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TR-10129
Glenn Goldsmith, President �® SU��� Town Hall Annex A. Nicholas Krupski, Vice President ®w ®�� 54375 Route 25 P.O. Box 1179 Eric Sepenoski ' x -41 Southold, New York 11971 C05Liz Gillooly Elizabeth Peeples t : fi0 Telephone(631) 765-1892 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 % constructed When project complete, call for compliance inspection; r y+ �4 ° ep Q9@ r•€'p°P° ..., � 40dha 4°►°py°:. � '� aq;o_@J'a'sp -�et.i a �J"e•' - '�'.' ,. ��° .r,•tea 0 '�.. .�� oaya a6� ",� na a°,da�-•P°P mac° ,..l:.S!2 4 BOARD OF SOUTHOLD TOWN TRUSTEESy SOUTHOLD, NEW YORK PERMIT NO. 10129 DATE: APRIL 13 2022 ISSUED TO: LAURIS RALL ao,� �• l _ G PROPERTY ADDRESS: 5400 GREAT PECONIC BAY BLVD. LAUREL SCTM#: 1000-128-2-12 ° x a4 r ' AUTHORIZATION l �r Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in r i accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 13, 2022, and in .>d' consideration of application fee in the sum of $250.00 paid by Lauris Rall and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: ; Wetland Permit for the removal and replacement of existing failing sanitary system in new _= a {f. landward location of existing with new low-nitrogen UA style sanitary system; and as depicted on the site plan prepared by Daniel R. Falasco,P.E.,P.C.,dated September 28,2021,and ` stamped approved on April 13,2022. �a=' 44 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed,and these '•3� rs presents to be subscribed by a majority of the said Board as of the 13th day of April,2022. 3 4 s r eBaaaf� �- fy ��® t�"a-'i�rt(p'�'.a"r�q�^�. cei`�5.i"ePC'ip i4r•:[.i^P7nTF5i'S"t-nA'.2'Ore,"'S.F1'Sa`ia"iC°'�2?'�'L4��.0 wY""taw.1 r:+°°"7".°'S'^7FiR^�"✓r,i '^�y,„S' p} +?>-? e/ �., g:�+J F a.. _-� ..: 'ti.:age aae!'+. t+. �.,a'b��p��°J0,`4�e. i 9�ae a+aaQob+ ap4 a e��"m' •gyri 8°�`'. TERMS AND CONDITIONS The Permittee Lauris Rall, residing at 5400 Great Peconic Bay Blvd., Laurel 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. That the said Board will be notified by the Pennittee of the completion of the work authorized. 9. 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. 10. 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 perm it. Glenn Goldsmith, President �Q� s®(/�� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 Eric Sepenoski P.O. Box 1179 Liz Gillooly Southold, New York 11971 Elizabeth Peeples 0 Telephone(631) 765-1892 ® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 15, 2022 Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716 RE: LAURIS RALL 5400 GREAT PECONIC BAY BOULEVARD, LAUREL SCTM# 1000-128-2-12 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 13, 2022 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of LAURIS RALL 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 February 22, 2022, 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 recommended that the proposed application be found Consistent with the LWRP, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 13, 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of LAURIS RALL for the removal and replacement of existing failing sanitary system in new landward location of existing with new low-nitrogen I/A style sanitary system; and as depicted on the site plan prepared by Daniel R. Falasco, P.E., P.C., dated September 28, 2021, and stamped approved on April 13, 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 truly yours, Glenn Goldsmith President, Board of Trustees GG:dd S �OHE--OHE o S 2003740" EE OHE OHE�OHE — 10' R.O.W. , y OHE — . — . —. — . — —•—• —•—• —•\• —• —• —• — — 483.56 WOOD PAVED STONE DRIVEWAY OOHF WALL N 0 — — —_ 777� `�. . — . — .— . — — . — . —.— .— . — .— .— .—.— . — .— . — .—.— . . — . — OHE UTIL POLE — — —WOOD FENCE � oy� 10' R.O.W. UNDERGRO�UyND ELECTRIC P TANK BALCONY 5.2�KT�EAD 5D-DEV: O ELEC. 3.2 c9, W \ µ� - - - -- - - � METER vb p 1 W W `\ LOT AREA=46,741 S.F. / DECK p oy� 1 t J v 1.07 ACRES STONE DRIVEWAY 2' POLYETHYLENE S(� ,T � \ SiAAR 5 TREATMENT UNIT0,P) 519 S14 appppb H pn \y W y W w \i \ EDGE OF Z — (PRESSURIZED) �, ��N15� `Y� C 1 c0 PHRAGMITES SEPTIC TANK 0 /f1�a 2665 c� poo \'I' 41 �L �Y �Y �Y W\\ / /y �Y �L L, + � GFp �0. tt V. yc^ \* _ —ate � w yl 0 E S05 WOOD �oG�f TO VPI �?� — / FRAME 0� WALK -- —w_ _w y w w w w y w w 41 41 w/ ARAG 1'V � w y w y w .--.6 /� 2nd FLOOR 0. BALCONY W rG G oy v v v v yILIw t �y 16f m J ABANDON EXISTING ELEV. 6.5 _ BORWG 5' MIN. SANITARY SYSTEM _ _ 5.2 r, — — — — — — — — — — PROPOSED C0M'OURS� PROPOSED VENTPROPOS2" /ANP NE 502. 71 �w�. 210 22'50CHARCOAL FILTER MIN. 3' D ECEIVE FROM DOOR/WINDOW BIRCH DRIVE S. 1r PVC RECIRCULATION LINE FEB 2 z 2022 _ SYSTEM DESIGN CALCULATIONS Southold Town BOAR® O� G RUSTEES 110 GAL/DAY X 4 BEDROOM =440 GAL/DAY e0atiftIdrd of ami, stees TOW OE SOLITHOLD 440 GAL/DAY / 2.83' (INFILTRATOR QUICK4 PLUS WIDTH) / 3 (CAT 1) = 5400 PeCOII1C Bay Boulevard 52 LF REQUIRED ®ATE Afp4j_ 1.3 ZoZ2 52 LF PROVIDED SIAURAT LEL TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCTM . 1000-128-2-12 N.T.S. TEST HOLE DATA SCTM 1000-128-2-23 BORING BY: ROY K. REISSIG, PE TAKEN ON: MAY 1, 2021 EXIST. GRD=6.0 (GOOGLE EARTH) OF NEw 0.0'-0.3' TOPSOIL PT �P�� R q Y0, DANIEL R . F'ALASCO , P .E . , P . C . of 0.2'-2.0' K BROWN SILTY SAND SM CONSULTING ENGINEER WATER EL HIGHEST IXP 2 5 a 3 DARK BROWN EV. 25 2.0'-4.0' FINE SAND SP WATER ELEV. 2.0 94 STEUBEN BLVD., NESCONSET, NY 11767 _4' (516) 317-7209 4.0'-10.0' WET BROWN cP � ' SAND & GRAVEL SP ��Q �0. 056999 �� DATE 9-28-21 SCALE DRAWING NO. pR�FONP�' COMMENTS: NO WATER ENCOUNTERED ESSISUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1"=40' B PR❑VIDE SECONDARY SAFETY COVERS (TYP) A A' 12 ' 0% % Z� O O 62.2 \\••' 115801 9\ EXTERIOR D OUTLET R INLET WH 13 6 4' 36' TRENCH WIDTH-may B' 4'-6' 3 4'-3' 127.0 13,2261 EXTERIOR LENGTH )KPR❑VIDE DEADMAN ANCH❑RING SYSTEM ��s 2 TOP VIEW PER MANUFACTURE SPECIFICATI❑NS PROVIDE SECONDARY SAFETY COVERS CTYP x-10.2 12607 FREEBOARD TUF-TITE EF-4 1j 4' EFFLUENT FILTER PRESSUIZED PIPE �KPR❑VIDE DEADMAN ANCHORING SYSTEM 16. % HOLE L❑CATI❑N PER MANUFACTURE SPECIFICATIONS 7PER _ AIR SP OUTLET END CAP PER 0,2 CS] WALL INFILTRATOR QUICK4 PLUS CHAMBER (PSD) PARTMENT c°L THICKNESS 13 6 Media Bags (Large) 15 CUFT A Ci 1i 33 LIQUID COMPARTMENT 12 2 FRALO Plastic Riser and Llcl ' DEPTH $ LOW LEVEL 11 1 Air Intake Assembly FLOAT SWITCH (WHITE) 10 2 Wall Insert Assembly CONTROL HIGH LEVEL 9 1 Inlet Pipe POWER FLOAT SWITCH 8 1 Pump Back Stand 2/3 TOTAL VOL- m. . 1/3 TOTAL VOL 115 VAC (YELLOW) 15 AMP 7 1 Recirculation Pump, Tsuruml 50PU2.15S Nores: SECTION A-A' STAAR DISCHARGE PUMP CONTROL PANEL 115 VAC 6 1 Spray Header Assembly 1. ALL DRAWING DIMENSIONS IN INCHES[MILLIMETERS]OR AS NOTED. PUMP (CLEAR) 5 1 Pump Back Pump Assembly, Goulds LSP03 2. EXTERIOR OF ACCESS OPENING LID INCLUDES THE FOLLOWING WARNING IN POWER RETURN PUMP4 1 S Header Support Structure ENGLISH,FRENCH 8:SPANISH:"DANGER DO NOT ENTER POISON GASES." Spray 115 VAC p y pp 3. TANK MARKINGS WILL INCLUDE:MANUFACTURER NAME,MODEL NUMBER,LIQUID 115 VAC (BLACK) 3 1 Support Structure CAPACITY,DATE OF MANUFACTURE,MAXIMUM BURIAL DEPTH,INLET,AND OUTLET. 2D AMP 4. THE TANK MAY BE BACKFILLED WITH SUITABLE NATIVE SOIL.SEE INSTALLATION INSTRUCTIONS FOR RECIRCULATE PUMPI 2 1 Discharge Pump Assembly, Goulds LSP03 GUIDANCE.IF THE NATIVE SOIL DOES NOT MEET THE INSTALLATION INSTRUCTIONS GUIDANCE THEN 11 AC 1 1 1000 60.1. Poly Tank BACKFILLING WITH SELECT MATERIAL WILL BE REQUIRED. (RED) 5. MAXIMUM BURIAL DEPTH IS 48 in 11,219 mm]. ITEM QTY, DESCRIPTION S. MINIMUM BURIAL DEPTH IS 6 in[152 mm]. SINGLE LINE WIRING DIAGRAM 7. MAXIMUM VEHICLE LOAD IS APPLICATIONS. IONS.J AXLE LOAD. . E C E I V E 8.TANK IS FOR NON-TRAFFIC APPLICATIONS. N.T.S. 9. AIRSPACE IS 16.5%. STAAR .5 TREATMENT TANK DETAIL 10. OUTLET TEE IS COMPATIBLE WITH EFFLUENT FILTER. 11.INTERIOR LENGTH TO WIDTH RATIO IS 2.3:1(118.84NCH INTERIOR LENGTH/ N.T.S. 51.7-INCH INTERIOR WIDTH=2.3). PQ 2 Z �10n�]2G EXIST. RES. 12.FREE VENT AREA BETWEEN TOP OF BAFFLE WALL AND BOTTOM OF TOP B FFLE EB L SLOT IS 39.7 in'. F.F. EL. 10.5 13.BAFFLE WALL THICKNESS IS 0.31 In[8 mm]. C/0 INV. EL. 7.37 INV. EL. 7.27 GROUND ELEVATION7.0 Southold Town INV. EL. 8.5 45' - PRESSURIZED 12" MIN. COVER Board ofTnlstees 44 SEPTIC TANK74'_ STAAR .5 INFILTRATOR BOTTOM ELEV. 5.5 (BUOYANCY KITREATMENT TANK / 2' ROWS - 26 LONG INFILTRATOR IM-1060 SEPTIC TANK DETAIL REQUIRED (BUOYANCY KIT L INV. EL. 7.62 INV. EL. 7.02 INV. EL. 6.0 N.T.S. REQUIRED) EXCAVATE DOWN TO HIGHEST EXPECTED NATIVE SAND AND GRAVEL. 3' MIN ABOVE GROUNDWATER EL. 2.5 (SEE SOIL BORING) SANITARY SYSTEM PROFILE ! 13F NEW N.T.S. �P�` o�, DANIEL R. F'ALASCO , P .E . , P . C . CONSULTING ENGINEER 94 STEUBEN BLVD., NESCONSET, NY 11767 �. (516) 317-7209 FO ° 05699 ��� DATE 9-28-21 SCALE DRAWING NO. pR�FESSIci N.T.S. 2 ��g�FFOl, O Glenn Goldsmith, President Oak,k, Town Trustees A Nicholas Krupski, Vice-President y = 54375 Route 25 Eric Sepenoski o "* P.O. Box 1179 Liz Gillooly '��j® ao�� Southold, NY 11971 Elizabeth Peeples Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: LAURIS RALL c/o JEFF PATANJO Please be advised that your application dated February 22, 2022 has been reviewed by this Board at the regular meeting of April 13, 2022 and your application has been approved pending the completion of the following items checked off below. 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 �6.v�js BY: Glenn Goldsmith, President Board of Trustees SIA Glenn Go" pith,President fol Town Hall Annex A.Nicholas Krupski,Vice PresidentAQ SA 54375 Route 25 Eric Sepenoski P.O. Box 1179 Southold,NY 11971 Liz Gillooly , hone 631 765-1892 Tele Elizabeth Peeples P ( ) Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 3 -50 Completed in field by: ids t J4 Jeffrey Patanjo on behalf of LAURIS RALL requests a Wetland Permit for the removal and replacement of existing failing sanitary system in new landward location of existing with new low-nitrogen I/A style sanitary system. Located: 5400 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-128-2-12 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 v,- WetlandCoastal 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: �- r Present were: G. Goldsmith N. KrupskiE, Sepenoski L. Gillooly ,-/_E. Peeples Other OHE---_OHE E \ o S 20°37'90" EOHE OHC---OHE — 10' R.O.W. y --- -- - • —• — —• - --- -•- - -- - - -• -- - oHE. —. — . — .— .— — - - -- -- -' —y' -- - - - •— • —• -\ 483.56' WOOD PAVED STONE DRIVEWAY o — WALL — — 0 OHE — L POLE — — WOOD ENCE a oy� — . — . — . — — '— — — — — — — — — — — — — 10' R.O.W. UNDERGROUND ELECTRIC P. TANK- - - - - - ---- -- -- - 2nd FLOOR -BULK DELEV �cr�_ y� BALCONY 5.2 a c7�a _ ELEC. 3.2 W W� u v METER WOOD O 1 \ LOT AREA =46,741 S.F. / r0 DECK NG p0 p+ oy 1 y y �\ 1.07 ACRES 2° POLYETHYLENE o SNE DRVEWAY 't O STAAR .5 TREATMENT UNIT E 9\�l 1519 SFE 0010 10) C~1 \ �W W y y \ PHRAGM TES\1 EDGE OF ! Z— (PRESSURIZED) N06 TANK 1�sk 2 d X665 �/ �FO� moo �� \ i z. 0 �PN�' 05 IV 14, _ �� y w v C WOOD 9t C. ��•� _-4. 41 1p y w qe � IV w w w�� I G - -s. \� /off 2nd FLOOR IV w w W C.O. BALCONY W W 1p W W W W I&, 'p / ELEV. \ ABANDON EXISTING ELEV. o d �&tA: Win:.=r �y � � � � � � I, 4, ,i, 1p � 6.5 _ _BDIRN --7��---5' MIN. � SANITARY SYSTEM _ — 5.2 PROPOSED CONTOURSJ PROPOSED I/A PANEL 502.71 PROPOSED 2W/ rN 21022'50" W FILTER 3'CHARCOALy0- FROM DOOR/WINDOW D BIRCH DRIVE S. 1j" PVC RECIRCULATION LINE Ift 2 2022 SYSTEM DESIGN CALCULATIONS 110 GAL/DAY X 4 BEDROOM =440 GAL/DAY Southold Town Board of Trustees 440 GAL/DAY / 2.83' (INFILTRATOR QUICK4 PLUS WIDTH) / 3 (CAT 1) = 5400 Peconic Bay Boulevard 52 LF REQUIRED 52 LF PROVIDED SITUATE LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SCTM#. 1000-128-2-12 TEST HOLE DATA SCTM#. 1000-128-2-23 N.T.S. BORING BY: ROY K. REISSIG, PE TAKEN ON: MAY 1, 2021 EXIST. GRDP s (GOGGLE EARTH) yob DANIEL R. FALAS C 0 , P .E . , P . C . 0.0'-0.3' TOP SOIL Pi �a o 0.2'-2.0' K BROWN SILTY SAND SM Q'\ �s� HIGHEST EXPECTED o3 CONSULTING ENGINEER WATER ELEV. 2.5 - 2.0'-4.0' DARK BROWN WATER ELEV. 2.0 FlNE SAND SP 94 STEUBEN BLVD., NESCONSET, NY 11767 4�j (516) 317-7209 4.0'-10.0' WEr BROWN SAND &GRAVEL SP °- 05699 �� SCALE DRAWING NO. pROFESSIONP�'� � DATE 9-28-21 COMMENTS: NO WATER ENCOUNTERED SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 1��=40' B PR❑VIDE SECONDARY - SAFETY COVERS (TYP) A A' 12 1 °0 El I2 O 62.2\ \ INLET 9OUTLET EXTERIOR 13 WIDTH 6 4 36' TRENCH WIDTH 1_ B' 4'-6' 3 4'-3' 127.0 13,2267 EXTERIOR LENGTH Tj PROVIDE DEADMAN ANCH❑RING SYSTEM IQs a TOP VIEW PER MANUFACTURE SPECIFICATIONS ' PROVIDE SECONDARY SAFETY COVERS CTYP 10.2 1260] FREEBOARD TUF-TITE EF-4 4' EFFLUENT FILTER PRESSUIZED PIPE WXPR❑VIDE DEADMAN 'ANCHORING SYSTEM INLET 16. HOLE LOCATION PER MANUFACTURE SPECIFICATIONS _ AIR SPAC OUTLET END CAP �i6°] PER 0,2 CS] WALL INFILTRATOR QUICK4 PLUS CHAMBER (PSD) PER COMPARTMENT COL THICKNESS 13 6 Medla Bags (Large) 15 CUFT CCIDE A Ii 1107 LIQUID COMPARTMENT 12 2 FRAL❑ PLastic Rlser and Lld DEPTH B LOW LEVEL 11 1 Alr Intake Assembly FLOAT SWITCH (WHITE) 10 2 Wall Insert Assembly CONTROL HIGH LEVEL 9 1 Inlet Pipe POWER FLOAT SWITCH B 1 Pump Back Stand 2/3 T[ITAL wL. -1/3 TOTAL VOL 115 VAC (YELLOW) SECTION A-A' 15 AMP DISCHARGE PUMP 7 1 Recirculation Pump, Tsuruml 50PU2,15S NOTES: STA115 VAC 6 1 Spray Header Assembly CONTROLL PANEL (CLEAR) 1. ALL DRAWING DIMENSIONS IN INCHES[MILLIMETERS]ORAS NOTED. PUMP 5 1 Pump Back Pump Assembly, Goulds LSP03 2. EXTERIOR OF ACCESS OPENING LID INCLUDES THE FOLLOWING WARNING IN POWER RETURN PUMP 4 1 Spray Header Support Structure ENGLISH,FRENCH&SPANISH:"DANGER DO NOT ENTER:POISON GASES." 115 VAC 3. TANK MARKINGS WILL INCLUDE:MANUFACTURER NAME,MODEL NUMBER,LIQUID 115 VAC (BLACK) 3 1 Support Structure CAPACITY,DATE OF MANUFACTURE,MAXIMUM BURIAL DEPTH,INLET,AND OUTLET. 2O AMP 4. THE TANK MAY BE BACKFILLED WITH SUITABLE NATIVE SOIL.SEE INSTALLATION INSTRUCTIONS FOR RECIRCULATE PUMP 2 1 Discharge Pump Assembly, Goulds LSP03 GUIDANCE.IF THE NATIVE SOIL DOES NOT MEET THE INSTALLATION INSTRUCTIONS GUIDANCE THEN 115 VAC 1 1 1000 Gal, Poly Tank BACKFILLING WITH SELECT MATERIAL WILL BE REQUIRED. (RED) 5. MAXIMUM BURIAL DEPTH IS 48 in 11,219 mm]. E C E ' V E ITEM QTY. DESCRIPTI❑N 6. MINIMUM BURIAL DEPTH IS 6 In[152 mm]. SINGLE LINE WIRING DIAGRAM 7. MAXIMUM VEHICLE LOAD IS 4,500-Ib[20-kN]AXLE LOAD. B.TANK IS FOR NON-TRAFFIC APPLICATIONS. N.T.S. STAAR .5 TREATMENT TANK DETAIL 9. AIRSPACE UTLETTEEIS5%. 10. OUTLET TEE IS COMPATIBLE WITH EFFLUENT FILTER �1f1019 11.INTERIOR LENGTH TO WIDTH RATIO IS 2.3:1(118.8-INCH INTERIOR LENGT I Cu(-L N.T.S. 51.7-INCH INTERIOR WIDTH=2.3). EXIST. RES. 12.FREE VENT AREA BETWEEN TOP OF BAFFLE WALL AND BOTTOM OF TOP BAFFLE F.F. EL. 10.5 SLOT IS 39.7 In'. SmilholdT°wn CSO INV. EL. 7.37-7INV. EL. 7.27 GROUND ELEVATION7.0 13.BAFFLE WALL THICKNESS IS 0.31 in[6 mm]. Board ofTnlstm INV. EL. 8.5 45' - PRESSURIZED 12" MIN. COVER 44' SEPTIC TANK STAAR .5 INFILTRATOR (BUOYANCY KIT TREATMENT TANK BOTTOM - ELEV. 5.5 REQUIRED (BUOYANCY KIT 2 ROWS - 26 -LONG INFILTRATOR IM-1060 SEPTIC TANK DETAIL INV. EL. 7.62 4' REQUIRED) INV. EL. 7.02 INV. EL. 6.0 N.T.S. EXCAVATE DOWN TO HIGHEST EXPECTED NATIVE SAND AND GRAVEL. V 3' MIN ABOVE GROUNDWATER EL. 2.5 (SEE SOIL BORING) SANITARY SYSTEM PROFILE N.T.S. '�`O NEW gwYO� DANIEL R. FALASCO , P .E . , P . C . CONSULTING ENGINEER 94 STEUBEN BLVD., NESCONSET, NY 11767 (516) 317-7209 F��Fp pNO 0569g� DATE 9-28-21 SCALE DRAWING N0. R�FESSIfNj N.T.S. 2 i 5Ufi;'\/EY OF PROPERTY SIT DATE: LAUREL , TOWN: SOUTHOLD N SUFFOLK COUNTY, NY SURVEYED 10-22-2004 �� W E AMENDED 11-2q-2004, 11-50-2004 .9 0 3 12-10-2004 DIMS 04-16-2018 @ SUFFOLK COUNTY TAX # v a'�,' \ \\\\or L�,fi �i S 1000-128=2-12 1000-128-2-25 CmTmmm. E C E I V E_'D TAIA RI LJoenG.RAUU 4 °.� \\oe FEB 2 2 2022 StewastIT a \\ ` • Ifoeaa=cs Compmy I Southold Town Board of Trustees QI 1� \\1�2\ q, C, ►C,9' t, r % O ` Of & � N y ;. I c4 \ \ �\1•\1� y Np i QOOa, Zt t 1 \ V o � z. 911 sk S .9, 0 U. \O APR � OZ 1..a �o�o , �.-. .��- � \ � a� O� �t a� a Q gyp' PJ $ , 9 Bldg Dept copy froraeA O \5' BOJ mit i� Final reviewed da `S q� �A m , zea File*7!7% @til§ C,9• 0°w a Da ora q Eye NOTE5l y �� N� s o ,,� is • �' 'r MONUMENT FOUND O O O S \ a3'�p YJ uwaeo.v.a olwmmn ar o7mw,b a Mrvay Q► .uwyarK eeol b a ELEVATIONS REFERENCE NGVD '2q ANn°\\ ����,,, PC� /� "vvw''a.a'm°ioksb",'am'"• 9� alapa*sad ill ba tmulerw to ba PARCEL 1000-128-2-12 AREA = 42,864 5F OR OAA ACRES G� `O U6 /y'Y •ce.lxka{bro mmcm d wd.dKI DO Ihb PARGELI ODO-128-2-23 AREA = 5,81151' OR O.Oq ACRES ,,J(J ,� � ,mm"to� y�e o1d�oofd br Iko W.York Slob commYbn o/PFvlermlanl LDn*9aNalJCra 571*LarIBYA{,Z-:rwon b No parson For Man IM prvry b TOTAL AREA = 46,741 5P OR 1.0-1 ACRES Iwo lol'�tne[q"1e1't�ar�o�'fW al a117koan NOTE A: 10 FOOT R.U.W. A5 PER DEED JOHN C EHLERS LAND SURVEYOR L.5822 G.P. 60 AND L.4586b GPG.P.. 70 6 BAST MAW SMUM N.Y.S.LIC.NO.502M GRAPHIC SCALE I"= 40' RIVERIMM,NY.11901 369,8288 Fax 369-=7 REF.C:\UsasVobnUkWbox104104\04-305a pm ,aux W wises A ,n mi"i w"TGN SEE SEC.NO. uwE // R Nxrtm ♦ 1 SENA,NO Q.J +xSeWx..23 / B SEE SEC NO 5 / ri .P EERN� i �r SEE.SE.C.r10 • J,/ ,x 5 fy a +e / Rt, / t•= >z ( � e / ; ♦ rel s /, 71 t / ,ewa`• p > Y•/r vt�O� / R N 'yt ♦�T �O % u cR+> NOTICE .exv,?� COUNTY OF SUFFOLK © E a, SOunwLn SECTION NO ------ E d,,,� ,,,,,,___,,.__ 5�Real Property Tax Service Agency r m � N r.r_. µ. .. ,.. —_ o...,.. —_—_ ! p rmcr wo 1000 P0.0PERTN WP M OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex " P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971Telephone: 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: April 5, 2022 Re: LWRP Coastal Consistency Review for LAURIS RALL SCTM# 1000-128-2-12 Jeffrey Patanjo on behalf of LAURIS RALL requests a Wetland Permit for the removal and replacement of existing failing sanitary system in new landward location of existing with new low- nitrogen I/A style sanitary system. Located: 5400 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-128-2-12 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. 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 Of F04 John G.Stein,Chairperson Town Hall,53095 Main Rd. coo Lauren Standish,Secretary A P.O.Box 1179 Southold,NY 11971 r , 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., April 6, 2022 the following recommendation was made: Moved by Carol Brown, seconded by Maggie Merrill, it was RESOLVED to SUPPORT the application of LAURIS RALL for the removal and replacement of existing failing sanitary system in new landward location of existing with new low nitrogen I/A sanitary system. Located: 5400 Peconic Bay Blvd., Laurel. SCTM#128-2-12 Inspected by: Shannon Wright, Carol Brown, Maggie Merrill Vote of Council: Ayes: All Motion Carried Glenn Goldsmith, PresidentrNkl �. Town Hall Annex A: Nicholas Krupski, Vice PresidentN. 11 ,; �Y. 54375 Route 25 John M.Bredenieyer III P.O.Box 1179 Southold,New York 11971 Michael J.Domino Telephone(631) 765-1892 Greg Williams Fax(631) 765w6641BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application FR E C E I 1i' E X Wetland Permit Application __Administrative Permit k Amendment/Transfer/Extension i ffs 22 29 Received Application: .2.ZZ•22, .. Received Fee: $ MX Southold Town V leted A lication Z' •2v " P PP Board of Trustees __Incomplete: __SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead.Agency Determination Date: _ Coordination(date sent): ►� WRP Consistency Assessment Form Sent: l —�V cCAC Referral Sent: 3 _1d Date of Inspection: _ Receipt of CAC Report: -..-- m Technical Review: ......._ V_Public Hearing Held: Resolution: Owner(s)Legal Name of Property(as shown on Deed): Lauris Rai Mailing Address: 5400 Peconic Bay Blvd., Laurel, NY 11948 Phone Number: 917-226-8283 Suffolk County Tax Map Number: 1000 128-2712 Property Location: 5400 Peconic Bay Blvd'., Laurel, NY 11948 See location map (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Jeffrey Patanjo Mailing Address: P.O. Box 582 Bohemia, NY 11716 290 Phone Number: 631-487-5m_� Email: 4PatanjQpgmai1.com a C Board of Trustees Application GENERAL DATA Land Area(in square feet): 42,864 Area Zoning: Res Previous use of property: Res Intended use of property: Res _ --- �— — Covenants and Restrictions on property? ❑ Yes 0—No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _❑_Yes 0 No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? ❑ Yes No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? 0 Yes _�N0 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 project includes the removal and replacement of existing failing sanitary system in new landward location of existing with new low-nitrogen I/A style sanitary system. Board of Trustees Applicarion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: The project includes the removal and replacement of existing failing sanitary system in new landward location of existing with new low-nitrogen I/A style sanitary system. Area of wetlands on lot: 10,253! square feet Percent coverage of lot: 23.9 % Closest distance between nearest existing structure and upland edge of wetlands: 77 feet Closest distance between nearest proposed structure and upland edge of wetlands: 77 feet Does the project involve excavation or filling? — —No ❑✓ Yes If yes, how much material will be excavated? N/A cubic yards How much material will be filled? N/A _ _cubic yards Depth of which material will be removed or deposited: NSA feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): There will be a positive effect on wetlands due to reduced nitrogen and sanitary discharge entering waters. f Short Environmental Assessment Form Part 1 -Project Information Instructions for Comnletin r Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1—Project and Sponsor Information Name of Action or Project: 5400 Peconic Bay Blvd-Laurel Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action: Remove and replace existing failing septic system with new landward location of existing with new I/A low-nitrogen style system Name of Applicant or Sponsor: Telephone: 917-226-8263 Lauris Rall E-Mail: laurisirall@dentons.com Address: 5400 Peconic Bay Blvd. City/PO: State: Zip Code: Laurel NY 111948 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 ❑ 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 government Agency? NO YES If Yes,list agency(s)name and permit or approval:Town of Southold Trustees/NYSDEC/SCDHS ❑ 3. a.Total acreage of the site of the proposed action? 0.98 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.07 acres 4. Check all land uses that occur on,are adjoining or near the proposed action: 5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial ❑✓ Residential(suburban) ❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify): Parkland .Page 1 of 3 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ 7 ❑ b. Consistent with the adopted comprehensive plan? R] El 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? NO YES ❑ Q 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, If Yes,identify: 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 b. Are public transportation services available at or near the site of the proposed action? ❑ c. Are any pedestrian accommodations or bicycle routes available on or near the site of the proposed W ❑ action? 9. Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ Lr 10. Will the proposed action connect to an existing public/private water supply? NO YES 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: ❑ 21 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the ❑ State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated.as sensitive for Z ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 13. a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbod ? El y 0 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: Page 2 of 14. Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply: [I Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑Wetland ❑ Urban ❑✓ Suburban 15. Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? 16. Is the project site located in the 100-year flood plan? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑v ❑ a. Will storm water discharges flow to adjacent properties? ❑ ❑ b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ ❑ If Yes,briefly describe: 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO 'YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: .0. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spo sor/name: Lauris Rail _Date: K Signature: Title:Owner PRINT F®RM Page;3 of EAF Mapper Summary Report Wednesday, January 26, 2022 9:23 PM Disclaimer: The EAF Mapper is a screening tool Intended to assist f t"i ��s ` project sponsors and reviewing agencies In preparing an environmental assessment form(EAF).Not all questions asked in the EAF are rF� answered by the EAF Mapper.Additional information on any EAF ting the the EAF questionEAF M pper provides the most tlup--tto-date digital data available to F Workbooks, h DEC,you may also need to contact local or other data sources in order r to obtain data not provided b the Mapper,Digital data is not a P Y PP 9 substitute for agency determinations. i2 II�74. I At 12 t rs z, ' 1 _ t&tl"a r�F94I I2 telA. s , $a�$ i�"20 }A 3if f Fst fi i r ,���.� WL�^`Y'�•'t•G=am � S' 1 t� �„o�� F��E4""��k�$, i��!`,,Z �, Y E py : It- ,128-44Q pew � 128 4s z p$fs€ t< f( , ntittl t� s i=� :� 'T.fac� trC4�fxtIai1k1ta st �rtrtctnt€tlgt nth s ►7ttt 1e t�tJi # 3 uc� Part 1 /Question 7 [Critical Environmental 'Yes Area] _.. _...._........... ..: . Part 1 /Question 7[Critical Environmental `Name:Peconic Bay and Environs, Reason:Protect public health, water, Area-Identify] :vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National or State No Register of Historic Places or State Eligible Sites] t Part 1 /Question 12b [Archeological Sites] No Part 1 /Question 13a [Wetlands or Other Yes-Digital mapping information on local and federal wetlands and Regulated Waterbodies] rcM H waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15[Threatened or No Endangered Animal] Part 1 /Question 16[100 Year Flood Plain] ;Yes Part 1 /Question 20[Remediation Site] JNo Short Environmental Assessment Form - EAF Mapper Summary Report 1 Part 2-Impact Assessment The lead Agency is responsible for the comet-e-V of Part 2. Answer all of the following questions in Part 2 usin 'information contained in Part 1 and other materia 'mitted by the project sponsor or otherwise available to t._.'viewer. When answering the questions the re view,-sr►ould be guided by the concept"Have my responses been reasonable considering the scale and context-of the proposed action?" No,or Moderate E small to large impact impact may may ! occur occur i i. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 13 2. Will the proposed action result in a change in the use or intensity of use of land? r "j 3. Will the proposed action impair the character or quality of the existing community.) El 4, Will the proposed action nave an impact on the environmental chwadxdsumthat,caused the establishment ofa Critical Environmental Area(CEA)? L,J S. Will the proposed action result in an adverse change in the existing level of traffic or affect existing Infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an.increase in the use of energy and it foils to incorporate T reasonab!y available ever, conservation or renewable energy opportunities? 7. Will the proposed action impact existing: A.publicprivate water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, �'''� ar+ehitectural or aesthetic resources? � » 9 Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, f `l w . _ waterbodies,groundwater,air quality,flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage --4 Problems? 1 J LEJ 11. Will the proposed action create a hazard to environmental resources or human health? El 0 Part 3 Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part,2 that was answered"moderate to Iarge impact may Occur''* or if there is a need to explain why a particular element ofthe 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 slgnificaant.Each potential impact should be assessed considering its setting,probability o€accurring, duration,lweversibility,geographic supe 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 targe 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,raid any supporting documentation. that the proposed action will not result in any significant adverse environmental impacts. Town&Southold-Want of Trustees Mame of Load Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) 'Board of':Trustees Application AFFIDAVIT Lauds Rall 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 MAN NER:SETFORTH IN THIS APPLICATON .AND ASMAY 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 AUTIIORIZE THE TRUSTEES,THEIR AGENT(S):OR REPRESENTATIVES,INCLUDING THE CONSERVATION AD'VIS'ORY COUNCIL;.TO ENTER ONTO MX PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZK.THE BOARD OF TRUSTEES TO ENTER ONTO'1VIY-.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.: v Signature of Property.Owner Signature of Property Owner SWORN TO BEFORE.,ME THIS .DAY OFEl�R�A :,20'12 Z Date: �3 CIMUR Notary Name:` Comm ExpDate: dq— -MZ . . n L 1 - =; .—Notary Signature: Notary PubI1C NOTARY CERTIFICATION(St or$sal) ` tltrri STAL IV, ` ` �, NOTARY NOTARY = _ PUBLIC PUBLIC _ f► Comm:No. - Comm.No. a 18-496 is-tss OF kA % OFHP�.`� rrrlltrr ''rttl,a ` Board of Trusiee§ Application AUTHORIZATION (Where the applicant is not the owner) I/We, Lauris Rall 128-2-12 owners of the property identified as SCTM# 1000, in the town of Laurel New York,hereby authorizes Jeffrey Patanjo to act as my agent and handle all necessary work involved with the application process for permit(s) from the,Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS_! DAY OF ,,Ffg ,202 2-- Notary Notary lic Date: 2Oa 2' 3 Chcult Notary Name: S I Comm Exp Date: olSTAL I�Fy�� Notary Signature: NOTARY CER-nFICATION(Sta Or Seat) t 1 I NOTARY = ``�`�G��SIAL 1(r k PUBLIC Comm.No. j'%�:' NOTARY 18-496 ,r'� � ✓': PUBLIC Comm.No. 18-496 .. ST•'••• .... • Pte`: M APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE,F.ORM The Town,of Southold"s.Code of Ethics prohibits conflicis:of interest on.:the iart'of tordn QfBceriand employees.The.pumose of this forni-=is to°provide:inforrnafion which can^alert theaowri of nossibfe>confltcts`of interest and allow d to take:wh 646 action is necessary t�i avoid same: YOUR NAME: Rall,Lauris (Last name,first name,.giiddle initial,unless you are applying1h the name of someone else or otherentity,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 71 Variance Trustee ✓ Change of Zone y 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 iriterest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES _— NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/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): L]_A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); F_B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); _C)an officer,director,partner,or employee of the applicant;or _D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted is_2 " ' tlay of Fla 02 Sgnatitre11 Print Name Lauris Rail Form TS l APPIUMNUAGENT/l P21ANTATM TPANSACUONAL DUCIOSM FORK � �ro -- tgna�sihta r�t�tllats�#gt�starrd �,�intae vi�t�vc�r ; E�GotO�itlrOt�lya8f�[83�OOt.�� '�i@ot�t�' pRrcra's orc=v=rs X181 03 NANOOPAPPUCA?ION:Po*sltq) Tolvbmwo voum TOWN owpoam COMWIlodo App"ofpld MDaft ,.. over (if"f7diaa?�,amuse�ashy.) Do You P 3'(or YowV,spM Aft PMK or ddla haws with any offimorempbYge ofthaTovm oFSfluthrdd? "lt,el�iueludes 6y b1o�l,a�ri ,cr�iatare�.�6a�at" a YES NO iuctusli�s part�shlp,ise vohkh tltia arpapioy�� a�hrl owa�shlp oF(or cmployracant 6y)$easpu�tlo�n , in arhldr ttre bar air or ear�loyra owes ter 7- Ifyou arrsaretr '"YES",compirda the balaace ofthia arm and demand sip whuc ladkeed. Alaataofpe mmw*WbytheTom ofSwAdd T#8eotposidonaf�ptr� Desen't�s iha�bssi yof(lhe ep�lranUr��enl�ira�a�1 the#srwn ofllaz or amgq� . the UwA)*mv f D)errdAwdccr#belaths spoerate. The town offimor m*yworLis orlrerspotwo.slb b&pueA0c is(mac sU ftapglft. ft"w-orrwwftRftofttshasesaftheaarwftO*Gffta Ifoo ( rthe q"bs.=oP ', .—A)ftW orboM&M owwotoy lom bbraaowoo uft(vift&- applk PA is nota aur); C}an di ftbK"Mw,oremplo naf the soft or QI8SCR1PIM OFRMATIQ &W Subtn�ted �dapr of 'F�h Z4, PftNmo Dorm TS I w Board of Trustees Applin. Lon PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: 2ESS: C - ia �- a - ll STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20 , deponent 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 that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of , 20 _._. .._ _.----.......:........-- April 5, 2022 Town of Southold Trustees n, 4. Town Hall Annex Building 54375 Rte. 25 APR 1 1 2022 P.O. Box 1179 Southold, New York 11971 SoutholdTowo Board of Trustees RE: LAURIs BALL 5400 PECONIC BAY BLVD. -LAUREL SCTM No. 1000-128-2-12 AFFIDAVIT OF MAILING Dear Trustees: Attached please find affidavit of mailing and original return receipts. If you should have any questions or require anything further, please do not hesitate to call me at 631-487-5290. Very truly yours, effrey Patanjo P.O. Box 582 Bohemia, NY 11716 Board of Trustees Application PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: 100 - 12$ •2--12- NAME: ADDRESS: 1000-128.-1-5 1000-128.-2-13 5445 Pec Bay Homeowner LLC Coastal Peconic Hldgs Inc 54 Birch Ct Riverhead, NY 11901 10 Brief St London, United Kingdom SE59RD 1000-128.-2-10 1000-128.-2-14 1000-128.-2-23 Michael & Eileen Leccese Detrano SM Jr Rev Liv Trt Rail Lauris GL 5610 Peconic Bay Blvd Detrano MM Rev Liv Trt PO Box 325 Laurel, NY 11948 5390 Great Peconic Bay Blvd Laurel, NY 11948 Laurel, NY 11948 1000-128.-2-11 - - Frederick Liguori 1000-128.-2-15 123 Glen Hollow Dr Port Jefferson Sta, Coastal Peconic Hldgs Inc NY 11776 10 Brief St London, United Kingdom SE59RD STATE OF NEW YORK COUNTY OF SUFFOLK residing at J`�'( being duly sworn, deposes and says that on the day of�'i� , 20 2 2-, deponent 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 that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIP S g ure Sworn to before me this Day of 720 2 JESSICA L. GEREMINA NOTARY PUBLIC-STATE OF NEW YORK No.01GE6418131 Qualified in Suffolk County My Commission Expires 06-01-2026 Postal Postal Service7' CERTIFIED�IVIAIUP RECEIPT o . Domestic Domestic F"livery information,visit our website at wimmusps.co C3 CO y information visit our website at wimmusps.corn9. � Certified Mail Fee tO Certified Mail Fee O Extra.Services&Fees(check box,add tee as appropriate) �1 A I N Extra Services&Fees(checkbox,add fee as ap r(a C3 ❑Return Receipt(hardcopy) $ ,/ 0 1 - Q ❑Return Receipt(hardcopy) $. ��rn O ❑Return Receipt(electronic) $ Q Post at / ElReturn Receipt(electronic) $ POS 9rk ❑Certified Mall Restricted Delivery $ ❑Atlult Signature Required $ d t D I te; �¢l 0 ❑Certified Mall Restricted Delivery $ ti Here t TS' ❑AdukSignature Required $ ,J`` ❑Adult.Signature Restricted Delivery$ []Adult Signature Restricted Delivery$�. �� ti -41 0 Postage 3 O Postage 0 S ac �, �� E' N e - -- - — �` �t 3 d E3 M ���N 31d�4? m 1000-128.-2-15 1000-128.-1-5 ca ; Coastal Peconic Hldgs Inc ' 5445 Pec Bay Homeowner LLC --------- � ; 10 Brief St London, United Kingdom ---------------- �� ( 54 Birch Ct Riverhead, NY 11901 ,________________ SE59RD FT mBm ® ru Be O IMO C3 � Certified Mall Fee Certified Mail Fee U-11?' $ ' h �9i I Extra Services&Fees(check bow add fee as appropriate Extra Services&Fees(check box,all fee as appropr/ate 7 1 A/ 1 ❑Return Receipt(hardcopy) $ A ❑Return Receipt(hardcop $ T7•—` .`. ❑Return'Receipt(electronic) $. r 7 Q7 �p ,t ❑Return Receipt(electronfe) $1-3 ❑Certified Mall Restricted Delivery $ "� O Here /�� ❑Certified Mail Restricted Delivery $ a�S He t � ❑Adult Signature Required $ 1 ! O Adult Signature Required $ �� 11 m i ,Y ` �Y ❑Adult Signature Restricted Delivery$ 0 u1 Gy •r,t ❑Adult Signature Restricted Delivery$ )- Postage �OJ� Er Postage � �V -'D $ i C3 $ u 1000-128.-2-10m T 1000-128.-2-13 Cos Coastal Peconic Hldgs Inc $ Michael 8, Eileen Leccese 0 10 Brief St London, United Kingdom 5610 Peconic Bay Blvd r` SE59RD Laurel, NY 11948 .-_______________ Ln ® I © m m ®° ® ImLn /• O i COer C3• U l ru Certified Mall Fee i CO ❑ , jsnJe�j $ertLr) $ ified Mall Fee f MAIN Extra Services&Fees(checkbExtra Services&Fees p ❑Return eceipt(hardcopy) $ ❑Return Receipt(hard c(Cho ck box,add fee as ap r3 E3 Return Receipt(electronic) $ ❑Return Receipt(elecopy) $O Certified Mail Restricted Delivery $ ostmrE:3 ronic) $ O !�m Q El Certified Mail Restricted Delivery $ f PDstma p ❑Adult Signature Required $ gI ❑Adult Signature Required Here u$ []Adult Signature Restricted Delivery$ 41 rI o r") ❑Adult Signature Restricted Delivery$ D PostageI O Postage ti Lr M ' f�j ��d� m T 1000-128.-2-14 `` •tv ��b��� CO p 1000-128 I $ Detrano SM Jr Rev Liv Trt e .-2-23 Is. Rall Lauris GL to Detrano MM Rev Liv Trt PO Box 325 :________________ � o - r` N s' 5390 Great Peconic Ba Blvd -------------- Laurel, NY 11948 c Laurel, NY 11948 y • . :11 ., 1 1 111.,. ._-_ _ - •11 1 11 101•I. _ m lit ro 00 F rU rO Certified Mail Fee LO Extra Services&Fees(check box,add fesas epp{{opri 4e) t� ��� I T1 0 ❑Return Receipt(hardcopy) $ �� ❑Return7' Receipt(electronic) $ W . PCStrgar O []Adult SignatureReguiE-3 El Certified Mail ddDelivery $$��.T''�\ �i �refi E]Adult Signature Restricted Delivery$ �..�•- 0 Postage117 _ m S m ' 1000-128.-2-11 c Frederick Liguori 123 Glen Hollow Dr Port Jefferson Sta ----------------- r�- ' NY 11776 ------------------ :11' 1 111•I - - - NOTIC 'L' OF HEA 'KING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: LAURIS RALL SUBJECT OF PUBLIC HEARING: For a Wetland Permit for the removal and replacement of existing failing sanitary system in new landward location of existing with new low-nitrogen I/A style sanitary system. Located : 5400 Great Peconic Bay Boulevard, Laurel. SCTM# 1000-128-2-12 TIME & DATE OF PUBLIC HEARING: Wednesday, April 13, 2022 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold LWRP CONSISTENCY.ASSESSlY ENT.FORM A. INSTRUCTIONS L All applicants for permits* includirig 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 norlocated within the Coastal Erosion Hazard Area. 2 Before answering the,questions in Section C,.the preparer of this form,shouldreview the exempt minor action list, policies an'dexplanations of each policy contained in the:Town of Southold Local. Waterfront Revitalization Program '-A-proposed-action will be -evaluated= as to its significant beneficial and adverse e-ffects.upon the coastal area(which includes all of Southold'Iowa 3, If any question m Section C'on this form is answered."yes',' or "no", then the.proposed action will affect the'ach eveli, of the.LWRP policy standards and;:conditiozis'contained in the consistency review-law. Thus,,eaeh;.answer:Must"be__ex lained.in Mail,',listinji.both suppoifigg and non- stintorl"int;:facts If an action cannot be certified E&co with the MP policy standards and conditions,it.sliA�g f",be'rLuidertaken. 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 125 "�2 12 : 5400 Peconic Ba Blvd., Laurel PROJECT NAME . y. The Application has been submitted to(check;appropr ate,responsO-, Town Board . ❑ 'Planning Board❑ Building Dept: ❑ Board of Tru tees L Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,,planning-activity, agency regulation,land transaction) . (b) Financial assistance(e.g. grant,loan,subsidy): (c) Permit, approval,license,certification: Fv Nature and extent of action: The project includes the.:removai and replacement of existing failing sanitarysystem in new landward location of existing with new low-nitrogen IIA:style sanitarysystem. a Location of action:5400 Peconic Bay Blvd.-Laurel Site acreage 0.93 Present land use: Res Present zoning classification: Res,.,.. „ 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: Lauris.Rall. , (b) Mailing address: 5400 Peconic Bay Blvd.,Laurel,NY 11948 (c) Telephone number: Area Code ...,.._.917-226-8283 (d) Application number, if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes No❑ If yes, which state or federal agency? NYsoEc scoffs 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-,.C,OAST.POLICY, Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. F✓ Yes No ❑ Not Applicable Project is consistent with neighboring properties and make beneficial use of property and will not contribute to additional development. Attach additional sheets if necessary .. .. Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No R1 Not Applicable r ' No effect Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No❑✓ Not Applicable No effect 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 ❑ Yes ❑ No Not Applicable No effect Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria 0 Yes ❑ No ❑Not Applicable Project provides for new low-:nitrogen sanitary disposal system to replace failing conventional sanitary system which ultimately will reduce nitrogen loading and contamination of waters. 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. ZYes ❑No ❑Not Applicable Project provides for new low-nitrogen sanitary disposal system to replace failing conventional sanitary system which ultimately will reduce nitrogen loading and contamination of waters. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No❑✓ Not Applicable No effect Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No ✓❑ Not Applicable No effect _. 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. ❑ YeD No Not Applicable No effect Attach additional sheets if necessary I WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No❑✓ Not Applicable No effect 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 No effect 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 No effect _..�....: 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 No effect PREPARED BY Jeffrey Patanjo TITLEAgent DATE 01i14i22 February 14, 2022 Town of Southold Trustees Town Hall Annex Building AA 54375 Rte. 25 E e E I VE P.O. Box 1179 Southold, New York 11971 RE: LAURIS RALL 5400 PECONIC BAY BLVD. -LAUREL SoutholdTown SCTM No. 1000-128-2-12 Board of Trustees APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. The project includes the removal and replacement of a failing sanitary system with a new upgraded I/A low-nitrogen style system in a more landward location of existing. If you should have any questions or require anything further, please do not hesitate to call me at 631-487-5290. Very truly yours, Jeffrey Patanjo P.O. Box 582 Bohemia, NY 11716