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TR-10210
Glenn Goldsmith,President ®f 50 � Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric SepenoskiE Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � y� Fax(631) 765-6641 COUI�T`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 19, 2024 Roger K. Siejka PO Box 23 Mattituck, NY 11952 RE: 955 BLOSSOM BEND, MATTITUCK SCTM# 1000-115-6-22 Dear Mr. Siejka: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 19, 2024: RESOLVED that the Southold Town Board of Trustees grants a One (1) Year Extension to Wetland Permit#10210, as issued September 14, 2022. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerel Glenn Goldsmith, President Board of Trustees Roger K.Siejka P.O.Box 23 Mattituck,NY 11952 Date:8/7/2024. Board of Southold Town Trustees P.O.Box 1179 53095 Route 25 Southold,NY 11971 Re:Extension of Permit Permit#:10210 Property Address:955 Blossom Bend,Mattituck SCTM#1000-115-6-22 I am requesting an extension of time for the above-referenced permit. I can be contacted at the above address or 631-298-1422 Thank/you Property Owner shakradio@aol.com Glenn Goldsmith,President l��Ig so Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ��n ��� P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/z constructed �° When project complete, call for compliance inspection; § NSIZ a BOARD OF SOUTHOLD TOWN TRUSTEES F Jr SOUTHOLD,NEW YORK PERMIT NO. 10210 DATE: SEPTEMBER 14,2022 .1 ?,A ISSUED TO: ROGER SIEJKA R PROPERTY ADDRESS: 955 BLOSSOM BEND,MATTITUCK SCTM# 1000-115-6-22 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on September 14, 2022, rins and and in consideration of application fee in the sum of$250.00 paid by Roger Sieika and subject to the Te Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a two-story single-family dwelling with a basement; Basement Floor Gross g Sq. Ft.—1,216 sf; First Floor Gross Sq.Ft.—1,216 sf; Second Floor Gross Sq.Ft.—1,216 sf; Front Porch Gross Sq.Ft.—47 sf; Side Porch Gross Sq. Ft.—68 sf; Rear Deck Gross Sq. Ft.—206.5 sf; Driveway .6 Gross Sq. Ft.—751 sf, Sanitary—FujiClean CEN-10(1,000 gal.UA System)w/(2) 101-0" DIA.x 5'-0" deep leaching pools; establish and perpetually maintain anon-disturbance area seaward of the split rail fence; and as depicted on the revised site plan of Raymond Nernschick AIA,last dated September 21, 2022 and stamped approved on September 22,2022. Z IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,and these i. presents to be subscribed by a majority of the said Board as of the day and year first above written. 5� CW R 'SM TERMS AND CONDITIONS The Permittee, Roger Sieika residing at 955 Blossom Bend Mattituck New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. ®� U Glenn Goldsmith,President soTown Hall Annex®��' �i�0®� A. Nicholas Krupski,Vice President ® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 C®UNTI,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 22, 2022 Raymond Nemschick Nemschick Silverman Architects P.C. 66 East Main Street Patchogue, NY 11772 RE: ROGER SIEJKA 955 BLOSSOM BEND, MATTITUCK SCTM# 1000-115-6-22 Dear Mr. Nemschick: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, September 14, 2022 regarding the above matter: WHEREAS, Raymond Nemschick, AIA on behalf of ROGER SIEJKA applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 29, 2019, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 16, 2022, June 15, 2022 and September 14, 2022, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ROGER SIEJKA to construct a two-story single-family dwelling with a basement; Basement Floor Gross Sq. Ft. — 1,216 sf; First Floor Gross Sq. Ft. — 1,216 sf; Second Floor Gross Sq. Ft. — 1,216 sf; Front Porch Gross Sq. Ft. —47 sf; Side Porch Gross Sq. Ft. —68 sf; Rear Deck Gross Sq. Ft. —206.5 sf; Driveway Gross Sq. Ft. —751 sf; Sanitary— FujiC.lean CEN-10 (1,000 gal. I/A System) w/ (2) 10'-0" DIA. x 5'-0" deep leaching pools; establish and perpetually maintain a non-disturbance area seaward of the split rail fence; and as depicted on the revised site plan of Raymond Nemschick AIA, last dated September 21, 2022 and stamped approved on September 22, 2022. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very ruly yours, d i Glenn Goldsmith President, Board of Trustees GG/dd � s . M1A� SST �A TA DA7ID.BlE3,295,P1P>�i41®HY ,CYNLBL95LAND St.RVEYLI2 154-2-7 ,/ ci�q 5(BDIV/5/ON: M17LGK E5TA7E5 Y l�/l" l ! MAP �� 1>nt L�ao Fr lgll EKY/YA7l3t /� $ , o PROPERTY ADDRESS BL0550M B51D L�BAA®54NTARYhT�7LA �4 TOIN op \�y` © HAMnM MY ZOMW D15T -40 tp'amRd�' 2 S. 87°26'30"E. 128.74' �w� LOTAREa 40,MlWFr(01 ACI ace� A S BVILOW AREAS. MntUluck ^` . FLAG F/R.5T FLOOR 5FWW FLOOR cal Society c a 0��t� 3.2 — LIVABLEAREA: 1228 we I23/ 5�GT 5/TP ego nj• - - - - - - DEC FLA6 LOGATION5,TYP. PA 7705/7�RAGES/DFGK5,— 340 35 '�c0°DA1p ® ' W r �— —� EX15T1N6HELL gb �• - - - - - - - 4 LOCA T/ON5 Xc e 32 LOT 22 NYS RE6ULA7W FRE5HMATER 15' huh a AETLAW BOUNDARY A5 DELINEATED BY NY59EC ON 7112//9 A5 PER ZONE MAIAE 2 "a 115 Pie FEMA� �' N i� ki PROP05ED 'Q AAV LOCA47ID QN OCTOBER A X 20 � \• � 20/9 BY 5URVEYOR NATHAN TAFT (6.0 N6VD2�U n \. ' 5 r EM Y GORWIN Ill ._RAG Xe.165 ROC R SILL \ �c 11 - A _ (L11FROVED WITH PUBLIC INTER) / �' EX15T1N6 PELL I BUILDABLE AREA - ...... LOCATION - _ - - - LIMITS OF GLEARlN6 AND L.• -. P a �® ,.B' 'A'v 6ROUNDDl5TURBANGELINID WEAL LOCATION �1116. : �t� R�'.OF TRUSTEES usTEEs �Oy • - - e zaX 6 WITH HAY BALE AND/OR 51L - -� FENGIN6. 5g DETAlL5,DWG. N.T.S. • NETL4NDD157ZROANCE FP-3. F, SOIJTHOL® WITHIN 100 FT SETBACK 6 B_25 =1,52/50.1 r PROVIDE-SPLIT RAIL FENCE Xa 11.4 N ALONG NETLAW5 GLEARIN6 LIM/T5. ®�T 8p0p' r e. 5'-O'WIDE ACGE55 ARaW i.e. 11.05 Q®P�'lhE7ER OF HOUSE(N d EJ I s 74X s ° l SIDES GRADE. 15.0 - - o (REPLACE N NEW lA 5Y5TEM� LOT 21 FLAG ® pROPOSm Y LOT 23 11A — - 2-57ORY_ I i.e. 10.50 N/0/F XB_14.7 5.00' 51WLE TE5T HOLE B-1 / LP 1(dRN AIACNISN o Q (VACANT) FAMILY o� D{$LING i.e.10.40 . FE V I Pr EFLAG 'ry�os FF GO i.e. 10.35 24.42' '• • h � CLEANOUT 6 LP i.e. 10.35 • 8•I3.0 I A IIEW l/A 5YE,A 57EM(RUICLo P o SEP 2022 4000 GAL.CEN-10 11A 5YSTPM) 6 8.14a / (2)10'DIA.5 FT.DP LEAGHIN6 g Southol Town � F FL40 NEWGRAVELDRIVEWAY. PART. 6RA�.I I 6 PLAN Board o rustees a 131 X / MO' ° NEW O.H.P011ER LllES. SCALE= I"=20'-0" 8.145 VERIFY TION 1N F1EL9. _ LOGAT/ONOFAEWPUBLIC 41 ,5�(pANSION OOL ARE® q � plt HATER-S�wcE GOMECTE? R pp 5 O W>4TER RETENTION CALCULATIONS � DAIEoFa7 „ TO WATER MAIN IN STRg7 , lv"' X8.224 �i� 4/29/19 ICDrV WWM U5E MATERIAL AREA(5F)X RUNOFF WEE=E&VIV.DRAIN DE5/6N X D£5/6N RAINFALL=DES/6N VOL(GF1 i .'� Q� S� � 5/50/19 DEG/WWM COMMENT) \ .3 .y e 21.0 I�r D XB_� RCOFING ASPHALT W2 5F X 10 X 0.16=1385 AREA 1 GF STORAGE REGUIRID = 1385 USE(U DRYWELLS 3'-6'DEEP �- � fn 52820 DeG COMMEAT./' g A'� 99 X a.2�9 J V 5H/N6LE STORAGE CAPACITY OF 8'DIA 8116 =4224 B'DIAME7£R R/N6=3S VF. j{}1 x y_. 00 1/821 DEG COMMP_fcf ��®fi �� ��� Y C11 _3 102221 TRWTF�/ w1 XH 212 O S S 0'r BOADWA AREA 1 VF.OF STORAGE REWRE9 =33 VF. 06/1122 TRUJ711U B_219x B PH N o/P RG1OFlA� ASPHALT 707 5F X 1.0 X 0.16=1/3.1 AREA/CF.5TORA6E A55VIREV = 2713 USE(U DRYNYL5 6'-6°DEEP a\ ' 06/5022 TRW7EFf COMMENT! SCALE= I"=40'-0• // �� �- ' Citi AS YARYBE o PALIcIo 5H/A57LE 51ORA6E CAPACITY OF B'DIA RING =4224 8'D/AI-VER R/N6=65 VF / 092122 REVIA01V PER ReQUVT (IdIPROVND IF=PUBLIC 1I TER) o� fit I �O DRIVEWA ASPHALT 9B9 5F X 10 X O.16=1592 4 ON EARNN DNYEY AREA l VF OF STORAGE REC.Y/IRED =6.4 VF. ��.i•'' ILVPROVED) TOTAL: 2713 Nemschick Silverman Architects PRD'E`TTME DATE NSA RtDEcr.. '...the buslre"a WARCHITECTURE' JIF 1KA Rr-APEACE 1025/18 17-1938 6L0JJEM bEAD SCALE DRAWNG NO: MATTITUCIC NY 160 MAIN STREET,SUITE 200F-s�,AxA/NOTED SAYVILLE, NEW YORK 11782 D6114CT: WC71M aLoac tor. a+AWN BY. Phone: 6315632130 Fax: 631 563 2139 www.nsarch.com .conaanmoraemocR.rmaw.nan<asrc 1000 115 6 22 ECF t S. 870261-30"E. 128.74' .aG S�GQ��,v►1O�►' - - - - - - vEG FLAG LGCATlO1K5,7YP. 6 NY5 REGULATED FRE-5"TER V l9ETLAW BOUNDARY'AS - W DEL1NE47ED BY NY5DEG ON 7A2/l9 rn l= ANP LOCA6 MV QN 0CTj=R*'q, D 20/9 BY 5ANEYOR NATHAN TAFT GORW/N 111 7� 1/0/P ROGER SIEJIG _ FRESHWATER _ ' (IM PROVED WFZf PUBLIC INTER) 'a PEnAND5 l iiJJ` + LIMITS OF CLEARIM6 AND ��pA• GROUND DW HITH HAY BALE AND/OR FENCING. 5,EE DETAM5,PH&. PP-3. PROVIDE 5PL/T RAIL FENCE O ALONG PE77-AND5 GLEARIN6 LIM/75 6p ax, yp s 5'-O'WIDE ACCE55 AROUND DECK o PERIMETER OF ISE(N d EJ - • m 725' 15b0 5/DE5 FLAG PR7' fi.Y. Opo-a� '2-STORY- 5.0 51N6LE I FAMILY I DhELLIN6 FLAB Tlq b FF.HF✓200 I 0 00 ;X-" . o GLEANOUr MA WJY l/A SYSTEM 11GLEAN I,01.'10 , E C E I E � , GAL.GEN-l0l/A 5Y57PM) (2J IO'DIA,5 FT.DP LEACHING POOL-5 RM S E P 2 2 2022 cz a i '' 41' Southold Town EXPAN5/ON POOL Board of Trustees /1 BEND _ .5,'+-`E® `'�/.�1� � DATE DFSCWMK SSI g0ADyyAY �L ��tJp W. M 'S 08/30/22 TRIJ/TEZ/COMMrJ1T/ `► B L OAS PHALT ��/ sin i 0921/22 REVU10/Y/PER RE9UE/r NON DISITURBANCE ZONE PLAN N� w ,� SCALE_ I°=40b" O N E\N Nemschick Silverman Architects PROKT7Q1a PATS NSA PMECT' ...the b.,....(ARCHITECTURE.• ,/IEJKA R12,/IDEACE. 10725718 17-1938 6LOJ,/r-M 5EAP MATTITUCN AY 160 MAIN STREET,SUITE 200 A/-ryOTEp �— SAYVILLE, NEWYORK 11782 DslacT: sE -- e0oac nor. DaAwner. Phone:6315632130 Fax: 6315632139 www.nsarch.com oCOT'�M3Nt6BOQaNiIWA�RECfBFA 1000 115 6 22 ECr 6 22'-3' o — — — — — —— — - VBWVA I I � 22'-3" A2'- 22'--Ju I -1 r __ v�siNsl KASTIR er�ooM N � II 0 II I I i t —1J - - - _ —_ - -11 —_ —_ 24`-5" I 24'-5„ —I - - 24'-5„ fill MEDIA PZ M I I I I I I I I I Vt"IN I I I MAT WOM I I p I I o I II II I I o I I I I I MASS SATO 1 NALL 1 sr _ 1 0 r - ppll L -i p 1 DINE ° — — o — v srAIR I I I I KIMEN I I I I I I , eexiooM p BATH o EI.E 1 1 oiI I SEP 2 2 2022 10MI: K W "TORAW FORM Southold Town I I I IBoard otTrustees m o _ _ I� I L........... snJDriaursr —J _ = IBATM I I PROP05ED 5 C®NP ffL®®R. FLAN — — I p I I SCALE= IV= I'-0" ��- gr _ L — — JIP Gj� DATE D6SC(BTM 429/19 JCPIV wwM 5/30/19 DEC/wwM COMMFJITJ PROP05 P BASEMENT PLAN o ® ® o SCALE = IV= I'-0" 6 O,i \ l• .0 T-ROP05EP f I R.5T �L®®R PLAN SCALE= I/8" _ I'-0" PRO.ECT TIRE DATE M PROXCT r. Idemschick Silverman Architects ,Ar-JURE IMACE 10/25/18 17-1938 °...Ihe buai�as"tARCHRECTURE.° 6LO,/,/EM 15E 17 SCALE DRAWNG N0.' MATTITUCR,11Y 160 MAIN STREET,SUITE 200 Af AOTED �— SAYVILLE, NEW YORK 11782 DBIRCT: SECTIOIt BLOCK LOT; DRAWN BY: Phone: 631 563 2130 Fax: 6315632139 www.ns-arch.com ..carauuamasaQavx,ww .,e"n 1000 115 6 22 ECF 171 lGINN•76NlaEA7�l61YSAADWLY� wri- -2ta 4 R'PLPFLAIS o nww-s wLxR TGP'c 10 a".Apw 4 AVHPAff_� I Q V � HEY.mr I I SEP 2 2 2022 I I W"..11w — — — — — — SoutholdTovun E - - - - - - - - - - - - - - - - - Board of Trustees sEY.a�a•ru+vc HEv aw•n�svvav SEAL REvmoraisenusors DATE DEBCIBrck 7/8/19 JOUTHOLD c? !sc ) ®?Ell F- ®NT E PATI®N J Elm, Nemschick Silverman Architects PRO.ECT TDLE DATE NBA PROWT r. "...ftbu.]..rARCHRECTURE." _AEJKARM0C (:t 10/25/18 17-1938 6LOJJCM brA17 DRAWNG NO. MATIITUCK/0' 160 MAIN STREET,SUITE 200 A//TOTED /w\ ••�'� SAYVILLE, NEWYORK 11782 DBTMCT: gcick BLOCK LOT: DRAWN BY. /�—J Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com �pyg�R mp �yg�yy�appy pL 1000 115 6 22 CCF 4 a �frW Il36l7ff1F®lEM1VHA1DR6i� ElE1!�G�O' 12 4 TCPGPFLAi6 aW..+3+o o ' iLTLF51B9QaR �, . Tai .AV-01 � n I FT E 4 Doo 4D D a D 4 aD �� ECEIVE AVIFAMOM IF aEu.mgr I SEP 2 2 2022 I I Southold Town — — —— — — — — —— — WE Board of Trustees esu a�•nwvtt�v BEY.6rO•IPKYD?7l SUL r. DATE DESCIi rM 7/8/19 JOUTHOLD VAnM >, No• 3 ��"5 �oly JV\ fr FRO.ECT TREE DATE NM PROECT r. Nemschick Silverman Architects ...Ihe business orARCHm:CTURE.' JIF�KA QF.,/IDFJICE 10/25/18 17-1936 0-14 6L01./EM 611fiD SCALE No: MATT[TUCK.AY 160 MAIN STREET,SUITE 200 1 IL AlNOTto SAY L'E NEWYORK 11782 D61RCT: gCllOrt BLOCK LOT: DRAWN BY: Phone: 6315632130 Fax: 6315632139 www.nsarch.com .carrmrtzm/aea�is�euwµanccsvc 1000 115 6 n ECF 4 a b b MWM3SWWD rAVSAAVRVW 6EY.ICb• P 4 uva aATa eFv.mow• F13 [Ell :01 B o M El 01 EF111 >� I n n n n H seu3ro• � F=—]F=—]M m m oaDo �� ri- I I II rl� I I - �LIJ� I I I Lull I I L J 4 SSP 2 2 -' I 2022 I I I I "P`F `ar Southold Town --- - - - - - - - - - -- - -- - - - -�E Board of Trustees SE✓.6'-0'f?KVDIgI gAL G \ DAZE DESCWTK)k L 1; 1 `z 778719 JOUTHOLD r `. 15" y DAM ��®�®� � �It9�� ® IT � [ ��I®1 , l �J• �dlti4 1i% P Nemschick Silverman Architects °A°ECr1D`E DATE: NSA PROX-CTc '...the business WARCHITECTURE• JIE'"Rr-1117 iCE 10/25716 17-1938 6L0_//FM 5EAD SCALE DRAWnG ko: 160 MAIN STREET,SUITE 200 MATTI UCK,AY - Af nOTrD �—� SAYVILLE, NEWYORK 11782 Dsnacr MC.TK)k BLOCK Lor. DRAWN BY. Phone: 631 563 2130 Fax: 631 563 2139 www.nsarch.com ,cavxaR aro�asacs aw�w accts v� 1000 115 6 22 ECF �oSUFFo400 Glenn Goldsmith, President j° Gym Town Trustees A Nicholas*rupski, Vice-Presidenty a 54375 Route 25 Eric Sepenoski o ^' P.O. Box 1179 Liz Gillooly '1.dj® ao�� Southold, NY 11971 Elizabeth Peeples 'x` Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: ROGER SIEJKA c/o RAYMND NEMSCHICK AIA Please be advised that your application dated July 29, 2019 - has been reviewed by this Board at the regular meeting of September 14, 2022 and your application has been approved pending the completion of the following items checked off below. xx Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) %Constructed ($50.00) x Final Inspection Fee ($50.00) - Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE: $ 50.00 q• �6 BY: Glenn Goldsmith, President Board of Trustees R,orRAy w=,gsRw; 5/TE DATA >a„2P"4� � J M oHL915LAIIDS,RYEYA2AA NN V/G/N17Y MAP SOWIc�l�-6-n awAlslom MATTnwx f 5TA7E5 M715�MKOFb��M„ER AeO�rYADDR5$ aco5e7Mae� LMoW SWARrFUIM a N/o/l HAMWA NY MIN O OUTHMD ZOA M5 DI5T R-40 q Baan Rd S- 87026'30"E. 128.74' y © LorAREa 4015aFr(07Acl W n�ara„ �fib. MRSTribae 5415:�riaae 32 ► DEC FL46 LGOAnGkS, LIVAa-EAR5a 1,228 1,28 1,2N S"r SITE TYP. PATIOS/7ERFAGE5/nDrAM— 340 35 Ar NR LOCA non%s X LOT 22 l C3 NY5 RE6"7EP FRES”TB? or �, - PETLAND BaWARY A5 « FLOOD ZOAE LllE ' DaIMA TEP BYW-50E6 ON 71724g A5 P6e FH lA MAP AAV LOc(1TED QN 6cTpBaz 2q, x 24 (6.0'A6VDZv C� " ,�' —— 5ANI rARr 20/9 BY 5GRVEYOR NATHAN TAFT sYSTEM OORW/N ll1 Nom . "" .ReE5fi1G4THZ xa 16.5o Ro �raa LI1�1 « (n�Rovan WITH puerrc Reran) ! OCA BION ),FrlAAms —BUWA&E AREA « . « LIHIT5 OF G1EARlN6,W - - - 6RO1'.11lDD1571,404 .ELIAEP KNELL LOCATION DIACS. 4x H/TH HAY SNFAND/OR SILT Q . FH40IM6. SE DEWL5,DIMS N.T.5. NEnAMP D157MZ%AAGE « Wl7HIN/00 FT�7BAOK B- =1,52/5QF7: PROVIDE SPLIT RAIL FEWE - - xa 11.4 ALONG{'IE7LA 25 OLEARlAk5 eo'��1 O'M M AGOE55 AROLIID . . • AAMC OF HAW(N t F.1 �f « « a-7.4x WE5 GRADE. 15.0 d/A -�h�L�V, '� l' �'lA 5Y5TEM� LOT 21 A ' . LOT 23 Awpostv N o NNw' X�/4.7 S.00 6L E T£ST MOLE B-I . //fi�rr DAELONO Dr Ali dlA SY5TH4 O 2 022 - - /,61017 GAL.064-10//A 9L 4. 10'DIA 5 FT DP LEACHIN6 aD/lrrol Town 1 ;11000 PART. 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C 1.Cs 9S 9 Ti FP ASR U1LT 989 5F.X lAX O.16=l-V2AIWA/VF.OF STORAGE RC�d',/IRSJ =6.4 VF. w ,FtLtPla PRO=717LE oA1E e rJ1F9(.9RF_/IDE cf 10%5✓18 17"1958 Nemschick Silverman Architects� nea c4alt cauaE" .. - 6LOf/EMMAP n .__. ....... _..: _ ..._ acs riw o Not MATTITUCK./1Y 160 MAIN STREET,SUITE 200 •—•• "'""' "' ��� I SAYVILLE, NEWYORK 11782 22 tcr Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com S. 87130"B. 128.74' . DEC FLAG LOCA TOM, TYP. NYS REM A7EP FRES"TfR PEnAAV BaWARYAS N DBIWA7ED BY NY59EG ON 717219 _ ANP LOGt17ED 4N OCTA M A 1� 201gBY5GRVEYOR M4 7W TAFT GOWN N r - LIMITS OF GL.EARW AND • - - 6ROMV Dl57 R9AWE LIN® W17H NAY BALE A/m/OR 51LT FMWAK SEEDETAILS,0* PP-3. - - •--PROVIDE 5f LIT RAIL FBrE r ALON611E71AND5 CLEARING . 4 L/H/75 5 O'WIDEAZE 6AROW - IVPBPJPETfR OF HOUSE(N t E) SIDES nAC .Y 5 2P FAMILY piJI LING OO UA 5Y57Ehf IFUJIGLEAN I E� /poo GAL.CM-IO UA 5*9511 - ( IO'DIA.5 FT.DP LEACHING PO L5 w " aauffi d Town WA E1PAN5/ON POOL Board of la alst8a s � 4 k �' - ND BEM DATE DMCWTM �7 08/3022 TRIJ�!COMMFJfC/© O " ' r9P L � J a° r 4a NON 1;)15TUR5AN0E ZONE FLAN NIYL IY 40'-0Y µq �^m" I. i✓qH "✓„ pPl M �, 1MIal VAM WA F1DJ9=R Nemschick Silverman Architects 1025/18 17.I' ,.the badness MARCHRECT RE' wp.... ...... .................�. .. ....�... ., M MATnrucl�nr 160 MAIN STREET,SUITE 200 SAYVILLE, NEW YORK 11762 �� � � aa7Y' � 1000 115 6 22 Ecf Phone: 631 5632130 0 Fax: 631 5632139 www.ns-arch.com '�'° '" `" - 22'-3„ -a N, 0O _ I N 2'-2" 2'-2" \ 22'-3" 22'-3" I N YAWM 51MMM N N I NN GAN I I _11 _ 11 245" I Y HMA ieooH N N I I I N N u N C N ~T NWM I I N N N o N I I NV' II �o I 1 G N I MA9=BIAIN M.L 1 F -I LJ All o o STAR v d —� Knr40 I I n N I Ionwam Ld DAN I I N I S GOND FLOOR PLAN SAM m I I N N PRO�OS�' N N I SGALE= iie -0� N NN N "w. 4/29/19 JCDFIJ WWM I'JI ..CB _ �, r�1,4,3 haF 1M,- 5/30/19 DEC/WWMCOMMFJ'fTf o PROP05En BASEMENT PLAN I I Iii ° � 5CALE= IV = 1'-0 PROP05�n �I R5T FLOOR PLAN SGALE= I/8'= I'-0' ` 71RP Nemschick Silverman Architects If-JKARUPCACE 10/25/18 1.0958 "•.,.(hebusln—of ARCHRECTURE," „. ....... ...., ..,..,.,.. ....... 6LOf/rm2)mp MATTITUCr,AY 160 MAIN STREET,SUITE 200 •--• .•—^ ""”" """" """'"" --- � SAYVILLE, NEWYORK 11782 Phone: 6315632130 Fax: 6315632139 www.ns-arch.com •aar�+r�ras,awrcraxa+awwcar�c 1000 115 6 22 ECF a� ri Ll 41 L01 Ila] Liu _........... L J _ _ ® ® _ — _ f _ _ I� 5n " a IC�Wn eev rs•—ewvayv � ® � �.�.. .��.. � ,_ � ._. ...�... ..._. ,� �... ��,., P�yc r� �t�na.�t es CE3CWTK)R �r � 7/6/19 J0UTf10LD O104 "4 FR0P05ED LEFT 51 OE ELEVATION I SCALE= 1/8' - V-0' rr, MK)=WLE DAV: o FFA)W V. Nemschick Silverman Architects _ ^^^^ _ M mJnicK�D 171958 .....Ne busl�ss al ARCHRECiURE." e:KEw�.� A/AOTW 160 MAIN STREET,SUITE 200 -- ._................. ..._.._ -....._ ..----.-. - !"�1—� DOF 'p';" ..LOAF. C�yMIr SAYVILLE, NEW YORK 11782 Phone: 6315632130 Fax: 631 563 2139 www.ns-arch.com w.�;mn +,nuacnms; 1000 115 6 22 �.CF s B � J r Ti OF r.' 's y �C�F Mr ae✓rs%ewraea �ulttlt Town .......,�.`�. ....moi—... �. —.�. �. ,�� �... .— -.....� i .e.w..."��'�..«..�.-... �veoreias,®ola DATE DBKMM n w 7/8/19 PAW /OUTFIOLD I FROP05ED i!RONT E>�.EVA7I0N I�I aur i Nemschick Silverman Architects "...the busl—of ARC HrrECTURE" 1K)ECT 71R$ — MA ROAM K �_...:-. .... ..... ..�� °. -._.,....—.:.... llLRV[)EAC.E 1025/18 17.1938 �wr....r�► - ...�.mmW ..�:......:........ '" .. ••••• 6LO1J>=M 6FJ1D 160 MAIN STREET,SUITE 200 "" "" °`- •••• -•-•- ,,,..... - SAYVILLE, NEW YORK 11762 ... -. MdTTIIUCf</1Y ... �1'D Phone: 631 5632130 Fax: 631 563 2139 www.ns-arch.com .•...�... .-_... —�+ oaree� anc• 1000 115 6 22 CF • 12 iD �rufifloNel Town say e+�r tl oar of "Us �veo►eiasrealore DAUB CEKA"pg a �� 7/8/19 JOUTHOLD LNiW d AR �� IIATI ON Nemschick Silverman Architects '.,Ahe badness oIARCHITECTLRE,' M 160 MAIN STREET,SUITE 200 -.. _ ..... """""'�""'"'": Mon 1111,'E �.�.. SAYVILLE, NEW YORK 11782 JIPJtC9 RF./1DFJ1Ci= 16 � ��Y Phone: 631 5632130 Fax: 631 563 2139www.ns-arch,com 6LOIJEN 6�D- 17-1953 N9TTITUGK.11Y 1D. wacw�wwawa�.ac+tiW+w ec �00 � � l�Ni'i 11N1b!@ - ��•4 115 6 22 ECF �1 + AW FED] [FBI [FBI In F=0 C3 Ing Ing aIC3 C3 > 1W Ff r3l r' _ J Southold Town n J`. DAM .. b 7/6/19 ./OUTHOLD 8lY.OfO' N r r'Y q C � SIGHT 51� TION ; ALE I/8 � f (roe` Nemschick Silverman Architects ° ...the husf-ss of ARCHRECTURE„" 160 MAIN STREET,SUITE 200 .-._.,..... _ � _ „. - �-,... Jl�ll(A RF,/IDFJICE tlt7,r�,5A1�8 SAYVILLE, NEW YORK 11782 l7µ1456 6LOIJEM 6PJ1D Phone r 631 563 2130 Fax c 631 583'2139 www.ns-arch.com ---••• MAT7ITUCI�/1Y - A+° 6T0Dca //►� •mmpgRrWmea+aaa.aauwwA aauz 00 115 NLS 6 IL1,-•: 17 1 ,..6Y: �\—5 ECF —{ Cantrell, Elizabeth From: Nick Marcinek <n.marcinek@nsarchitects.com> Sent: Monday, August 15, 2022 2:58 PM To: Cantrell, Elizabeth Cc: Ray Nemschick; Paul Gartelmann;Jason Merkel Subject: 1938_Siejka Residence-Project Description Elizabeth, Please see below for an updated project description of the Siejka Residence: Basement Floor Gross Sq. Ft.-1,216 sf First Floor Gross Sq. Ft.-1,216 sf Second Floor Gross Sq. Ft.-1,216 sf Front Porch Gross Sq. Ft.-47 sf Side Porch Gross Sq. Ft.-68 sf Rear Deck Gross Sq. Ft.-206.5 sf Driveway Gross Sq. Ft.-751 sf Sanitary-FujiClean CEN-10(1,000 gal. I/A System)w/(2) 10'-0" DIA.x 5'-0" deep leaching pools Please note the FujiClean CEN-10 replaces the septic tank that was shown on the drawings. Please let me know if there is any further information needed,thank you, Sincerely, NICK MARCINEK Project Manager 1L (,;£ ARCHITECTS P.C. 66 East Malin Street Patchogue, New York 11772 631 563 2135 ext 16 Fell 631 563 2139 Fax This e-mail and any attached files are intended solely for the use of the individual or entity to which this mail is addressed and may contain information that is privileged,confidential and exempt from disclosure under applicable law.Any use,disclosure,copying or distribution of this e- mail or the attached files by anyone other than the intended recipient is strictly prohibited.If you have received this e-mail in error,please notify the sender by reply e-mail and delete this e-mail and any attached files from your system.Thank you. ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i 5l TE DA TA a�»�.,r�A�74A�A1®B11 t� �E +aetexs u►csr�a SG7MaM AX704a4-22 1/lG/N/7Y MSP saVnIaM MATn7VAK E5TA7E 5 elEr.l c><n fr�lw>r,re¢ =002=0 / PRaTW ADLf�6 EYO=rE0M EGD c 5aV1p I S o HAT7F=NY 717167V o0 2=0 ZaWN9 DIST R-40 Ma n as S. 8702' 6'30" 11.0./4� � � Pnneuck F1NI�b F1125T FiLL'12 7.M1 5d.�cdnty `� "" ®® tti 4 31 ZV DEC H A6 LOCA71DA51"TIP - Anon/7E3az4oE/DFGK5.—LIVAREAFFA /,220 1,2W l T S/TrD 11 V FR - y �° - E JSTJl 1 LLFAJG02 �. . . . ��� LOCATiON5 X 32 LOT 22 . '' " �. Town - - - - d A uth of — So » IJtl17LAW BaWAJZrASW ROODMELIAE N ,, . of Tr TERW DESEA7ID BY NYS X ON 7A?/19 a ��P <. 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O, 2 r T 0r4N IBA PROJ T t Nemschick Silverman Architects JIUI(9 R[JIDC/1CL 1025/16 97-4956 ..... 61-0IJCM E)EM ff 160 MAIN STREET,SUITE 200 M9T11TUCK SAYVILLE, NEW YORK 11762 DM=-. JECTM LOT DMw"��° PP-1 3 2130 Fax: 631 563 2139 www.ns-arch.com Phone. 631 56 .dwtppyw�+pur,.dr.wwa�w^a�t, 1000 115 6 22 C. 22'-3" . .......... _ I O IV O O 2'-2" 2'-2" ILI L, 22-3 22'-3" ..... AUG2 222 wle�ee I I I Southold Town hoard of Trustees 11 —11 24' a, N _ 24-s N I I I N '' ✓ � �—� N N I I 6MT Moot+ N I N N N o I II NN � I I o DDj rN N I N N N wase ewTM LM LJ o 0 ac o v rw,M N ( iatla�, I I L e�moM N DAV o �. I N I_ I I N I M,v MH N N I MWWWASTORAN r -� �p � I � I SRO 050 �S��ON� FLOOR PLAN N I I1"`W I N u xa E_ I/V I I I N IN L J urn oExxrrok 1 \ i 4/29/19 JW CVHl WM p Q0 W, n V1 "J7 5/30/19 DEC/WWM COMMLfiT/Q FR01=05E1;) BABEMENT PLAN ,y x WALE= 1/8"= r-0^ No. u Pi THM VA pwOAC-r« Nemschick Silverman Architects Mann ME)n � ...mew. .:mnacw�cTURE• /10T[D JIrJKA PZAPJiC.E 10 18 1^1 160 MAIN STREET,SUITE 200 - - SAYVILLE, NEW YORK 11782 " MA"-41 Phone: 631 5532130 Fax: 631 563 2139 www.ns-ar&.com 1000 115 6 22 ECL EC _ V Southold Town Board of Trustees xt. fl-ro a a ---11—IM 4 rr�e� T1�S i I P J ' FMI I. 11 It r--------- ♦ ✓ dot L J — - - - - - - - - - -- -- - - - - - - - - - - - -- - - -- - - - - -- - - - - -- - - - -.............. - - - - - - - - - - asv�e�a►��srN — DATE DBK3rmN 7/8/19 JOUTNOLD 10 VATW LEFT 5I�F. ELEVATION P Nemschick Silverman Architects JIUQRC/IDC/1CC 10/25/18 17-p958 RLE ISA Ih.Wu i...IARCHnECTU.. _ 1C11(A 61-0Jl1=M 6EHD SCAM DWAA,h11Kr 1A. MATTITUCr,/1Y 160 MAIN STREET,SUITE 200 ^ SAYVILLE, NEW YORK 11762 A 1G5 -2 Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com 1000 L= 6 IAT. 22 ta •oma wm+r�roi,m^�wwx�mz L ECEIVE U 1 022 Southold Town Board of'Trustees _ 4 lSYNik..ANbAT6 a� "tea i ICIM � M -- - - - - - -- --- -- -- - seu.ra�aK� BA!6�O'IMN'D2P DATE DBKXFMk 7/8/19 tOUTHOLD "fir, 1 tq aver w is,, a1 P '0� � FRONT ELE�IATION �'�Mo='Vw�= V-o- Nemschick TmF DATE'. raw PRO=Silverman Architects • � -AW RP,/IDE/iCt ltial"w5m"16 � µ 'P-6}56 � � ._.. ._- ;. .-.�..__. ........V., 6LOlJfN 6FJiD �� � DRNSYbMD HOr 160 MAIN STREET,SUITE 200 NAT nTUCJC/1Y J1OfiG •a r7 SAYVILLE, NEW YORK 11762 111.x= ' DFAVM BYr —� Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com 1000 115 6 ECF r�mr mw aun rt,. nl � southoid OW11 12 °' �p fi1+YN�d�YYo�17�9FGAl4"�ekMlt ' BEV 4OW' aw. B . .... ........ u u FMIM COCO u u I I 1 �Y EN.*P pNYI�y Hti!i�0'AdvD1V DATF DE9CIMk i 7/8/19 JOUTHOLD 0 � K PROPO��� scaa e Architects �Tmu nnlr W RMS=. Nemschick Silverman a /I�IKARE-AI) CL 1o/z5/1e 17-1956 6LOJhM MA17 mu-nTUcl,/1)' 160 MAIN STREET,SUITE 200 VL 3i/C1b 6CD /f, - A SAYVILLE, NEW YORK 11782 LC+!'IXc EC Ff �.-\{ 4 Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com �78b.�R'MNWwM., 1000 115 n 6 22. F o I i p n 1 r,R p VEP Souffiold Town oerd el Thisloes I, A, r PMRAIM Imay.OLOV El P-1 IF111 IM-11 1 41 po 13 I L I N i�� � �L)L�j I L J N JI _tet iED DAM 7/8/19 YOUTHOLD PROP®�1 RISHT SDE EEVATIDN , s p 0. ' " Nemschick Silverman Architects FRDZ=Tink DATE Nin erwwt snmmzurrW arvrT;cxuJae[;• __ JI�IKARMPrACE 1025/18..... 13-I958 61-0f/r-M 511AP CRAV4C N0: AY 160 MAIN STREET,SUITE 200 -- MATTITUCrI Af AOT! 7 SAYVILLE, NEW YORK 11782 �_� Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch. 1000 p1.51� 6 ILOT' 22 ECP /� _ •omwr,�nxw�at�xxrwwmr� Glenn Goldsmith,President u , smfFO � Town Hall Annex A.Nicholas Krupski, Vice PresidentIN -" 54375 Route 25 Eric Sepenoski 'r P.O. Box 1179 Liz Gilloolywwi Southold,NY 11971 Elizabeth Peeples ' ' y, Telephone p (631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: �✓3_4_22 Completed in field by: (91 adJ)s-r•1►,"4 Raymond Nemschick, AIA on behalf of ROGER SIEJKA requests a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5"wide by 50'0" deep; front porch is 11'0" wide, 07 deep; rear veranda (deck) is 24'5"wide by 10' deep; and overall max height is 32'3". Located': 955 Blossom Bend, Mattituck. SUM# 1000-115-6-22 Tof area to be impacted: yp Saltwater Wetland ,_Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: /Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: Present Were: G. cldsmith ✓N. Kr ski ✓E. Sepenoski L. Gillooly ✓ E. Peeples DiSalvo, Diane From: Ray Nemschick <r.nemschick@nsarchitects.com> Sent: Wednesday, May 18, 2022 11:12 AM To: Cantrell, Elizabeth; DiSalvo, Diane Subject: RE: NSA Project#1938_Siejka Residence-Wetland Permit application As per call earlier today, unfortunately my daughter has tested positive for Covid and we are waiting on my results. At this time, please postpone our hearing until June. Thanks, Ray Nemschick Sincerely, RAY W NEMSCHICK principal _ . S 66 East Main Street Patchogue, New York 11772 631 563 2130 ext 11 Tel 631 563 2139 Fax 631 921 5701 Cell r n rn cch Jck@n _ar !1,gg,D_. www.ns-arch.com p hi:,�e maoll airuh,niny,gita hed flies 1i e lnteindod snr i ly Vnii the use cif fl'teIii divo dual+n enu:irr,:y Lo tAlhidhi this rnod is adryirwa aed uird nriay d'r a rr ar iu :n tkit is pr'miegerg,c crffldennttu all anid e^,r.rrup t fi nim aykc lrnum uurdeo-sp plllc,cbllc ixQv.Andy uu c, yu��u;Or:c,uuirn,mp.uyirr+:air aiistiruGcuuo^arui rap t-hip,c,.. uu'.u'ip urr rif'rr^ert,aa.hed HIP", V;y;'ruoyrairW ctther a i t;:,h0l2.r"ichA reclip lent is I16 yrm Iro,uvv wce�veru I,lyuo:r;^7 rurelip'iru erimir,lypeaaa,orr'uifih6 kll ue se,indcr by o` piy e-irurnuV and ruga.°floe t :e m,:.0!a[-id any aU dhed Wes fu¢:mr 'ou.u�r ay;dem, V 6rr,ufl¢.+,rnuu, From:Cantrell, Elizabeth<elizabethc@town.southold.ny.us> Sent: Friday, May 6, 2022 8:19 AM To: Nick Marcinek<n.marcinek@nsarchitects.com> Cc: Ray Nemschick<r.nemschick@nsarchitects.com>;Jason Merkel<j.merkel@nsarchitects.com>; Paul Gartelmann <p.gartelmann@nsarchitects.com> Subject: RE: NSA Project#1938_Siejka Residence-Wetland Permit application Thank you very much for sending this. The Siejka application will be added to our May 18th public hearings. If there is any concern about dropping off the two sets of revised plans, please let me know. Thank you and have a nice weekend. Senior Office Assistant Town of Southold Board of Trustees i Glenn Goldsmith, President �; , Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 CD Eric Sepenoski �" P.O. Box 1179 Liz GilloolR ' '" Southold,NY 11971 Elizabeth Peeples � Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: S110jr4l Completed infield by: 1-• �I ad Raymond Nemschick, AIA on behalf of ROGER SIEJKA requests a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5" wide by 50'0" deep; front porch is 11'0" wide, 6'2" deep; rear veranda (deck) is 24'5" wide by 10' deep; and overall max height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM# 1000-115-6-22 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: c Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: I t wo r , . r Present Were: G. Goldsmith N N. Krupski K' E. Sepenoski _X L. Gillooly >e' E. Peeples R OrFL4N WIXd44770N BAS CN-9Ae& 5/T 1�/4 T/4 DAIM,UE3,205,FPMPAVM DY .,��•• .,06B, � AM Y/GIN/Ti' MAP AM -C"/ /amus- �DmsioN: MAmneK 15 EsrATEs FR9ArEW OF AO Fr.WEENHATM FRO E RTY APPRE:55 BLO550H aEN9 L616AND-1AWARrl IIS TOWN ��os UTAOLD ALATr/nm NY &NIAG DIST R-40 S. 87°26'30"E. 4, �y LOT AREA 4OA31 WAFT.(937 ACI ® BINLD/NG ARFAS= - lVldlttlCvic1e X 3 8.7 BAIT fw F/R5T FL A9R SEGOA�J FLOOR r4 �a if r Y* DEC FLAG LOCAT/ON5, TYP. LA770-5/TERRACES/ 128 340 l35/ PATIOS/TERR,4GES/DECKS:— 340 35 ���I . .. . . . . ® � .. . L�/SIIN h11 r QD to AM d 'ZXATION5 - - X -32 LOT 22 0 NY5 RE6ULATEV FRESNWATB? ` - HETIAND BOUVARY A5 W ROOD ZONE LINE tJ DELIAEA TEP BY NY5DE:ON 7172//9 - A5 FER FEMA MAP _ FROMM "7,o AW L0QA7EP QN ccTpeSR� X zs ALON5 E XAApLIr RAIL FSE - 5ANITARI' 20/9 BY 5IR2VEYOR NATHAN TAFT (6.0 N6VD2v ALOA45 NETL4/dJ5 GLEARMI6 5)'5 FEN = -GGRIVIN 111 - - - �� LIMIT � �� of �' . .FRESMhWTET� . » XH.165 RSJEJJGI ROC �p.� _ (LVPROVED IIJ9'7J"PURUC WATER) � �...^_ �' �. � L�rC4`�I�;,IIr M14?,I'�LLL rETLAAM LIM/T5 OF CLEARING AND LOCATION - NETADIS 6RaW D/51UR9ANCEWTH w N - WITHIN/A'J FT Gly HA BALE AND/OR 51L =8,954 W.FT - /AI5 56 DETA/L5,DWG. X�99 lNLL L®CA7 I®N LOT 23 N.T.S. HEALTH DEPARTMENT APPROVAL STAMP «. ... a,,2-5 BI7II� w' E AREA co X7 � - 4 GRADE l50 LOT 21 nAQ �T( ... XH N1 FAQ MART NISH TAT HOLE B-1 (VACANT) ..,.. „,.,. /Pr" I(. E C RM 0 LP A OR a 022 'DIA,12W 67AL 5EPTIC TANK 0 x EP (2)b'DIA,6 Fr.DP LEACHING 4uJPdi Town 5 'ART. Board of Trustees ' `"~ .,., S �A� NO PLAN IN FIAG REIN PAVED 7VAY. EJ�AALSION POOL H 2'x x ASW O.H.POKER LMES. 20'-0" &L.145 'MF Y GONIEiTION IN FIELD. L06ATION OF AEW FUBLIC 4 r A MT ER 5R MANN IN ONAEC p DAM r Tlor� WATERSERwcE: coNAEcrm STORMW,4TER RETENTION CALCULATIONSTO � a """ xH.zz4 USE MATERIAL AREA(5F)X RUNOFF GOEF-EC 1V.DRAIN DE-5/6N X DFSl6N RAMIFALL =DE-516N VOL(CFI ' , a29/19 �....... ./t,�.�'�W �Mw pft/Tr % 5/30/19 �'LC:It�M.+h1c, RAF/N6 A5PI4ALT 462 5.F.X l.O X 0.16=I385 . 4 I CF,5TH� - W„ Dt?Yid t a �5 �' P I�.., 1 „ ° ° k 328/20 00111 AT,A XH.�l� v D xs tae 15HIN6LE 5F0�CAPACITY ar,VPK RAO 4224 b'DIA�RING� VF �u'.z , " �f t/eat otCCCMMLsfTJ ?l2 y" ee �d 1022/21 TRQ(T",/ ®� PLAN 0 ' AREA I VF,OF 5rCRiE RL P.ED =3.3'VF. X r ( I L� T . / _ _ H.pisX " �,�V R00F/N6 A5PHALT 7075F.XlAX0.16=I13,1 AREA l G.F.5TORA6EREOUIRE9 = 270 I,I (II 5616 „^i.�2 f..o .✓ r QL �50ALE- 1"- 40'-O' B Ar N J6AR�Ff PAJ'CJp SHINGLE 57 CAPACITY OF B'D/A.R/M6 =4224 b"D1ve RJia =fi S 4!F MD XITU PVBJJC IFATER,P r AF DRIVEHW ASPHALT 9B9 5.F.X LO X 0.16=1592 /VF.AC STORAGE RE&Y/IRED =6.4 VF. Z,ARFA (08 'V TOTAL: 27L3 a (JYPRora rch itects PROJECT TITLE DAIS WAPROJECTr. Nemschick Silverman A 1heb.1—.AR�HfTE=RE -/1fjr\ARP�PEACE 10/25/18 17-1938, MdTTfTUCK,lIY 160 MAIN STREET,SUITE 200 -m• •� -------- ------ - ••• -•-- ••- --- A/ SAYVILLE, NEWYORK 11782 a n xa Awv .ux nrt I.... LOT: 22 DRAWN CCRW' Phone: 631 563 2130 Fax: 631 5632139 www.ns-arch.commm _ 1000 115 . s'-O" O Q) MAMA O O O d 24'-s" MASTM E®RooM N w. V N dP N N N 24'-s 24 5' .�-� w 24'-s" N NN Nl ° MMA RWM d NN NI R N N GREAT ROOM V I N Q p VN VqN N o N VI NI K49MBATM _J onne o o 0 � I — —1 11 WAR I I p KIT&M i I V eEORooM E C E I V E I I D I N I I � II I N Southold Town MMIANo+"TORME MUD RM I I .� _� N Board of Trustees PORhO�9 I I Et11Eli/1NGE 1 N N ® ®5 5C®N ®® FLAN IMN V 1 p SCALE= I/8"= I'-0'• I VV q P .._.. L .-,. ..T � _,,, J r ,,., ogre DEKWTM 4/29/19 /C[)UWWM 13 „ 'k 5/50/19 DEC/WWM COMMF_/V"[! ® ®� 5A5 M NT PLANFMH SCALE= 1/8"= 1'-0" f R5T FLOOR PLAN r SCALE= 1/8"= 1'-0" Nemschick Silverman Architects r Me business of ARCHRECTURE' DA JIP JICA R�/1DFJYCE 10/25/18 17-1938 6LOlJEM 6FJ1D ..._. ,. .... �.._._. ..��� .,..,... ,.�...,:. MATTfNCN AY SCALE 0 160 MAIN STREET,SUITE 200 •�• --- -��� At M=' SAYVILLE, NEW YORK 11782 DISTRICT: WOWN N BLOCK Lot DRANK BY: �-\�1 Phone: 631 563 2130 Fax: 631 563 2139 Nv✓w.ns-arch.com ♦acxwernamV49C4xa, AC4"YC 1000 115 6 22 r„ .,C' _1 N 4 I FGVlW '19' /!'A61 „,,,,AM7 n 9 WeV 40W �a Twiwsafuvp .. °P EE H 77-7 Ln i ee715 ®® ..... r iD A')` 202 L J - - - -- - -- -- - - - -- - Southold Town BFE sn!a�•rx4vmUBoard of SAL IEV9016/90A69De DATE DESCRPMN r 7/8/19 JOUTHOLD � rT nn / MA s Nemschick Silverman Architects jlrjKA gLJh� DA,E w n theb.h—oIARCHITECTURE. Q 1D� 10/25/18 17-1958 SCALE u L.. __ Narrrruca�.nv D1rA 160 MAIN STREET,SUITE 200 �.w �--• •• - -- --,G/11OM[7 SAYVILLE, NEW YORK 11762 DBIRCf: ii=—, OT: DEAw4Ml BY: A-2 Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch.com � � ,* ,,,,,� �, 1000 115 6 b� �b 4 JW OF FAW Q L2 F�Wl,NlAN7 i ' Q L11 ar"W-Cr I i''1), E C E I V E:— .... N I R M � 02 1 2 I I I — = Wold Town e,E _ _ .�. — � �.... — �. ...._ ® — Board of Trustees seu ra M—Vfinl S.Ei!6W'MWT72T1 gAL IEVBOf6l9.9A49014 ,. DAME DESCWTM 7/8/19 fOUTHOLD cwnN � "0 " , ra SCALE 1 All MO.ECT MIRE DATE NSA PR ECT Nemschick Silverman Architects JIfJKAR4V11PC ICE 10/25/18 0 4938 mr rvro�a rmu+.a�a nr..mnT gter' .- .....w..!— W.,. ........... .... 7, !-!77 SCALE "" DItA �. . 160 MAIN STREET,SUITE 200 N®�� - SAYVILLE, NEWYORK 11782 Cown.. MCWR 'K=, LOT' DPA BY` Phone: 631 563 2130 Fax: 631 563 2139 wwwns-ns ,� �, � 1000 115 __6j___32 ECF b d1�V�IJ�NAt�A �. ucr eA ECEIVE 92 $EA6+W#&,yqa+ BowBowd of Trustees WAL ., .w• DAZE DE9CW7pk 7/8/19 fOUTKOLD ® ®� � fil® P N � �. Nemschick Silverman Architects 160 MAIN STREET,SUITE 200 Ne business of ARCHRECTURE." PRO ECT rM P'. DAM, JIPJICA R�/IDFJICE �t �.� � 6LOIJEM 13PJ1D 10/25/18 1.,.. ...._. U7^C'58 � .,_.. _" SAYVILLE, NEW YORK 11782 Mem„ �C .W M9TTfNCIC lU' CIRiSN! No_"" Phone: 631 563 2130 Fax: 631 563 2139 www.ns-arch,wm MOTCCF 61 22 ECF I":... aim G�m AW ogi& 13EN M EM M D 010] n"WaK, r � N tl L,J L, L _J II I f. Southold Town — _ Board of Trustees ..�.W.. ....... ...._. ...... ,..... sig ra•dwvmW ,,�^^•'•';�"" rod*� � `�.� DATE De9p81pk a 7/8/19 JOUTHOLU LIANH sev.olo ........� Nemschick Silverman Architects PRO.ECTT M DATE WA PRO-CT. theb.h or ARCHRECTURE"' CE IV,2 I 17-1938 ,.. .� 6LOJJEM 6FJ1D SCALE 'Aillil �NO_ MATTITUCN AY 160 MAIN STREET,SUITE 200 �-- � �- •- -•�-- _ � .... � � afd�"+�C7TC.G� A-5 —C SAYVILLE, NEW YORK 11782 P 4'1T9C1: ' , �L T" DRAWN BY. J Phone: 631 563 2130 Fax. 631 563 2139 www.ns-arch.com + apw�ae�,:pc+,arwr ;n,N, 1000 qi5 6 22 ECF Cantrell, Elizabeth From: Nick Marcinek <n.marcinek@nsarchitects.com> Sent: Thursday, May 5, 2022 5:24 PM To: Cantrell, Elizabeth Cc: Ray Nemschick;Jason Merkel; Paul Gartelmann Subject: RE: NSA Project#1938_Siejka Residence-Wetland Permit application Elizabeth, The dimensions of the front and rear decks are as follows: Front Deck: The proposed front deck is 6'-0" wide by 5'-0" deep,the stairs on each side on the deck are 4'-5"wide. The square footage of the deck is 30 sq.ft. Rear Deck: The proposed rear deck is 24'-5" wide by 10'-0"deep,the stairs on the left side are 6'-6" wide and the stairs on the right side are 5'-0"wide. The square footage of the rear deck is 245 sq. ft. Sincerely, NICKNLARCMK Project Manager N=msci 3c ' 1 R.eRilA NgFR01=:'I17 —CTS P-�.,.v. 66 East Main Street Patchogue, New York 11772 631 563 2130 ext 16 Tel 631 563 2139 Fax From: Cantrell, Elizabeth <elizabethc@town.southold.ny.us> Sent:Thursday, May 5, 2022 3:49 PM To: Nick Marcinek<n.marcinek@nsarchitects.com> Cc: Ray Nemschick<r.nemschick@nsarchitects.com>;Jason Merkel<j.merkel@nsarchitects.com>; Paul Gartelmann <p.ga rtelma nn @ nsa rchitects.co m> Subject: RE: NSA Project#1938_Siejka Residence-Wetland Permit application Good afternoon, Thank you for the attached. if two copies of that revised packet please be dropped off to the office it would be appreciated as what you sent will not print out to scale. Also, I may not have fully explained what we need. As the office (clerks) are not permitted to take information off of plans can you please email me in writing the proposed dimensions or square footage of each deck. Adding the dimensions to the plan was also required, but we need it written out as well. Thank you very much. 1 er Senior Office Assistant Torn of Soutlrotd Board of Trustees Office. 631-76.5-1892 matt c,im , ti:a ,t,t�: � From: Nick Marcinek<njrarcine,k@ a ctit ts,com> Sent:Thursday, May 5, 2022 2:53 PM To: Cantrell, Elizabeth< liza cfti(: t n,south�ptJ,.gy,q s> Cc: Ray Nemschick<r,a e�p w ,p r o,sar �ita is o: �>i Jason Merkel <jw,!1iL p e t�s�r t ite�t5, ox�°a>i paul Gartelmann <�°i tlg2ann . r.bsarchite t ,c:oi i> Subject: NSA Project#1938_Siejka Reside nce_Wetland Permit application Good afternoon Elizabeth, Please see attached PDF showing dimensions added to the proposed front and rear decks. Let us know if there is any other information needed,thank you, Sincerely, NICK MARCMK Project Manager NEMS:1HJC',� SILVERIMAN APCHITEICTS P.0 66 East Main Street Patchogue, New York 11772 631 563 2130 ext 16 Tel 631 563 2139 Fax t��•I��r fifty 7i r1^; Ir I, M i ui 7 use rl lile irr�li diol,,i M ii1itrt r171:;M7 IIMi rr°i,7 l i, 7r11ies ed alid Ii 'rp'u i10 airr ,,ri � aid 7 r P,s ,r al l drld :^„�.im rO li q f :c1 sul'iw .,ir,i r pf k ibl l,r . 'rrr°,,ri.^, (I ,,:,l+rsI�IQ" :;ca ",,iII, a �91si 111 I C)m (,i t iM„ w�. rr71i�M ori^a1�rk'��r1t,.7, lre,Mlil' ;u Ii^r^„. i i° lv(+ 1 017 r o lid its mll Ird.^r e file,,Irs� rrrlr.r��iitl`r+ i 11i,sir�91r,� iir9i:�,��i,1, +I i m;llre,�rl� it��i II, Ian �riP,olI�^t:1 11 �"^��� torr ^ruk:r l rell^. irr,gll aild delek(' f:N� Mil Yrom r^„is sysreir. NK:urb;,Y+,.riU ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 2 N, Town Hall Annex Michael J. Domino, President ,, 54375 Route 25 John M. Bredemeyer III,Vice-President w C P.O. Box 1179 Glenn Goldsmith qr Southold, New York 11971 A. Nicholas Krupski , Telephone (631) 765-1892 Greg Williams Cr Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To: Southold Town Building Department Re: Verification of Building Department Permit Requirements SCTM#: I ✓ 6 `" c a Property Owner Name: 'e5i� 'Na Date Sent to Bldg. Dept.: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO oll the proposed project require a Building Permit? Will the proposed project require a variance determination from /heZoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: 5 0014- Sign4ureo viewer Date ROIRMI/!CI@i4TXHB45®GH�RYtY, _.._s/T 1/A TA � SGTT� Y/G/N/TY MAP A�IISfr22 of vlV &1/l MATInnCK EMMES vLer�c�aPr�n�v�wtaz A?0FBZWAVVRr6 a_0_5OMBw LItE+MDS4II�ARVRM'SN/0/!r °"', MATTMAX MY TOWN 0 STOUf�oLD ZONIN5 DIST R-40 �a'�Rd ' " C E S. 870'26'30-K y Q LOTAWA 40,Wl_52FT.(W A0 128 74' _ n • FIAI rJ/Al4 ARFAS. l�Nattitl.lck ^�• . . . 3 DSC fiAS LOCA710N5,y11 P LIVABLE AREAr l FI,esT 0 / u soGle�y o sit�i.r s�TPI ...7 n PAn9517BW.4Q5VDEGeS.— 340 3 y -•• ., 15T1 9 c eb ScTuhuYd Town • 4�7 -' OGArIONS Board of Trent + X .42 LOT 22 LS ...t NYS RE6/ilA7PD HeESIi TBA NETLAND BaWARY A5 FLOOD ZOAE LIRE Da 9 s � . NY5DEG ON 72/1AS RER F&44 AAV L Q4T BY A (6A AI6VDZgJ APAP AL0N5{�7LAAD5/GL EAR/N6 „" ". AAlP LOc�arID QAI aCrpa�z x ,�"° — 5ANlTARY 20/9 BY 5IRVFYOR X4N4N TAFT 5Y50.1 GOWN Ill nAQ LIMITS i XfL A6_5 .fTIESf�Y,41S,: .w...,..• �..�-..�_...,_._.,.�. PEnAADS Llt s of aEAR Ar7 AND LOCATION ., hETLAAD DlS 6RaW DlsnRB"WITHMTwN 100 FT H4 Y BALE AA921OR `. µ 8,954 SQFT. fETIGIN6. �DETAIILS,DM •• 3 WALL LOCATION n CS I . PP-3. X#9 as HEALTH DEPARTMENT APMOVAL STAMP �+ I , LOT 23 ?S LDABd.E`AREA L T # X 74 Q GRADE. 15.0 - LOT 21 nAR 2-5T _ ,rte 1cN1sa AUL 14.7 NO TEST`HaEB-1 (vd�) __ . �T X B''DIA 1250 6AL S�nG rAAK O (TJ B'DIA 6 FL DP LE400115 ART. / &RAI;)I NG PLAN nmASN PAVH7 DR �': E�ANsION R'1'JL IL X x AEC O.N.POPER LAM VZOPY COAW-C77ON IN FIND. MAL I �nsorsrso�s LOCA77ON of MEN FNXIC 3 ON CALCULATIONS DATE DESCRPTION _ _ .,�y WA7H25�VIGE. GOIIPEG7E7 .'.` STORMW,4TER RETENTIF* TO I1G41t72 MAIN IN S7R�T. - - - W � � 4/29/19 pf-C/ WWM Xa�4 l� AL41He%4L Al�i4(SF)X 10',/110f7=C�Off-C�d'/IV.DR,41N DESl6N X DESIGN R4MEALL-D1E5I6N VOL.(GFJ 7" »2 � 5/30/19 DEC/W WM COMMEPf[l D X&22g ROVRW AS<t'IALT 662 5F.X IA X O.16-I365 AREA l GF.STORAGE REWIR87 - 1385 �'N DRYP* L5 3 L6DB3' 5/2820 DEC COMMIL/Ir Z/6 SMA&E STO4A6ECAPACITYCF B'DIA R/NS -4214 B DWETH2 R/N5=35 VF w � 1/821 DEC COMMS u 1► x .7l �{ ea �y 102221 IRIJjT PLOT FLAN �,� x� Z� r .�'� ��' KOA �� ARb4/VP OF STORAGE REWIRW =33 VF. SCALE= I" = 40'-0' a�sxB Y + " f RGCING A_54W4LT 107 SF X LO X 0.16=113.1 A 54/GF.STORA6E REWREV = 27/.3 USE N DRYPW 5 6'fi'Dl�' � No.028086 " AUR SMWE STORA6E CAPACITY OF B'D/A RIAS =4224 BD/AWIER R/N5=65 VF. w 6InIV PURUC rersR) OF STORA6E R V.F. FIOR® -6.4 VF. % tl DRIV514 ASFH4LT 9B9 5F.X IA X 0.16=1582 A 54 I _ ?R01EG'T TIRE DATE WA M**CT ec Nemschick Silverman Architects w, of ARCHITECTURE' F)L�jTM E)E/�D 1025/16 I7^1 938 the Ww MATIITUCK PiY 'SCALE IIRiMN!M6 NO_ 160 MAIN STREET,SUITE 200 - PIP—] SAYVILLE, NEW YORK 11782 DrT:•. *VICtk & LOT: DRAWN BY: Phone: 6315632130 Fax: 6315632139 www,ns-arch.wrn •4aMI�Rtlraawmrmralucr�ww.MpAr�roplr:e 1000 1tl5 6' 22 C.C7 � a O VBRAlDA O I I O O I MASTC!B®�aooM � i I I I11 I I I 1' I MmIA�mGM I G I I V I II I p I I fill II II .I I GREAT RocM i I II II I I o Ll I I I II I MAO=BAIN 24-5 - HALL N �T W � e L J o nne ofill — . Q o v _ I V Know I I I SEMWOM L I I V' BATH I — N I N N MLD RMHIEWMALSTOPME p+oRCF+ I I I I FMIJ. I I 571Dr/M51�9T I L - -, J FLOOR PLAN _ I N I � PROP05�n SEGON� L - SCALE= 1/8' _ 11-0' MAL p �.�� .,, DATE DESC1�lI0N: Li" CAf1 WWM POI11CH W. 429/19 / 1_. �h " � 5/30/19 DEC/WWMCOMMFJIT/I 0 0;!OP05�1� SSMNT PLAN _��_ _(' "I� �IRST r-LOOR PLAN PRO CT Nemschick Silverman Architects ,-,... hoard gaffTrustees ""`E ' ' " � Ihe buvnesolARCHITECTURE.'" q�KAQ�DE/1[L 10/23/16 17^19 _ .— 6LO/1=M M/V I)CALEDRAWNG N0L, MATTITUCK.PD' 160 MAIN STREET,SUITE 200 •---_-- """" SAYVILLE, NEW YORK 11782 i OIBip1 �GK7pk BLOCX 107: DRAM�NI BY: r Phone: 631 5632130 Fax: 631 5632139 www.ns-arch.com wrael+wwAwr ouww�aa+n.M.+amtco�ne 000 n &M-MAMMA 41 wallo- LLI DIU H I KIIEP I I - I L �y o- M" � YY L' LJ _ — J _ - - - - - — - - - - --- J-- - - - -- - - --- -- - - - - - - - DATE DESC18MM �RCi, q `N 7/8/19 y0MOLv 14 , APR . esv.oa— " � n O�F!R �,�?Erl � L � .�L , J111Boar oaf Trustees �= ......� Ill TIME Dal M PROXY.. Nemschick Silverman Architects J1ii 10/25/18 17-1958 " the be5n—of ARCHITECTURE: ......: ._.._. ........,�,.. _........_. 6LOJJEM 61 � DRAWNG NO: 160 MAIN STREET,SUITE 200 MATTITUCK ByJ/10TPD SAYVILLE, NEW YORK 11782 OISIRCT: CiK7kk ',9p.OdG: LOT: DRAWN BC A-2 563 2130 Fax: 631 563 2139 www,ns-arch-- Phone. 631 1000 1[S� 6 22 ECF wcvaoer'muaaL+wu+w ararhrruTw�c a �a 1�r � dd tz JMw 13 4 4 AM pr-or I I APP _. ,........ — —_ — —,._....,. AA:iW'AKYIT2D IEVOONSISLIMNSM � ,.• MALREG ," ,'�°�d DAIS DE9C18MR C C C M � 7/8/19 IOUTPIOLD AD N3.02E0?^ ✓� u . I OL E1: FRONTL �ITI O � i Tows ..8•_ -0. �.�mrr esBoard nf Tri t MECT OATE MOECT Nemschick Silverman Architects JIEJKARPAMMCE 10/25/18 17-1938 ',.,..the buslneaof ARCHIMCi RE: 6L0lJEM 6FJVR ie......�ww ...�....® 94.'ALfc DRANM('N0. 160 MAIN STREET,SUITE 200 _ MATIIIUCK W' AM(-- �A\ SAYVILLE, NEW YORK 11782 D61RCF. �9fEGIYCl9R 93 r DRAWN BY. /101FD A-5 Phone: 631 5632130 Fax: 631 5632139 www,ns-arch.com '.. ra w amrlwrl.,eacmrc 5'. 1000 115 6 22 � /�" 4 �o �� �b l�Mi!PLIAPI,NP". kP,R1r6�Ndi". �Y9 , NX N ,_.._. ____ ......... if f,_..,_. f APE eA!rvApuelY SEY.I�O'sAKIIt! MAL Wvsowy8wm90f8 DATE DFSCWW* 7/8/19 JOUTf10LD aw. PP 2 7 2022 x PROP05�n REAR ELEVATION cu �3r� rd of" rjj f SGALE= I/8•= r-o� PROECT 118.E DATE NA NOW w. Nemschick Silverman Architects ICJKAaP, OLACE of ARCHITECTURE"ess 10/25/16 7-19. the busin8 ... - _. E3LOIJEM 6FJ'® 9CJILE DPAYM+A�NO: �� � MATTITUCA.Ay w A 160 MAIN STREET,SUITE 200 •••• - ------�. �,`\ SAYVILLE, NEW YORK 11782 '..�' LOT; /�_4 Phone: 631 5632130 Fax: 631 5632139 www,ns-arch.com .wr r co.aww�.wrAc ,cr�+•ae 1000 115 6 22 CC? BAK AW FI3FI3 � ' F=71 � F=—] 000— ---------- Jim, a� Lu ii 1LJ LJ Tp SEAL wNsCNID'aawasm fi E D. p DATE DESCWMR rr r .n 7/8/19 JOUTHOLD PARN APR 2 7 2022 07� I� F1IGHT 51n ELEVATIONv8• - r-0• o B° u� nn 22 _ Board of Trustees .,,.m.,.,_ '......PROECT 11ME DATE ...NSA PROECT'r. Nemschick Silverman Architects 6 1a"19sa '..Ne Euslness of ARCHITECTIRE` ,SCALE r�'J/I J1rJKA RrA(? ICE 10 �_—� 6LOl./EM 6FJYD MATTITUCK,PD' 160 MAIN STREET,SUITE 200 "" "" SAYVILLE, NEW YORK 11782 DISTIBCT. SECTIOk dL=. LOT: DRAWN BM �Y Phone: 631 563 2130 Fax: 631 563 2139 www,ns-arch.com rw�mraalmwa�weacw ws, 1000. 115 6 22 :01" Glenn Goldsmith, P lent Town Hall Annex A. Nicholas Krupski, Vice President 54375 Route 25 Eric Sepenoski P.O. Box 1179 Liz Gillooly `,y Southold,NY 11971 Elizabeth Peeples ` ` Telephone(631) 765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DateMCompleted in field by: Raymond Nemschick, AIA on behalf of ROGER SIEJKA requests a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5" wide by 50'0" deep; front porch is 11'0" wide, 6'2" deep; rear veranda (deck) is 24'5" wide by 10' deep; and overall max height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM# 1000-115-6-22 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: a . I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were.: G. Goldsmith /N. Kru ski ✓ E. Se enoski ✓L. Gillool p p Y E. Peeples Other Cantrell, Elizabeth From: Cantrell, Elizabeth Sent: Thursday, January 13, 2022 12:46 PM To: r.nemschick@ns-arch.com Subject: Siejka; SCTM# 1000-115-6-22 Mr. Nemchick, Last Tuesday,January 11, 2022 the Board of Trustees performed their field inspections and went to the property noted above. The Board found that the project was not staked and that it did not have the Notice of Hearing sign up as required. Due to these factors the application is postponed from our January public hearing agenda. You will have to re-notice all adjacent property owners to which all information will be mailed to you for February's public hearing date. The next field inspection is scheduled for Tuesday, February 8, 2022 and the next public hearing is scheduled for Wednesday, February 16, 2022. Senior Office Assistant Town of Southold Board of Trustees Office: 631-765-1892 Email: elizabethc@southoldtownny.gov 1 sul Fotk Glenn Goldsmith, Pre it O Town Hall Annex A.Nicholas Krupski, Vice-rreisident �� �'< T 54375 Route 25 Eric Sepenoski N P.O.Box 1179 Elizabeth Gillooly Southold,NY 11971 Elizabeth Peeples Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 11111—:22 3 %©-S Completed infield by: G. Go 1015M Raymond Nemschick, AIA on behalf of ROGER SIEJKA requests a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5" wide by 50'0" deep; front porch is 11'0" wide, 6'2" deep; rear veranda (deck) is 24'5" wide by 10' deep; and overall max height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM# 1000-115-6-22 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 r/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 tco'mpleteness/comments/standards: NA po5 TeJ rs� SQej I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: ✓ G. Goldsmith /N. Krupski ✓ E. Sepenoski � E. Gillooly _E. Peeples Other 5 U RVEY' OF LOT 22 N AS SHOWN ON A CERTAIN MAP ENTITLED"MAP OF-MATTITUCK ESTATES,INC FILED IN THE SUFFOLK COUNTY CLERKS OFFICE SEPTEMBER 8, 1965 AS MAP NO.4453 51TUATE: MATTITUCK TOWN : 5OUTHOLD � E CE C VE � � 5UFFOLK COUNTY, NY SURVEYED OG-03-2015 JUL 2 9 2019 SUFFOLK COUNTY TAX # 1000 - ! 15 - G - 22 Southold Tou'm o d olirusteu CERTIFIED TO: ROGER SIEJKA FIDELITY NATIONAL TITLE INSURANCE COMPANY MCS MORTGAGE BANKERS INC. LAND NOW OR FORMERLY OF: 0C. TOWN'OF SOUTHOLD eQ a��P 5870203-011E 128.71 Q��P oj2 w11, w w11 x 3.2 w W w w w 0 O 3.2 w w w FRESHWATER WETLANDS x2.8 w w w w w w w w w w w w G,5 p LOT 23 w / w w w NS w w w�/ \11 w EDGE OF FRESHWATER WETLANDS LOCATED ON MARCH 15, 2015 0 w w w orf BY NATHAN TAFT CORWIN III xl G.5 �23 x5.4 x9.9 N w � w LOT 21 -- --- :�--- ��;- w why � W �z.s- - XI 1.4 - - - - - -- --- - - w w o w w x 7.4 LOT 22A _ Z w2.9 —VACANT--- 71 / x14.7 S\ 01 x13.0 X14.4 X3-2 X14.5. 1 CZ_200 00 x22.4 x21.8 x21.8 x 22.8 550 dray X21.2 lbv0 halt r X21.3 asp ELEVATIONS REFERENCE NAVD'88 DATUM NOTES' "llnouthorized'oltsrailon of addition to o survey mop bearing a licensed land surveyor's seal is a 10 MONUMENT FOUND 1 of Ni 'w violation of section 7209,sub—division 2,of the JOHN C. EH LE R5 LAN D -5 U RVEYO R f New York Slate Education Law "Only copies from the original of this survey {fr marked with on original of the land surveyor's stomped'seal shall be considered to be valid true copies" G EAST MAIN 5TREET N..Y.5. LIG. NO.`50202 - "Certifications Indicated hereon signify that this survey was prepared In occoidonce with the ex— Area, = 40,53 s Ft. RIVERHEAD. N.Y. 11901 3G9-8288 Fax 3G9-8287 �' " a is Ung Code of State for Land Surveys adopted s �.. s � t '`� � by,the New York Stale Association of Profeaslonal Area = 0.9374 Acres s Land Surveyors. Said ceilifirollons shall run only GRAPHIC SCALE I"=30 lon9t5landlandsurve—yor.com ri, t� r to,he person for wham the Survey is prepared. and on his behalf to the title company, governmen—tal agency and lending institution listed hereon,and to the ossignees,of the lending,Institution. Cerlifiro- 15-14 I ^`---_._ it..or.net tren.feroble to odddWn.1 Institutions a F 5/T PA Thr q -4M 144,,�gTa� AM Y/G/N/T1' MSP 71t)1RV irgur=&v I ® AwN6 DIST R-/O ' ��� tAa1'n ad s S. 870M 128.74' �g LOTAA�A 4oa3i5t�rGx�7Ac) --�-Q` w _ WLM AR64rx Mattituck FLAGRRSTRLYJR —$Q� Society �_,10 g6 0' �j• DECRA6 LOGA77OA5,77P. ENABLE AR54, /.729 /,218 l,2/ 5flL3L�,GT 5/7F ,,�_,� APAn05/1�4�.f5/DELI'S,— 340 35 X00 - - - - - - - Ft�o EX15UZHELL ' 1S• - - - - - - - o y r d \ LOCA T/ONS �'Gc X 32 LOT 22 A _..1� N���YS�rR,�W�,,."� 7W F7eE5d61647E? - •AE LAAV D[/rWARI 11J - 111 N • ��\�• , Cap.a 0"9d Da1AF47W BY NY5DEG ON=A9 rn s i . 1 PROP05EP ANP L06A7ID QN 0CW6 R,;9, x 2e PROVIDE SPLIT RAIL FBrAF \ .e 2014 BY SUQVEYOR N4TIMM TAFF n LIMITS \ :i �i 5Y5TEM > ALONGWMANDS-GLEARlAES ! 5ANlTARY oae ao 2 GORWIN III FLAG � calRO�, (l X��S WADVED 1 NH PUBLIC WA2ZR) \'� �'��ry EX15T1N6 WELL 5 1E7LA1M5 LIMITS OF GL.E40W AAV I LOCATION 1*-gAAV D/57LK'wm 6RCW DI51UR8ANGEMTH `.._.. MTHIN ILII FT SEIBAr.K s NAYBALE AND/OR SILT J� //�� ; =9,9s4SQFr. I�YGN& 5WDETAIL5,DWfi �)�ELL LOCATION �Il��. �s a 2.9 H.54 XH.9.9 Pp 3 •�' - - 150 LOT 23 kT HEALTH DEPARTMENT APPROVAL 5TAMP • 5. • 8.25 a 11.4 BUILDABLE AREA nx, LP GO ie 11.21 - 75 Y i e 1100 xa 24�A flPr9® I 0 GRADE 150 O - - 24 42' LOT 21FLAD 2rr I p p�►��n�//p� � 5I - I � le 1050 �f.._,_M_j�,.__....._ �=�} `_1;J"�� . uersX Ydwvrsa ,00 X3 H.7 FAM► TEST NOLE B-I }',I t'; I 1uI M��; 11 Y 1�� �� 290 I �J le 1040 - nAG C9L ' FF �D - fy O LP o DEC 2 7 2021w. X D13,045' B'DG 1 GAL TIG TAAK 0 6'DIA.6 FT.DPLEAGNIN6 / `R I U'Cify``..`^tll•r�`__s`� ''_..._.�._ _» N P001.5 I NG PLAN 0-1 FMO ABN PAVED DR/VfWY. EIWN 5/ON Poa EL X XAl3M ON PO/1ER LlNFS e i4s SCALE= I°,20'-0° VH7#YCaWZ"aV/N P/HD. bXAnON OF MH PDBLIG g,41 ^ _— t 9 WATERSERVIGE GOAOIff.'G7L37 — • STORMW,4TER RETENTION G,4LGUL,4TION5 ��ED �R� °^'E °�"°" TO f^WER A4A/N/N STRr�7: X'100.013 XB.224 4/29/19 ICVPY W WM Lw MAMMAL AREA(5F)X10VPF60AEF=E6V1V.DFAlNPBW6NXDE5/6N R41AF&L=DEW6N VOL.(CF.) L ���0 s�y� 1�1 5/50/19 DEC/WWM COMMC/f \ �6 X a as a 2� 3 E N D xa 27B ROOFlN S ASPHALT 962 5F X Lo X OJ6=13195 AREA/GF STORA6E REWIR D = 1385 /LF N DRrM IS 3'-6'DHp C: ? � C 1 5/2820 DEC COMMCAV PLAN y .SHINGLE t STGRA6ECAPACITY OF9'DIA R/N6 -42.24 9'D/AFf7H2 RIAK=35 VF. 1/821 DEC COMMEPfU PLOT I—L A N �, xa 22 O C+s Q NRO�WAY AW-4/VF.OF STORAGE RrWREP =33 VF. ►7 t.+t Ifil 102221 TRU/TC/' •_ a 2/5XB AS 27/3 USF N MMML5 6'.b'DEQ �]•�1' 0 SCALE= I =40-0 Y Pi�� N�o/� RLl9FlAf6 ASPHALT 707 5F.X 10 X 0.16=113.1 AREA/GF.STORAGE REGL/1R87 = ov ra PPEFAUC WAWA) STORA6ECAPACITY OFB'D/A R1AK =4224 9'D/A OER R/N5=65 V.F HVo 18 r DOWN4 A5AY4T 989 5F.X LO X 0.16=1582 AREA I VF OF STORA6E R WIRS9 =6.4 VF. (!J(PROPSD,1 TOTAL, 27/3 Nemschick Silverman Architects "tOLEW'1111B CA78 WAPRDECT• m.b.5.—of ARCHITECTURE• -,IE1KA RF_(1I)MCE 10/25A 8 17-1958 BLQ/r-M BC/VD SCAM p� 160 MAIN STREET,SUITE 200 MATTIIUGK/1Y SAYVILLE, NEWYORK 11782 A.'NOTED Phone 631 563 2130 Fax., 631 563 2139 www nsarch.com D611eCT ZCMM BLOCX Lor DRAVYN 6C P-1 •canro.m,e�oa avow Avanern ra 1000 115 6 22 ECF LOCK/NG CA5T1N6 TO GRADE TRAFFIC BEAR/NG CONCRETE COVER O O CONCRETE CHIMNE G Y RADE �L,A ` Fi GRADE EL. 150 20'MIN. 0„M/ CHIMNEY rye' G.O. Q 01 INLET• MIN. 4”D/A1E. APPROVED PIPE, ' LE EL. 10,5 MAKE DROP "T" PITCH l/8"PER FOOT. 20'' EL. ll.O I•E NI llACCES51BLE FOR MIN _ 1250 GAL. R. 10.4 LEACHING `R) MAINTENANCE, `N. SEPTIC TANK POOLS INLET ----- -- —� OUTLET I1-1I 0❑❑ 0 ® 111= —III III=1_I d - 11 I—I I 0❑❑ � 0 —I 11— Q DESIGN FORA 4 BEDROOM Y INLET MIN. 4"D/A. MIN. 4"D/AM, 1=1 I I MIN. 3'O" z MIN. 3'O" 111=11' X SINGLE FAMILY RESIDENCE =1 11=1 I I I I- 4 APPROVED PIPE, O APPROVED PIPE, 1=1I I COLLAR COLLAR I-11 m PITCH l/4"PER FOOT. FLOW PITCH l/8"PER _ =1 1= q 1=1 11= WATER LEVEL EL. 2.83(-l2'-2 FOOT111 IIS 1 BAFFLE TTI I I11 w II I II II SAN I TAR%' PROr-I LE I�=11 6 0" -III— II1=1 I1—III —III= GYLINDR/GAL /250 GALLON SEPTIC TANK I II 111 I I I II I II NOTES: —III III-1 1. A MINIMUM OF 4 /NGHE5 APPROVED REINFORCED PRECAST BOTTOM AND 3-INCH WALLS. z 2, AN.6 FEET/N D/ANETER BY 5 FEET HIGH APPROVED REINFORCED f�EGA5T CONCRETE M/N/MUM 6' � BACK FILL MATER/AL HEALTH DEPARTMENT APPROVAL STAMP SOLID RING. PENETRATION p --BACK BE GLEAN SAND 3. AN APPROVED REINFORCED PRECAST CONCRETE 6 INCH THICK SLAB TOP/N LAWN INTO A VIRGIN cit AND GRAVEL. AREA5. 57RATA OF ..... . ..... ... ..... ...... S�PT I C. TANK Gr , HIGH 5E450N GROUND WATER 2 SCALE=NT.S. 3 LEACHING POOL SCALE=N.T.S. SOLID CAST IRON MANHOLE �r"•-f�- FRAME AND LID N/TY TYPE 'F" LOCK NOW NEEHAH FOUNDRY R/922 TO GRADE gBowNc No. f Q E C 2 7 2021 •'_j pz PVC 5DR 35 PIPE SEELa SITE PLAN FOR 5/ZE - PRECAST COAG. MANHOLE � Wflm 6 �• F1M8 BaHCA 8t®Hd81[B8W9 7 PRECAST SOLID FLAT TOP si sT aA�a'�T¢Ae¢"maea¢° a s 7)9ATEi{IPtl¢L s� t9 THIN MHASw 09 THE OaTE x903COF ,,.�...;......+—.i• . daL MAY 80i°¢W:FL80ir'2 OF _ J 0 —T eT0 tlE0I0M 880X9 MO DART Ofl ffd509AL VAaiAriO.'e I.`1I✓1 t.i{ft I iy.i 77 O f= f=O f= 6"PRECAST TRAFFIC BEAR/NG 5 g 8 aiST aM04V 8A40.TPACC 9 TR&GPOCIDNATEA LLVEL [ M+ ^F 7� r./c, O •••••, % O O O O O •• 5 ` tlPDlal(ro F1HH R¢st BaeNa 50H-506F�M.88W.e�Di°T'N88 uE _ E'�f•-r,.i ``',+i -.-a J-. •w SLAB TOP- 40'00 P5,1•-REM AFD ti08T SAW,__T 0 0 0 0 0 MIN 24"CRUSHED STONE OR b wc¢ � aOHI90 OCAitHa H91,A�AHE�x •.; 4teassAMi¢,aeraae¢MtaM of tT1H 1 sp mA9iT2095 AT Of 8¢H IAf... n1 _ 0 l- o GRAVEL ON ALL 5/DES o 70 s t FiMe ro 7�uuef ueeT PROVIDE 2'-O"MIN. 5AND �. . 3 x O v u-ASM M) COLLAR AROUND R/NG ; j o RING TO RE5T ON UND15T• 50/L ' ' •. .. •, ' : H dM1°A8�SWM W/A MIN,BEAR/NG CAPACITY �• TO _ t .t• 16 sMeu eaarv,csv) rATea iRE. 7s x• to m Alp MAL _ � _�_ IEV6ONY&M 33M • ; ' 4 OF 2 TONS/5.F, ,.H,9.TT Txe¢,e,x°AM - ED A, � DATE oF.s�art DIA , 7 a 7 i¢®TmE.::v ex '(Fi� ��'.I��•. 4/29/19 ./CDq/'WWM PRECAST RING-4000 P5/ G^5�o�,o w. r F�`c !t 1 5/50/19 DEC/WWM COMMLAV R ��L �1:'F-T�Al REINF- TYP/GAL 8 x ���m M w. /�� 8 x —LO 6510 ISGHI BHOie •l 02==�E SC . - 4 J o[ee l0 MIDt¢4 trot a s e¢Lfia SA9D,SOYE PTTE (P - m mass¢case¢(sal £ID OF mYQO, 4710" emschick Silverman Architects PROXCr TME DATE NSA FROECT. • a,OWgO°aerARCHrrECTURE• jlrjKA RUPEACr 10/25/18 17-1958 6LQfj LM 6EJ1D SOME DRAWHG NO: MATTITUCK./1)' A//TOTED 160 MAIN STREET,SUITE 200 ^^_ SAYVILLE, NEW YORK 11782 061R1CF. SECTION BLOCK LOE op Be 'r/Ir/ GJ Phone 6315632130 Fax: 6315632139 wwwns-arch.com .mnaaemuaaMaQaetiaM�nRaenMe 1000 115 6 22 ECF r FLOW GRAD + 4" VERTICAL SLOPE FACE + PERSPECTIVE VIEW BEDDING�DETAIL 36" MINIMUM 2 x 2 ANGLE FIRST STAKE TOWARD _ __ FENCE POST �!�� n--�7 -�� „ _I 3 PREVIOUSLY LAID BALE. �^�®`j=� ' � "'• � �: tf - ----- WOVEN WIRE FENCE j /��/ t`• ,, n ` (6 x 6-10110 WWF) FLOW / `r^_.� �,� G�'�i•-G�� !}r�%i -_�.._.__.. �__ — 1 i i k - - ---- 2 d FILTER CLOTH o ,,i f� n f�~.• C'Gy? _ j f N DEC 2 _ 2021 EMBED FILTER CLOTH MIN.6"INTO GROUND = ` / BOUND HAY BALES PLACED ON CONTOUR �'•-Htrold 1-ow'j `4 Boa NOTE: -— 2 RE-BARS: STEEL PICKETS OR ---=-•-a -.... ,- MAXIMUM DRAINAGE AREA __ '' 2"x 2"STAKES 1.5'to 2' IN GROUND. 112 ACRE 1 100 LINEAR FEET DRIVE STAKES FLUSH WITH TOP OF HAY BALES. SECTION DETAIL ANCHORING DETAIL gnL - REvslora/sue►lssore DATE DFSCRPIOk v+� d5GALE �\ 4/29/19 -fcDmf WWM 5/80/19 DEC/WWMComm ECE �ETAIs 5TRAWBALE nIK� LJETAILSILTT SALE NT .N4 i I' I No' 029085 P emschick Silverman Architects PRCLECf TIRE DATE NSA fROECT +hewd._.fARCHRECTURE! J11JKA RC/1DCPiCC 10/25/18 17-1958 15LQ/JFJ-16uv SCALE DR V-00 Na 160 MAIN STREET,SUITE 200 MATTifUCK,A)' A/'/1OTtDIr/^^-5 SAYVILLE, NEW YORK 11782 D6tpCT SEC110N [!LOGIC LOT DRAWN Bl` Ir/ Phone 631 563 2130 Fax: 6315632139 www ns-arch.com .00rorw�Qavew. ren�.e 1000 1 115 6 22 ECF ° - - ° --77 IIIII IIIII o - - „MMM,, - - o --- - -- -- I I II -T,- I 1 I I II I - - I 2 5 I / I 24'-5" — — — — —— —— —— 24'-5" be. I II II I I II II r � I I 6MAT WMM I I I I I woman+ I II II Q I I I II II - I I MMM DAM 1 ® 0 HAUL LI BT 1 J Dim BTW _ I— � L-j IIII arcs I I IIII , 0LI MMMM.sror a DEC 2 7 2021 {, ° IeeEtiw�l I I ° — — I FALL I I BTuvr/�r 10, I _ I L _ _ J PROPOSED SECOND FLOOD � eo�r��� It,; �4�5 _d, ° ° ° ° SCALE= 1/6'- I'-0' Mx DAX DESQBDON I IIIII POPM I I I I �;+ o � ` 4/29/19 lC[?vWWM I I III III I I I I ,c���NO NF4, Yia`� 5/50/19 DEC/WWM COMMIZKYLJL /Q Pfi�OPO5ED BASEMENT PLAN SCALE: I/8° -0° 101ROPOSEI7 F I RBT FLOOR PLAN No 02 033 SCALE= 1/8"= I'-0° 40 Nemschick Silverman Architects ME=IMB DATE N"PROECT u b,slnessofARCHITECTIRE.• -AIJKA RP PEACC 10/25/18 17-1958 BLQ/-r.M e)M1? SCAlE DRAWN6 N0. MATTfTUCK/1Y 160 MAN STREET,SUITE 200 AlnOTCD /A\ SAYVILLIE, NEW YORK 11782 DoRMCT *C7101i BLOCK LOT. DRAWN BN /�_1 Phone 6315632130 Fax: 631 563 2139 Www ns-archcom .wnmvmoMMM&v MAM==P. 1000 115 6 22 ECr • I I TV 2 6EY.'Jlrf K I ID I 7CFLFf1A713 4� .24W 1LFL�FIAIB 6N.Dw 4 N R aDo - 7LPLFFIAID LJ 61 {:! `ice _.. -- ,, DEC 2 7 2021 IWLF'J6RLCR +—�— —— — —— —— —— —— —— ———— — — - ---- -- -- -- -- ----F J- ---- -- -- -- - - -- --- �iCiBC^ci O� ��0�®5E� 51I� L Y TIONMAL __ , DADA M �Pic7/8/19 JQUTHOLD 5 O F Ci r 11 Nemschick Silverman Architects fltOJB=71RE DATE N9A FROLCT r NebuSnessalARCH1iECTURE' JICIKARC/IDFJiCC 10/25/18 117-1938 6LQ/JCM F)Uv 9CNE DRAY&G N0. 160 MAIN STREET,SUITE 200 MATTf1UCK,/1Y AJ/VOTCD SAYVILLE, NEW YORK 11782 _ ��—� Phone: 631 563 2130 Fax. 631 563 2139 www ns-arch com 061feCT *0710!! BLOOL LOT: DRAYM 91" LLL .aarnov mo�Ct nv�uromcnrc 1000 115 6 22 CCP THIS IS NOT A PERMIT N"pw York.State Dopartment;of Environmental ConservAtioh, Notice' of"Complete Application late: "09/02/2020 ' Applicani-ROGERSIEXA. f�� (� f� fl �� (� is Il Facility S1EJKA.P Q"P TY I L�+ 955 BLOSSOM BEND11004-115-6-22 (s IvI�TTIT`C7M WX-1195z o 2 ZO Application 1'13: 1=478-0468.1100001 Southold Town oar of Tru tees Termits(s)-Applkd far> 1.=.Article 24.Freshvvater'Wetlands Prgject,64ocated• mi -SOUTHOLD in SUFFOLK'Q_QV ITI'Y Project Description: Appl cagt„proposes-tp constructa new.single.faffi ly dwelling within the•,regulated acljaeeritarea(AA)of,lUewYorlc State fresfivratet Wdtiands)'r.`esulting;in approximately 11,929 sgpare feet of dist4r4ance to ihe-,AA:,The dwelling-will-be located a minimum 075”fromthe freshwater wetland,boundary,and the.sa6itarysystem is propbsed'beyond the limit of freshwater wetlands jutrisdictiop;The project-is located`955 Blossom Bend,Mattituck,Town cif Southold;SuffA, j County,-SCTKU 1000=115-6442 -�ivaila8itityofiipplicaiianIloc�menls; liilei3 application doeutnerifs,,andDepartmeztt d�raltpermits'whefe applicable,are,available fcirJnspection during normal:business hours_at the,adclress of the;contact pdmbii. T6 ensure-timely service ai the time of inspection,it, ig recommeiided that-Ml-apppuitzriezitbe marJe Wtli the contact person. ,State Emurorimental-QualityRevim(SEAR)Determination Pf6ject,is not:snbject to-SEQR because it,is'lei Type 11 action.. SEQRLegdgge?ic"y NoneDesigraated Slate Historie-Preservation Act•(,SHP.4)Determination A cultdral resources surveylias been'completed. The`repori,of the survey is on file. No archaeological sites or historic-structures were identified at-the- 'ect location. No further review-in accordanee�With SHPA is iequ�red. = _ Availability For Publfc Comment Contact Person C6mmdnts"6tf this projectmust be ELYSSA E:SCOTT _submitted•in writing to the Contact NYSDFC Persomno jaterthan 10/0.1/2020 SUNY @;Stony&6415bCircle Rd br,15 day's after tits prabiication date Stony l rook,NY 11790-3409 of this notice,whichever is later. (03i)444-0365 CCI:List,fo�--Complete Notice J B U �) l 11 SEP - 2 2020 Southold Town Board of Trustees a i • 111 �, /►j a' r`m ;' � ^•*"� 6' �µ s1 ��^' ., ��.' �;A r .^' / � •� X44' . . y'Ar,• Ah yy _`;_ �3�•t.. R .. - i '� �Rq`���•� � }1,`� �s'��d }jai^, � .,� � s� y' `ate � l� i\ 1{,`•� 1♦ nFr r� - • I••r I • '.i " • 111 p f y ,' J 44�• a�i �, iy � A `�. "� fi� � �!Y / 1 '"x '�„� ,g• S, #•. Aj WE IM�k .l� J w�� ����..' ` .,,_;�.�t�'�,,� } i! �y�L t4ttty�� * ✓ `.` \�i.<`�, �±'�r +17p Rt �� 'Ii�( � ..- `• ,fig �' - . 'N me tot -44 ' �r;rte t� t R..�” ,� 5,��p Y� ,�j`: ,. 3 �" ik q Y+� '`� �� •.p v ,•;.'�' �,;�,. � w "�' _- ,.mac-d� r '�..' � / i .. r v +1 ,g ;� ;ir► �r, g i • 111 r, 1 Ii.T `i� <„`pro' ''o- ',� •, ► r:f, '�'�r t,,..... 7�N� � �'„. .y..a„ �� ”`t• �j', �� � i r t,c � `��,�. 1 4� �/� � .r ��� :1�4n'+r `�s•�i,��•b!�� �� is iT• � pyo n ��4� a e x'"��, �, I R , � \� � �,'✓ t ,�!! T�t_t�� +,'r5"'' � � `Zk �` � �� h"".I '..+1'� y --n�'t c� __. AL WWI r:� a .M: � - .. �, ,, TCF '�� e,•F� , � ` Y:�,� ��. h -a l.w rye 3:'t►. 4 i i i� An `� .:x, .� �s� ••+l �.• -- `*�: - `rte _ ... r-1 r 7 ' �f r � "E+ `tel � -h°� ;1•�i'y'}���'��✓' :.: ,�„t �..i. +-�n i 1_ bi,' 4=�.r� .�. •.. •; fi �JL NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY ccs Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www.dec.ny.gov Notice of Incomplete Application May 15, 2019 Raymond Nemschick, AIA 160 Main St., Suite 200 Sayville, NY 11782 Re: Application #1-4738-04681/00001 Siejka Property: 955 Blossom Bend SCTM# 1000-115-6-22 Dear Mr. Nemschick: The Department of Environmental Conservation (DEC) is in receipt of your application for a Freshwater Wetlands permit to construct a single family dwelling, and we find it to be incomplete for the following items. 1. All site plans for projects proposed within freshwater wetlands jurisdiction must depict the perimeter of any proposed disturbance, labeled "Limits of Clearing and Ground Disturbance" verbatim. Therefore, you must resubmit the site plan with this boundary clearly shown. The resubmitted site plan must also show dimensions of all proposed structures and must specify any erosion control methods. 2. You must complete and return Part 1 of the enclosed Structural-Archeological Assessment Form (SAAF) 3. Your client is proposing to construct a single family dwelling in a freshwater wetland adjacent area. This activity is classified "major" pursuant to Uniform Procedures [6NYCRR Part 621.40)(2)]. Therefore, the application fee is $200. Your client submitted $50, and an additional $150 fee must be submitted. This application will remain incomplete until all the above items are adequately addressed. Do not hesitate to contact me at 631-444-0364 if you have any questions. Sincerely, lyssa opkins Scott Environmental Analyst cc: R. Siejka File NE YORK Department of OPPORTUNITY Environmental Conservation M � NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY c4b Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www,dec.ny.gov Notice of Incomplete Application May 15, 2019 Raymond Nemschick, AIA 160 Main St., Suite 200 Sayville, NY 11782 Re: Application #1-4738-04681/00001 Siejka Property: 955 Blossom Bend SCTM# 1000-115-6-22 Dear Mr. Nemschick: The Department of Environmental Conservation (DEC) is in receipt of your application for a Freshwater Wetlands permit to construct a single family dwelling, and we find it to be incomplete for the following items. 1. All site plans for projects proposed within freshwater'wetlands jurisdiction must depict the perimeter of any proposed disturbance, labeled "Limits of Clearing and Ground Disturbance" verbatim. Therefore, you must resubmit the site plan with this boundary clearly shown. The resubmitted site plan must also show dimensions of all proposed structures and must specify any erosion control methods. 2. You must complete and return Part 1 of the enclosed Structural-Archeological Assessment Form (SAAF) 3. Your client is proposing to construct a single family dwelling in a freshwater wetland adjacent area. This activity is classified "major" pursuant to Uniform Procedures [6NYCRR Part 621.40)(2)]. Therefore, the application fee is $200. Your client submitted $50, and an additional $150 fee must be submitted. This application will remain incomplete until all the above items are adequately addressed. Do not hesitate to contact me at 631-444-0364 if you have any questions. Sincerely, � Q���'�iv��,S .�c.�/ lyssa Hopkins Scott Environmental Analyst cc: R. Siejka File NEW YORK Department of SIATEF OPPURTUNRY Environmental Conservation d�l NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY @ Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www.dec.ny.gov Notice of Incomplete Application May 15, 2019 Raymond Nemschick, AIA 160 Main St., Suite 200 Sayville, NY 11782 Re: Application #1-4738-04681/00001 Siejka Property: 955 Blossom Bend SCTM# 1000-115-6-22 Dear Mr. Nemschick: The Department of Environmental Conservation (DEC) is in receipt of your application for a Freshwater Wetlands permit to construct a single family dwelling, and we find it to be incomplete for the following items. 1. All site plans for projects proposed within freshwater wetlands jurisdiction must depict the perimeter of any proposed disturbance, labeled "Limits of Clearing and Ground Disturbance" verbatim. Therefore, you must resubmit the site plan with this boundary clearly shown. The resubmitted site plan must also show dimensions of all proposed structures and must specify any erosion control methods. 2. You must complete and return Part 1 of the enclosed Structural-Archeological Assessment Form (SAAF) 3. Your client is proposing to construct a single family dwelling in a freshwater wetland adjacent area. This activity is classified "major' pursuant to Uniform Procedures [6NYCRR Part 621.40)(2)]. Therefore, the application fee is $200. Your client submitted $50, and an additional $150 fee must be submitted. This application will remain incomplete until all the above items are adequately addressed. ,Do not hesitate to contact me at 631-444-0364 if you have any questions. Sincerely, llyssa Hopkins Scott Environmental Analyst cc: R. Siejka File NEWYORK Department of oPr QiuNIn Environmental Conservation NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY @ Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03651 F:(631)444-0360 www.dec.ny.gov Notice of Incomplete Application May 15, 2019 Raymond Nemschick, AIA 160 Main St., Suite 200 Sayville, NY 11782 Re: Application #1-4738-04681/00001 Siejka Property: 955 Blossom Bend SCTM# 1000-115-6-22 Dear Mr. Nemschick: The Department of Environmental Conservation (DEC) is in receipt of your application for a Freshwater Wetlands permit to construct a single family dwelling, and we find it to be incomplete for the following items. 1. All site plans for projects proposed within freshwater wetlands jurisdiction must depict the perimeter of any proposed disturbance, labeled "Limits of Clearing and Ground Disturbance" verbatim. Therefore, you must resubmit the site plan with this boundary clearly shown. The resubmitted site plan must also show dimensions of all proposed structures and must specify any erosion control methods. 2. You must complete and return Part 1 of the enclosed Structural-Archeological Assessment Form (SAAF) 3. Your client is proposing to construct a single family dwelling in a freshwater wetland adjacent area. This activity is classified "major" pursuant to Uniform Procedures [6NYCRR Part 621.40)(2)]. Therefore, the application fee is $200. Your client submitted $50, and an additional $150 fee must be submitted. This application will remain incomplete until all the above items are adequately addressed. Do not hesitate to contact me at 631-444-0364 if you have any questions. Sincerely, lyssa Hopkins Scott Environmental Analyst cc: R. Siejka File NEWYORK Department of orr'Eoaru"mr Environmental Conservation WWM-042 (Rev.9/2004) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFFICE OF WASTEWATER MANAGEMENT 360 YAPHANK AVENUE, SUITE 2C YAPHANK,NEW YORK 11980 (631) 852-5700 NOTICE OF INCOMPLETE APPLICATION-RESIDENTIAL TO: Edward Farrell, AIA H.S. REFERENCE NO.: R10-19-0050 160 Main St., Suite 200 PROPERTY LOCATION: Blossom Bend- Lot 22 Sayville,NY 11782 Mattituck,NY 11952 The plans for your proposed sewage disposal and water supply systems have been reviewed and the following will be required prior to further processing of the application for approval to construct. PLEASE RETURN A COPY OF THIS FORM WITH ANY RESUBMISSION. NOTE: CHANGES TO PLANS MUST BE MADE BY A LICENSED DESIGN PROFESSIONAL (I.E. SURVEYOR,ARCHITECT OR ENGINEER . 1. PRELIMINARY APPROVALS—OTHER AGENCIES ®N.Y.S. Dept. of Env.Cons.Wetlands ❑ Approval ❑ SEQRA Determination-Town Permits ® Town Wetlands Permit ❑ S.C.D.H.S.Vector Control ❑ Submit certificates of occupancy for 2. PLAN DATA AND INFORMATION REQUIRED ® 3 prints of revised survey(or plot ❑ Indicate on plan the specific location(s)[with Indicate any surface waters within 300'of plan)required with design measurements]of all water supply wells plot;show wetlands limit as flagged by professional's original stamp and (within 150'of all property lines)or state if NYSDEC and/or Town. signature. See below. dwellings are connected to public water. ❑ Application form : ❑ must be based upon NGVD(1929),USC &GS Datum,or NAVD(1988) ❑ Application Fee:$465.00 ❑ Minimum separation distances not maintained: ❑ Sewage disposal system undersized . See See below. below. ❑ Submit floor plans of the basement. ❑ Show area for 50%expansion of sewage ❑ Retaining wall must be designed by P.E.or disposal system R.A. ❑ Surveys(or plot plan)must be no ❑ Show highest recorded groundwater and ❑ must be shown on plan. larger than I1"X17" calculations ❑ Indicate area of lot(sq.ft.) ❑ Show proposed water service line location(s) ❑ Show 1 ft contour lines for 20ft from edge ❑ Show All utilities on site. on plan. of sanitary system Cleanout must be proposed on the septic tank inlet wasteline. ❑ S.C.Tax Map Number required ❑ Test well required on your lot as per attached ❑ Grading plan showing invert elevations of bulletin sewage disposal system,foundation and ❑ Public sewer stub location from ❑ Show location of existing water facilities. final grade. sewer district shown on plans ❑ Surrounding property—vacant or ❑ Submit letter from water district indicating ❑ Slope exceeds standards:5%maximum improved(within 150'of all distance to nearest public water main and within 20'of sanitary system,including property lines). availability expansion. ❑ See enclosed Form WWM-043, ❑ Show sanitary system design based upon ❑ See additional comments on marked-up Notice of Non-Conformance highest expected groundwater elevation survey enclosed. 3. OTHEWREMARKS:Plans do not scale in properly. REVIEW OF THE ADDITIONAL INFORMATION REQUESTED MAY RESULT IN THE NEED TO MODIFY THE PROPOSED WATER SUPPLY AND/OR SANITARY SYSTEM DESIGN. FURTHER INFORMATION MAY ALSO BE REQUIRED FOR REVIEW BY THIS DEPARTMENT. DATE PREPARED: May 23, 2019 REVIEWED BY: Anthony Lalonde No. 1 WWM-042 (Rev.9/2004) SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFFICE OF WASTEWATER MANAGEMENT 360 YAPHANK AVENUE,SUITE 2C YAPHANK,NEW YORK 11980 (631) 852-5700 NOTICE OF INCOMPLETE APPLICATION-RESIDENTIAL TO: Edward Farrell, AIA H.S. REFERENCE NO.: R10-19-0050 160 Main St., Suite 200 PROPERTY LOCATION: Blossom Bend- Lot 22 Sayville,NY 11782 Mattituck,NY 11952 The plans for your proposed sewage disposal and water supply systems have been reviewed and the following will be required prior to further processing of the application for approval to construct. PLEASE RETURN A COPY OF THIS FORM WITH ANY RESUBMISSION. NOTE: CHANGES TO PLANS MUST BE MADE BY A LICENSED DESIGN PROFESSIONAL (I.E. SURVEYOR,ARCH_I_TECT OR ENGINEER). 1. PRELIMINARY APPROVALS—OTHER AGENCIES ®N.Y.S.Dept.of Env.Cons.Wetlands ❑ Approval ❑ SEQRA Determination-Town Permits ® Town Wetlands Permit ❑ S.C.D.H.S.Vector Control ❑ Submit certificates of occupancy for 2. PLAN DATA AND INFORMATION REQUIRED ® 3 prints of revised survey(or plot ❑ Indicate on plan the specific location(s)[with ❑ Indicate any surface waters within 300'of plan)required with design measurements]of all water supply wells plot;show wetlands limit as flagged by professional's original stamp and (within 150'of all property lines)or state if NYSDEC and/or Town. signature. See below. dwellings are connected to public water. ❑ Application form : ❑ must be based upon NGVD(1929),USC &GS Datum,or NAVD(1988) ❑ Application Fee:$465.00 ❑ Minimum separation distances not maintained: ❑ Sewage disposal system undersized . See See below. below. ❑ Submit floor plans of the basement. ❑ Show area for 50%expansion of sewage ❑ Retaining wall must be designed by P.E.or dis osal system R.A. ❑ Surveys(or plot plan)must be no ❑ Show highest recorded groundwater and ❑ must be shown on plan. larger than I1"X17" calculations ❑ Indicate area of lot(sq.ft.) ❑ Show proposed water service line location(s) ❑ Show 1 ft contour lines for 20ft from edge ❑ Show All utilities on site. on plan. of sanitary system Cleanout must be proposed on the septic tank inlet wasteline. ❑ S.C.Tax Map Number required ❑ Test well required on your lot as per attached ❑ Grading plan showing invert elevations of bulletin sewage disposal system,foundation and ❑ Public sewer stub location from ❑ Show location of existing water facilities. final grade. sewer district shown on plans ❑ Surrounding property—vacant or ❑ Submit letter from water district indicating ❑ Slope exceeds standards:5%maximum unproved(within 150'of all distance to nearest public water main and within 20'of sanitary system,including property lines). availability ex ansion. ❑ See enclosed Form WWM-043, ❑ Show sanitary system design based upon ❑ See additional comments on marked-up Notice of Non-Conformance highest expected groundwater elevation survey enclosed. 3. OTHER/REMARKS: Plans do not scale in properly. REVIEW OF THE ADDITIONAL INFORMATION REQUESTED MAY RESULT IN THE NEED TO MODIFY THE PROPOSED WATER SUPPLY AND/OR SANITARY SYSTEM DESIGN. FURTHER INFORMATION MAY ALSO BE REQUIRED FOR REVIEW BY THIS DEPARTMENT. DATE PREPARED: May 23, 2019 REVIEWED BY: Anthony Lalonde No. 1 6C ) WWM-042 (Rev.9/2004) u SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFFICE OF WASTEWATER MANAGEMENT 360 YAPHANK AVENUE, SUITE 2C YAPHANK,NEW YORK 11980 (631) 852-5700 NOTICE OF INCOMPLETE APPLICATION-RESIDENTIAL TO: Edward Farrell, AIA H.S. REFERENCE NO.: R10-19-0050 160 Main St., Suite 200 PROPERTY LOCATION: Blossom Bend - Lot 22 Sayville,NY 11782 Mattituck,NY 11952 The plans for your proposed sewage disposal and water supply systems have been reviewed and the following will be required prior to further processing of the application for approval to construct. PLEASE RETURN A COPY OF THIS FORM WITH ANY RESUBMISSION. NOTE: CHANGES TO PLANS MUST BE MADE BY A LICENSED DESIGN PROFESSIONAL (I.E. SURVEYOR,ARCHITECT OR ENGINEER). 1.PRELIMINARY APPROVALS—OTHER AGENCIES ®N.Y.S.Dept. of Env. Cons. Wetlands ❑ Approval ❑ SEQRA Determination-Town Permits ® Town Wetlands Permit ❑ S.C.D.H.S.Vector Control ❑ Submit certificates of occupancy for 2. PLAN DATA AND INFORMATION REQUIRED ® 3 prints of revised survey(or plotF1Indicate on plan the specific location(s)[with I ❑ Indicate any surface waters within 300'of plan)required with design measurements]of all water supply wells plot;show wetlands limit as flagged by professional's original stamp and (within 150'of all property lines)or state if NYSDEC and/or Town. signature. See below. dwellings are connected to public water. ❑ Application form : ❑ must be based upon NGVD(1929),USC &GS Datum,or NAVD(1988) ❑ Application Fee:$465.00 ❑ Minimum separation distances not maintained: ❑ Sewage disposal system undersized . See See below. below. ❑ Submit floor plans of the basement. ❑ Show area for 50%expansion of sewage ❑ Retaining wall must be designed by P.E.or disposal system R.A. ❑ Surveys(or plot plan)must be no ❑ Show highest recorded groundwater and ❑ must be shown on plan. larger than 11"X17" calculations ❑ Indicate area of lot(sq.ft.) ❑ Show proposed water service line location(s) ❑ Show I ft contour lines for 20ft from edge ❑ Show All utilities on site. on plan. of sanitary system Cleanout must be proposed on the septic tank inlet wasteline. ❑ S.C.Tax Map Number required ❑ Test well required on your lot as per attached ❑ Grading plan showing invert elevations of bulletin sewage disposal system,foundation and ❑ Public sewer stub location from ❑ Show location of existing water facilities. final grade. sewer district shown on plans ❑ Surrounding property—vacant or ❑ Submit letter from water district indicating ❑ Slope exceeds standards:5%maximum improved(within 150'of all distance to nearest public water main and within 20'of sanitary system,including property lines). availability expansion. ❑ See enclosed Form WWM-043, ❑ Show sanitary system design based upon ❑ See additional comments on marked-up Notice of Non-Conformance hi est ex ecterl arnundwater elevation curve enclosed. 3. OTHER/REMARKs: Plans do not scale in properly_ REVIEW OF THE ADDITIONAL INFORMATION REQUESTED MAY RESULT IN THE NEED TO MODIFY THE PROPOSED WATER SUPPLY AND/OR SANITARY SYSTEM DESIGN. FURTHER INFORMATION MAY ALSO BE REQUIRED FOR REVIEW BY THIS DEPARTMENT. DATE PREPARED: May 23, 2019 REVIEWED BY: Anthony Lalonde No. 1 ------------------------------------------------ WWM-042 (Rev.9/2004) 1 J SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES OFFICE OF WASTEWATER MANAGEMENT 360 YAPHANK AVENUE, SUITE 2C YAPHANK,NEW YORK 11980 (631) 852-5700 NOTICE OF INCOMPLETE APPLICATION-RESIDENTIAL TO: Edward Farrell, AIA H.S. REFERENCE NO.: R10-19-0050 160 Main St., Suite 200 PROPERTY LOCATION: Blossom Bend - Lot 22 Sayville,NY 11782 Mattituck,NY 11952 The plans for your proposed sewage disposal and water supply systems have been reviewed and the following will be required prior to further processing of the application for approval to construct. PLEASE RETURN A COPY OF THIS FORM WITH ANY RESUBMISSION. NOTE: CHANGES TO PLANS MUST BE MADE BY A LICENSED DESIGN PROFESSIONAL (I.E. SURVEYOR,ARCHITECT OR ENGINEER . 1. PRELIMINARY APPROVALS—OTHER AGENCIES ®N.Y.S.Dept. of Env.Cons. Wetlands ❑ Approval ❑ SEQRA Determination-Town Permits ® Town Wetlands Permit ❑ S.C.D.H.S.Vector Control ❑ Submit certificates of occupancy for 2. PLAN DATA AND INFORMATION REQUIRED ® 3 prints of revised survey(or plot ❑ Indicate on plan the specific location(s)[with ❑ Indicate any surface waters within 300'of plan)required with design measurements]of all water supply wells plot;show wetlands limit as flagged by professional's original stamp and (within 150'of all property lines)or state if NYSDEC and/or Town. signature. See below. dwellings are connected to public water. ❑ Application form : ❑ must be based upon NGVD(1929),USC &GS Datum,orNAVD(1988) ❑ Application Fee:$465.00 ❑ Minimum separation distances not maintained: ❑ Sewage disposal system undersized . See See below. below. ❑ Submit floor plans of the basement. ❑ Show area for 50%expansion of sewage ❑ Retaining wall must be designed by P.E.or disposal system R.A. ❑ Surveys(or plot plan)must be no ❑ Show highest recorded groundwater and ❑ must be shown on plan. larger than 11"X17" calculations ❑ Indicate area of lot(sq.ft.) ❑ Show proposed water service line location(s) ❑ Show 1 ft contour lines for 20ft from edge ❑ Show All utilities on site. on plan. of sanitary system Cleanout must be proposed on the septic tans:inlet wasteline. ❑ S.C.Tax Map Number required ❑ Test well required on your lot as per attached ❑ Grading plan showing invert elevations of bulletin sewage disposal system,foundation and ❑ Public sewer stub location from ❑ Show location of existing water facilities. final grade. sewer district shown on plans ❑ Surrounding property—vacant or ❑ Submit letter from water district indicating ❑ Slope exceeds standards:5%maximum unproved(within 150'of all distance to nearest public water main and within 20' of sanitary system,including property lines). availability expansion. ❑ See enclosed Form WWM-043, ❑ Show sanitary system design based upon ❑ See additional comments on marked-up Notice of Non-Conformance highest expected groundwater elevation survey enclosed. 3. OTHER/REMARKs:Plans do not scale in properly. . REVIEW OF THE ADDITIONAL INFORMATION REQUESTED MAY RESULT IN THE NEED TO MODIFY THE PROPOSED WATER SUPPLY AND/OR SANITARY SYSTEM DESIGN. FURTHER INFORMATION MAY ALSO BE REQUIRED FOR REVIEW BY THIS DEPARTMENT. DATE PREPARED: May 23, 2019 REVIEWED BY: Anthony Lalonde No. 1 ' SET:SEC.NO 1. BSc no tm ` RD t .dtnt 34 rye e MATCH .� —�� U MATot�uei tf�F+N oesovnrxo u xlm mf --_--..�----- --�.-- —_— °s less(=�1. aY�• toe t� afTgloA.fNrximmt GREENPORT J3 fi aei" 92 19Nc),c n ^tJ e( r fa 1 !y \ta\2 ti SA(c) 93A(c) ,� 9 2BA X11 ,12.n�• •wU mK •n _ n a O Z 2 O 5 n,Uum raCxl51 O N 132 '1 284A _I a Z< a u o W � J27A(c) $ 2 , q g m 3 � \B 16 aA(c) 4 oavf,.ow� (fOarvaFSMlna'4D 5 '�,i �1B1 m • �I OEv60wwEMwWlal ,"4 t`� 15 19�i.- 9 m � s 1] 1a g _'-- "p pc ` 9U4 a,0 a �♦ A t, T3r1(L) O c 20 m�9qo,,�, s aY .6 •" '.A ,. 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Main Rd. &Youngs Ave.) Southold,,NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: January 12, 2022 Re: LWRP Coastal Consistency Review for ROGER SIEJKA SCTM# 1000-115-6-22 Raymond Nemschick, AIA on behalf of ROGER SIEJKA requests a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5"wide by 50'0" deep; front porch is 11'0" wide, 6'2" deep; rear veranda (deck) is 24'5" wide by 10' deep; and overall max height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM# 1000-115-6-22 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the following is considered to further Policy 6. Protect and restore the quality and function of the Town of Southold's ecosystem: 1. Limit or prohibit the proposed clearing of the 8,954 square feet within the 100' setback from the freshwater wetland. 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 SkIFF0 t t John G. Stein,Chairperson Town Hall,53095 Main Rd. Lauren Standish,Secretary NP.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 12, 2022 the following recommendation was made: Moved by Maggie Merrill, seconded by John Stein, it was RESOLVED to NOT SUPPORT the application of ROGER SIEJKA to construct a two- story single-family dwelling with a basement. First floor is 24.5' wide 50' deep. Front porch is 11' wide, 6'2" deep. Rear veranda is 24'5" deep. Overall max. height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM#115-6-22 Inspected by: Maggie Merrill The CAC does Not Support the application because the proposed setbacks are not in compliance with Ch. 275 of the Town Code. The proposed dwelling should be setback at least 100' from the wetland boundary, the requirement of an I/A system, and an impervious driveway. Vote of Council: Ayes: All Motion Carried E Cantrell, Elizabeth From: Cantrell, Elizabeth Sent: Monday, December 20, 2021 12:18 PM To: r.nemschick@ns-arch.com Subject: Roger Siejka; SCTM# 1000-115-6-22 Mr. Nemschick, The office of the Board of Trustees has begun the review of your application for the above referenced applicant. Please be advised that your project plans submitted on October 27,2021 are not to scale. This may cause a postponement of said application from our January public hearings. At your earliest convenience, please submit four full revised and stamped sets of the site plan that are to scale so that the Board and other departments can correctly read said site plan. Please note that all Town Hall offices will close at 11:30AM on Thursday, December 23rd, closed all day Friday, December 24th, closing at 11:30AM on Thursday, December 30th, and all day Friday, December 31"for Christmas and New Year holidays. Thank you. Senior Office Assistant Town of Southold Board of Trustees Office: 631-765-1892 Email: elizabethc@southoldtownny.gov 1 F Board of Trustees Application NOV 10 2021 1 GENERAL DATA 5outhola`Gown LandArea(in square feet); 40;83.1 gourd of Trustees Area Zoning, R-40 Previous use of property: 'Unimproved /vacant Intended use of property; Single,family residence Covenants and Restrictions on property?` Yes No If"Yes",.please provide a copy, Will this project require a Building Permit as,per Town Code? V( 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_req�-- any-demolition as per Town Code•orAs determined by the Building,Dept'.? Yes V No Does the structure(s)on property have a valid Certificate of Occupancy? Yes, No Prior permits/approvals for site.improvements: Agency Date VNo prior permits/approvals for site,improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? Z No Yes If yes,provide explanation: Project Description,(use attachments ifinecessary): The applicant proposes to construct a 2-story single familly residence with a basement. First floor is 24'5"wide 50'-0" Deep. • Front porch is 11'-0"wide,6-2"Deep,Rear Veranda(deck)'is 24-5"wide,i0'-0"Deep.•Overall mai height is 32`4" 1 r DiSalvo, Diane From: DiSalvo, Diane Sent: Wednesday, October 27, 2021 8:55 AM To: 'r.nemschick@ns-arch.com' Subject: Siejka - Blossom Bend Receipt is acknowledged of site plan which you dropped off for this office this morning. The application which we have in the file stamped received July 29, 2019 and plan last dated May 30, 2019—when reviewed by Building Dept. was determined to need a variance. Please advise. Assuming that your project has changed—we would need an updated project description to accompany this updated site plan. Di2vk'p DLsCiLvo office Ass�St2 V"t soL'ttNOLd 79WV, TYu_Ste"S P D -ox 1171) (Osl) 70,57-1292 NOW CAN hVd TV 6i6T qhs VNAM P'e0 Des . SUFFac�- ; Michael J. Domino, 1.0dentTown Hall Annex John M. Bredemeyer, III, Vice-President o "54375 Route 25 Glenn Goldsmith � x P.O. Box 1179 A Nicholas Krupski y Southold, NY 11971 Tele hone 631 765-1892 Greg Williams I ,�c �a _ P ( ) Fax (631) 765-6641 SOUTROLD TOWN BOARD OF TRUSTE.ES TO: SOUTHOLD TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS 22 `� L4 ��r t' i r, SCTM#: i ► S1 67rKA- Property Owner Name: JUL 3 0 2019 Date Sent to Bldg. Dept: 7 30 �q �?g pYdJl .iilVS P"6•: idn The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting-requirements stated below: YaEIS NO Will thero osed project require a Building Permit? p p Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition as described under Town Code? rg 1 6r�- Krct S� G In Iso COMMENTS: �,r��S I' i I' Set" OignUature of Reviewer Date V�"�U8l9 Michael J.Domino,President �i�/®' , Town Hall Annex John M.Bredemeyer III,Vice-President �® ,, �O 54375 Route 25 j Glenn Goldsmith _ " - LD P.O. s' P.O.Box 1179 Southold,New York 11971 A Nicholas Krupski . �Q Telephone(631)765-1892 Greg Williams �`/ w, Fax(631)765-6641 �c®US,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only 2 " E n r E 15 l� Coastal Erosion Permit Application Wetland Permit Application JUL 2 9 2019 Administrative Permit Amendment/Transfer/Extensipn Received Application: 7. •11 Southold Town EReceived Fee: $ SD BO Board o Trustees Completed Application: �Z Incomplete: SEQRA Classification: Type-I Type H Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: { Coordination:(date sent): LWRP Consistency Assessment FqTm Sent: y 77 CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Technical Review: n Public Hearing Held: r Resolution: l 119/ate Owner(s)Legal Name of Property(as shown on Deed): Roger Siejka Mailing Address:, 1075 Blossom Bend, Mattituck, NY 11952 Phone Number: 516-429-5737 Suffolk County Tax Map Nqnber: 1000- 115-6-22 Property Location: f Blossom Bend, Mattituck (If necessary,provide LILCO Pole#,distance to cross streets,and location) AGENT(If applicable): Raymond Nemschick, AIA ' o t i lSCfrt,'C,K6) CF 0 „ Mailing Address: 160 Main St, Suite 200, Sayville, NY 11782 Phone Number:" 63-1-563-2130 12/Z,0/Z I Board of Trustees Appl_.:,ation GENERAL DATA Land Area(in square feet):, 40,831 Area Zoning:. R-40 s Previous use of property: Unimproved /vacant Intended use of property: Single family residence Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? V( 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 requie any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s)on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: } Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?�No Yes If yes,provide explanation:- Project Description(use attachments if necessary): The applicant proposes to construct a 2-story single familly residence with a basement. ./Ll �( �,cc L Board of Trustees Appl-�__stion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Construct new single family residence Area of wetlands on lot: 12,049 square feet Percent coverage of lot: 4.2 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: 75 feet Does the project involve excavation or filling? 'No N( Yes If yes,how much material will be excavated? +/- 350 cubic yards How much material will be filled? Same / backfill cubic yards Depth of which material will be removed or deposited: 6 @ Base. feet 2 @ sanitary pool Proposed slope throughout the area of operations: 1 Manner in which material will be removed or deposited: Mechanically 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): No impact \l 617.20 Appendix B Short Environmental Assessment Form Instructions for"Comnletinli° Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses E become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: Siejka Residence Project Location(describe,and attach a location map): North side of Blossom Bend, +/- 250 ft NE of Cardinal Dr. Brief Description of Proposed Action: New single fmaily residence Name of Applicant or Sponsor: Telephone: 631-563-2130 Raymond Nemschick, AIA E-Mail: r.nemschick@ns-arch.com Address: 160 Main St, Suite 200 City/PO: State: 'Zip Code: Sayville NY 11782 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 Z a 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: NYS DEC; Suffolk County DHS - , Wastewater Management, Southold Building Permit = - 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? 7 5--acres ; c.Total acreage(project site and any,contiguous properties)owned or controlled by the applicant or project sponsor? .97 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial ®Residential(suburban) ❑Forest QAgriculture ❑Aquatic ❑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 F71, ❑ b.Consistent with the adopted comprehensive plan? © ' ',❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural -NO . YES_ landscape? as 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty Agency:Suffolk County,Date 7-12-88 ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES R-7 171 b.Are public transportation service(s)available at or near the site of the proposed action? ❑✓ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 17 • ❑, 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: rzi 0' 10. Will the proposed action connect to an existing public/private water supply? -NO YES I If No,describe method for providing potable water:___ ❑ a 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: On-Site Septic and leaching - FJ 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? o EJ 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? a If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: ET 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline El Forest ❑Agricultural/grasslands E3 Early mid-successional Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? Q ❑ 16.is the project site Iodated in the 100 year flood plain? NO YES '✓ 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ®NO ❑YES b.Will storm�water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly,describe: [Z]NO DYES - - j 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: Li 710.Has the site of the proposed action or an adjoining property been the location of an active or closedNE O YES solid waste 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 1 YES completed)for hazardous waste? If Yes,describe: bLi 1 AFFIRM THAT TE INFORMATION VIE VE IS TRUE AND ACCURATE TO THE BEST 0 F KNOWLEDGE Applicant/sponsor name- ay emschick, AIA Date: Signature: Peart 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 Dart I and other materials submitted by the project sponsor or otherwise available tet the reviewer, When answering the questions the reviewer should be guided by the concept"Dave my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large l impact impact may may occur occur I- Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 1Z E 2. Will the proposed action result in a change in the use or intensity of use of land? ff El 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? F 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate a asoma 1 available energy conservation or renewable energy opportunities? LVA 7. Will the proposed action impact existing: I El a.public/private water supplies? El b.public/private wastewater treatment utilities? El 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9 Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, _ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of No,or I 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? El 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 N me of Responsible Officer in Lead Agency Title of Responsible Officer11 [I Signature of Responsibly Officer in lead.Agency Signature of Preparer(if different from Responsible OfficePRINT I r) Page 4 of 4 -' Board of Trustees Appl_ration f AFFIDAVIT 3 Roger Siejka 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 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. Si ature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS __ DAY OF ,,20 LAWRENCE E.SILVERMAN Notary Public,State of New York Reg.No.01S14977025 Qualified in Suffolk County rTOtar P C Commission Expires January 22,2023 Board of Trustees App's-ration AUTHORIZATION (Where the applicant is not the owner) Roger Siejka I/We, owners of the property identified as SCTM# 1000-_ 115-6-22 in the town of _-Mattituck _ ,New York,hereby authorizes Raymond Nemschick, AIA 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. Pr perty Owner's Sign a Property Owner's Signature SWORN TO BEFORE ME THIS _ DAY OF ,,20 LAWRENCE E.SILVERMAN Notary Public,State of New York Reg.No.01 S14977025 Qualified in Suffolk County p Commission Expires January 22,20 r APPLICANT/AGENT/REPRESEN'TATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and em Io ees.The pumgsc of this form is to provide information which can alert the town of pgssible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME = (Last name,first name,.rX►iddle initial,unless you are applying in the name of — - someone-elseother 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 applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the appliquit (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 Dated: Signature. L Print Name Form TS 1 r r 1 APPLICANT/AGENUREPRESENTATIVE } TRANSACTIONAL DISCLOSURE FORM Tlie Town o SorithQld`s`Code a'Ethi prohibits' nflicts of interest on the part of town'offisers and'emalayees The nurimses thislorm'is to'pixrviile iirfarination which can alerftfie't'own,of nass�b a canfltcts of tnterest a allow rt tatake_whatever action is neccssarvtoavdid same. _ - - - - - - . Siejka, Roger YOUR NAME: (Last name,first name,irpiddte initial,unless you are applying in the name of i 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 f6i throughryour company,spouse,sibling;',parent or child)�have,a reladoriship,tivith'any offtcer;or drnployce of the Town dSouihold? "Relationship"includes by blood,i-oarriage,.or business'in 'rest"Business interest"means°a business, including a partnersliip,-ip which the town officer oremployee has'evun apartial'ownership of,(oremploymcrit by)h1corporation, in which the town'officer or employee owris-more,than'5%'offrie shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): ,-A)the owner-ofgreater than,5%,of the shmes•of the-corporate stock of the applicant (�vlteWthe applicant is'u corporation); B)the legal'or,beneticial o�vnet of any'interest in a non-corporate entity(when the -applicantrisnot;acorporation); , C)an officer,director,-partner,--or,em-Ployee of the,applicant,or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 4±ay of A 20 F Signature PrintNarrieo er Siejka Form TS I �,rvzn Glenn Goldsmith,President {�o�pSOFF�I�coo Town Hall Annex A.Nicholas Krupski,Vice President k�o y1 54375 Route 25 Eric Sepenoski y z P.O.Box 1179 Elizabeth Gillooly oy �� Southold,NY 11971 Elizabeth PeeplesTelephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 20, 2021 Raymond Nemschick, AIA 160 Main Street, Suite 200 Sayville, NY 11782 Re: Board of Trustees Application of Roger Siejka 955 Blossom Bend, Mattituck SCTM# 1000-115-6-22 To Whom It May Concern: You are receiving this letter as notice that this application is now scheduled to be heard by the Southold Town Board of Trustees via a combination of an in-person meeting and videoconferencing on Wednesday, January 19, 2022 beginning at 5:30 P.M. Please continue to check the Town's website as the meeting date approaches for the latest meeting agenda and videoconferencing information. Enclosed is an informational notice regarding the videoconferencing meeting and how to access the online meeting. Please mail a copy of the informational notice along with all other required paperwork to each of the adjacent property owners. Please keep a copy of said informational notice for your records so that you can access the meeting in order to have a conversation with the Board during your application review. V ry Truly Yours, -- - - - - -Glenn--Goldsmith,-President- - -- Board of Trustees Glenn Goldsmith,President �OSIIFFUL,��o Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski y z P.O.Box 1179 Elizabeth Gillooly oy o�� Southold,NY 11971 Elizabeth Peeples Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD WORK SESSION & PUBLIC HEARINGS WEDNESDAY, JANUARY 19, 2022 at 5:OOPM & 5:30PM TOWN HALL MAIN MEETING HALL AND VIA ZOOM ONLINE PLATFORM A Regular Work Session and Public BoardHearings of the SOUTHOLD TOWN BOARD OF TRUSTEES will be held on Wednesday. January 19. 2022 with the Work Session beginning at 5:OOPM and Public Hearings beginning at 5:30PM. The public is invited to attend the meetings either in person or virtually via the Zoom online platform. MASKS ARE REQUIRED AT ALL TIMES FOR,EVE_ RY.ONE INSIDE ANY OF THE TOWN BUILDINGS.- Written UILDINGS:Written comments may also be submitted via.email to the Trustees Clerks at elizabethc@southoldtownny.gov and diane.disalvo@town.southold.ny.us. Said comments,will be considered at the public hearing provided that they are submitted no later than.12:00 P.M. (Prevailing Time) on the day of the public hearing. The public will have access to view and listen to the meeting as it is happening via Zoom. If you do not have access to a computer or smartphone, there is an option to listen in via telephone. Further details about how to tune in to the meeting are on the Town's website at https://www.southoldtownny.gov/calendar or call the Board of Trustees office at (631) 765-1892 Monday through Friday between the hours of 8:OOAM —4:OOPM. Options for public attendance: • Online at the website zoom.us, click on "join a meeting" and enter the information below. Zoom Meeting ID: 871 1570 5581 Password: 401423 • Telephone: Call 1(646) 558-8656 Enter Meeting ID and Password when prompted (same as above). In order to "request to speak" when the application you are interested in has begun, please press *9 on your phone and wait for someone to acknowledge your request. When prompted to unmute your phone press *6. To view the application files please visit: https://www.southoldtownny.gov At the bottom of the picture on the main screen click on the second button from the right "Town Records, Weblink/Laserfiche"; go to bottom of page and click on "pg. 2"; click on "Trustees" folder; click on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on the name of the application to view the file. 1 t Glenn esident own Hall A.Nicholas Goldsmith,hrupski,Vc e President DS�Ff01k�OG 54375 RoutAnnex5 Eric Se enoski p o �� P.O.Box 1179 Elizabeth Gillooly o cJ Southold,NY 11971 Elizabeth Peeples y�jol 0� , Telephone(631)765-1892 < � Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BE ADVISED — AS PER CHAPTER 55 NOTICE OF PUBLIC HEARINGS Failure to submit the following originals to this office by or no later than 12:OOPM the day prior to the scheduled Public Hearing for your application will result in a postponement of said application. This office WILL NOT contact you to request said information: • All original white & green certified return receipt mail receipts stamped by U.S.P.S. • Completed original Proof of Mailing Form Failure to,submit the following originals, to this office by or no- later than 12:OOPM the day of-the'scheduled Public Hearing for'your application will result-in -a-postponement-of--said--application,.- - _ -- • Original Affidavit of Posting-form — DO NOT COMPLETE SAID FORM UNTIL THE GREEN SIGN HAS BEEN IN PLACE ON THE PROPERTY FOR AT LEAST SEVEN (7) FULL DAYS. Sign the, form on the eighth day that the green notice of hearing sign has been up on said premises. All green signature cards related to said application that were returned to your office should be either dropped off in our "Trustee drop box" or mailed into our office whenever they are received. These cards are not required prior to the Public Hearing, unless specifically requested for by this office. This specific requirement is subject to change. Board of Trustees Appl,_ Ition PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: ADDRESS: ij _ I STATE OF NEW.YORK, --- COUNTY-OF'SUFFOLK - residingat being-duly sworn,Jdeboses and says that on .the day of ,,20 , deponei7t mailed-a truecopy of the Notice.set forth in the board of Trustees Application, directed to each of the above riamed' persons at the addresses set opposite their respective names;that the addresses set'oppo'site the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at -that s=aid Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of , 20 Notary Public Glenn Goldsmith,President ti o %gFDL�Z\' Town Hall Annex A.Nicholas Krupski,Vice Presidenty�A 54375 Route 25 Eric Sepenoski y z ty P.O.Box 1179 Elizabeth Gillooly o Southold,NY 11971 Elizabeth Peeples { y4j� ,a0� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------=---------------------------------- In the Matter of the Application of ROGER SIEJKA COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING DO NOT COMPLETE THIS FORM-UNTIL THE POSTING HAS REMAINED IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE— COMPLETE THIS FORM ON EIGTH DAY OR LATER residing at/dba(V being duly sworn, depose and say: That on the 2 day of JkWA12� , 20 4-1.I personally posted the property known as by placing the Board of Trustees offlciaf noticing poster where it can easily be seen from the street, and that I have checked to be sure the noticing poster has remained in place for a full seven days immediately preceding the date of the public hearing. Date of hearing noted thereon to be held Wednesday,January 19,2022. 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C+,`MO*'$AK, ` I1�51 Tmm of -�okx"loltk GINS tics h "?-5,Po Box 111 , SQAAUI 11171 STATE OF NEW YORK COUNTY OF SUFFOLK Roa non'A ohms cWct � A 1 A , residing at &.S- nin ` •, f oJtk5tie i NY U17 , being duly sworn, deposes and says that on the day of , 20deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at i 1-?0 E�S-� -N� n SV pohi s pie i 11�) �i , that said Notices were-mailed to each of said persons by CERTIFIED MAIL/RETURN RECE T. Sig ture Sworn to before me this Day of , 20 LAWRENCE E.SILVEF3MAN Notary Public,State of New York Reg.No.01S14977025 Qualified in Suffolk County Commission Expires January 22,2dj otary NOTICE F HEARING NOTICE IS HEREBY GIVEN that a Public Hearing concerning this property will be held by the Southold Town Board of Trustees both in-person and via the online Zoom platform. OWNERS) OF RECORD: ROGER SIEJKA SUBJECT OF PUBLIC HEARING: For a Wetland Permit to construct a two-story, single-family dwelling with a basement; first floor is 24'5" wide by 50'0" deep; front porch is 11 '0" wide, 67" deep; rear veranda (deck) is 24'5" wide by 10' deep; and overall max height is 32'3". Located: 955 Blossom Bend, Mattituck. SCTM# 1000-115-6-22 TIME & DATE OF PUBLIC HEARING: Wednesday, January 19, 2022 — at or about 5:30P.M. — Either in Person or via ZOOM. To access the Zoom meeting please see the meeting agenda located in the Trustees section .of the Town website. If you have an interest in this project, you are invited to view the Town file(s) through the Southold Town website. To view the application files please visit: https://www.southoldtownny.gov At the bottom of the picture on the main screen click on the second button from the right "Town Records, Weblink/Laserfiche"; go to bottom of page and click on "pg. 2'j; click on "Trustees" folder; click on "Applications"; click on "Pending"; all files are listed by name in alphabetical order. Click on the name of the application to view the file. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 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,sigau_fi_cant beneficial-and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or"no", then the proposed action will : affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer-,must be explained 1n detail,_listing,both supporting and mon- suuporting_facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall,not,be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 115 - 6_ - 22 PROJECT NAME Siejka Residence The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ✓❑ 1. Category of Town of Southold agency action(check appropriate°response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) FT (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Construct new single family residence. Location of action: North side of Blossom Bend, +/- 250 ft. NE of Cardinal Drive Site acreage: '937 Present land use: Unimproved /vacant Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Roger Siekja (b) Mailing address: 1075 Blossom Bend, Mattituck, NY 11952 (c) Telephone number: Area Code( ) 516-429-5737 (d) Application number,if any,: 1 q Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ Non' If yes,which state or federal agency? a 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 y 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. v- Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary r Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Section III—Policies Pages 3 through 6 for evaluation criteria Ell, Yes I❑ No 2 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes'Q No Not Applicable t 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 El Yes O No W1 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section IH —Policies Pages 16 through 21 for evaluation criteria 13 Yes ❑J No Z Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ ©, Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LNW Section III — Policies Pages 32 through 34 for evaluation criteria. Yes 0 No Not Applicable Attach additional sheets-if necessary - Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. 'FlYes No 0 Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. Ye�:] No© Not Applicable Attach additional sheets if necessary WORIING 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. Yes ❑ No Q Not Applicable Attach additional sheets if necessary , Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No © Not Applicable ` Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. Yes ❑ No ❑✓ Not Applicable PREPARED BY Raymond Nemschick, AIA TITLE Architect DATE