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HomeMy WebLinkAboutTR-9909A Glenn Goldsmith, President QF S0 Town Hall Annex A. Nicholas Krupski,Vice President ,`O� Ol0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold,New York 11971 Michael J. Domino • Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 lrouff ,Nc� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1838C Date: August 2, 2021 THIS CERTIFIES_-that the as-built 10'x30.6' lower deck with an 8' hot tub and 10'x21.6' upper deck; At _675 Windy Point Lane a/k/a 675 Private Road#12 Southold Suffolk County Tax Map #1000-87-4-7 Conforms to the application fora Trustees Permit heretofore filed in this office Dated May 24, 2021 pursuant to which Trustees Administrative Permit 99909A Dated June 16, 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 as-built 10'x30.6' lower deck with an 8' hot tub and 10'x21 6' upper deck The certificate is issued to Robert& Donna Drummond owners of the aforesaid property. 3 Authorized Signature Glenn Goldsmith,President QF S0(/T _ Town Hall Annex A. Nicholas Krupski,Vice President ,`O l 54375 Route 250 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Z— INSPECTED BY: G 8' Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection COMMENTS: � /J -} JT- 1 CERTIFICATE OF COMPLIANCE: ® sS Glenn Goldsmith,President �QF SOUjTown Hall Annex A.Nicholas Krupski,Vice President �Q� Ol0 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 COUNV i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9909A Date of Receipt of Application: May 24, 2021 Applicant: Robert & Donna Drummond SCTM#: 1000-87-4-7 Project-Locatiion:'675 Windy Point Lane a/k/a 675 Private Road #12, Southold Date of Resolution/Issuance: June 16, 2021 Date of Expiration: June 16, 2023 Reviewed by: Greg Williams Project Description: As-built 10'x30.6' lower deck with an 8' hot tub and 10'x21.6' upper deck. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Jeffrey Patanjo, dated May 10, 2021 and stamped approved on June 16, 2021. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees Glenn Goldsmith, President �QF S0 Town Hall Annex A.Nicholas Krupski,Vice President ,`O� yp�o 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III l�[ [ Southold,New York 11971 Michael J. Domino G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 COU f 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-constructidn,,hay,.bale"line/siltb66m/silt curtain 1St day"ofi construction 'h constructed X " When project complete, call for•compliance inspection; I N22'58'10"W i 210.81' DOCK ` 1 STORY DECK 0 W/ HOT TUB LO GARAGE G.F. ELEV. 6.3 DRIVEWAY �� o�o�� `J Z S�GRY 4 gEORGOM 2 iso o F F0 0 6PSEME�� '� o? AREA = 10,709 SF �e OR 0.246 ACRES 10' sls'3o'o0"E — _4' X 6.3' WIDE STEPS ,. v 199,97' APPROVED BY �OA►�D OF 'i RUSTEES TOWN OF SOUTHOLD �.. DATE -Ax PROJECT - Q aa , LOCATION - 1 - PRO _ PERTY OWNER: r;''' k" C- ,�..; = .,_, ROBERT H. DRUMMOND (� DONNA K. DRUMMOND MAY 4 2O Li . 21 106 CENTRE AVE. EAST ROCKAWAY, NY 11518 a , '€hci�i Town PREPARED BY: f3oo�a is=eos JEFFREY PATANJO P.O. BOX 582 BOHEMIA, 11716 676 Windy Point Lh MIA, NY T A, sout6oia;iw-ilsi�;. r", ` 631-484-9332 ..,3, ,,✓, '<`l• - `°xJ".'4s:.'W',x xy lu,.,rl .At t j' i,tr: _3_ JJPatanjo@gmail.com DECK PERMIT PLANS SCALE: "JU ..x„ = Y; ` PROPOSED PLAN NOTES: & LOCATION MAP DATE: 1. ELEVATIONS REFER TO N.A.V.D. 1988 DATUM 5-10-21 PROJECT LOCATION MAP 675 PRIVATE ROAD #12 A ' 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: AKA 675 WINDY POINT LANE SOUTHOLD, TOWN OF SOUTHOLD N.T.S. JOHN MINTO LAND SURVEYOR SUFFOLK COUNTY, NY SHEET: LATEST DATED JUNE 18, 2008 TAX YAP N0. 1000-87-4-7 1 of 1 ' 1 Glenn Golipith, President, a ���SUFFO Town Hall Annex A. Nichoia's Krupski, Vice-President „� yJ, 54375 Route 25 John M. Bredemeyer, III a 't P.O. Box'1179 co Qr Michael J. Domino Southold, NY 11971 Greg Williamsoy�lp® �`aTelep on 765 6641-1892 BOARD OF TOWN TRUSTEES ,I l q,a,, TOWN OF SOUTHOLD Date/Time: �1 Z `(40 A '` :Completed in field b p Y Jeffrey Patanjo on behalf of ROBERT & DONNA DRUMMOND requests an Administrative Permit for the as-built 10'x30.6' lower deck with an 8'hot tub and 10'x21.6' upper deck. Located: 675 Windy Point Lane a/k/a 675 Private Road #12, Southold. SCTM#: 1000-87-4-7 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275LZ, 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 complete ss/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski :ZG. illiams Other -- --TFT � — > w . Q r � e F+.1 r i t> 93 z p z 12 Jj Q3� • RED R . N:MH IMSE SITE PHOTOS __. .._ "� a Z 1 s t (�� I. arti 00 SCALE: NOT TO SCALE _ji MAY k4 2021 t(�f}) 22339 O outhold`Gown Board of Trustees off' -76 , `yo 4�O oa O�� 6hQC 4A 9g 0� w W E 3 aWD Q x SURVEY OF \ N�D�F E RR O 'ER T Y GAS Rp1DVerr A T BA YV1E W TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. x C4 1000 - 87 - 04 - 07 Scale 1" = 20' Sept. 18, 1990 ✓UNC is. 2008 GL 0 WE GAR MAY 2 4 2M =D� Southold Town Board pf Trustees o m . AREA 70,688sq.ft, s • ANY AL IOM TION OR AOO MY TO Rf SW%r S A YAkA 77RY +I/ �..•:' •t' OF SEC)m.V 7P09 OF iNF A�6 YORk STATE EOt iTON LAlL MVIT AS PFR SE4TlAY 7109•M68AM1�R*P ALL CERTMT)ONS `��'•'° FLrdfLY!ARE VALM FOR mr ANP AM COPS IA1tE0F OAB.Y F SaD M,AP OR nix net'.o%Cf BEAR W AMESSEO SFAL OF THE S[K�YEYOR �j+' "�"'•'-., . eurorrW ` �•.. ,"X fe. NO. 4S N22°58'10"W 210.81' DOCK 1 STORY DECK 2 0 vot W/ HOT TUB co GARAGE so S\NG\-E 5 G.F. ELEV. 6.3 DRIVEWAY AREA = 10,709 SF OR 0.246 ACRES 10, 4_ .3' WIDE STEPS S18'30'00"E X 6 — 199.97' - _ PROJECT L BaYviLOCATION PROPERTY OWNER: f. - z v , i - "�'"" - ROBERT D UMMOND - . - H. R >' 2 DONNA K. DRUMMOND MAY .i 4_1 _ _ 20 T - _ 21 �,':' :" 106 CENTRE AVE. EAST ROCKAWAY, NY 11518 ��ol,,thold Town a {_ PRE oaoz b, te•�s PARED BY: i�--- `C o r i` JEFFREY PATANJO ix JEFFREY - ti5'ti„ P.O. BOX 582 �.e1e.k,,,. „Y`r,R, ;; ,r,,,� ; 'z: "' •: BOHEMIA, NY 11716 r+„ :'",° f,:', =;x = °,scuihoia;=Nv atg��,;;'•'„F., 3";' :. 631-484-9332 JJPatonjo@gmail.com DECK PERMIT PLANS Y, 1 9 SCALE: 1 =20' M=. " PROPOSED PLAN NOTES: DATE: & LOCATION MAP ;5',r�".:; way,€ :, .°,,m ,, f,. -,• - = 1�. ELEVATIONS REFER TO N.A.V.D. 1988 DATUM s-10-21 675 PRIVATE ROAD #12 PROJECT LOCATION MAP 2. PORTIONS OF PLAN FROM SURVEY PREPARED BY: AKA 675 WINDY POINT LANE SOUTHOLD, TOWN OF SOUTHOLD N.T.S. JOHN MINTO LAND SURVEYOR SUFFOLK COUNTY, NY SHEET: LATEST DATED JUNE 18, 2008 TAX MAP NO. 1000-87-4-7 1 OF 1 ReuSigns. y 4f s2 xa B'It\ Fra,z G ai3as S a s� �. )� (�4 xr z o° oi oea Gs + ..,E ;r i \i �! ke (; 1 -a#.JxY:� S .t ti12 \ o`iA a _ 3 ozmzJ •.xs rxk r`s. '«.. (,�aa Y �w',a`+'"x`�• I - r 1/ L�„3�� seese of x 2;7 s zTmo ^ p 0.1 ) y se 3 a,A� - 1 /P��i rNecovz:rsourNDLo .Sl n. ns '.• "! r a'o' o ,: x",s+� ....-,; _I� sk / x,r. 2.sa. zsnat w1 .� ° a, rr�°,+ mwu of sovrNoto r ��� ,cl , •, t� ' 9L ..N 1 ns •4,.i T fi �° �,� . Y ,fib(e6 ! Saa 13 123 -, �0 l"• P S\tit � .��pewo t9nx-z._s f� s A j a4 ro �i _i 3; F�ti a. 31N0 2x a Iml )=rR P-�'•• \ r � 162. ; 32Nai ol3rwcr � FD.26 L.D.43po VI _ t a+j3 i t9� ^v • x� 42 Al r t e d, " to 09 N/ v 0 F. 2 ti tl V I2.• u.a - s OOLNTY OF SUFFOLK,$~ ' .•..�.- *OWN Oi3WINgD.ff BAY COUNTY OF SUFFOLK© N NOTICE K 1ooP s� ec,ir r.� E SOU E _ __ ___ __ ,,,,,,,,, Real Property T..Service Agent, xreWnw Reds v wos N n"'�P— �.—— _�x� —_— •••• x """^ IMI C.Ner(}i.e M�nhnx(:\Y 1190/ N/ ♦x NV AmIHIED M 1110LD 087 0 __. "T __.«__ '^ —__— r,r a. 121) OFFICE LOCATION: ®f S® �® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 -' Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) Tele 631 765-1938 Southold, NY 11971 _ Telephone:- cOu ,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director, AICP LWRP Coordinator Date: June 14, 2021 Re: LWRP Coastal Consistency Review for ROBERT AND DONNA DRUMMOND SCTM# 1000-87-4-7 Jeffrey Patanjo on behalf of ROBERT & DONNA DRUMMOND requests'an Administrative Permit for the as-built 10'x30.6' lower deck with an 8'hot tub and 10'x21.6' upper deck. Located: 675 Windy Point Lane a/k/a 675 Private Road #12, Southold. SCTM#: 1000-87-4-7 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is INCONSISTENT with Policy Standards and therefore is INCONSISTENT with the, LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The structures were constructed without obtaining a Wetlands Permit. 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 r T Glenn Goldsmith,President � � F Town Hall Annex x ' ;, A.Nicholas Krupski,Vice President 54375 Route 25," t° P.O.Box 1179 John M.BrBdemeyer Ial Y { Southold,New fork 11971 Michael J.DominoN ' - �` y Telephone(631)765-1892 Greg Williams _ Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension k Received Application: 5- X _Received Fee:$ 2004Wfid- 4t* Completed Application: Incomplete• SEORA Classification: Type I Type 11 Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): -7—MRF'Consistency Assessment Form Sent: CAC Referral Sent: r" 7Z-Date.Of Inspection: p K MAY 4 2021 Receipt of CAG Report: Technical Review: =Public Held: ��,w,n Resolution: Owner(s)Legal Name of Property(as shown on Deed):MailingAddress: 106 Cer,+r e A'Ve . �, ry2 o c""JCL(-, ri Y ! I 5-le Phone Number: S/6 - 86 ,0-q738 Suffolk County Tax Map Number: 1000 Property Location: 6 75- v✓r roey ®r n r LAn 4e 6 tAW ' 0 0- Sft tvc^41vn ^4 (If necessary,provide LILCO Pole#,distance to cross streets,and location) AGENT(Lf applicable): ��F��e �°``fat V Mailing Address: P•y • ��X �82� o��,-,-� �., y t l"1 i Phone Number: 6 3 q p y •g 3 3 1- ��PA-��,n l�@ q ma,C. e'o'-n t�J RE: 675 WINDY POINT LANE -SOUTHOLD SCTM No. 1000-87-04-07 PROJECT DESCRIPTION Project includes the legalization of the as-built 10' wide x 30.6' long lower deck with 8' wide x 8' wide hot tub and 10' wide x 21.6' wide upper deck. Board of Trustees Application GENERAL DATA Land Area(in square feet): Area Zoning: 5' Previous use of property: �S ' Intended use of property S Covenants and Restrictions on property'? ✓ Yes' +To N o�►-T„f � If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? —Yes ,-_ No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes ✓No If"Yes",please provide copy of decision. Will this project requireany demolition as per Town Coda or as determined by-the Building Dept.? Yes �_ N✓ o i Does the structure(s)on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date 5AnI1e,al No,prior permitslapprovals for site improvements. Has any permit/approval ever beery,revoked or suspended by a govermuental agency? �Na Yes If yes,provide explanation:. Project Description(use attachments if necessary): _ L 0-4L/_it—,--h s bol y l I.''I den x- �-VwcL ctce'� VJ04, /DI w�r�c >! 21. 6 (oN1 ecle- Shard ,of Trustees Applicatlon WETLAND/TRUSTEE LANDS APPLICATION-DATA Purpose of the proposedoperations: L:31-Ju� ti---- �- } Area of wetlands on lot: :. square feet Percent coverage of lot: V. Closest distance between nearest existing structure and upland edge of wetlands: `�°�feet Closest distance between nearest proposed structure and upland edge of wetlands: q 0 feet Does the project involve excavation or filling? No ,Yes If yes,how much material will be excavated?,.. cubic yards Mowmuch material will be filled !" '' cubic yards Depth of which material will be removed or deposited: N (4 feet Proposed slope throughout the area of operations: N A Manner in which material will be removed or deposited:, "' Ar 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): Th e rt- w%ll bt n o l EBF-,c-f o j owe 44 t ncl S . i Board of Trustees Application ,A,�FIDAVIT ' • i lZo 6,C+ a n r,c, Dr u Mi►'t o%l BEING DULY SWORN ROPOSI+;S•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 KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A-FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF-ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THUS 1 L' DAY OF 20a� IC JEANNE IaA. RiEL ' Notary Public, at f Now York No.OI GA5066738 Qualified in Queens County Commission Expires September 30, Board of Trustees Application WETLA.N RUSTEE LANDS"PLICATION DATA Purpose of the proposed operati s: L ep 1l to --- tory s-1-or y t o'wide- w So.& lm.•� Lotoca— et,ea& anjC lo` cm(t ,� 21• to., ,, t�L r�tclL Area of wetlands on lot: square feet Percent coverage of lot: f� % Closest distance between nearest existin structure and upland edge of wetlands: feet Closest distance between nearest proposed tructure and upland edge of wetlands: q 0 feet Does the project involve excavation or fillin ? ,No Yes If yes, how much material will be excavated? ^' 4 cubic yards How much material will be filled? cubic yards Depth of which material will be removed or dep ited: N (4 feet Proposed slope throughout the area of operations:-. A Manner in which material will be removed or deposi Statement of the effect, if any,on the wetlands and tidal wate of the town that may result by reason of such proposed operations(use attachments if appropriate): Therc woo 6-e /to e i-4,ec-f ?,-j ,.vt��ancQs . Board of Trnsteea Application ALTMORUATION (Where the applicant is not the owner) ' I/We, _ owners of the property identified as SCTM# 1000- a -a y - o-i in the town of _--,New York,hereby authorizes 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. ropeOwner's Signature Property Owner's Signature SWORN TO BEFORE ME MIS �� DAY OF_ f r .20,E Notary Pub c JEANNE M.GABRIEL Y�� !Votary Public,State of New York No.01 GA5066738 Qualified in Queens Counttyy Commission Expires September 30,c;W—kA APPLICANUAGENTAREPRESENTATWE TRANSACTIONAL DISCLOSE FORM e To Sou 's of ib' co ict interest o e rt o o� kers d e 10 e e o this form Ls to provide thformatignwhigh can alertthe town pof Msible 2mflicts of ln!Mgand allow it to take ate r ct' is mcessaa avoid same YOURNAIVIE: r�.,�.�® n r.L, �° ame,first name gilddle Initial,unless you aro applying in the name of som ne else or other entity,such as a company.If so,indicate the other person or company's name.) NAME OF APPLICATION: ( eck 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, use,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"inclu by blood,marriage,or business interest.`Business interest"means a business, including a partnership,in which the town oirwccr employee has even a partial ownership of(or employment by)a corporation in which the tatvn officer or employee owns mare 5°!°of the shares. YES NO If you answered"YES",complete the balance of this farm d date and sign where indicated. Name of person employed by the Town of Southold Title br position of that person Describe the relationship between yourself(the applicanVagem/rep tative)and the town officer or employee.Either check the appropriate line A)through D)andlor describe in the space provi The town officer or employee or his or her spouse,sibling,parent,of chit is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock o e appl lcout (when the applicant is a corporation); B)the legal orbeneficial owner of any interest in a non-corporate entity( 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 of Signature i3 ;r=Ci = Print Name Form TS 1 APPLICANVAGENT REPRESMATIV]E TRANSACTIONAL IDLSCLOSU3M FORM DUM 9M*-2Wr—s Do& f Ethics m0b ran in ci a pw Ram 0M ad MMI-0-WMe MMMLe Of r c fo.MnUdac e eta an ow . 1ll�tiCY to av d'same. YOIURNAMBs (Last name,first name.gdddle initial,upiew you are applying to the name of someone else or otter entity,such as a company.If so,indieap the other petson's or c ompaWs name.) NAME OF APPLICATION: (Check all that apply.) Tax encs: Building Trustee Change ofzone Coastal Erasion Approval ofplat ung Exemption from plat or official map Planning Other (lf"Other'',tame 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? "Relationshir includes by blood,ma 'age,or business interest"Business interact"means a business, includinga.part�►e Mp,in which the town officer oremployee -even a panlal o%vnenhip of(or employment by)a corporation In which the town officer or employee owns more than 596 the shares. YES ,.. NO Ifyou answered"YES",complete the balance of this fbrm 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 applicantiWttttrepresentAve)and the town officer or employee.Either check tht appropriate line A)through D)andlor describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,of child is(chock all dtat apply): A)the owner of greater than 396 of the shares of the corporate stock ofthe applicot (when the applicant is a cotpom ion% B)the legal orirettaficial owned of any interest in a not-corporate amity(whf1 the applicant is not a corporation); C)an oMom director,partner,or employee of the appliearpt or D)the arthral applicant DESCRIPTION OF RELATIONSHIP Submitted this of� r^ 20 sipaturme PritttName o r !1 1, pti w Form IS 1 ' r -A—PPLICANT/A.GENT ENTAI I W TRANSACTIONAL DISCLOSUR9 FORM The Town of SouthoWs ofEthics ambibitsconflicts of interest onitig lart o officers and to The pwrme of this farm I.e to otovlde information which can alert the town of passible conflicts of Interest anti 8110w It to take whatever action is necessary to-oid slime. YOURNAM : rte,„r�»r►r� r o n n (Last name,first name *ddle 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 c:ompaWs name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building =^� Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other'',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 59!oaf 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 applicantlagenthepresenWive)and the town officer or employee.Either check the appropriate line A)through D)andlor 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 appilcmA (when the applicant is a oorpor UOUo , 8)the legal orbeneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partrter,or employee of the applicant;or D)the actual applicant DESCRIMON OF RELATIONSHIP Submitted this l�day of 20 a 1 Signature Print Form ✓1 A ` f kwt wt,o n Form TS i APPUCANUAGENTAWI.2ESENTATNE TRANSA GNAL D ISCL SURTO FORD is to . e• iierst�a¢oidsama. - . - .. - . . YOUR NAME, V a 'F a r) Fri QAduartte,Erstnutmv,40dlc initial,unleWyou are applying4the nameof sameont elm or otherentity,such as acompany.If so.mdii tato the other person's or company's nerve.) NAME OF APPLICATION: (Check all that apply) - Tax grievants; Building Variance ,^ Trostee. ,ts ChangeofZone „r Coastal Ewdon Approval of plat Mooring Exemption from plat or official map,.,,,- _ __ Plauarrrg �— Other (If"Odun,"►1lMO ft activily.) Do you pers1rtalty;(Or*MUgirYaW*ernopany, a SIIM%pawnt,orddid)have arelad=hip.vAthany officer oremployee of the Town cr$"nld? "ReUO.6u ilp"inohrd r,$y;blood,'�Wbus4hew-fiftaL"BusFaftlaie titans a business, including& n ltt�htch the r►o o esnplpyeal sevact a paitia rr, t ipflf(c>3 pfaJ+tnettt. r. corporation in which the tov�arai r9,remployce a*mm t:thud 5% shares. YES NO �- if you answered"YES,complete the balaace of this form and date and sign where indicated. Name of person employed by the Town of Southold Title,or position ofthat person 1. 1. I - DesenU the relationship between yourself(the appkcanVWntJmpresentative)and tht town officer or employee.Father check theappmpriatc tine A)through D)and/or describe inthe space pmvided. The town officer or employee or his or her spouse,sibling,pareaat,or child is(check all that appift A)tho owner-OfspOorthan SPAofft si -of*agwiic Mck oftheapprkW (when the apiAgotis avanwationk -0)the eue eiafetsvaterofa itan �3ee�it [ # appiiis not a�lunk C)an officer,director,partner,or employee of the applicang or i))the actual applicant. D1Eirlt"CYN OF RELATIONSHIP Subn4 ted this -10 clay of AA 20„111, Print Warne • o�1!.�1�y M+l 1_ IM Short Environmental Assessment Form Part I -Project Information Instructions for Completiniz Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Name of Action or Project: 675 Windy Point Lane-Southold Project Location(describe,and attach a location map): 675 Windy Point Lane-Southold Brief Description of Proposed Action: Legalization of existing 10'wide x 30 6'long lower deck and 10'wide x 21 6'long upper deck on existing residence Name of Applicant or Sponsor: Telephone:P 516-860-9738 Robert&Donna Drummond E-Mail: rdrumm@optonline net Address: 106 Centre Drive City/PO: State: Zip Code: East Rockaway MY 11518 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 1:1may 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval:Town of Southold Trustees ❑ 3. a.Total acreage of the site of the proposed action9 0 245 acres b.Total acreage to be physically disturbed? 0 030 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 245 acres 4. Check all land uses that occur on,are adjoining or near the proposed action. 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial ❑ Residential (suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): ❑Parkland Page I o l 3 r 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ Fv—/] ❑ b. Consistent with the adopted comprehensive plan? ❑ FV-1 ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES Name Corey Creek,Name Peconic Bay and Environs,Reason Significant coastal fish&wildlife habitat, If Yes,identify: Reason Protect public health,water,vegetation,&scenic beauty,Agency Southold,Town of,Agency-Suffolk County,D ❑ NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ✓❑ ❑ b. Are public transportation services available at or near the site of the proposed action? Fv—(] ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed ❑ action? 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑✓ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the ❑ Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: Page 2 of 3 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 W1 Wetland ❑ Urban m Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? Piping Plover,Least Tern ❑ 7 16. Is the project site located in the 100-year flood plan? NO YES ❑ ❑✓ 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ✓❑ ❑ a. Will storm water discharges flow to adjacent properties? ❑✓ ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ If Yes,briefly describe: , y,, �1777 Ar,,, 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: ❑ ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: 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 CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor/name: Robert&Donna Drummond Date: Signature: Title:Owners PRINT FORM Page 3 of 3 EAF Mapper Summary Report Friday, January 1, 2021 2:18 PM Disclaimer: The EAF Mapper is a screening tool intended to assist "_ �. 1 a project sponsors and reviewingagencies in preparing an environmental "� 8_6-41 ` �' _ _ ;•j -6-15 1 ,#I assessment form(EAF) Not all questions asked in the EAF are i ,r .54,5 _ € `—. 7 �-9 11'78-7-47,� answered by the EAF Mapper Additional information on any EAF -; , , ;: (' question can be obtained by consulting the EAF Workbooks Although '$^ : Qui g the EAF Mapper provides the most up-to-date digital data available to r"tf . `` `% .,�.,��° t DEC,you may also need to contact local or other data sources in order -�j` _� € <( tc 1 to obtain data not provided by the Mapper Digital data is not a r#~: z e ,•Qy< + 7€-6-6 ;• substitute for agency determinations 78 ",,> 1 F #7a € 7. 5-€ ,'"3 >.�s �Et, ,,RE a heal •>, 7 -4- €.� 7:- - a� - s t r'`° i� Z:---: _ 3 ':x, a';;�..1=.fie-`% ''` E;,�, a�,5 V ,.•. , f"- -ci a 7,87,5 . is .�- , . •,, .• �. , �•," `�.� t,.." - _.„ "I r`. _ 87i4-1-1 87-5 i f ,. ,874-3, r Vis: etN. aP ,ts �� 1 Rix, ��r •may` " 7. 5 ,,�,� ,. �'`" E%'',%•� ;,+. � ' %t E.,r}+*�_` ,�'`�- �` `<, � .�"^.,-.i�a'Ht;�, •, � � ,z, ra _,���'7�'#�x`-°la��r91 ���$" ,Q 110" , „ t� �t n ...: P'IiI�adE�refM1r� r , t tj,a l ,, t �r�nil ;fr�t�n� t3�[ IEI1EM1lTF,rFa�%E'`n1n,tiERE [i, hirl �HngI, t� ;Er%. t�tEhf@ri�E t��)a��n: 1Eft ohm H�,i� i�.t Ern° ' C i r ii t i ilr�r, fl,tSi a t nS i' tt t la ooiitrrb6t�+F,_Qnd the (r r i rt nr.ir i ?.00P�pstr,6APit)r e GIS Us r19 t r m ilii c b� ���, _ .. _.x� _ v01,110”. ' 5 Part 1 /Question 7 [Critical Environmental Yes ,Area] 'Part 1 /Question 7 [Critical Environmental Name-Corey Creek, Name:Peconic Bay and Environs, Reason:Significant iArea- Identify] coastal fish &wildlife habitat, Reason:Protect public health,water, vegetation, i &scenic beauty,Agency:Southold, Town of,Agency:Suffolk County, Date:3-9- 90, Date:7-12-88 yy Part 1 /Question 12a [National or State ;No `Register of Historic Places or State Eligible ,Sites],,.,, °Part 1 /Question 12b [Archeological Sites] IYes `Part 1 /Question 13a [Wetlands or Other 'Yes-Digital mapping information on local and federal wetlands and . E Regulated Waterbodies] .waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15 [Threatened or ;Yes 'Endangered Animal] iPart 1 /-Question 15 [Threatened or ;Piping Plover, Least Tern Endangered Animal-Name] _ <Part 1'/Question 16 [100 Year Flood Plain] Yes �., � � •�-����� �- � ����� ������ _������ �� �� :Part 1 /Question 20 [Remediation Site] No �� ����� ������������ � � ��� a��•� � _����������� J� ��� Short Environmental Assessment Form - EAF Mapper Summary Report Part 2-Impact Assesst The Lead Agency is responsible for the comp t of Part 2. Answer all of the following questions in Part 2 usin q g,_s^nformation 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?" a No,or Moderate r small to large impact impact may may occur occur 1. Wi11 the proposed action create a material conflict with an adopted land use plan or zoning _❑ ❑ regulations? 1 2. Will the proposed action result in a change in the use or intensity of use of land? L� 3. Will the proposed action impair the character or quality of the existing community? a 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment ofa Critical Environmental Area(CEA)? F-1 El 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ �} 3 affect existing infrastructure for mass transit,biking or walkway? [ -- 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ (� reasonably available energy conservation or renewable energy opportunities? t 7. Will the proposed action impact existing: El a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage a problems? 11. Will the proposed action create a hazard to environmental resources or human health? El 0 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 detennined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-tern,long-term and cumulative impacts. ECheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation. that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lend Agency Date President § I Print orType Name of Responsible Officer in Lead Agency Title of Responsible Officer s f Signature of Responsible Officer in Lead Agency - Signature of Preparer(if different from Responsible O(ficer) F Town of Southold MFO A. INSTRUCTIONS l,. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterf coat Consistency Review Law. This assessment is intended to supplement other infommation used by a Town of Southold agency in making a.d m h.Won of consistency. *Except minor exempt aetions including B 14ng Permits and other ministerial permits not located within the Coastal Erosion H'au rd 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 Waterfrmt Revitalization Program. 4 OURMA+acdon-will be matuated- as to its 11. `., x on. a a -inc lct n 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. aa. _ boft jong;ftft If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall��be,uitde���. 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. DESCRIMON OF SITE AND PROPOSED ACTION SCTM# 8? °q ,. v PROJECT NAME 6 15-'5- wind o..,+ tan c - Sa h o t oP The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept ❑ Board of Trustees I. Category of Town of Southold agency action(check appropriate'response): (a) Actiou undertaken directly by Town agency(e:g.capital constnicfion,planning activity,agency regulation,land transaction) (b) Funancial assistance(o g.grana,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: WIA X30161 t-1-1 ko.,,e.c_ d-ee-IL Location of UUM `75'- W+acQ11 �o n L 1.n - S 4-Imo l[� Site acreage; Present land use: . -fLe s.• . Present.zoning classification: �S 2. If an application for the proposed action has been filed with the Town of Southold agency, the following ittformation shall be provided: (a) Name of applic� '�a��R+ PO,17Q t�M�►d (b) Mailing address: /'v 6 C'e n-�r e _A.%t e_` (e) Telephone number:Area Code .,J,- v - q-7 3 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes f] loo ED If yes,which state or federal.a 'MY 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. RJ1_%L P D COAST40LICY. . 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 .0 No [] NotApplicable PCO e 5 eonC#g-fe_n-t &.01+k ,Ilei h bd 24 n h �••SeS a�ne,Q G..✓t•✓J �rr� Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section M—=10 hrough 6 for evaluations criteria Yes No Attach additional sheets ifmccssaq 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 [I. Yes 0 No E3/Not Applicable Attach additianai sheets if nfx=ary NATEMAL COAST POLICIES Policy 4. Aftnimize Ioss of life, structures, and natural resources from flooding and erosion. See LWRP Section LR—Policies Pages 8 through 16 for evaluation criteria El. Yes`0 No u Not Applicable Attach additional sheets' necessary Policy 5. Protect and improve water quality and supply in the Town of Southold.See LWRP Section III Policies Pages 16 dwough 21 for evaluation criteria 0- Yes0 No uNot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Sig®Mant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Sermon M—Policies-,Pages 22 through 32 for evaluation criteria. 'Yes No Not Applicable _ Attach additi©naI sheets if nec:essaty -• - ' Po&y 7. Protect and improve air qualW iu the Town of Southold. See LWRP Section M -.policies Pages 32 through 34 for evaluation criteria. Ej Yes ,o-No Not Atpplicable Attachaddi�ional sheets ifnecessary -- Policy 8. Minimize environmental degradation. in Town of Southold from solid waste and hazardous substances.and wastes. See LWR P Section M—Policies; Pages 34 through 38 for evaluxio4 criteria. Q Yes 13 No MNot Applicable PUBLIC COAST P4LfCIES Pollr,Y 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 45 for evaluation criteria. Yet1 No ErMot Applicable Attach ad tiomi sheets ffnecessMy WGRIMG COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in ' A suitable locations. See LUMP Section III-Policies;Pages 47 through 56 for evaluation criteria. Yes 0 No Q Not Applicable y Attach additional sheets Wnecessaly 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 E Not Applicable Attach additional sheets Wnecessary Policy 12. Protect agricultural lands in-the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. Dyes 0 No E-1-31"N' Not Applicable r.+�•.++...+..Yw..e A#wh additional sheets Wec=wy Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III-Policies;Pages 65 through 68 for evaluation criteria. El Yes 0 No �NotApplicwe PREPARED BY TITLE-! , DATE May 15, 2021 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 Lj U f MAY 2 4 2021 P.O. Box 1179 Southold, New York 11971 Southold Town 6oar'i o'Trustees RE: 675 WINDY POINT LANE—SOUTHOLD SCTM No. 1000-87-04-07 APPLICATION SUBMISSION Dear Trustees: Attached, please find four (4) copies of plans and application package for the legalization of an existing two story deck on existing residence. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716