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Polidora, Joseph & Deborah
Glenn Goldsmith, Pr nt 0�0$UfFO(�C01 � Town Hall Annex A.Nicholas Krupski, V;�G eiesident �� � 54375 Route 25 John M. Bredemeyer III y P.O. Box 1179 Ze Michael J. Domino Southold,NY 11971 Greg Williams dap! ��0� Telephone(631)765-1892 I Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD r Date/Time: ;��/21 2%20 Completed in field by: Nigel Williamson on behalf of JOSEPH & DEBORAH POLIDORA requests a Pre-Submission Inspection to discuss proposed additions/modifications to the property consisting of: demolishing the existing single story entrance and bathroom and construct a new single story foyer and bathroom with basement under; construct an enclosed outdoor shower open to the sky; construct a new covered entry porch; construct a new enclosed connection between the new foyer area and existing garage has a laundry area; demolish the existing covered porch at the rear of the dwelling and construct a new 38'x18.8' single story addition; construct a new window well; construct a stone patio between the new addition and existing garage; and remove the existing cesspool and install a new I/A OWTS system enclosed with a new concrete retaining wall. Located: 1055 Point Pleasant Road, Mattituck. SCTM# 1000-114-1-1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: �Ilro P OS�a oUSe .�,ac 4® r�o,l�. �uc���C' lard wacj :A na-i r-,np APS` Ii41CC A0" 0,3n Til6� I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: ✓ J. Bredemeyer M. Domino /G. Goldsmith V1 N. Krupski ,,//G. Williams Other r VIE JUN 2 3 2021 Southold--,----J TOwn :j LBOard Of Trustees AbbITIOIJ j/ sxvr,-mv-&q- VaEt 4 It 38!-& 9 D D a D r.r P r rw rt c , FATIV 181 T&AT FcYm-- ExTrv- &I L)4 LE -441 EXT-Cr. CT I&QArve- .S=tqo 1B�� hREA silt _C't-VgA4 BA-m-m Ev L)A.JD" . P-. 4 NILS- POLIZ)OIZA, 1.5-S pvtOlr PLEASANT ROAD t-IATTI-ruc,1:7 O.Y 11952. 24'HA S)c A L__6: 1I-04 SURVEY OF PROPERTY LOT 3- MAP OF POINT PLEASANT FILED: MAY 17, 1 91 6-MAP NO. 720 SITUATE MATTITUCK I S CREEK TOWN OF SOUTHOLD HOWARD'S SUFFOLK COUNTY, N.Y. lo-7.26 N79°17'28"E TAX MAP NO.: 1000-1 14.00-01.00-001.000 , LOT AREA: 29,985.57 S.F. (0.688 ACRES) A�64N-_ _ LOW----- -WATER'/ °W DATE SURVEYED:JUNE 29, 2020 r Y o PROPOSED ADDITIONS:JUNE 17, 2021 r LO � 2 LO r O (� 1 ELEVATIONS REFER TO NAVD88. INTER-TIDAL VEGETATION � 0 40 80 Feet SCALE: 1 INCH= 40 FEET 6 6 6 PPI STONES 10 12 TIDAL WETLAND BOUNDARY AS FLAGGED 10 _ BY SHAWN M.BARRON.M.S.ON JUNE 22.2020 1 12 ,6. 2 14 011 6 1 (31 CLW 9 ERW is NATURAL VEGETATION LINE BOU1J� 0!?, _ PROPOSED RETAINING WALL 20 PROPOSED I/A SANITARY 1 `?' '18 DESIGNED BY OTHERS 50•ADJACENT O T' WELL RADIUS 011,�,1L2 Y aSL- R ypgLL - -- a w EXISTING LOT COVERAGE: W APPROX.CESSPOOL 20 I BOULDER WALLTO BE REMOVED J U LOCATION AS PER 38.00 PROPOSED 1 STORY ADDITION RESIDENCE=930.39 S.F.OR 3.1% 0 ADJACENT SURVEY 26 WITH BASEMENT UNDER � .7 O (TO BE PROPERLY p•� r GARAGE=489.25 S.F.OR 1.6% L4 ABANDONED)- - - -22 �a a m pEN-� / 2 OPEN PORCH= 214.30 S.F.OR 0.7% J 1W ADJACENT P4 CELLAR PORCH I PROPOSED NEW 4.BXS.9 / O Z WELL RADIUS )S.� ENTRANCE --ENCLOSED CONNECTI ON � GAZEBO=81.58 S.F.OR 0.3% FRAME 1,5 STORY z 0 SHED 1&02H � = TOTAL=1,715.52 S.F.OR 5.7% N 2.6W VSTORY RESID ENCE NCEM \ J / Q #1055 J I.., z, $APQt' 1 1.2' 6. = 20.3 LY EXISTING SINGLE STORY 24. STORY PROPOSED LOT COVERAGE: 1.5 J PLAT / O Q (FOYER/BATH AREA)TO BE FRAME RESIDENCE=930.39 S.F.OR 3.1% 0 DEMOLISHED& 26 AT. GARAGE j 1i RECONSTRUCTED WITH G.FL.=29.3 LL GARAGE=489.25 S.F.OR 1.6% \ BASEMENTBASIfMENTUNaER- _ WELL 1.6' 100'ADJACENT Z \ j WELLRADIUS Q GAZEBO=81.58 S.F.OR 0.3% Z Z W 100'ADJACENT 5HQ ER TO OUTDOOR BE Z REAR ADDITION=709.46 S.F.OR 2.4°/D Q WELLRADIUS RELOCATED PROPOSED I JJQ COVERED PORCH=`42.00 S.F.OR 0.1% J PROPOSED \ .s OUTDOOR SHOWER OVERED RED PORCH ENCLOSED ADDITION=42.73 S.F.OR 0.1% LOT 3 'l TOTAL= 2,295.41 S.F.OR 7.6% Q UTILIT' UTILITY OPOLE POLE p �/ a WELL (O LJ _ " Y Y 0 TEST HOLE, QQ N Qm Y O J ELEV.29.16: W 00 W 0 m O 00 O z N. ('� 0 ° (� 102.00 MON.FND. IJON.FND. t, v /x f^ 51.00 S$3°16'00"W v 1 .......:.....OY.................-........... ...............2K........... O 29ry_ GRAVEL ROAD I' JUN 17 2021 I Y ...........,fix.:...._.............. ..................e,......... HOME PjKE Southold Town Y (POINT PLEASANT ROAD) Board of Trustees EGAL NOTES g '..COPYRIGHT 2O 19 AJC LAND SURVEYING PLL.C.ALL RIGHTS RESERVED. UNAUTHORIZEDALTERATIONORADDITIONTOT SSURVEYMAPBEARINGAUCENSEDLANDSURVEYOR'SSEALISAVIOLATIONOFSECTION72°9, UB-0NISION 2,OF NEW YORK STATE EDUCATION LAW. -I.ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYORS EMBOSSED SEAL ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK Y % OPINION. n.CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFYTHAT THE MAP WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF PRACTICE -0R LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS,INC.THE CERTIFICATION 15 LIMDED TO PERSONS Z -OR WHOM THE BOUNDARY SURVEY MAP IS PREPARED,TO THE TITLE COMPANY,TO THE GOVERNMENTAL AGENCY,AND TO THE LENDING INSTITUTION LISTED ON Q HISBOURDARYSUFNEYMAP. Pmt TEST HOLE (NOT TO SC,i�E_ 1 THE CERTIFICATIONS HEREIN ARE NOTTRMISFERABLE. Q THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE NOTALWAYS KNOWN AND OFTEN MUST BE ESTIMATED,IF ANY NDERGROUNDIMPROVEMENTSORENCROACMMENTSDUST ORARE SHOWN.THE IMPROVEMENTS ORENCROACHMENTS ARE NOTCOVEREDBY-5SURVEY. SHAWN M.BARRON,M.S. i.THE OFFSETS(OR DIMENSIONS)SHOWN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE �A �fiY-O� DATE:JUNE 19,2020 _ ;,RE NOT INTENDED TO GUIDE THE ERECTION OF FENCES.RETAINING WALLS,POOLS,PATIOS PLANPNG AREAS,ADDITIONS TO BUILDINGS.AND ANY OTHER TYPE 7 -IFCONSTRUCnoN. i.ONLY SURVEYS BEARING THE MAKERS EMBOSSED SEAL SHOULD BE RELIED UPON SINCE OTHER THAN EMBOSSEDSEAL COPIES MAY CONTAIN GRADE ELEV.29.16 O .!NAUTHORREO AND UNDETECTABLE MODIFICATIONS,DELETIONS.ADDITIONS,AND CHANGES. ,.PROPERTY CORNER MONUMENTS WERE NOTSET AS PMT OFTHIS SURVEY UNLESS OTHERWISE NOTED. SANDY LOAM W/GRAVEL -� 0.ALL MEASUREMENTS REFER TO U.S.SURVEY FOOT. ♦ * SM 5, SW COARSE SAND W/GRAVEL J a i AJC LAND SURVEYING PLLC oao -_ 10, SAND W/GRAVEL LAND SURVEYING & PLANNING �,,�� SP MIX ED y 77 S. COLEMAN ROAD, CENTEREACH, NY 1 1 720 15' PHONE: 631 .846.9973 17' EMAIL: AJC246@OPTONLINE.NET ANJOSEPH CECERE PRNO WATER ENCOUNTERED PROFESSIONAL O ONAL LAND SURVEYOR r� r Nigel Robert Williari son .Architect P.O. Box 1758 Southold, NY 11971 Phone 631.834.9740 E 6 2 n U V -E June 23, 2021 Mr. Michael J. Domino, President l5 U0 Board of Town TrusteesFRJUN2 3 2021 54375 Route 25 P.O. Box 1179 Southold,NY 11971 Southold.Towrr, Board'ofTrustees Re: Polidora residence 1055 Point Pleasant Rd.,Mattituck SCTM 1000-114-0001-001 Dear Mr. Domino: The following is a description of the proposed project. 1. Demolish the existing single story entrance and bathroom and construct a new single story foyer,bathroom with basement under. 2. Construct an,enclosed outdoor shower open to the sky. 3. Construct a new covered entry porch. 4. Construct a new enclosed connection between the new foyer area and existing garage as a laundry area. 5. Demolish the existing covered porch at the rear of the dwelling and construct a new 38'-0"x 18'-8" single story addition. 6. Construct a window well from the new basement. 7. Construct a stone patio between the new addition and existing garage. 8. Remove the existing cesspool and install a new UA OWTS system enclosed with a new concrete retaining wall. I am also enclosing a sketch plan labelled"SKETCH F". I trust that everything is in order. If additional information is required please do not hesitate to contact me. I thank you for your assistance in this matter. Your's faithfully, tigel�Robert Williamson R.A. Encs. 7 1 � Nigel Robert Williamson D Architect JUN 17 2021 P.O. Box 1758 Southold, NY 11971 outhold Town Phone 631.834.9740 Board of Trustees June 17,2021 Mr. Michael J. Domino, President Board of Town Trustees 54375 Route 25 P.O. Box 1179 Southold,NY 11971 Re: Polidora residence 1055 Point Pleasant Rd.,Mattituck, SCTM 1000-114-0001-001 Dear Mr. Domino: I am requesting a pre-inspection on the above mentioned property on the next available date. I am including the following items. 1. Affidavit. 2. Applicants Transactional Disclosure Forms. 3. Agent Transactional Disclosure Form. 4. Authorization form. 5. Copy of the survey showing the existing and proposed structures. 1. A check in the amount of$50.00 for the application fee. I trust that everything is in order. If additional information is required please do not hesitate to contact me. I thank you for your assistance in this matter. Your's faithfully, N' el Robert Williamson R.A. nes. Board of Trustees 1- ,lication _AFFIDAVIT OJ ,A BEING DULY SWORN D OSES AND AFFIRMS THAT HE/SITE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/TIER KNOWLEDGE AND BELIEF,AND THAT ALL WORD WILL BE DONE IN THE MANNER SET FORTIS IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLID TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO FOLD 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 PROPER'T'Y 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. 4Of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS 12 DAA'OF 2�� DAVID J.JANNUZZI NOTARY PUBLIC,STATE OF NEW YORK Registration No.02JA6052585 Qualified in Suffolk County 2n2� Commission Expires February 13, Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tlry Town of Southold s Code of t'thics prohibits conflicts of interest pn the pari of town officers and-cmployees.'1`he�n19pOse of this form is to�rovidc information whicircan alert thy to�wm ofnossible conflicts of interest and allow it to Iake whatm cractton is necmigy to avoid same. YOURNAME: (Last name,foist name,�tiddl 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 Tnistee Change of Zone Coastal Erosion _ Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) 00 you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of thcTown of Southold? "Relationship"includes by blood,marriage;or liusiaess'intcrest"Business interest"organs a business, including a partnership,in which the town officer or employee has even apartial owngfship or(or employment by)a corporation in which the town officeror employee owns more than`S°/a of te_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/agGnt/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 ofgreater than S%a of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the Iegal orbenefieial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this da f ��?l Signature _ Print Name 0 Form TS I 1, - APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL.DISCLOSURE FORK[ .The Town of'Southold's'Code of Fthics nrahibits conflicts of i itetcst on-the part oi'town 4ficers and emnloyecs.'1'he-nurnose of this form is piavide inforindtion-whicii can-alert the,town of possibl&conflicts of interest and allaw if to take whatever action is- ne,ssary-to avoid same. YOUR NAME: _6 1( I O rQ,-_ Woo --- (Last name,-first name,iriddle initial,unless you are applying lrr 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,patent,,,or child)hapc a relationship wiEh anyofficer or employee of the-Town of Southold? "Relationship"includes-by blood;agarriage;_or.business'uitereik°`63 iness,interest'?"means=a businc"ss, including a partnership,in.--which the town ofliccr or employee has even apartial'owdctsitip ot(ttr employment by )a corporation hich the town oflieci•or cuiployee.'owns more than 5%of the shares. in i� 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 applies►itltigcnVrepresentative)and the town officer or employee.Either check the.appropriate,line A)through D)and/or descOhc;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'ofgreatertlian.5%,of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial'owner of any interest in a non-corporate entity(when the' applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP ' Submitted this � day Signaturd Print Name�b^�rab (ul i do ra- r, . Form TS 1 APPLICANT/AGENT/REPRESENTA.TIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emp]oyees.The purpose of this form is to provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is nemssaa to avoid same. YOUR NAME: l LL L A PA C4J (Last name,fust name,griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood, marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO Ifyou answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicantlagent/representative)and the town officer or employee.Either check the,appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of v 201 Signature l Print Name Form TS I f l Board of Trustees J,, _1l ication AUTHORIZATION (Where the applicant is not the owner) UWe, �0 +P(k 00A/VdV\ D V owners of the property identified as SCTM# 1000- d 14-QO 1 - ®®OI in the town of Ha r-r l Tuck ,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. Property ex's Signature Property Owner's Signature SWORN TO BEFORE ME THIS L �DAY OF 20 Notary Public „-13M --- SH BCC.110.101 "W wnr2 xo. z——————— s-0ot �._ sEc.No. wm �•• ____ j' �� O '\t scr7on oisacrs viN oc SOurlrol9 / i0 a 2 M1 h II.Y 4 WTRIICI(PAM g9TPoC! �� ex_ .W 9 .� ' �` ,^p ,b~ •rt��� ,��? % � SRS M1, � E 1 Sy e A' \ ,,•]yM1 .� ? 9 E tt to ,ny u., ` ap ,ylcl ,9K1 IOR PCL NO. K fA. m as ��. t , 14. o SEE 3EC.W. ., 19 20imkd ,2 TAA ns,2as IEM sVROtX ' 9 • 0.1 9 6 142- IOPasMr£i S I I � 14 7 42 UA I 2AN” 3 132 M fOR PCL ND. SEE]EC.NO. / SEE 8E4 N0. ft Mlq! 1MTGN ----z----y,¢ 1]H } 7'0•� 9 W1G --� l9VE 13a..T L COUNTY OF SUFFOLK © K a __ NOTICE TY ,s, gO�OEp SECTION NO Eo ______ s9.u. — -- Real Property Tax Service AgenCy v r —�— (Z7) twz,Hrvcx K,v9*�c9.9v[aP E v N °r.s.— -- _ 99v9„9.�M1,RN.11�9.NY,,., N t 114 O rwria a 9. a,,Wl 121'] ONs N 7v Crrq 10M ---- PROPERTY IMP