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HomeMy WebLinkAboutHintze, Hank 4RCHILTECTURE Operating Business Address:15400 Main Road.Mattituck,NY 11952 Brooklyn Office:254 36"'Street,Building C 256-257.Brooklyn,NY 11232 C Business Phone:(516)214-0160 Anthony Portillo:(716)572-4741 Date: August 17,2021 Southold Town Trustees 54375 Main Road Southold, N.Y. 11971 E LLL E 0 1111 E qD ! RE: Hank Hintze a AUG 18 2021 SCTM#1000-053-01-15 5902 Brooks Road Greenport, N.Y. 11944 Southold Town Board of Trustees Dear Trustees Board, We are withdrawing the Administrative Application for the deck, steps and proposed non-turf buffer. We have reapplied for a Wetlands Application for the expired application#9426. Please contact our office if you have any questions. Thank you, Jess Magee AMP Architecture Glenn Gol )lith, President O��Su . pG Town Hall Annex A. Nichoias Krupski, Vice-President „� tip, 54375 Route 25 John M. Bredemeyer, III o �` P.O. Box 1179 Michael J. Domino 0 Southold, NY 11971 Greg Williams �1'd1p® Telephone�a®�� x -1892 631 765 6641 Fax BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: AMP Architecture'on behalf of HENRY HINTZE, LYNN McMAHON 8 & MARIE BASILE request an Administrative Permit for an as-built 403.5sq.ft. deck with steps to ground; establish and perpetually maintain a 437sq.ft. landward of the bulkhead. Located: 560 Pipes ,Neck Road, Greenport. SCTM#: 1000-53-1-15 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 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment 'Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other L'OT 1 SITE LAYOUT - NOTE 2 1 TH15 IS AN ARCHITECTS SITE PLAN 4 IS TAX MAP# 5UBJ00T TO VERIFICATION BY A LICENSED SURVEYOR THE INFORMATION REPRESENTED ON THIS 517E PLAN 15 TO THE D19TRICT R-50 (NON-CONFORMING) ARCHITECT'S BEST OF KNOWLEDGE. 2 SURVEY INFORMATION WAS OBTAINED Dr=50RIPTION AREA %LOT FROM A SURVEY DATED MARCH 26,201q COVERAGE AND PREPARED BY, PROPOSED NO-TURF TOTAL LOT AREA b'SCIB'o 9 F. SUFFER,451 5 F,AREA TO MICHAEL K WICKS 5E PERVIOUS TERRAIN 200 BELLE VIEW AVENUE EXISTING HOU5r=W SCREEN PORCH 1,4&1.0 S.F. 1'7. CENTER MORICHES,N.Y.IIq54 544 00'35 TELEPHONE. (651)8-74 0156 EXISTING FRAME!DECK 405 5 S.F. 4.1% Dry TOTAL AREA OF ALL STRUCTURES le,64 5 5F. 2117% MAXIMUM COVERASIE ALLOWED20% -ALL LOT COI 15 EX15TINS 41 z & Loc OF DEAD-ME LLI INSTALL m IN REPAI m 10'MIN. EXISI--------------------------------- 2 STORY FRAME 41 0 i� :':I DWELLINO U) FF-10.bq' u BF=3.4.2 > T� al ka" E C E iIr > > 6 0 9 1019-------- Io JUL 2 --- ----- --- 0 j 1 i O( � � ,t opt 2021 qI ut PROPOSED I/A OKTS A.1 235, I ----------- - - - Southold Town -111I — —L— — �L - ci� N44°53 40"W I Board of Tr-m6- 51 SF EXISTING 1 SEAWARD STEPS ARCHITEOTURAL 51TE PLAN SCALE,I-I .9 r6 MEN RIDGE HEIGHT-FROM GRADE 2 In az . < r6EXISTING SECOND FLOOR z FRAME DECK PRO)ECT-, (REBUILT) BULKHEAD,(DI ExiSTINS,FIRST FLOOR IL zoom AND REBUILT AFTER ADDITION ----------- RELOCATED HURRICANE SI ELEV +10.1' ---------Fj ml - STEPS _.tXISTIN6 5ULKHEADljd['-, %NORTH ELEVATION&RADE NEWLY INSTALLED DEAD-MEN ELEV.-;-755'�P' 590 BROOKS ROAD ELEV 416' GREENPORT,N.Y.11944 ISI BASEMENT DRAWING TITLE: ARCHITECTURAL SITE PLAN EXISTING 13A5EMENT EX15TINO EARTH SOUTH ELEVATION 5RAQE SITE SECTION/SIDE ELEVATION ELEV +o ol PAGE:- MEAN 1-115H kqATER MEAN LOk4ATER lz I A-100 INLET CONNECTING TO--7 51TE NORTH SIDE ELEVATION PIPES COVE AF=07/06/2i t GRAVEL DRIVEWAY LAND N/F OF COUNTY OF SUFFOLK Pipes Neck RoadE E D W E (BROOKS ROAD ` ) POLE E z N94050'20"E 50.00 `�% JUL 2 0 2021 m MON. FND. -+9.42 +9,15 Southold Town Board of Trustees Lq d 5.4'r W f 'A 6FR0 ME � p O SHED +7.92 +7:90 21.9 SCREEN ROOM "y °O 1 STORY 0O 22.8 +7.9 d Ile -6.4' +7.67 SHO ER a, o U93 2"i Cq 0 1 STORY T 33.3 c� h 0 y +7.72 O 1007 WOOD DECK (241 m +7.56 O CL o Irj m Cq 6 WD. PLAT. .F FLOOD MAP DATA: MAP #: 36103CO159H RAG #1 MAP DATE: SEPT. 25, 2009 +7.81 +7.81 "� FLAG #7 0 FLOOD ZONE: XA,FAG#2 BULKHEAD i7 \ � J r co a FLAG #3FLAG #5 FLAG #6 W +2.32 a FLAG #4 MEAN HIGH WATER TIDAL WETLANDS BOUNDARY v FLAGGED BY CHUCK HAMILTON, +1.30 +0.87 AM WEBER ASSOCIATES - 00 JULY 27, 2018 0 +0.49 v z V w MEAN LOW WATER 0 0 0 0 a N5>°58'0511 z 50.36 y W TOWN a OF SOUT.HOLD n SUR VEYOFPROP�'.R�'Y r1I 0- SITUATE 1. .7 PROP 1. PROPERTY KNOWN AS TAX MAP# 1000-053-01-15 GREENPORT 2. LOT AREA =8,593 SQ.FT. (0.206 ACRE(S)) 3 TOWN OF SDUTHOLD 3. THIS SURVEY WAS PREPARED USING A TRIMBLE S3 ROBOTIC TOTAL STATION. c SUFFOLK COUNTY, N Y. 4. PROPERTY CORNER MONUMENTS 'WERE NOT SET AS m PART OF THIS SURVEY. a SURVEYED: FEB. 21, 2018 5. ELEVATIONS REFER TO A NAVD88 DATUM. 3 W,FLAGS: AUG. 13, 2018 STANDARD NOTES: ° r 1.COPYRIGHT 2017 MICHAEL K.WICKS,LAND SURVEYING COPIES OF THIS N NOT BEARING THE LAND SURVEYOR'S INKED 2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY'MAP BEARING A OR ElABOS Yy 9 , OTti RECONSIDERED TO BE A VALID COPY. E LICENSED LAND SURVEYORS SEAL IS A VIOLATION OF SECTION 7209, .+5 � SUB-DUSION 2,OF NEW YORK STATE EDUCATION LAW. Y 3.ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL �„ r..L�. y ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL �I�;'�� IN'3\% MICHAEL K WICKS WORK AND OPINION. U, fgl;,l, .�y f!b•�" ` Y 4. CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP v 1{ � 1� LAND SURVEYING WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE Or-- PRACTICE FPRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE, ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, INC.THE CERTIFICATION IS LIMITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED, 200 BELLE VIEW AVENUE, 'E TO THE TITLE,COMPANY,TO THE GOVERNMENTAL AGENCY,AND TO THE CENTER MORICHES, NEW YORK 11934 LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP• ' 5,THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE. VOICE: 631,874.0156 - FAX: 631.909.3845 m B,THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE `�C O 4' unm-wickslandsuroeying.com P NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED. IF ANY UNDERGROUND �+� m IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN.THE - JPO VP RECORDS OF RICHARD C. DRAKE IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY. LAND - M 7.THE OFFSET(OR DIMENSIONS)SHOWN HEREON FROM THE STRUCTURES TO SCALE: SURVEYED BY: DRAWN BY: SHEET: _ THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS, 1 =20' B.W./S.S. ,S.S. 1 OF 1 U' POOLS, PATIOS PLANTING AREAS,ADDITIONS TO BUILDINGS.AND ANY OTHER MICHAEL K WICKS, P.L.S. ,#50390 TYPE OF CONSTRUCTION. U VIII ����il u� s iil''I►IIIIIIII, �lif�lllllil IIIA Iglllllll(I i ri �li�h 111 �r til IlBlul►'" I(11(�Il1l���I����I�'�I��� ��� q''� PHOTO #5 PHOTO #6 J i.. 17 1 PHOTO #7 Application: Hintze, Renew Trustees Applica- tion AMP Architecture—Applicant 590 Brooks Rd Greenport All flags and photos taken July 1, 2021 „-,f.YE WTCH SEE SEC.ND.Or3 O1,N00 ° SEE SEC.NO.WS xv0 • x 061101 / I3 WTCM 1r1E 602 >J10] t.a0 1.]Nq FeEWE 9EC.NO. OI8d6aa ,�/1�/ Q`rI NO .�aFOR GSLNO1 > ].erycl d e q SEE 4 0,-0J01 CWNTV o-0� ]owN6F s°urltotn ,S.0 0]62548 ],8 / law ai H011]ltOtD d �//i �I acxim I F'lP i ` 1 1 I `M J t]AA(q I SOUI,gID / � --SUFFOLK SUFGWN I t.'6'J I ( -- , � uq r'J iNEI 0>.to-tr leu t lr �a° 3 v J � r 0.14A a O 2 z � ..P -- � ]OWN OFMSWZNaA O SAT >� •, PIPES GREEK P� , lo � e•. B ',v,iw a� a dd �, rtcw'�:mr8OV1��is]n p �►, re 9 w , ,,f > B d d AfJ w y;' '• PJGJ y ,y C b. >u ra r�.. asp` 4O w t yb y a O'r y R. w' •y ,0e O be �T ya y'•O w w � y� y,� d 'RdM e �-�i`�� m.Ncl be 30 w 0't Q N0 Y'y SEE SEC NO s z....... ._. ____..... .... .. �....z ....... _._ ._.7....__..' �.. 8 WTCH UNE WTCM R. > SEE.C.00.0S] SEE SEC W0.1 ...C.-- M EESEC.-06)M _ NOTICE COUNTY OF SUFFOLK C x SouIeOEO SEGTKIN NO r •” Real ProPertY Tex Service Agency v ---� °xN]°„wR�xN.x,NY,,.F <� 053 A W �xcr xo N Y P W 000 PROPERtt MAP J BOARD MEMBERS y ' Southold Town Hall Leslie Kanes Weisman,Chairperson i �M 53095 Main Road •P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora + Office Location: Eric Dantes v Town Annex/First Floor, Robert Lehnert,Jr. 54375 Main Road(at Youngs Avenue) Nicholas Planamentor Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel.(631)765-1809,-,Fax (631)765-9064 August 2,2021 D r-= C E P V Jessica Magee AUG AMP Architecture,PLLC 9 2021 1075 Franklinville Road Laurel,NY 11948 Southold Town Board of Trustees Re: De Minimus Request,File#7234 Hintze, 590 Brooks Road,Greenport,NY SCTM No. 1000-53-1-15 Dear Ms. Magee; We are in receipt of your correspondence dated July 26, 2021 requesting a de minimus approval for proposed additions and alterations to a single family dwelling. In your letter,you explain that the applicant wishes to relocate the framed steps to the ground from the frame deck and to add a non-turf buffer,as depicted on the revised site plan dated July 7,2021. You further explain that the changes will not affect the natural resources behind the property. I reviewed your letter,the revised site plan,and the Zoning Board of Appeals determination dated January 17,2019, and have determined that your request is de minimus in nature because the changes do not increase the degree of nonconformity and upholds the intent of the ZBA decision. Please be advised that the conditions set forth in Appeal No. 7234 will still apply. Please submit to our office two signed and stamped site plan, floor plans,and elevation plans depicting the aforementioned changes, and contact our office if you have any further questions or concerns. I will instruct the office to s lid a copy of this letter and your request to the Building Department. Sine A' Leslie Kane"s Weisman Chairperson cc:Michael Verity,Building Department Michael J.Domino,President SO Town Hall Annex John M.Bredemeyer III,Vice-President °v O 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski A K GregWilliams Telephone(631) 765-1892 �yc®� � Fax(631) 765-6641 11 ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD n This Section For Office Use Only JL)) Coastal Erosion Permit Application Wetland Permit Application JUL 2 0 2021 Administrative Permit ---,,���Amendment/Transfer/Extension Southold Town Received Application:_ 7.20°21 Boar of Tru tee. Received Fee: $ �0.� li.0 Completed Application: $°q, Incomplete: SEQRA Classification: Type I Type R Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: oordination:(date sent): LWRP Consistency Assessment Form Sent: AC Referral Sent: Date of Inspection: _ -24 Receipt of CAC Report: Technical Review:. tPublic Hearing Held: ./5•°� Resolution: Owner(s) Legal Name of Property (as shown on Deed): Hank Hintze,Lynn McMahon and Marie Basile Mailing Address: 560 Pipes Neck Rd, Greenport NY 11944 Phone Number: 347-265-6606 Suffolk County Tax Map Number: 1000 - 053-01-15 Property Location: 590 Brooks Rd,Greenport NY 11944 End of Pipes Neck Rd (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): AMP Architecture Mailing Address: 1075 Franklinville Rd Laurel NY 11948 Phone Number: 516-214-0160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 8,593 SF Area Zoning: R-80 (non- confomring) Previous use of property: 1 Family Residential Intended use of property: 1 Family Residential 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? X Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s) on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: Agency Date Building Department August 1971 Building Department July 2003 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description(use attachments if necessary):_ FRAME DECK,REBUILT (403.5 SF) -RELOCATED FRAME STEPS,TO GROUND -PROPOSED NON-TURF BUFFER(437 SF) Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: EXISTING FRAME DECK,REBUILT (403.5 SF) - RELOCATED FRAME STEPS TO GROUND FROM EXISITNG FRAME DECK Area of wetlands on lot:_ 2,158 square feet Percent coverage of lot: 21.7 Closest distance between nearest existing structure and upland edge of wetlands: 26.5 feet Closest distance between nearest proposed structure and upland edge of wetlands: 30.4 feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? - cubic yards How much material will be filled? - cubic yards Depth of which material will be removed or deposited: - feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: N/A 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): WETLANDS ON PROPERTY WILL NOT BE AFFECTED BY ADDITIONS. 617.20 Appendix B Short Environmental Assessment Form Instructions for Cowletin� 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 _ P Name of Action or Project: HINTZE RESIDENCE Project Location(describe,and attach a location map): 590 BROOKS RD GREENPORT NY Brief Description of Proposed Action: -EXISTING FRAME DECK,REBUILT (403.5 SF) ; - RELOCATED FRAME STEPS TO GROUND FROM EXISITNG FRAME DECK - PROPOSED NON-TURF TUFFER(437 SF) Name of Applicant or Sponsor: Telephone: 516-214-0160 AMP ARCHITECTURE E-Mail: jmagee@amparchitect.com Address: 1075 FRANKLINVILLE RD City/PO: State: Zip Code: LAUREL NY 11948 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 thatX❑ 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: SOUTHOLD TOWN BUILDING DEPT ❑ MI 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •2 acres 4. Check all land uses that occur on,adjoining and near the proposed action. E]Urban El Rural (non-agriculture) ❑Industrial [—]Commercial ®Residential(suburban) El Forest ❑Agriculture KlAquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ a ❑ b.Consistent with the adopted comprehensive plan? ❑ X❑ ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ FRI 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:' a ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES LLJ —1 b.Are public transportation service(s)available at or near the site of the proposed action? L ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X❑ 1_1 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: ❑X 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ® ❑ b. Is the proposed action located in an archeological sensitive area? a 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES , wetlands or other waterbodies regulated by a federal,state or local agency? ❑X b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? I Ar 1 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional M 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? © 0 16. Is the project site located in the 100 year flood plain? NO LYES X 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? ®NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ®YES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: - _ r as 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ® ❑ s 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: ® ❑ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsornamme�e: ANTHONYPORTILLO Date: 7/13/21 Signature: {;,(fGB01 B•2�l�&4. 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 ® ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the a ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate =71 ❑ reasonably available energy conservation or renewable energy opportunities? - 7. Will the proposed action impact existing: ❑v ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? L�J ❑ 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, ❑ Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 i 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? 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. Town of Southold-Board of Trustees 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 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Imo'f 6 \2c f e._ 25r�-c. L nKoeI�t an ` owners of the property identified as SCTM# 1000- in the town of New York,hereby authorizes AMP Architecture 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. roperty Owner's Signature Prope y wner's Signature SWORN TO BEFORE ME THIS DAY OF 20 2 Notary Public CARA L.DEY NOTARY PUBLIC,STATE OF NEW YORK Registration No 01 DE6232372 Qualified in Kings County Commission Expires December 13,2022 Board of Trustees Application AFFIDAVIT J, LJO01 " BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE,TO THE BEST OF HIS/HER 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 INCONJUNCTION 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. ZZ__--7 Signature of Property Owner Signa a of Property Ovner SWORN TO BEFORE ME THIS DAY OF - -,20� otary Pu is CARA L.DEV NOTARY PUBLIC,STATE OF YORK Registration No.01DE6232372 -Qualified in Kings County Commission Expires December 13,2022 APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emolovees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. �/� I YOUR NAME: f1"r!f w 1 �.� �� Lc.AAA A !A0JVM)_ (Last name,first name,middle initial,unless you are applying in the name of some ne else or o her entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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 1'1� 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 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 that 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 l Submitted this day of' V(L{ ,200 Signature \ Print Name APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the nart of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: 6 �o (Last name,first name riddle 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.) TYPE OF APPLICATION:(Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or ,employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest" means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X— If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply) A)the owner of greater that 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 y f .20 Signature Print Name U l"h I t i _ I I Town of Southold LWRP CONSISTENCY-ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed ,action -will be evaluated, as to, its si ' cant beneficial and adverse-effects upon ihe-coastal area(whioh includes-all:of South6ld'TownZ- 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 sunnortina and non- sup ortina fa'ets. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall no"t'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# 053 _ 01 _ 15 PROJECT NAME HINTZE RESIDENCE The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Q 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) El (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: -EXISTING FRAME DECK,REBUILT (403.5 SF) -RELOCATED FRAME STEPS TO GROUND FROM EXISITNG FRAME DECK - PROPOSED NON-TURF TUFFER(437 SF) Location of action: 590 BROOKS RD GREENPORT Site acreage: 2 ACRES Present land use: R-80 (NON-CONFORMING), SEASONAL SINGLE FAMILY Present zoning classification: R-80 (NON-CONFORMING) ? 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: 3 (a) Name of applicant: AMP ARCHITECTURE (b) Mailing address: 1075 FRANKLINVILLE RD LAUREL NY 11948 (c) Telephone number: Area Code( } 516-214-0160 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑, No R 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 PROPOSED ADDITIONS TO THE EXISITNG HOME MAINTAIN_S THE CURRENT CHARACTER OF HOMES IN THE AREA, Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria 0 Yes❑ No 0 Not Applicable THERE ARE NO HISTORICAL OR ACHEOLOGICAL RESOURCES ON-THE PROPERTY. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III-Policies Pages 6 through 7 for evaluation criteria ❑ Yes ,❑ No Q Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III-Policies Pages 8 through 16 for evaluation criteria 0 Yes ❑ No ❑ Not Applicable EXISTING BULKHEAD AT THE WATER SIDE OF THE PROPERTY HAS A HIGHT OF 7.8 WHERE THE FEMA FLOOD ZONE IS AE 7. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria ® Yes ❑ No ❑Not Applicable NEW STORMWATER DISCHARGE AS A RESULT OF NEW BUILDING AREAS-W-ILL3-E-C�� NEW DRYWELLS. 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. ❑ ❑ 0 Yes No Not Applicable NO CONSTRUCTION WILL BEIN WETLANDS AREA. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable s 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. 0 Yes ❑ No ❑ Not Applicable ALL WASTES WILL BE CONTROLLED AND PROPERLY DISCARDED PIOBLIC 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. ❑ Ye -1l— No 0 Not Applicable THE SITE IS PRIVATELY OWNED AND DOES NOT AFFECT THE OPEN SPACES IT NEIGHBORS Attach additional sheets if necessary WORKING COAST POLICIES 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. 0 Yes ❑ No F1 Not Applicable PROPOSED ADDITIONS ARE WITHIN THE EXISTING BUILDING AND DO NOT TAKE AWAY FROM THE REMIANING NATURAL SHORELINE. 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. FVI Yes ❑ No ❑ Not Applicable ` EXISITING WETLANDS WILL NOT BE AFFECTED. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No❑ Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. 0 Yes ❑ No ❑ Not Applicable THE ADDITONS ARE DESIGNED IN ACCORDANCE TO BUILDING ENERGY CODE PROGRAMS. PREPARED BY ANTHONY-PORTILLO TITLE AGENT DATE 7/13/21