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HomeMy WebLinkAboutTR-10101A Glenn Goldsmith,President p��®f S®U-� Town Hall Annex A. Nicholas Krupski,Vice President ®�v ®�® 54375 Route 25 P.O. Box 1179 Eric SepenoskiR Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 4UNV,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1910 C Date: April 13, 2022 THIS CERTIFIES that the existing 29'x9' side brick porch, a 26'x15' brick patio at grade and a rear wooden deck 24.6'x 15'5" deep 37'' above grade with 5'4" x 6'2" wide access stairs seaward of the deck, lig 32.6' landward of existing permitted timber bulkhead. At 130 West Lake Drive, Southold Suffolk County Tax Map #1000-90-1-19 Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 23, 2022 pursuant to which Trustees Administrative Permit#10101A Dated April 13, 2022, was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing 29'x9' side brick porch, a 26'x15' brick patio at grade and a rear wooden deck 24.6'x15'5" deep, 37" above grade with 5'4"x 6'2" wide access stairs seaward of the deck, lying 32.6' landward of existing permitted timber bulkhead; The certificate is issued to Victor P. & Gloria E. Alsobrook owner of the aforesaid property. } Authorized Signature Glenn Goldsmith, President �QF sou Town Hall Annex A. Nicholas Krupski,Vice President �® �® 54375 Route 25P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Elizabeth Peeples � ® � Telephone(631) 765-1892 Fax(631) 765-6641 cou�r�,� ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10101A Date of Receipt of Application: March 23, 2022 Applicant: Victor P. & Gloria E. Alsobrook SCTM#: 1000-90-1-19 Project Location: 130 West Lake Drive, Southold Date of Resolution/Issuance: April 13, 2022 Date of Expiration: April 13, 2024 Reviewed by: Elizabeth Peeples, Trustee Project Description: As-built 29'x9' side brick porch, a 26'x15' brick patio at grade and a rear wooden deck 24.6'x15'5" deep, 37' above grade with 5'4" x 6'2" wide access stairs seaward of the deck, lying 32.6' landward of existing permitted timber bulkhead. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Kenneth M. Woychuk Land Surveyor, dated December 9, 2021, and stamped approved on April 13, 2022. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. ,�*_ 441e'll Glenn Goldsmith, President Board of Trustees S.C.T.M. NO. DISTRICT: 1000 SECTION: 90 BLOCK: 1 LOT(S): 19 DCj T E ' E 2=32022 Southold Town Board of Tnidees W W 1L_J S 1L LAKE KE ROA D EDGE OF PAVEMENT S 67°25'20"E 100.00' U.P. MMme+ U.P. TIMBER CURB 3.0'N BRICK TIMBER CURB 3.0'N 0 APRON MON. MON rJ 84.38' LOT 125 toLOT 124 LOT 123 LO .N, Ln D N co U -r � Y U U r U GRAVEL DRIVE AY m Q SRICK OOP SHOWER °� T 3.8'x4.2' o� 24.6' L.P.GAS O BRICK 14.9' W 18.3' O CONC. 2 STY FRM. ¢ _ o DWELLING a, m= Y GARAGE .-, #130 0 c ° orn V" a x m N Y N 6' FENCE Z v 0.5'W m BRICK PATIO 24.7' 24.6' 26'X 15' BAY BAY ZONE X \ WOOD DECK 0.2% CHANCE ANNUAL FLOOD J rel J 0.1'W s r N N ZONE X Z STK. 3.9'E TIMBER WALL 0•5'W STK. co a — FLOO ZONE BOUNDARY 0 ZONE VE(EL10) 3 SPIKE VINYL BULKHEAD 67°25'20" w MHW LINE ALONG BULKHEAD SPIKE A P P�0 V E® BY 100.00' BOARD ®F i RUSTEES TOWN ®F SOLoTH®L® ITTLE PEC O NII C BAY DATE APR`L_ 13 Z02,2� THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL FEMA MAP 36103C0169H 09-25-2009 LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. AREA:12,646.57 SQ.FT. or 0.29 ACRES ELEVATION DATUM: _________________________ UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY 1S PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUffURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: LOT 124 OF NFw CERTIFIED TO: MICHAEL RENDEL; MAP OF:CEDAR BEACH PARK ����N M. wo�yO FIDELITY NATIONAL TITLE INSURANCE COMPANY; FILED: DEC. 20, 1927 No. 90 ���` G CITIZENS BANK; SITUATED AT:BAYVIEW o: - O TOWN OF:SOUTHOLD "T �v KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK ZsF 050882 JQJ Professional Land Surveying and Design ND P.O. Box 153 Aquebogue, New York 11931 FILE # 221-218 SCALE:1"-20' DATE: DEC. 9, 2021 PHONE (631)298-1588 FAX (631) 298-1588 N.Y.S. LISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk 7 S�FFO .Y� - Glenn Gold', ,-President �0 ;, Town Hall Annex A Nicholas KrupAwice-President „�� �� 54375 Route 25 Eric'S'epenoski o ` P.O. Box 1179 Liz Gillooly o Southold, NY 11971 Elizabeth Peeples � 0�- Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Nyjr In 31,2D2,1 4Z!-oo p Completed in field by: C-Yeealy Martin D. Finnegan, Esq., on behalf of VICTOR P. & GLORIA E. ALSOBROOK requests an Administrative Permit for the as-built 29'x9' side brick porch, a 26'x15' brick patio at grade and a rear wooden deck 24.6'x15'5" deep, 37" above grade with 5'4" x 6'2" wide access stairs seaward of the deck, lying 32.6' landward of existing permitted timber bulkhead. Located: 130 West--9five, Southold. SCTM#: 1000-90-1-19 I Ake Dnve 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-Submissiony/ 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: Wooaw deck acAval 24'D" X 15'D" a►n.d s-Wy5 Are 5'ew x 5'0"d-DyM[1. SlroatQ� 6(W&A. I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: E.' Peeples L. Gillooly G. Ooldsmith N. Krupski E. Sepenoski Other S.C.T.M. N0. DISTRICT. 1000 SECTION: 90 BLOCK: 1 LOT(S): 19 p ECEIVE MAR 2 3 2022 Soud►ald Town Di Board OfTrusbees EDG WEST LADE ROAD E OF PAVEMENT S 67025'20" E 100.00' U.P. �+ U.P. TIMBER CURB 3.0'N BRICK TIMBER CURB 3.0'N 0 MON. APRON _ 84.38' MON LOT 125 O LOT 124 Q p LOT 123 Ln U U W Y GRAVEL DRIVE AY U BRICK STOOP SHOWER 3.64.2' 24.6 : :::;::: L.P.GAS O BRICK STY ERM.': m C) :DWELLIN1G;':'4' x Y 90':GARAGE:..:.'.: 0 14 Cx m cv Y N 6' FENCE Z 0.5'W citm BRICK PATIO 24.7' ' ::' 24.6 : 26'X15' BAY BAY ZONE X \ WOOD DECK 0.29. CHANCE ANNUAL FLOOD d' 'rn 0.1'W 3 v" c0 W ZONE X STK 3.9 E TIMBER WALL 0.5'W STK. C1 FL00 ZONE BOUNDARY o° 3 ZONE VE(EL10) SPIKE VINYL BULKHEAD N 67°25'20" W MHW LINE ALONG BULKHEAD SPIKE 100.00' LITTLE PECONIC BAY THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL FEMA MAP 36103C0169H 09-25-2009 LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS AND OR DATA OBTAINED FROM OTHERS AREA:12,646.57 SQ.FT. or 0.29 ACRES ELEVARON DATUM: _________________------— UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLA77ON OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO 7HE ASSIGNEES OF THE LENDING INS7ITU770N, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 7HE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADDITIONAL STRUCTURES OR AND 07HER IMPROVEMENTS EASEMENTS AND/OR SUBSURFACE STRUffURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT 7HE 77ME OF SURVEY SURVEY OF: LOT 124 CERTIFIED TO: MICHAEL RENDEL; MAP OR CEDAR BEACH PARK FIDELITY NATIONAL TITLE INSURANCE COMPANY; FILED:DEC. 20, 1927 No. 90 CITIZENS BANK; SITUATED AT:BAYVIEW TOWN ORSOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design P.O. Bog 153 Aquebogue, New York 11931 FILE SCALE: "_ ' DATE: PHONE (831)298-1588 FAX (631) 298-1588 #221 -218 1 20 DEC. 9, 2021 N.Y.S. IISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. 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OR Polxvr 1 _ i w � ,pKE51DE c nn Om C _ samwio` xt EQ9R POINT TonN of swrNan ] ^ i t a lSNcI y 17 - ,'g ISpI d x, A 1 is r VEST O1FLP nwx.,..xn gni ---'-f.�l - e a m � soun,oin faf' r� i t `OR. E. lsm l 16 J nw nu mx Ixn ,mi "y �� mb m � my imn mm 1xn M, as i xm mx HOG - xm„ , \...� NECK BAY a E "" m 2, '^' —� "' ' NOTICE mcW'� COUNTY OF SUFFOLK © E °i gOUT/0LD SECTION NO G, ,., -� In f __ __ __ __ _ ] e Real Property Tax Service Agency r Nr«^ .. o.e... --.v-- '.-- \TR F county m C.NY1,M1 090 O v...r. .Xxz .. �ziyam �^- —- omeu. --r-- aru.--wr-- .e.. '' P .nw,xo 1000 PROPERTY MAP OFFICE LOCATION: a MAILING ADDRESS: Town Hall Annex �F SOU,, P.O. Box 1179 54375 State Route 25 0�� /y01 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) ® P Southold, NY Telephone: 631 765-1938 www.southoldtownny.gov Ooum,� PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: April 6, 2022 Re: LWRP Coastal Consistency Review for of VICTOR P. &GLORIA E. ALSOBROOK SCTM# 1000-90-1-19 Martin D. Finnegan, Esq., on behalf of VICTOR P. &GLORIA E. ALSOBROOK requests an Administrative Permit for the as-built 29'x9' side brick porch, a 26'x15' brick patio at grade and a rear wooden deck 24.6'x15'5" deep, 37' above grade with 5'4" x 6'2" wide access stairs seaward of the deck, lying 32.6' landward of existing permitted timber bulkhead. Located: 130 West Lake Drive, Southold. SCTM#: 1000-90-1-19 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 INCONSISTENT with LWRP Policy 6.3 and therefore, INCONSISTENT with the LWRP. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The as-built structures were constructed without Board of Trustee review or permit. In the event the action is approved, it is recommended that the Board establish a vegetated non-turf buffer incorporating existing vegetation. 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 �i Glenn Goldsmith,President �,Q1��J1 Town Hall Annex ' 54375 Route 25I A.Nicholas Krupski,Vice President '' s "' P •�`` P.O.Box 1179 :+ Eric Sepenoski Southold,New York 11971 ;per f Liz Gillooly G �r Telephone(631) 765-1892 Elizabeth Peeples Irv, Cyz Fax(631) 765-6641 _ BOARD OF TOWN TRUSTEES =i TOWN OF SOUTHOLD ' This Section For Office Use Only :l Coastal Erosion Permit Application E V Wetland Permit Application X Administrative Permit r` Amendment/Transfer/Extension MAR 2 3 2022 Pornpleted eceived Application: %'Z3•Zeceived Fee:IS WOO Q,d�k Application:, 3•Z3.2y Southold Town Incomplete: Board of Trustees SEQRA Classification:Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Dater oord ination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: ,T'echnical Review: ,/Public Hearing Held: 1 ZZ— Resolution: Owner(s) Legal Name of Property(as shown on Deed): VICTOR P. AND GLORIA E. ALSOBROOK a Mailing Address' 130 WEST LAKE DRIVE, SOUTHOLD, NY 11971 Phone Number: 631-765-8650 Suffolk County Tax Map Number: 1000 - 90-1-19 Property Location: 130 WEST LAKE DRIVE, SOUTHOLD, NY 11971 ,` (If necessary, provide LILCO Pole#, distance to cross streets, and location) ; AGENT(If applicable): MARTIN D. FINNEGAN, ESQ. Mailing Address: PO BOX 1452, 13250 MAIN ROAD, MATTITUCK, NY 11952. 1-3160M_...F._.I.N._.N_EGAN _NORTHFORK-LEGAL.COMThone Number: i Board of Trustees Application GENERAL DATA Land Area(in square feet): 12,646.57 SF Area Zoning: R-40 Previous use of property: EXISTING SINGLE FAMILY RESIDENCE Intended use of property:SAME Covenants and Restrictions on property? X Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s)on property have a valid Certificate of Occupancy? Yes X No Prior permits/approvals for site improvements: Agency Date TRUSTEES WETLAND PERMIT#4675 11/25/1996 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary: APPLICANT SEEKS A WETLANDS PERMIT FOR `ick �R%atA Pow- , A 210-.14 15' cK rA'ilo &r&"V� awe? A AN AS-BUILT/25^19' x REAR WOODEN DECK DEPICTED ON THE ATTACHED SURVEY MEASURING 24.6' WIDE, 15'5" DEEP AND 37"ABOVE GRADE WITH ACCESS STAIRS 5'4" SEAWARD OF THE DECK, 67"WIDE, LYING 32.6' LANDWARD OF THE EXISTING PERMITTED TIMBER BULKHEAD. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations. LEGALIZE AS-BUILT DECK Area of wetlands on lot:_ N/A square feet Percent coverage of lot: N/A % Closest distance between nearest existing structure and upland edge of wetlands: 32.6 feet Closest distance between nearest proposed structure and upland edge of wetlands: 32.6 feet Does the project involve excavation or filling? X No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: . feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: N/A Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by ason of such proposed operations(use attachments if appropriate): ECK HAVRBEEN IN EXISTENCE FOR OVER 20 YEARS WITH NO IMPACT ON THE ADJACENT WETLANDS OR TIDAL WATERS. 61 Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -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 al 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: ALSOBROOKAS-BUILT REAR DECK Project Location(describe,and attach a location map): 130 WEST LAKE DRIVE, SOUTHOLD, NY 11971 Brief Description of Proposed Action: St Oi✓ ! APPLICANT SEEKS A WETLANDS PERMIT FOR AN AS-BUILT 29'x 9"RffEAR WOODEN DECK DEPICTED ON THE ATTACHED SURVEY MEASURING 24.6'WIDE, 15'5"DEEP AND 37"ABOVE GRADE �y® WITH ACCESS STAIRS 5'4"SEAWARD OF THE DECK, 67"WIDE,LYING 32.6'LANDWARD OF THE A EXISTING PERMITTED TIMBER BULKHEAD. Name of Applicant or Sponsor: Telephone: 631-315-6070 MARTIN D. FINNEGAN, ESQ. E-Mail:AFINNEGAN NORTHFORK-LEGAL.COM Address: PO BOX 1452, 13250 MAIN ROAD, MATTITUCK, NY 11952 City/PO: State: Zip Code: 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 My may be affected in the municipality and proceed to Part 2. If no,continue to question 2. LK El 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: BUILDING PERMIT ❑ 3.a.Total acreage of the site of the proposed action? � acres b.Total acreage to be physically disturbed? +-0.14_acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.29 acres 4. Check all land uses that occur on,adjoining and near the proposed action. [:]Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®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? ❑ ❑ ❑ 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? ❑ 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: M 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? 1771 ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ M 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ] 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ImX\I ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES I _ Places? � ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 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? [X1 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Do Shoreline El Forest ❑Agri cultural/grasslands ❑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 located in the 100 year flood plain? NO YES X 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO_ YES If Yes, [:]YES ❑ a.Will storm water discharges flow to adjacent properties? ❑NO YES X b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: [_]NO AYES 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: 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO _ YES solid waste management facility? If Yes,describe: F 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 AFFIRM THAT THEINfORWTION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE—— Applicant/sponsor name: NOWLEDGApplicant/sponsorname: D. FINNEGAN, ESQ. Date; MARCH 2022 Signature:. Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.fol lowing questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning o regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? f ❑ 3. Will the proposed action impair the character or quality of the existing community? u 4. Will the proposed action have an impact on the environmental characteristics that caused the I(—jt ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or.renewable energy opportunities? 7. Will the proposed action impact existing: �' a.public/private water supplies? El b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 1 No,or Moderate small to large impact impact may may ; occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? j 11. Will the proposed action create a hazard to environmental resources or human health? a 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 wil I 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. F] Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer i Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT - Page 4 of 4 Board of Trustees Application AFFIDAVIT VICTOR P. AND GLORIA E. ALSOBROOK _ BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)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. s J � Signature Prop-erly Owner Signature of Property Owner VICTOR P. ALSOBROOK GLORIA E. ALSOBROOK SWORN TO BEFORE ME THIS . V DAY OF MARCH -2022 N ary Public U0l� �D7 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, VICTOR P. AND GLORIA E. ALSOBROOK owners of the property identified as SCTM# 1000- 90-1-19. in the town of SOUTHOLD ,New York,hereby authorizes._MARTIN D. FINNEGAN, ESQ. 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- nature Property Owner's mnature VICTOR P. ALSOBROOK GLORIA E. ALSOBROOK SWORN TO BEFORE ME THIS DAY OF.MARCH 2022 _ _ x Notary Public APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of toiVn:&icers and emolovees.The ourn6se of this form is to provide information which can alert"tlie town of possible conflicts ofintetdf and allowit to,take w atever>iction is necessary to avoid same. YoURNA.VICTOR P. AND GLORIA E. ALSOBROOK (Last name,first name,4riddle initial,unless you are applying In name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee _ X, Change ofZone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you`persoiially. (or through your company,spouse,sibling,.pare,nt,or child)havee-a relationship with any officer or employee of the To,.vn ofSouthold? "Relationship"includes by blood,ntarringe,or business jbt*r LC'Business interest"means,a,business, including a partnership,in which the town officer or employee has evens partial ownership of(or cniploymcnt icy,)a corporation in which the town offlq:r or employee owns:more than,5%ofthe shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitte t 0 MARCH ggg 2022 Signature Print NameVIC RP. LSOBROOK G ORI 'E. LSO P Form TS 1 f APPLICANT/AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSUn FORM The Town of Strut nld's Code of Pthiess Rrohibitc conflicts of interest on the part of town n#f'ycers and em}il_o ees A1e numos of this form is't r provide inforination which can Plert the town of passible conflicts of interestand allow'it to.take whatever action is necessary to avoid same. YOURNAME: MARTIN D. FINNEGAN (Last name,first name jpiddle initial,unless you are applying"I the name of someone else or other entity,such as a company.If so,indicate;the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling;parent,or chile!)have a relationship-with any officer or employee of the Town of Southold? "Relatiortship"includes by blood,mL" marriage;or intcre Business interest"means it business, including a'parmership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town off icer or employee owns more than 5%of the shams. YES NO lf,you answered"YES",complete the balance of this form and date mud 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/pgresentative)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,of child is(check all that apply): A)the owner of greater than 5%of the shames of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thisday of March aw 2022 Signature Print Name _ FINNEGAN Form TS I Town of Southold LWRP CONSISTENCE'ASSESSMENT FORINT 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 significant 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 beM. lained in detail..listinp,both supporting and non- supporting 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# 90 1 _ 19 PROJECT NAME ALSOBROOK AS BUILT DECK 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) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: 0 51 PC—i3R�Gt� t� , Nature and extent of action: fAM� A-r APPLICANT SEEKS A WETLANDS PERMIT AN AS-BUILT/29' x 9' REAR WOODEN DECK DEPICTED A?1(9 ON THE ATTACHED SURVEY MEASURING 24.6'WIDE, 15'5" DEEP AND 37"ABOVE GRADE WITH A ACCESS STAIRS 64" SEAWARD OF THE DECK, 67" WIDE, LYING 32.6' LANDWARD OF THE EXISTING PERMITTED TIMBER BULKHEAD. Location of action:130 WEST LAKE DRIVE, SOUTHOLD, NY 11971 Site acreage: 0.29 ACRES Present land use: EXISTING SINGLE FAMILY RESIDENCE WITH DECK 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: VICTOR P. AND GLORIA E. ALSOBROOK (b) Mailing address: 130 WEST LAKE DRIVE, SOUTHOLD, NY 11971 (c) Telephone number: Area Code( ) 631-765-8650 (d) Application number,if any: %U 1A Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 0. If yes,which state or federal_agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. IX Yes No F-1 Not Applicable THE EXISTING DECK AND PORCHES PROVIDE CRITICAL ACCESS TO THE HOME AND ARE NECESSARY FOR THE BENEFICIAL USE OF THIS WATERFRONT PROPERTY. 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 E] Yes 0 No 0 Not Applicable ' 1 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 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 a Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 0 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 LVVRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes D No X� 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 LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes R 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. 0 YOE I No� Not Applicable THE EXISTING DECK PROVIDES ACCESS FOR THE WATERFRONT HOME TO THE ADJACENT WATER BODY. Attach additional sheets if necessary WOKING 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 [XI 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 L'_�t_I 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 0 Not Applicable PREPARED BY MARTIN D. FINNEGAN, ESQ. TITLE AGENT DATE MARCH 2022 FINNEGAN LAW, P.C. 13250 MAIN ROAD P.O. BOX 1452 MATTITUCK,NEW YORK 11952 (631) 315-6070 MARTIN D. FINNEGAN, ESQ. MFINNEGAN@NOKTHFORK-LEGAL.COM By Hand - March 22, 2022 rE E- Q V E Town of Southold VAR 2 3 202? Board of Trustees 54375 Route 25Sout _ Board Post Office Box 1179 Ecard t�lcl lo�of Trust ees _ Southold, NY 11971 Attn: Glenn Goldsmith, President Re: Administrative Wetlands Permit Application 130 West Lake Drive, Southold SCTM 1000-090.00-01.00-019.000 Dear Trustee Goldsmith: With respect to the above-referenced Application, enclosed please find a check made payable to the Town of Southold in the amount of$200.00 representing the required "as-built" filing fee and an original and one (1) photocopy of the following documents for your review: 1) Administrative Wetlands Permit Application. 2) Executed Short Environmental Assessment Form. 3) Executed Owner's Affidavit. 4) Executed Owner's Authorization. 5) Executed Applicant Transactional Disclosure Form. 6) Executed Agent Transactional Disclosure Form. 7) Local Waterfront Revitalization Program (LWRP) Consistency Assessment Form. 8) Color photographs of the subject area. 9) Copy of the existing deed. 10) Copies of Covenants and Restrictions. 11) One original and three (3) photocopies of the existing survey. � `sr Kindly advise if you require any further documentation to place this matter on your next available agenda. Thank you for your consideration. Very trulFinnegan s, Marti MDF/as Encl.