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HomeMy WebLinkAboutTR-10163A Glenn Goldsmith,President lg� S®(/j� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples ® ,® Fax(631) 765-6641 C®UN 1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1931C Date: June 15, 2022 THIS CERTIFIES that existingbuilding uilding addition for fireplace-15 SF(6.3 x 2.4) and covered stoop- 40.7 SF (9.7 x 4.2); At 5805 Main Bayview Road, Southold Suffolk County Tax Map#1000-78-7-5.5 Conforms to the application for a Trustees Permit heretofore filed in this office Dated June 2, 2022 pursuant to which Trustees Administrative Permit#10163A Dated April 14, 2021,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 existingbuilding addition for fireplace-15 SF (6.3 x 2.4)and covered stoop-40.7 SF (9.7 x 4.2);. The certificate is issued to William J. Earl owner of the aforesaid property. Authori ed Signature Glenn Goldsmith,President s 0 s®U��® Town Hall Annex A. Nicholas Krupski,Vice President ,�® �® 54375 Route 25 P.O. Box 1179 Eric Sepenoski '' �:''; ,,.rrte� `za' Southold, New York 11971 Liz Gillooly Elizabeth Peeples '� Telephone (631) 765-1892 O .�® Fax(631) 765-6641 c®UN�,�� 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 Y2 constructed X When project complete, call for compliance inspection; Glenn Goldsmith, President ®(/�� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 �r�, Eric Sepenoski3 Southold, New York 11971 Liz Gillooly Q0 Elizabeth Peeples �, Telephone(631) 765-1892 Fax(631) 765-6641 ®, 'rouf1fm� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10163A Date of Receipt of Application: June 2, 2022 Applicant: William J. Earl SCTM#: 1000-78-7-5.5 Project Location: 5805 Main Bayview Road, Southold Date of Resolution/Issuance: June 15, 2022 Date of Expiration: June 15, 2024 Reviewed by: Elizabeth Peeples, Trustee Project Description: As-built building addition for fireplace -15 SF (6.3 x 2.4) and covered stoop -40.7 SF (9.7 x 4.2). 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 site plan prepared by AMP Architecture LLC., received on June 2, 2022, and stamped approved on June 15, 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. . A, A \ Glenn Goldsmith, President Board of Trustees SITE PLAN HATCH KEY: SITE CATGUT NOTES D_ I. TH"S 15 AN ARCHTEGT•S SITE PAN 4 15 Q ® PROPOSED Ed)MINE,ADDITION 5J5JEGT TO VERIFICATION 5-A LICENSED 0 SJRVEYOR. THE INFORMATION W PROPOSED ACCESSORY STRUCTURE REPRESENT'.D CN THIS SITE FLAN IS TO THE EARL RENOVATIONJ ARCHITECT'S BEST OF KNOWLEDGE. ® PROPOSED 2ND STORY n,FRCM IA-ORNATION D 06/2CI,D Q FROM A SLRVE"DATED 09/26/2015 AND PREPARED BY: O J VAN E,PC I4 J VAA WPELE,PC 1- 15ACOMMERCE DRIVE HA, 0 TELEPHONE:(650,435 1 II D- PRO�JGT SCOP : FAGE KAY: C7-00I.OI PROJECT LOCATION&SCOPE < 0 PROPOSED 55 So. Ft. ADDITION B NEW COVERED STOOP Q FRONT ( SITE PLAN&ZONING DATA t rz G- O O S E G R E E <^- i ENTRY. INTERIOR RENOVA T ION 9 =IRS- FLOOR. APPROXIMATELY 109)I} S 1 Q oa 550°O6'S,"E OF EXTERIOR ^ALLS TO BE REFLAGED 0. �.JO_% 'GENERAUNOTES -' w 00 ENERGYTABLE »0 1 STRUCTURAL DESIGN CHARTS z m O / - PROJECT/ IN _ - (3-0055.00 HOLDOWN,ANCHOR BOLT, \ _ / Q TAX MAP° 1000--18--I-5.5 Z*'I STRAPPING,&NAILING DETAILS J N ZONING DISTRICT R-40 GONFGRMINS FASTENING SCHEDULE Lf)i SLI r Lor AREA 4.4 ACRES FRAMING GRAPHICS r 3 s S 6 Com-004.00 a g o If1 N EXIST.FRAME CER-IFIOATE OF OCCUPANCY Z-15464 10/16/59 BEAM CONNECTION PATTERNS w 1 DECK ,\ / .� j W CER-IFICATE OF OCCUPANCY Z-29565 OV 09/03 FIREBLOCKING DETAILS -ry m % In on ND FEMA FLOOD ZONE SHADED X 4 AE(EL b) W - 133•/ .4 ,w,,.. „Y„ % N PROPOSED DEMOLITION PLANS _ u, m A-101.00 WETLANDS DISTRICT NO PERMIT EXISTn U J � o .2 STOR" qb, FRAME HOUSEc �m PROPOSED \� } Q m DEC DISTRICT ... NO PERMIT o -` -�,^-v" .!'�/-�,-�.-.-.�"�-.!_'�^•.„"--`/'�"_-.% ✓ - O 4 GARAGE FOR GAS FLLOR ADDITION _ O Q r FIREPLAG S ADO, - -- - 153• V� f _ A-I QZ-Q PROPOSED BASEMENT PLAN \ a HABITABLE SPADE EX:ETIN6 PROPOSED \ -ry BASEMENT AREA O S.F. O S.F. i ( I h FRLFOSED / FIRST FLOOR AREA 1-6.2 S.F. I,gT6.2 S.F. PROPOSED FIRST FLOOR PLAN SOD PIED ^- LCVERED STLOP� / �4*cy 1 1.10G,5Lk'i +q ` SECOND FLOOR AREA 5F. 1,1093 S.F EXI5T. % GRAVEL TOTAL BEDROOM COUNT 4 4 j R DRIVEA- //, _ A-I04,0I PROPOSED SECOND FLOOR PLAN J .LOT COVERAGE - / DESCRIFTION(FOOTPRINT) y AREA %LOT •�I 1 O 0 GOVERA6E r TOTAL LOT AREA 105,460,0 S.F. ' A-201.01 PROPOSED EXTERIOR ELEVATIONS i 5 0 EXISTING 9UI-DIN6 21066.1 S.F. J% ( ' t z EXISTING DECK 543.9 5.7. 0.3% ', TII N Jr20?.OI PROPOSED EXTERIOR ELEVATIONS EXISTING STOOPS 50.0 S.F.s.r- o.c�% .i & PROPOSED WLDINO ADDITION 15.11 S.F. O.G2% SC LE:I'-O"-20-0' PROPOSED COVERED STOOP 40.7 S.F. O.G<% BOAR® OF 'i USTEES m�% -IOI.oI i 0 TOTAL AREA OF ALL 5TRJCTLRE5 2,746.3 S.F. 1.4% DWV WATER SUPPLY RISER o ' h' -MAXIMUM LOT GOVERAGE ALLOWED-20% / GAS RISER 1 A o z TO�/I� OF S uTHOL® h°j c 1 = z �% REQUIRED SE78AGK�^-- 1�91'`fE_"�-- REOUIRED EX157. PROPOSED GOMFLIE5 w z p---�-- - ' --- . I J/J I FRONT YARD °O.I' .6' YES TVI�� GIDE YARD 15.01 43.2' 45.2 N YE5 BOTH SDE YARDS 35,0' 324.9 324.9' YES n\ i REAR YARD 50.0' 51,5' SI,B' YE5 c O 1 1 I I I UN 2 ®� 'PROJECT: °J EARL •� � RENOVATION (`I 5outholdTown pry% Ln Board ofTrustm 5805 MAIN BAYVIEW ROAD SOUTHOLD,NY 11971 560°SQ -)T! I DRAWING TITLE: 46 0'J _ PROJECT LOCATION&SCOPE I I \ LANDWARD L M-5 OF �N51°00 000'W SITE PLAN&ZONING DATA mom" •� WE-LANDS A5 DETERMINED w BY 'BAReET-BONAGGI 6 I- � 3a• � \ -15'SETBACK VAN WEELE PG ON II/02/21 Is-' �, I y' ,y, Sysa .- s .c - - •% PAGE: " •� -y FROM-Ir AL `� {(( 6 \ WE-LANDS -°„�, ,,,- ! ' ' SUBJEG-PRGPE:R'Y 4 a !!! �,r a G-001.01 LuO �) \ I3 be � /� J xt f Of V ..�8�4 DATEI .0 �, �� 1 . o o _ \\ J Ooa� s n w'? a 5 # x a 1n 545.00 \\ ----- - a- zt 'y? r 1� I '..n j Q ` .r,y PJ 0 N51°00'00- MA I N 3AYV I E W ROAD LOCATION MAP SITE PLAN SCALE:14T5 /// 03740'3 SCALE: -O" 40'-0 A—NEW N NDOWS I DOORS SHALL EE ANDERSEN;INSTAL AS PER NAW.SPEC.'S. SEE PASS"G-003"SCR VAI_IA6 I STRAP IN6 DETAILS, 0 ELEVATION NOTES WINDOW G}iART - Q Oi HATCHED AREAS IND GATE NEW WORK(T—.) EGRESS W NINS WINDON pIMENSION GLAR J ^ TAO 1'PE MODEL a OPCNIVG I Q NEW ROOFIIv^AO'E( 'P.1 � VDH EGT hW£IDETHT R RE GMLY RWw0" 51 51. � ].INSTALL LLE AAD NATER SHIELD FROM.FASCIA 1 TO A 51DEL:6H- FVSLI-168 24•FRO' INSIDE FACE OF S=WALL AND AT VALLEYS O R B Da)6LE FUND 7W2I0510 O'-II 9.IASTALL IS v M LN FE,T(SD.NJ CY R F 4.V]'LD%PLYWOOD SFEATHA6(BLOCK ALL SEAMS) d' 5.LAP—LE OVER RIDGE I H FS(AS-.v) C GLIDING 663 5'-II}•• �'-I I�" O 6.PROVIDE RIDGE VENT(AS—D) d 1.FLASH ALL VALLEYS D CASEMENT GX145 15F } D.I—AL.—IF EDGE AS R:OD i'� Z 9.INSTALL ALL AS PER MAW.SPEG.b E PIGNRE GIRBC Vim' - ~` :0'�' O'-II�° ]'-I I�" H IYFIGAL ROOF a CEILING GONSTRLGTION. Z • NEN ROOFING AS NOTED Q 0 • LYS'LD%PLYWD SHEATHING BLCLKIN6¢ALL CLW 9 SEAM) W • R.R.,GJ,!L.T.AS NOTED ON PLANS(¢R C, NTER OF J OVER H'INSTALL'X"BRIDGING O CE (���� • . ��'. . .i �.'�/�� J OB VIA.OF R-49 INSULATION ^ Z 0) TYPICAL EMERIOR WALL LON5TRUGTION(TVP). L'l\ Y a h O LPoN'TYVE'NplsE rI2Av (OR EWAU Z N"I • IPON I/�LD%PLYWD.SHEA.iHING IELOC—¢ ALL PLYWD SEAMS) ]x6'STI.D$¢16"O.L.W OBC.TCP PLATE `, ( LL W • MIA.R-]I IASlLAT1ON 4 •�- 9/4•PLYHOOD LLT t-Q�L0 • 5/H'6—E D.WnLL FIND, p/�\p I NEW 51D N �� M, Ll ii O I. NSTALL NEIY 5H -LAP 5 E- 12 ].TVEK'ALLA FERMREOUAL. 9.INSTALL ALL AS PER MAW.RIM FOR E I ( 1•\ 9.PROVIDE ALL NECESSARY TRIM FOR �....j� PROPER IN6TPLLATIOA 5.SIDING SHALL E%TEW TO TOP OF / FOJNDATION HALL I I I I 1 J- O EJE]] SIDING.STAIR ElEl � 1 A 1 4 i • �. IE 9 1 S. i E= 6 w 0. SOUTH ELEVATION (FRONT) o SCALE,1/4"a 1'-0" �i a 2 a i x ¢ E d N 'oE +c.�� ir'-a. V E o M a �l PROJECT: JUN a 2 20& EARL RENOVATION SoutholdToWfl 5805 MAIN BAYVIEW ROAD l O SOUTHOLD,NY 11971 B Board of Trustees r - — E -i DRAWING TITLE: ] s �, PROPOSED EXTERIOR ELEVATIONS I �U,JATE•04/22/ " � ' .f •y r- k ts�� IBJ: 'J'r•-•/ 03 4 y�J OF N� EAST ELEVATION (RIGHT SIDE) / SGALE� /4"=1'-0" �� ALL NEN WII.DOWS a DOORS SHALL BE ANDERSEN;INSTALL AS SER MANU.5PEG.'e. SEE FASE'6-003•FOR NAILING 1 STRAPPINO DETAIL. EL YVNL7DW CHART ELEVATION NOTES � O HATCHED AREAS IND GATE NEW WORK(TYP.) I' � EGRESS W ROUFfkI-O NIN5 W'NDOW DIMEN51ON CLEAR -� TA6 TYPE MOGEL> �,.+r OFLM. O NEW�ROCwF C NOTE(TYP): ,SME BY GAF ILR - WIDTN REOD.]O' WIDTH HEIGHT HEIGHT REOD:]4' Q OFEN REOD: 5.T S.F. K I•ECtALI M n'So Y0.w SRR,v.T,� ].INS.PLL ICE AND WATER SHIELD FROM FASCIA LP TO A SIDELIGHT FWSLITBb I--69- FACE -69"FKE 6 STUD WALL AN'D AT VALLEYS OVER ?.NSTALL M-$11LOIN6 F 7(J.O.N:OVER B DOUBLE HJVG TY�10510 ly^..p a• ]'-II�' <-O a- F <,I/]•LDX PLYWOOD SHEATMNG(BLOCK ALL S—) 5.LAP SHINGLE OVER RIDS'E.—(A5 REOD) G GLIDING 065 6.PROVIDE RIC6E VENT(A5 RLODJ d T.FLASH ALL VALLEYS D CASEMENT CXI45 ]'-T 4'-4 II S.F. )- B.INSTALL DRIP EDGE A5 RSGD Z 9.INSTALL ALL AS E PIC'1:RE CIR30 H ® TYPICAL ROOF.CEILING GONS'RI:CTION: Q 0 • NEA ROOF.V6 A5 NOTED • /]'LD%R"WD SHEATHING 2LDLKINO a ALL PL"hD SLAHGJ • RR.LJ.,a L.A.L NOTED CN PLANS(a SPANS NST OVER E'IALL'X"BRIDOINO o CENTER OF —AN I:ON) • zMIN.OF R-4R INSLLATION a a1.I TYPICAL E%TERIOR WALL CONSTRUCTION(TYP). Q MON"YVEK'HOJSE WRAP(OR EWAU Q Z a • Z LPON/]'LD%PLYAD.SHEATHIN6IBLOCK!N6 a Al FLYAD SEAMS) W W(D 6'STLLS a 16"OL..u/D.L.TOP PLATE • MIA.R-]I NA A N IISLLATI = • 5/E"6"PSLM BD.WALL FINISH �.I X38 O W SIDING NOTE F-1 I.cINSTALL NEW SHIP-LAP SIDING W ],'TYVEK"HOJSE hRAP(LYt EOUAJ - - - 2 B.INSTPLL PLL A5 PER MAN;. L I 4.PROVIDE ALL NECESSARY TRIM POR ` PROPER INSTALLATION ( \ U a.510 LWELLMLEND TO TOP OF , W F I. 2 J O NEW OL05CO P.CONC.STAIR f() 0 vE]EIL 1ELIE- IJ IJ5 ED NORTH ELEVATION (REAR) e SCALE:1/4"=V-G" rS ri IS a 0 w O Z x 2 f0 n an N La e El D �a o� V E PROJECT: EARL ID RENOVATION JUN - 2 2022 5805 MAIN BAYVIEW ROAD SOUTHOLD,NY 11971 > _ ] 5 Southold Town DRAWING TITLE: —-- - Bc�: of Trustees PROPOSED EXTERIOR ELEVATIONS .-. —•- PAGE: 9 I 1 4 2 11•I r Il `S,d�� Ell FH_l r. jl r wA 3740 0 WEST ELEVATION (LEFT SIDE) �O f N �y~ SCALE,I/4"_ _O" _. -� S0FF0�� Glen.',i �)Idsmith,President ��0�� �� Town Hall Annex A.Nicholas Krupski,Vice President a .� 54375 Route 25 0 Eric Sepenoski w P.O.Box 1179 Liz Gillooly oy ®�� Southold,NY 11971 Elizabeth Peeples �Ol �� Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: J'Vh&7, I'DOP Completed infield by: Bi za P40V 6 WILLIAM J. EARL requests an Administrative Permit for the as-built building addition for fireplace -15 SF (6.3 x 2.4) and covered stoop - 40.7 SF (9.7 x 4.2). Located: 5805 Main Bayview Road, Southold. SCTM#: 1000-78-7-5.5 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: MAJ Present Were: G. Goldsmith N. Kr ski E. Sepenoski L. Gillooly VE. Peeples Certifications indicated hereon signify that this plot of the property depicted hereon was,mace in accordance with the existing Code of Practice for Land Surveyors adopted by the New York State Association of Professional Land-Surveyors. This certification is only for the lands depicted hereon and is not certification of title,zoning or freedom of encumbrances: Said certifications shall run only to the persons and/or entities listed hereon and are not tionsfefable to additional persons,entities or subsequent owners. I V _E 4 s JUN 20 OSE CREEK f S 50'06'57" :E outhold:T2wn; 16.41' Board ofiTrustees,. -' to DECK '.w to / r V 16.4' / N 25 3 DECK 13.8' ri ri 13:2• 0 to V- 1 S 15'34'36-" E 1 .j ST°rzr 1 a Q M N GARAGE ISTORYI 2 STORY M Q• (n 67.77' 9.6' DWELLING N o �,r p DECK r -� N No.. 5805 Ata UNIT _ S2Q5�+'31'S4" W . -'• '- 43.5' P PLATFORM Fp WOOD 16.86' R o•+ G f 01�wS 3113`36" E � R 21.97' 4 �{t0 BITUMINOUS -7 BASKETBALL DRIVEWAY R kM�~ I HOOP 0 DETAIL a tr LOT MARSH / 7,4X 'LOT /oF RAMP LOT P4- SHED — CMZ V, (b // 0 ` OVERGROWN FLAG / FLAG N �F1AG 4 ' 2 FLAG 5 60.39'50 E FLAG FLAG 46.70 _ + I 2.9 P/0 / O '� FLAG — — 7 LOT �2 SEE ! '� N 51'00..0.0., W Wk FENCE s D TAIL eG 3 56.00' W 5 8 5.6 R I43.2 s.e \ OVERGROWN tit .Q M o 6,0 1. E F.F. EL . 9 G O6. . • I� a: I 11.69 t TAX .. 0 o I 6.7, 7.0 \ �, '_ LOT P U) s. l 7 = I 0) _°FE l .LCAT' 3 � \ O (0 am 71 LCAT LOT l LOT , FLAG Z prcz w °m 7 619 °fits 10 = avl I F \FjjG FLAG 14 FLAG FLAG V)FE FLAG � 2 345.00 0.8'N. g N. FE FE 12 12A FLAG 15 13 0.7E i AT 0.4'N TREE ROW 0.4N - 7.0 °H,. OS F AN NC .... FE OH OH OH 0.9'N. 0.5'N 'N 51'00'00" W 400.65' o.2'W MAIN BAYVIEW ROAD NOTES•. 1. THE EXISTENCE OF ANY COVENANTS, RESTRICTIONS, EASEMENTS AND/OR RIGHTS OF WAY OF RECORD, IF ANY, ARE NOT SHOWN ,OR ADDRESSED. 2. PROPERTY CORNER MONUMENTS WERE NOT PLACED AS PART OF THIS SURVEY. 3! SUBSURFACE AND ENVIRONMENTAL CONDITIONS WERE NOT EXAMINED OR CONSIDERED AS PART OF THIS SURVEY. 4. THE'OFFSETS OR DIMENSIONS SHOWN FROM THE STRUCTURES TO THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO GUIDE IN THE ERECTION OF FENCES, RETAINING WALLS, POOLS, PATIOS, PLANTING AREAS, ADDITIONS TO BUILDINGS OR ANY OTHER CONSTRUCTION. 5. PROPERTY APPEARS AS LOT 1 ON SUBDIVISION MAP FOR MARK BAXTER PREPARED BY YOUNG do YOUNG: DATED NOVEMBER 14, 2005 6. A PORTION OF PROPERTY IS KNOWN AS LOTS 68-71 INCL. AND PART OF LOT 72 AS SHOWN ON THE MAP OF GOOSE NECK FILED ON NOVEMBER 22, 1948 AS FILE NO. 1663 LM SURVEY VIEW: SURVEY 7. ELEVATIONS REFER TO N.A.V.D 1988. 2018 BBV PC The offsets or dimensions shown from structures,to the property lines are for a specific purpose and use;and therefore,are not intended to guide in theerection of fences,retaining walls;pools,patios;planting areas,additions to buildings and any tither construction. Subsurface•and environmental conditions were:not examined or considered as a part of ihis:survey.Easements,Rights-of=Way of.record;if any,are.not'shown.Pioperty,corner monumentswere not placed as part of this survey. Barrett Tax Map: DISTRICT 1000 SECTION 78 BLOCK 7 LOT 5.5 I ® BonaCCI & Mop of: SEE NOTES 5&6 Unauthorized alteration or addition to this survey is a.vio- karyon of section 7204 of New Yo, Sto EdtKoOan Low VCIh WG'@lG, PC Map Lot: -- Map Block: Engineers Surveyors. Planners File Date:-- File No.: -- County: SUFFOLK 175A Commerce Drive Hauppauge,NY 91788 �'' T631A35.11.11 F 631.435:1022 www.66vpc.com Situate: SOUTHOLD,TOWN OF SOUTHOLD Certified to: Title No.: Date By Revision WILLIAM JEFF EARL Copies of this survey.mop not bearing the land CATHERINE EARL surveyor's embossed seal and signature sholl not 1.7/2/21 CW ELEVATIONS, WETLANDS& UPDATE SURVEY 17e considered to.bevy true and valid copy Surveyed 6y,; RB Drafted 6y: BW Checked by: CW Project No.: Al 80576A Date: SEPTEMBER 26 2018 Scale: P= 80' SITE PLAN HATCH KEY: S115 A 1. HN ARCH TELT5 SITE P-AN G 15 C' Q ® PROPOSED EIIILDIN6 ADDITION 5J ECT TO VERIFICATION 8"A LICENSED SJRVEYOR. HE INFORMATION W PROPOSED ACCESsORY STRUCTURE REPRESENTED ON THIS SITE PLAN IS TO THE EARL RENOVATION J ACFRI'SLTE BEST THIS KNOWLEDGE. ® PROPOSED 2ND STORY SJRVEY IMORMA-ION WAS OB-AWED Q FROM A ELRVE"DATED G9/26/2O18 AND d' FREPARED BYE BARRETT BONACCII c; J V LE,PG O HA.FPAI,'GE,NY tiBB TELEPHONE:(63U 435 111FFCJ --��OFE: ` - h C7-OO I.OI PROJECT LOCATION&SCOPE S Z O 1 PROPOSED 55 Sc. Ft. ADDITION 8 NEW COVERED STOOP o FRONT SITE PLAN&ZONING DATA F -0 O O 5 E G R E E <- ( ENTRY. INTERIOR RENOVA-ION o =IRS-- FLOOR. APPROXIMATELY 105 ;x. a d OF EXTERIOR ^ALL5 TO BE REPLACED GENERAL'NOTES' ^' 1111 w 550°0615,..E �.. Com=-0012:00 Ul O 1641, i ENERGYTABLE oo STRUCTURAL DESIGN CHARTS z�fD PRO-Fr-T/ZONIN ::I.-I'i HOEDOWN,ANCHOR BOLT, z}d TAX MAP 1000--I8-1-5.5 E z N � 4.5.4' ..l " \ I �� � � STRAPPING,&NAILING DETAILS J 17- \ % - 1 ZONIN6 DISTRICT R-40 CONFORMIN6 FASTENING SCHEDULE i5 LOT AREA 4.4 ACRES r m N FRAMING GRAPHICS loiT FRAME CELK CER-IFICATE OF OCCUPANCY Z-18464 10/16/89BEAM CONNECTION PATTERNS LU !n m ° W CER-IFICATE OP OCCUPANCY Z-29565 O-1/09)03 FIREBLOCKING DETAILS Lr43.2' 93 / {°i 111 FEMA FLOOD ZONE 5HADED X e AE(EL 6) V ilk N ry IO PROPOSED DEMOLITION PLANS A-101.00 W _ [() U, n7 WETLANDS D157RIGT NO PERMIT s F-- EXIST.2 5TOR" �\ Oh/ N °_ FRAME HOUSE (P PROPOSED ` I17 DEC,DISTRICT NO PERMIT s .,�...^-v_./�,�.._-` r-,�`:-.�,.-�,..;,..._../`.� .- ^^,„\ u J U 9a 8 GARAGE M I FLOOR ADDITION 0 ll1 i Q FOR 6AS FIREFLAC- ` a A-102.0 n q ( ^N V / ( PROPOSED BASEMENT PLAN S HABITABLE SPACE E%'STING PROPOSED :-vSY�-^-^^ -• ,-•^.� BASEMENT AREA O S.F. O S.F. n l �PRCFCa� j FIRST FLOOR AREA 1,916.2 S.F. 1.976.2 S.F-. A_ OBJ.OI PROPOSED FIRST FLOOR PLAN MODF1� COVERED STOOP) hALK 1Z SECOND FLOOR AREA S.F. 1.1093 S.F. ( �1 EXI57. TOTAL BEDROOM COUNT 4 i GRAVEL DRIVEKA" I A-104,01 PROPOSED SECOND FLOOR PLAN LOT COVERAGE / - / DESCRIPTION(FOOTPRINT) AREA %LOT '$ COVERAGE TOTAL LOT AREA F5.4bo.o S.F. A-201.01 PROPOSED EXTERIOR ELEVATIONS S o +wan- In EXISTING E4)I_DING EXISTING DECK 543.9 S.F. 0.3% i A-202.01 PROPOSED EXTERIOR ELEVATIONS a PARTIAL SITE PLAN 111 C-XISTING STGOPS 80.0 S.F. O.G<% PROPOSED ISUIDING ADDITION 15.0 S.F. PROPOSED COVERED S70OF •Ifl.7 5.F. w �t0 f TOTAL AREA OF ALL STRtlGTURES Z,7A6.3SP. 1.4% F-101.01 DWV/WATER SUPPLY RISER o / "MAXIMUM LOT COVERAGW % E ALLOED-20GAS RISER F REQUIRED SETBACKS.=_L9L+If1-HU�L-0L � ....-L - .__ �._._ -„-.....��- �. _ .- ._. -- i i Y W I REQUIRED EXIST. PROPOSED COMPLIES / 0 O FRON-YARD 500 °O.I' 51.61 YE5 f(/�`` 2 V E ' /I SIDE YARD ISD' 43= 432 YE5 E " y Imo' ' I 11 1111 v IBJ v /9 w 'a ` BOTH S DE YARDS 35D' 324P 324.9' YES � DD i a w ft l/ REAR YARD A 50 ' 51b, 51.51 YE5 �'; o LL J U Itl — 2 2fv�7 ;PROJECT: I O u. EARL o°� m RENOVATION +I+r+ Southold Town bry� I N Board of Trustees 5805 MAIN BAYVIEW ROAD J I SOUTHOLD,NY 11971 'DRAWING TITLE: ` o PROJECT LOCATION&SCOPE •� LANDWARD L'M,75 OF N51 56.00' W to I '�- •� WE-LANDS A5 DETERMINED EP -_ , SITE PLAN&ZONING DATA BY 'BARRET-BONAGGI 8 ,,;� 7-� -+ �. �G 4 _ z` 33. 5'5ETBAGK VAN WEELE PG"ON 11/02,21 ``�� ,,`1H D)�'c-, ,^''`,'. •, PAGE: \ NE-LANDS ♦ .a.,-. �'• „� � `1UBJEG`PRGP=R^( - - L G-001.01 IIJ -f, - -_____—=296.1• - -2b1- 7,_r Y O 3 a ? GP `1 4 i DATE: r - O ! ) /!l�fQF W 3i.. �`.�3 y 078 Z ,� ♦ U I, _t E%•,,i��y�. a;' a, ( I c..,2zA j� `i.14 ^ `�1� .�•� 545.00' N51°00'00"l1 400.65' -—- <47 M A I N 3 A Y V I E N R O A D LOCATION MAP (p SITE PLAN SCALE:NTS // \ 037�0� SCALE. -O"=40'-O L— � �� A_NEW N 100N5 a ppORS SHALL BE AI ER5EN;INSTA-L A5 PER MA,W.5PEL.'s. SEE PAGE"6-005"POR NAU- a STR —Nr, DETAILS. CL ELEVATION NOTES WINDOW GFiART r— p Q (D HATCHED AREAS IND LATE NEW WORK(TYo) -c�Ess W -Yvo"gpENIN9 WINDON DIMENSION CLEAR J OPENNLS Q TAB PE MODEL^0WIOTH ROD,]O• ALN ROOFItG AOT/'YP). ` HE EMT REOD�19' 1 rATGw EA15T,GOLon S-YLC 0v OM'(CR "DTitWID1N HEIGHT OFEN REODi 51 5.F. I. AL;enAxp ].INSTALL ICE A,D NATER SHIELD FROM FASCIA LP TO A 51DEL6NT FN5LIT68 I'-6 g' 6'-7 J 14'FROv IA51GE FACE W 5TA WALL AAD AT(B COX PLYWOOD- VALLEYS _I OrER B DOUBLE MJI:G TY.`310310 9. /y`i(i' ]'-II�' A'-O a• 5.R: 15•9.ILDI FEST(J M OVER I/]'LOHP�ITMA6 LOCK ALL SEAr61 5.GAP SHRl6L OVER RID65 a H'PS(AS REOD1 L GLIDING 663 b.PROVIDE RI06E VENT(A:.ROOD) 1.FLASH ALL VALJEY9 DLA5ENE:NT H. CXI45 r-,;• A•-A g• 1 s.F >- INSTALL DRIP EDGE AS RSOD Z 9.MSTALL ALL AS PER MAW.SPEC.§ E PC— CIR30 �� 3'-II g' ]'-11�' 2 F Og TYPICAL ROOF[CEILING CONSTRICTION, • NEN ROOFING A$NOTED • U]'LDX PLYND SHEATHING(BLOCKING O ALL Q PL"Y•m S • 44.LJ..a al.L.T.AS NOTED0.PLANS(O 5PN6 'J OVER H'INSTALL'X'BRIDGING O CENTER OF ^•�' •�• -• `•���'.-�' "�•-'� ...1oo >ao OFR 9 INSULATION ' Zst TYPI RIORA TION • J a O LPON T'VE'IGIbE YdtAP(OR EWALJ �L I ` Z'• (BLOLK'N6 • 1P01:I..'CO.RYYO.:XCATNIN6 O / -� I_. IQ z ALL PLYND SE .SI 1 Y f'? LL J N • ]'r6'STIR^d le'6.OL.N D%.TOP PLATE ` ] 9 :J• - { W LO MIN R-]I IAS.LATION l/ N 2 li Ln • S/E'6YP5L ED.WALL FINISH ) A AEW 51DIN✓NOTE lTw:, 12� •I 9/4•PLYrOOD fA.T i 1�7 1(J . NsrAu AEw sHIP_LAP s.Dlw cur a Ie•DLo � �5(s O ].TYEK•H]LSE HRA (GR E-AU EOEIE] 5.INSTALL ALL AS PER MAW.SFEL.§ 4.PROVIDE ALL NELESSAR'TRIM FOR PROPER INSTALLATIOA \ ,J U 5..—SHALL E%TEND TO TOP OF \/1 / ' I= FOUADATION I I I I I I O NEW CLOSED P,CONC.5TAIR SHIP-LAP SIDI I 2 J -SHIP-LAP SIDING- - - ` f �'i Q 000 ( so b w SOUTH ELEVATION (FRONT) SCALE,1/4^=V-O' 0 � w a � a o0 i Y x 1 � i u: f � V ED I $ i E LL t-.. 5 a V=E PE] PROJECT: JUS m 2 2� EARL RENOVATION Southold Town 5805 MAIN BAYVIEW ROAD ( SOUTHOLD,NY 11971 Board of Trustees - DRAWING TITLE: t EE'I a PROPOSED EXTERIOR ELEVATIONS PAG��..�K=r'I /t;Y� �• Uj ts OF VNO EAST ION(RIGHT SIDE) �� l SCALE,./4'c 1'-0' �� ALL NEN hIt OA5 a DOCRS 5H ALL BE ANDERE=N;IN_TALL AS SER MAW.5PEL.'s. 5EE PAGE'6-003'FOR NAILING a STRAPPING DETAILS. ELEVATION NOTES4. YVImOWGHART O OI HATCHED AREA5 IN CATE NEW WORK(�) NI N6 N VDOh DIMEISCLEAR AR WION OPENING J TA6 TYPE MODEL v WDTY REOD.]O' C NEW RccPINO NciE(TYPJ. ,sirLE e+G v Iw I[3'fF♦' WIDTH HEIGHT FEI6M REOD�]4' Q AU MIN 90 TR.w.S�NTMtLR OPEN REL.. 5.l SF. ].INSTALL ICE AND WATER SHIEiD PROv,FASCIA LP TO A $10Ea.16HT FIVLIT6b ]4•FROM INSIDE PALE OP STLD WPLy AND AT VPLLEY5 ]ALL IPLYWOLD SHE TIib DOLBLE YJNG TW reLOLO K Au 5EA-1 H •�6 7-II�' 4-O a B ]10310 5 GAP SHINGLE OVER RIDGE a 4P5(A REOD) G 6LDIN6 663 5'-11}' -ll i' O .PROVIDE RIDGE VENT(AS REO.; �•' IL T.PLPSH ALL V•V.LEYS D LASE--- ]'-T}" 4'-4�' 11 S.F. r B.INSTPLL.RIP EDE:E AS RECD 4.INSTALL ALL A5 PER MAN,.-CG.b 9, E PIGI.RE L.R30 / �aiv] 3'-II�' 3'-I�' _ H 5 ICALCQ TION. Z In. —-L-AS NOTEDI Q 0 • I/]'GDX=L•'wD SHEAF N6 IELOLKII:S a ALL W R SEAMS; W R.C • RGJ"a G..-. NOTED ON BANS(a SPANS OVER H'NSTALL '%'BRIDGING a CENTER OF J W .11. • MIN.OF R-49 INSLLATIGN Z a(D O TYPI A 1-11 R W TION• LPoN'^lVEC- hRAP(OR EDUAU Z h • LPOV I/]'LDX RYw.SHEATHING(BI.CLKN6 O Q Z e'I ALL PLYW.SEAlS) ,y W� • . b•STLDS 6'OL.w/DBL.TLP RATE • MIN.R-11 INSLLA-ION I✓_� • 5/H'6"P�.M ED.Y:ALL FINI5H ' of NEW SIDING NCTE fTrP�. 1H.5 �O OI.INSTALL I.EW SHIP-LAP SDINS ].•TYVEK'HOUSE WRAP(cR EOUAJ ,�� a. 3.INSTALL ALL A P9L MAN;.S�EL.b 4.PROVIDE ALL NELE-A—TRIM SLR PROP ER INSTAILATCN S.SIDING SHALL EXTEND TO TOP OF F FOUI:DATION WALL � / W O KEA CLOSED P.LONG.5TAIR 7HE111 ol Il' 1 I. _ Emi LLLJI d " � o NORTH ELEVATION (REAR) S I z f � O ,Ell =A EDPROJECT: E 6 V EARL RENOVATION JUN - 2 2022 5805 MAIN BAYVIEW ROAD SOUTHOLD,NY 11971 _ 1 ] B SaLrthnldTown DRAWING TITLE: Beg!0ai Truskees PROPOSED EXTERIOR ELEVATIONS i PAGE: 10r A ( D a r zw , MUM 41 [0] 13 — — C I B I /i ( \ x 374016 � WEST ELEVATION (LEFT SIDE) �, I �()F bye\� .GALE.I/4"_ -O" —_— 4� rte^ PHOTO#1 PHOTO#2 t?� 4 j}. _ '-111 _ _ r; ice=_�,aut �� ��_.__,• t. PHOTO#3 PHOTO#4 Homeowner:Jeff and Catherin Earl Applicant:AMP Architecture Address: 5805 Main Bayview Rd Southold, NY, 11948 All Photos Taken: 10/28/21 OM PHOTO#5 Michael J.Domino,President ®�S Ino) � Town Hall Annex John M. Bredemeyer III,Vice-President '`' ' G> 54375 Route 25 Glenn Goldsmith �, P.O.Box 1179 A.Nicholas Krupski � x s., Southold,New York 11971 Greg Williams %_ , � Telephone(631) 765-1892 }& Fax(631) 765-6641 g co 9 B a t BOARD OF TOWN-TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application _Administrative Permit Amendment/Transfer/Extension ( Received Application: •Z�Z7i Received Fee: $ ZX Ap QQ Completed Application: Incomplete: SEQRA Classification: Type I Type II Unlisted v%C"— rVi D Lead Agency Determination Date: 4Coordination:(date sent): WRP Consistency Assessment Form Sent:, JUN — 2 202 AC Referral Sent: Date of Inspection: Receipt of CAC Report: Southo�dTown �11 echnical Review: Board of Trustees V Public Hearing Held: Resolution: Owner(s)Legal Name of Property (as shown on Deed): William and Catherine Earl Mailing Address: 5805 Main Bayview Rd Southold Phone Number: 619-301-6233 Suffolk County Tax Map Number: 1000 - 78-7-5.5 Property Location: 5805 Main Bayview Rd Southold NY (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): AMP Architecture Mailing Address: 10200 Main Rd Unit 3A Mattituck NY 11952 Phone Number: 516-214-0160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 196,480 Area Zoning: R-40 NC Previous use of property: Single Family Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? Yes X No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: Agency Date 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): BUILDING ADDITION AND COVERED STOOP Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:BUILDING ADDITION FOR FIREPLACE - 15 SF (6.3 x 2.4) COVERED STOOP - 40.7 SF (9.7 x 4.2) Area of wetlands on lot: 7'266 square feet Percent coverage of lot: 1.4 % Closest distance between nearest existing structure and upland edge of wetlands: 90.1 feet Closest distance between nearest proposed structure and upland edge of wetlands: 89.4 feet Does the project involve excavation or filling? X No Yes If yes, how much material will be excavated? - cubic yards How much material will be filled? - cubic yards Depth of which material will be removed or deposited: - feet Proposed slope throughout the area of operations: LAND IS FLAT 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): THE PROPOSED CONSTRUCTION WILL NOT HAVE ANY AFFECT ON WETLANDS. HAYBALES WILL BE USED TO PROTECT THE WETLANDS. 617.20 Appendix B Short Environmental Assessment Form instruetions_for C6ninlefing 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: EARL RESIDENCE Project Location(describe,and attach a location map): 5805 MAINBAYVIEW RD SOUTHOLD Brief Description of Proposed Action: COVERED STOOP AND PROPOSED 1 STORY ADDITION FOR GAS FIREPLACE Name of Applicant or Sponsor: Telephone: 631-603-9092 AMP ARCHITECTURE E-Mail: jmagee amparc rtect.com Address: 10200 MAIN RD UNIT 3A City/PO: MATTITUCK State: NY Zip Code: 11952 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 governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: DEC NON-JURISDICTION LETTER AND SOUTHOLD TOWN BUILDNG DEPT. 3.a.Total acreage of the site of the proposed action? 4.5 acres b.Total acreage to be physically disturbed? - -0_0T__acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 4'S acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural (non-agriculture) ❑Industrial [:]Commercial ®Residential(suburban) E]Forest ❑Agriculture E]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? ❑ Q ❑ 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: E 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES L'J D b.Are public transportation service(s)available at or near the site of the proposed action? ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ® ❑ 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: D � 10. Will the proposed action connect to an existing public/privatc water supply? NO YES If No,describe method for providing potable water: ao 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:_ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of'Historic NO YES Places? i Q b. Is the proposed action located in an archeological sensitive area? M 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? n b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? �<�� 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-.- El pply:❑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 NO YES by the State or Federal government as threatened or endangered? © El 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, a.Will storm water discharges flow to adjacent properties? ❑NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ONO EYES 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: 17 F-1 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Architecture Anthony Portillo 6/1/22 Signature: VJ Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I 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 I. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ F]regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? F-1 ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ D establishment of 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 ❑ D reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ ❑ a.public/private water supplies? _ 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)? Pabe 3 of 4 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 EJproblems? El 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant. Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. i ElCheck this box if you have determined, based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different fi•om Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application a AFFIDAVIT `Ul BEING DULY SWORN [-I/ 'a DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE.APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE - -� -m----BOARD>OF-TRUSTEES-HARMLESS-AND-FREE FROMANY 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. i , vl�e - - Signa of Property Owner Signature of Property Owner SWORN TO BEFORE ME' 13_ DAY OF ,20 TRACY KARSCH PALL MBO Not Public Notary Public,State of t .4ew York No.02PA6087274,Suffoik County Commission Expires March 30 a3 Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) UWe, 4X41LIQ Cev owners of the property identified as SCTM# 1000-i_79"l 5.-,5 in the town of New York,hereby authorizes AMP Architecture to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's Signature l�- SWORN TO BEFORE ME THIS DAY OF L'lJ ,20-2— TRACY 0dZTRACY KARSCH PAWMBO Notary Public,State of-New York No.02PA6Q87274,Suffolk-County / Notar Pu lic Commissi6n Expires March 30,a92-3 APPLICANVAGENUREPRESENTATIV]E TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on t e parr+of town officers and employees The pupose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is ` i necessary to avoid same. (( YOUR NAME: f I G haft'(, �A �P � � C � 1 kd-- ItAy t (Last name,first name,.»ddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of7.one�— —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,rrlarriage,or business interest `Business Interest!'•means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO 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)andlor 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); i B)the legal orbeneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); Cy an,officer,director;pprtner,_or emptoyee,ofthe,applicant,or - .�-. ter_ _,.-•.. _ �...-,.,-._.a-.=M,_,,,. _ �...-�-_.�>...- - D)the actual applicant. DESCRIPTION OF RELATIONSHIP I Submftted this da of V Signature Print Name 41St/ -1 G�(�li'►�tf� �, :�r^� Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A t roposed ,action will be evaluated. as to, its sigWficaut_ beneficial and adverse effects upon the coastal area(which includes all_of.Southold Town). 3 If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail,.listing 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# 78 5.5 PROJECT NAME EARL RESIDENCE The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: X i Nature and extent of action: COVERED STOOP AND PROPOSED 1 STORY ADDITION FOR GAS FIREPLACE Location of action: 5805 MAIN BAYVIEW RD SOUTHOLD Site acreage: 4.5 acres Present land use: SINGLE FAMILY RESIDENCE Present zoning classification: R-40 C 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: AMP ARCHITECTURE (a) Name of applicant: (b) Mailing address: 5805 MAIN BAYVIEW RD SOUTHOLD NY (c) Telephone number: Area Code( ) 516-214-0160 (d) Application number,if any:. /V Pq Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes �, Nor--' o0 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. CYes No ❑ Not Applicable OVE STOOP-AND PROPOSED 1 STORY ADDITION FOR GAS FIREPLACE PRESERVES THE SPACE AND ONLY.001 ACRES WILL BE DISTRUBED.THEY WILL ALSO ENHANCE THE VALUE AND CHARACTER TO THE 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 0 Yes ❑ No R Not Applicable THERE IS NO HISTORIC OR ACHAEOLOGICAL RESOURES ON THE PROPERTY Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable -THE PROPOSED WORK IS 89.4'FROM THE WETLANDS ARE WILL NOT AFFECT THE SCENIC RESOURCES. 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 THE PROPOSED CONSTRUCTION WILL BE CONTROLLED THROUGHOUT THE PROTECT AND HAY BALES WILL BE USED DURING CONSTRUCTION TO PROJECT THENLAND FROM FL.00DICT ANT) EROSION. 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 o Not T E PRO❑POISED❑WO KApplicable WILL NOT AFFECT THE WATER QUALITY. 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. a ❑ o Yes No Not Applicable THE PROPOSED WOKR WILL TAKE PLACE BEOFRE THE WETLANDS AND CONSTRUCTION EQUIPTMENT WILL BE AS FAR FROM WETLANDS AS POSSIBLE. 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. F-1, Yes F1 No' Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III-Policies; Pages 34 through 38 for evaluation criteria. Yes 0 No 0 Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III-Policies; Pages 38 through 46 for evaluation criteria. Ye�] No 0 Not Applicable THERE IS NO PUBLIC ACCESS ON THIS PROPERTY. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑,Yesn' No ❑ Not Applicable THERE IS NO PUBLIC ACCESS TO WATER FROM THIS PROPERTY.THE PROPOSED WORK WILL TAKE PLACE FAR FROM GOOSE CREEK. 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. ❑ Not 0 Yes ,._. No Applicable THE PROPOSED WORK WILL NOT DISRUPT THE MARINE WILDLIFE. 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 LIJ Not Applicable Attach additional sheets ifnecessary 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 Q No ❑X Not Applicable i PREPARED BY AMP ARCHITECTURE TITLE: DATE 12/15/21