II II n O GONG. BLOCK PIER ON =e� I _ i WOOD DECK II II II —3 14"x30"xl2" DEEP _ _ 3. IF, DURING THE COURSE OF GON5TRUGTION, A CONDITION EX15T5 P. GONG. FOOTING cv ; _ —� I II t Q WHICH D15AGREE5 OR CON=LICT5 WITH WHAT 15 INDICATED ON " " I I " " I Exr6 (NEN s-1�i4 X 14 ZW PARAU-AM — v z ,• , �_i (3)2 xl0 AGQ GDR i � I (3)2 xl0 ACG GDR I PLANS AND SPECIFIC - -; -- 1_ " _ II II _ll ATIONS, THE CONTRACTOR SHALL _ -------------------------------------- THE5E - I II II II II � Z N NEW ; i —1� LINE OF EXT'G DECK ABOVE —Id STOP WORK AND NOTIFY THE DE5I6NER/ARCHITECT. SHOULD THE #4 REBAR _ _ I I j , I I I w Y Z CONTRACTOR FAIL TO FOLLOW TH15 PROCEDURE AND CONTINUE EVERY OTHER GUT EXT'6 BLOCK P.G. PATIO I CV (A I II II II n II n n 111811-1111 II II II II WITH THE WORK, HE SHALL A55UME ALL RESPONSIBILITY AND V TO ALLOW FOR DIL LIABILITY AR151N6 THERE OF. ZD FOOTING I _ I I III II II V ,U _Z ® EXT'G ® j —1�j- -1d I II II II II II II II II II II II II II II I -wj 1G O 4. THESE DRAWING5 AND SPEI,.IFICATION5 HAVE BEEN PREPARED 1 P. GONG. ltn II II II II II II II II II „ 1 II II II II II I II �-- BY THE DE5I6NER/ARGHITECT AND TO THE BEST OF HIS Q PATIO Q _� _� II II II c ~ < KNOWLEDGE AND BELIEF MEET THE REG2UIREMENT5 OF THE N.Y.5. I I I I I I- — — — - — — — — — — — — — — — — — � I a — _ I II II O Q ENERGY GONSE NATION CONSTRUCTION GORE. _ — — _ — — — _ R � I 1 = _ II II II II II II II II II II II II II II II II II II II � _ I II II 5. CONTRACTOR 5HALL EXER0I5E GOOD JUDGEMENT IN ORDER TOLL_I I I I I I I MINIMIZE DAMAGE TO ANY EXI5TING AREAS AND CONDITIONS. i i i i i i 1 i = I I I I I I �� �, ,� �� , r- I I 1 I I I (3)2 xIO AGO GDR __ (3)2 xIO AGQ GDR I NEW (3) 2XIO AGQ - NEW (3) 2XIO AGQ II II n n n Z EXI5TING WORK DAMAGED A5 A RESULT OF NEW CONSTRUCTION __ __ __ __ __ __ __ . __ u._JL�._JLJL_JL_JJL_ �_� L-1-J- L-1-1_V - 5HALL BE RESTORED TO THEIR ORIGINAL CONDITION, AT NO - ---------------------- ------------------------=J � � < � � � I� I� � ADDITIONAL C05T TO THE OWNER. r I I q._2 I I I OLq._2 z 6. DO NOT 50ALE DRAWING5, WRITTEN DIMENSION5 5UPER5EDE (q _641 V 5CALED DIMEN5ION5. (N.T.5.) IQ'-6" IQ'-6" o u m 1. DE5I6NER/ARCHITECT HA5 NOT BEEN RETAINED FOR ON SITE INSPECTION OR 0135ERVATION OF CONSTRUCTION. REVISIONS 8. DRAWIN65 AND 5PECIFICATION5 A5 IN5TRUMENT5 OF SERVICE ARE AND; !5HALL F THE I DESIGNER/ARCHI EGTAIN WHETHER PROPERTYTHE E PRO�GT FOR WHICH THEY FOUNDATION FLAN 1:;)EC.,< FLAN 2NE� FLOOR FLAN ARE MADE 15 EXECUTED OR NOT. THEY ARE NOT TO BE U5ED ON ANY OTHER PROJECTS OR SITES OR EXTENSIONS AND SCALE: 1/4" = 1'-0" SCALE: 1/4" = 1'-0" SCALE: 1/4" EXPAN51ON5 TO TH15 PROJECT EXCEPT BY WRITTEN AGREEMENT ALONG WITH APPROPRIATE COMPENSATION TO TH15 ARCHITECT. DECK DETAILS (NOTE USE TRIPLE ZING CONNECTORS) 1. WHERE JOIST HAN6ER5 OR STEEL FRAME GARRIER5 ARE U5ED AND WHERE "TECO" TYPE CONNECTORS OR GUSSETS ARE P RAILING OF GALLED FOR ON THE5E •m ° • �P oN��'� 10. DRAWINGS, ONLY FASTENS :S RECOMMENDED BY THE •°• ' °• POS MANUFACTURER ARE TO BE; USED. m . . o NTMIN Simpson Strong-Tie •o °?z oz II. PROVIDE A STORM DRAINAGE 5Y5TEM FOR ALL ROOFS AND p DRTBSI PAVED AREAS. '� a'�'> Simpson Strong-Tie J 12. TH15 DESIGNER/ARCHITECT 5HALL NOT BE RE5PON5113LE FOR Simpson AB 44 ong-Tie PG DRAWN BY: J. TURNER CONSTRUCTION MEANS Simpson Strong-Tie SCALE: AS NOTED DBTI 13. METH005, TECHNIQUES, 5EGUENCE5 AND PROCEDURES EMPLOYED CHK'D BY: BY CONTRACTORS IN THE PERFORMANCE OF THEIR WORK, AND D C D M DATE: 12/20/20 5HALL NOT BE RE5170N515L.E FOR THE FAILURE OF ANY o JOIST SHEET H)MBER CONTRACTOR TO CARRY OUT WORK IN ACCORDANCE WITH H15 0 CONTRACT WITH THE OWNER. AND IN ACCORDANCE WITH THESE APR - 5 2021 PLANS AND SPECIFICATIONS. "TECO" JOIST HANGER Southold Town LEDGER SECURE TO STRUCTURE w/ II LAG BOLTS ® 16" O.G. Board of Trustees JOB 7 D12G-20-0008 V 1 EXI5TING O HOUSE TO REMAIN EXT'6 3' HIGH RAILING EXT16 TRELLIS 5/4" �-DECKIN- ON 2" X 8" AGQ 2X8 AGD. . 0 I 6 O.C." TRELLIS 012" O.G. 2" X 8" ACG (3) 2"x10, 75 (5) 2"x10" ACO 61RDER AGQ GIRDER (5) 2"x10" 51MP50N AQ GIRDER BG52-5/6 COLUMN GAP 11X61 AIII ACO POST Q — Z�V0f- Nd,V1 4 50. DECORATIVE I I I I I NEW COLUMN WRAP i t I i t 3 HIGH RAILING EXISTING YV/ GAP AND BASE ! I HOUSE TO REMAIN -4-- TYPICAL 4 -4 � V - °o°o 0 0 >,<o 00°000 ° $m0°ocmoo o o���°o �o°°000000000°o°o°oo°°o°°o°0000 o°o�oo°°o°o0 0 000�� 00 0� o000 0 00 00000000 00 0 0 0°000000 I I I I I I I I I I I I I 1 + I I I I I I li i i i 1 i i i i I i i li i i i i i i i I i t Ii i i i 1 i i i i I i i li i i i i i i i 1 i I p I I I I I 1 1 I 1 1 II 1 1 I 1 1 I 1 ( I II I NEW 12" DIA. P. GONG 5ONO TUBE FTG. TYP. (8 PLACES) I I I I � I I I I I I - _ _ _ _ _ _ _ � _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ � z REAR ELEVAT 1 ON. LEFT 51 DE ELEVAT 1 ON � SCALE: 1/4" = 1'-0" SCALE: 1/4" = 1'-0" 11.1 ILI V Q 3' HIGH RAILING _ v Q z LU ftu 5/4" Ar-,0 DEGKIN6 p 1- 2"X(b" ACO D.J. ® 16" O.G. D O z � O /--(2)2"x5" ACO < Q < GIRDER � Aco 61Rt7ER TO BE HURRICANE GL I P5 Rev AND REPI.A,GED wi ® EA. RAF=TER � I-I EXT'G 5I MP50N o 8' HI&H RAILING P044 POST GAP 411X411 AGQ EXISTING EXT'G HOUSE TO REMAIN 1=05T 2 8 TRELAGQ 5/4" DEGKIN6 ON m d) 2X8 ACO D.J. ® I6"O.C. ® 12" O.C. r- D E TA I L_- 1, 1 1 „ REVISIONS SCALE: I/2 -I O (5) 2"xl0" AGQ 61 RDER SIMP50N HURRICANE CLIPS BG525 5/6—� I LU5-26 ® EA. RAFTER J015T HANGER COLUMN GAP 6„ EXT'6 AGQ 61RDER ACO POST TO BE REMOVED AND REPLACED W/ ttsIEv`U 5-1/4" X 14" PiOMANIZED PARALLAM EXI5TIN6 8" 50. DECORATIVE HOUSE TO REMAIN COLUMN WRAP W/ GAP AND BASE NEW 5/4" DEGKIN6 ON HURRICANE CLIPS 2X8 ACO D.J. ® 16"O.G. ® EA. RAFTER —�� _- �P E OF NFA c (5) 2"xl0" ACO 61RDER ` 4"X4'i AGQ GRADE t POST 4'x4" AGQ POST i i 1 (5) 211x10" EXT'6 EXT'G GRADE A ° '�' 0 ON 12" DIA P. G. PIER I I m � I ACO 61RDER '` .�•: P. GONG. PATIO s2 pFFSSI a� EXISTING BASEMENT 51 MPSON NEw 6"xI6° PB44 POST 8WN A5E O z DRAM BY: J. + GONG. BLOCK PIER ON 20"x50"xl2" DEEP m SCALE: A5 NOTED — P. CONC. FOOTINGCHKD- - - - - - - - - - - DATE: B12/20 0 12 DIA D � � � � �� � P. G. PIER SHEET NUMBER APA - 5 2021 SECTION A - A SCALE: 3/8" = I'-O" DETAIL 11.211 Southold Town SCALE: 1/2"=1'-O" Poard of Trustees JOB #: DDG-20-0008 Glenn Goldsmith,President pf SOUjy� Town Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams '0 YO 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 TRUSTEES" TZ HOI 09 PRIOR TQ'COIVIMENCEMENT OF'THE ACTIVITIES CH �CEb', INSPECTION SCHEDULE 1 Pre-construct©h No' ain = 1St day-of construction - constructed Wt en project complete, call for compliance inspection; ' Glenn Goldsmith,President 0 SOUTy Town Hall Annex Michael J.Domino ,`O� ®0. 0 54375 Route 25 " P.O.Box 1179 John M.Bredemeyer III' [ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 �yCOUNT`1,� ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9748A Date of Receipt of Application: October 29, 2020 Applicant: John Abbott SCTM#: 1000-126-5-1 Project Location: 8630 Great Peconic Bay Boulevard, Laurel- Date of Resolution/Issuance: November 18, 2020 Date of Expiration: November 18, 2022 Reviewed by: Glenn Goldsmith, President Project Description: Construct a'341sq.ft. composite deck approximately 30"'over an existing patio with two sets of 5'x6'stairs. Findings: The proje"ct,meets,`all:"the "requirements for"issuance,of an Administrative; Permit set forth in Chapter,275,of-the Southold Town Code. The,issuance of an . 'Administrative Permit allows for_the operations as indicated on,the`project plan prepared- by Gary, Fisher, dated'September 28, 2020"and,stamped;approved"on November 1,8; 20,20. .Special Conditions: None- Inspections: Final Inspection. If the proposed activities do not meet the'requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. A, 644" " Glenn Goldsmith, President Board of Trustees �r ��e� Econ�r� _OL -PPR+OVEN BOARD O i 1 USTEES OF SOUTHOLD -- �. OCT2 ,9 2020 -DA. E-N�0 /g, zo�o I f �E-7TEHF I b — — F-- — I T-1odcz 7:f - I �� t iq L I I I I I Tic i m 6- Vv L Y- ell i 1 I -OC-T-2-9-2020- L C-T-2-9 2020 1- -�- �-- - - - V) Glenn Goldsmith, Pre;' nt O�� CpG Town Hall Annex Michael J. Domino 54375 Route 25 John M. Bredemeyer III o "` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Greg Williams p! Telephone (631)765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD Date/Time: l )/_ )b 2o2a 2-.o Completed in field by: �s Gary Fisher on behalf of JOHN ABBOTT requests an Administrative Permit to construct a 341sq.ft. composite deck approximately 30" over an existing patio with two sets of 5'x6' stairs. Located: 8630 Great Peconic Bay Boulevard, Laurel. SCTM#: 1000-126-5-1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 V/ Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission V1 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 Town of Southold Board of Trustees 4/5/2021 G. Fisher Building Inc. On Behalf of John Abbott requests an amendment to Permit # 9748A for 1 5'x35' handicap ramp 2 285' of Trellis above deck property located at 8630 Peconic Bay Blvd SCTM # 1000-126-05-01 DIECEDWE APO - 5 2021 Southold Town ' Roard of Trustees OFFICE LOCATION: ��+®� ��E�® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 ® ® � Telephone: 631765-1938 lac®U ,��� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President ,Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: November 18, 2020 Re: LWRP Coastal Consistency Review of JOHN ABBOTT SCTM# 1000-126-5-1 Gary Fisher on behalf of JOHN ABBOTT requests an Administrative Permit to construct a 341sq.ft. composite deck approximately 30" over an existing patio with two sets of 5'x6' stairs. Located: 8630 Great Peconic Bay Boulevard, Laurel. SCTM#: 1000-126-5-1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation;that . the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with-the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparindlts' written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Glenn Goldsmith,President �,QF so(/ry Town Hall Annex Michael J.Domino,Vice-President ,`o ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �O �� Fax,(631),765:6,641-, BOARD OF TOWN TRUSTEES N 0�! - 4., 2020 TOWN OF SOUTHOLD TO: SOUTHOLD TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS SUM ,•::fie-.-,- f (bvTr Property Owner lame: 'J1lr�//77(/ Date°Senttd'�Bld :'Dept: f6"- , L: The Office of the Board of Trustees is forwarding the above referenced application-for verification of the Building Departments_permittin requirements'stated below:ii-J -11 I . YES NO ­ - - - Will the proposed project require a Building Permit? Will,the proposed project require a variance determination from the Zoning Board of Appeals? Will an art of this a lication be considered,- Demolition � Y p pp as'described under Town Code COMMENTS: 144111 ature_ o Reviewer Date Glenn Goldsmith,President Tom Hall Annex Michael J.Domino,Pace-Presidents `' �t'� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer ffi Southold,New York 11971 A Nicholas Srupski Telephone(631)765-1892 Greg-Williams Fax(631)765-6641 BOARD OF TOWN TRUSTEES OCT 2 9 2020 TOWN OF SOUTHOLD This Section For Office Use Only uY'' Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension eceived Application:- 14.21.20 Received Fee:$ 100-00 Completed Application: 11,2,20 Incomplete: / SEQRA Classification: Type I Type Il Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: rdination:(date sent): WRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report:. Technical Review: Public Hearing Held: Resolution: Owner(s)Legal Name of Property(as shown on Deed):!,J2I) C) bLDo'+— Mailing Address: 'PD. Box 16-7 N 444(Adc NY M 5 2- Phone Number: Suffolk County Tax Map Number: 1000- Property 000-Property Location: to'30 l reAP PeCoro(C Ba�e S OW 2yai-et �-aL(tri (If necessary,provide LILCO Pole#,distance to cross streets,and location) AGENT(If applicable):,(�a V-W 'RS '\e r Mailing Address: F V , 80Y S � [— Phone Phone Number: - CQ 2- Pls�))rraa U',00°G'©°M r__zBoard of Trustees Apply )n GENERAL DATA Land Area(in square feet):. :3 A 4 Area Zoning: AR- H 0 Previous use of property: V e.S i � e mt 1 a l , one - ct m+ 1 y dwelh rl Q Intended use of property: (\I 0 Ch el A! , Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _yYes No If"Yes", be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ( No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ,_)'_No Does the structure (s)on property have a valid Certificate of Occupancy?_XYes No Prior permits/approvals for site improvements: AgencyDate r ee ami aQ i S No prior permits/approvals for site improvements. I� Has any permit/approval ever been revoked or suspended by a governmental agency? /� No Yes If yes,provide explanation: Project Description(use attachments if necessary): (.l l Ul 9x k9..S 341 S 4c 1 W-1 keeX lob 1 � lega LZ 2 C�Wr Lk)A'y s ,oard of Trustees lsppl t 1 WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: B U I I J DeGV, oo r (2Xl T 1 k)U At D C reJe-, Pee+ (-iqe\(- P01+00 V `TD ASG ®� �� �' 2 S�ati�S• �u Area of wetlands on lot: 10 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and upland edge of wetlands: / �} feet Closest distance between nearest proposed structure and upland edge of wetlands: n feet Does the project involve excavation or filling? No X Yes If yes,how much material will be excavated? .L cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: DST hole A lv/C— & '(Xre Statement of the effect,if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): 61 Z20 Appendix B Short Environmental Assessment Form Insti•me#eoois For C-OMPI,Deling 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 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part I. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information /��t bb� + C�,ck �l S`1 e Name of Action or Project Project Location(describe,and attach a location map): SCI" M I OCC) ( aG -s-- Brief Descripti n of Pro osed Action: Con �-<'LLFF a- 3�-I .S' -��- toCaC- ®0e-v- C�' >C9" i�l N Co n cvre-+e- �arq t o deQ.l6 n be, (4 Name of Applicant or Sponsor. Telephone: 96—W2-- 1®6G a s 2 E-Mail: Co cNl AdeLA d cityrP � ®IV- / �� State:N % 9 p �� L Does the proposed action only involve a 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 D may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: TVq El bt i d w c e V--Me(of- 3.a.Total acreage o the site of the proposed action? acres b.Total acreage to be physically disturbed? D acres c.Total acreage(project site and any contiguous properties)owned® 7� or controlled by the applicant or project sponsors acres 4. Check all land uses tha occur on,adjoining and near the proposed action. ❑Urban ural(non-agriculture) []Industrial ❑Commercial Residential(suburban) ❑Forest ❑Agriculture []Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 • 5. Is the proposed action, NO YES NIA a.A permitted use under the zoning regulations? ® 0 b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ( 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES l 9 - -1, b.Are public transportation service(s)available at or near the site of the proposed action? R] Ill l � c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? M 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply. NO YES � If No,describe method for providing potable water. ill 1 El � I I.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:_ 5671 D 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 0 ►� b.Is the proposed action located in an archeological sensitive area? R 13.a.Does any portion ofthe site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: �u I 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO 1 YES If Yes, a.Will storm water discharges flow to adjacent properties? [RNO ❑YES b.Will storm water discharges be directed to established conveyance systemsrunoff and storm drains)? If Yes,briefly Jescnbe: nNO DYES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO I YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: T, F11 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO I YES solid waste management facility? If Yes,describe: j 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor n e• �� FS Date: oZ�2c2-0 Signature: Part 2-Impact Assessment The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning a regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? EL 3. Will the proposed action impair the character or quality of the existing community? jn 4. Will the proposed action have an impact on the environmental characteristics that caused theF71T establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level oftraffic or affect existing infrastructure for mass transit,biking or walkway? El il 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ;� reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? EI 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? El I Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur%or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. i Town of Southold-Board of Trustees I Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 A 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 ferm is to rovide•inforination which can alert the toam of ossible conflicts of interest and allowAt to tal.-e.whntever action-is necessary to avoid same. YOURNAME: I Shed (Last name,first name,Viddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone _ Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,-or child)have-a relationship with-any officer or employee of the Town of Southold?'"Relationship"includes by-blood,njarrlage,-or business interest."Business interest"means a business, 'including a partnership,is which the town officer oremployee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of t�he.shares. YES NO V 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 applic4nt (when the applicant is 11 rporatiod); B)the,le'al_or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi �- day of V / 20 29 Signature a,,�. Print Name Form TS ] y mrd of Trustees Appli�: AFFIDAVIT � ) r BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. f4nature of Pvfirty Owner Signature of Property Owner SWORN TO BEFORE ME THIS Z0 DAY OF . 20-40 -(?Aq4-9-- Notary Public )ard of Trustees Appli�: AUTHORMATION (Where the applicant is not the owner) I/We, JO#4/ V A9902t owners of the property identified as SCTM# 1000- Z- in the town of New York,hereby authorizes �� s�e( 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. Cis P erty Ow6gs Signature Property Owner's Signature SWORN TO BEFORE ME THIS 'Z-6 DAY OF _ __, 2000 Notary Public o f-7166-54:5)Zi-96 O /�/Z APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL DISCLOSURE FORM The To,,vrn of Southold's Code of obits prolDibif s conflicts of interest on the 2ait of Iowa)Dffcers and crinpJovees.The pUMMe of this farm is to rxrominforirnation which on-.alert the toAwD of possible conflicts of interest and allow-it to take whatever action is necessary ID avmid sarrme.. / �— YOUR NAME: � (Last name,first name,griddle initial,unless you are applying iia 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 ofZone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business'interest"Business interest"-means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered'YES',complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agenttrepresentative)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 corporationx B)the legal or beneficial owner of any interest in a non-corporate entity(whea the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this d of SCS 2OT2020 Signature , Print Nam Form TS l Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evalluaterl as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus. each answer must be explained in detail, Listing both supporting and non- Mgpordng.laett. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it sba11 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# - -0S7 PROJECT NAME J O b n A bb c+ The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: ❑ Nature and extent of ac'on: On � L� Jec�(, Q UC Co r)cv�4e n Location of action: r + ee,ors I C- L)a L't Site acreage: L1403 Present land use: Re-SAeO-- iet[ ,0/1e- -am& Present zoning classification: V-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: J© O (b) Mailing address: T.0 � 1 b� pla y�Qct ,lo I (tea (c) Telephone number.Area code( ) 631 ;R a— (d) Application number,if any: , Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes 0 No® If yes,which state or federal agency"? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 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 LNW Section III—Policies Pages 3 through 6 for evaluation criteria F1 Yes No 0 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria F Yes Q No ® Not Applicable Attach additional sheets if necessary NATURAE, COAST POLICIES Policy 4. Mnimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section M—Policies Pages 8 through 16 for evaluation criteria ,l Yes n 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 M —Policies Pages 16 through 21 for evaluation criteria In Yes F] No 4Not 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. 17 71 0 i Yes No N 1pp cable 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. R1 Yes R 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 M 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. Y l-INo® Not Applicable Attach additional sheets if necessary • WORIMG COAST PO] Ire Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. F Yes 'Q No F1 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes 1:1 No ® 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. 7 Yes 'E] No PQ 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 IE No ® Not Applicable PREPARED BY TITLE DATE q �