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1000-116.-7-2
1 OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex ®� sort P.O. Box 1179 54375 State Route 25 ®�� ��®� Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY www.s outholdt ownny.gov CP- U01 PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, AICP Assistant Town Planning Director LWRP Coordinator Date March 18, 2022 Re: LWRP Coastal Consistency Review for ZBA File Ref THOMAS ANNICO#7612 SCTM#1000-116-7-2. THOMAS ANNICQ #7612—Request for a Variance from Article III, Section 280-15; and the Building Inspector's October 5, 2021 Notice of Disapproval based on an application for a permit to construct an accessory in-ground swimming pool, at; 1) located in other than the code permitted rear yard; located at 305 Halls Creek Drive (Adj. to Halls Creek), Mattituck,NY. SCTM No. 1000-116-7-2. 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, the proposal is recommended as CONSISTENT with the LWRP. This recommendation is based upon: 1. The proposal is not discordant with community character. 2. Retain the existing vegetation in a vegetated, non-turf buffer landward of the wetlands. Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: John Burke, Assistant Town Attorney BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson hO"Of SUyolo 53095 Main Road• P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora Office Location: Eric Dantes Town Annex/First Floor, Robert Lehnert,Jr. COQ 54375 Main Road(at Youngs Avenue) Nicholas Planamento ��ycouSouthold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS RECEIVED TOWN OF SOUTHOLD �— Tel.(631) 765-1809•Fax (631)765-9064 DEC 1 2021 Southold Town Planning Board December 13, 2021 Mark Terry, Assistant Town Planning Director LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold,NY 11971 Re: ZBA File Ref.No. #7612 Annicq, Thomas Dear Mark: We have received an application to construct an accessor inground swimming poo A copy of the Building Inspector's Notice of Disapprova under Chapter 280 ning Code), and survey map, project description form, are attache ce. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairpe n By: _Zt6V Encl. Survey/Site plan: AJC Land Surveying, PLLC dated June 23, 2021 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: August 3, 2021 RENEWED: October 5, 2021 TO: Kate Rummel, Cole Environmental Services (Annicq) 425 Montauk Highway East Quogue,NY 11942 Please take notice that your application dated July 9, 2021: For permit to: Construct an accessory in-ground swimming pool at: Location of property:.305 Halls Creek Drive, Mattituck,NY County Tax Map No. 1000 - Section 116 Block 7 Lot 2 Is returned.herewith and_disapproved.on.the.following grounds: The proposed pool construction on this rion-conforming 5.0 257.88 sq.ft. lot in the A-C District isnot permitted pursuant to Article-III Section 280-15, which states: "Accessory buildings arid'st uctitres or other accessory uses..shdll be located in the feguired teat jaid. In the case of a waterfront parcel, accessory buildings and structures may be-located in the frontacrd provided that such buildings and structures meet the front yard principal setback requirements as set forth by this Code and the side yard setback requirements for accessory buildings". The survey shows the proposed.in-ground swimming pool to be located in the side yard. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application may require further review by the Southold Town Building Department. CC: file,Z.B.A. FORM NO. 3 TOWN OF SOUTHOLD BUILDING.DEPARTMENT SOUTHOLD,N.Y._ NOTICE OF DISAPPROVAL DATE: August 3, 2021 TO: Kate Rummel, Cole-Environmental Services(Annicq) 425 Montauk Highway East Quogue,NY 11942 Please take notice that your application dated July 9, 2021: For permit to: Construct an accessory in-ground swimming pool at: Location of.property:-305 Halls Creek Drive, Mattituck,NY County'Tax Map No. 1,000 - Section 116 Block 7 Lot 2 Is returned herewith and disapproved on the following grounds: The proposed pool construction, on this non-conforming 50,257.88 sq.ft. lot in the A-C District, is not permitted pursuant to Article III Section 280-15, which states: "Accessory buildings and structures.or other accessory uses shall be located in-the required rear yard. In the case of a waterfront parcel, accessory buildings and structures may be located in the front yard, provided that such'buildings and structures meet the front yard principal setback requirements as set forth by this Code and.the side yard setback requirements for accessory buildings". The survey shows the proposed in-ground swimming pool to be located in the side yard. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application may' require further review by the Southold Town Building Department. CC: file,Z.B.A. �ps' 0jko TOWN OF SOUTHOLD—BUILDING DEPARTMENT N Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631)765-1802 Fax (631) 765-9502 https://www.southoldtownny.gov Date Received APPLICATION! FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an-- Owner's Authorization form(Page 2)shall be completed. Date: 07.09.2021 OWNER(S)OF PROPERTY: Name: THOMAS ANNICQ SCTM#1000- 11600-0700-002000 Project Address: 305 HALLS CREEK DRIVE, MATTITUCK, NY 11952 Phone#: 617.834.5141 Email: THOMAS@ANNICQ.COM Mailing Address: 100 HUDSON STREET,APT 8D, NEW YORK, NY 10023 CONTACT PERSON: Name: KATE RUMMEL,AGENT,COLE ENVIRONMENTAL SERVICES Mailing Address: 425 MONTAUK HIGHWAY, EAST QUOGUE, NY 11942 Phone#: 631.369.9445 Email: KATE@COLEENVIRONMENTALSERVICES.COM DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: JASON PETERS, NORTH FORK POOL CARE Mailing Address: 9700 MAIN ROAD, MATTITUCK, NY 11952 Phone#: 631.298.4014 Email: JASON@NORTHFORKPOOLCARE.COM DESCRIPTION OF PROPOSED CONSTRUCTION ONew Structure ❑Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑OtherMINIMAL ALTERATION TO EXISTING DECK, PROPOSED NEW POOL& PATIO $ Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ®Yes ❑No 1 `PROPERTY INFORMATION: Existing use of property:IF2ESIpENT I hL Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to ACthis property? ❑Yes CA No IF YES, PROVIDE A COPY. M.C'h d<Go)(Ai er Pead";.ig:'�'The owner/contractor/design professionai.is responsible for all drainage and.storm-water Issues as,provided by- Chapter 236 of the Town code. APPLICATION IS HEREBY MADE to the Building Department for the,issuance of.a Building Permit-pursuant to the Building Zone ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances of Regulations,for the construction of buildings, additions,alterations or for removal or demolition as herein described:The applicant agre9to comply with all applicable'IaWs,ordinances,building code, housing code and regulations and to admit authorized inspectors on premises and In buildings)for necessary inspections.False statements made her®ln are punishable as a Class A,misdemeanor pursuant to Section 210.45 of the New York.State Penal Law. yG�e, P.1' A9 e V1 t, L�Authorized Agent Owner Application Submitted By(print name): Cal @ jail OV1VY161�1+r t Sowgice S signature of Applicant Date: -Al,10-00 l( STATE OF NEIN YORK) COUNTY OF _) M1 1LG�'2 �U VVl VYI� being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing,contract)above named, (S)he is the Ac eyi (Contractor, Agent, Corporate Officer,etc.) of said owner or owners, and is duly authorized to perform'or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his/her knowledge and belief;and that the work will be performed in the manner set forth in the application file therewith. Sworn before me this � _day of G�•- 202 Notary Public DENNIS W COLE PROPERTY `, _ ` I r �y, „ NOTARY PUBLIC,STATE OF NEW YORK ti�� aF��''L ��"I. '(' I" �i�Pfegistration No. 01006317241 µ (Where the applicant is not the ow er) qualified in Suffolk County Commission Expires December 29,2022 305 HALLS CREEK DRIVE, MATTITUCK, NY 11952 I, -114 0 AC /Vr(�_residing at* do hereby authorize COLE ENVIRONMENTAL SERVICES to apply.on my behalf to the Town of Southold Building Department for approval as described herein. ®x- 14—?021 Owner's Signature Date 1ROM.A 5 Al I C� Print Owner's Name 2 Fee:$ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No. 305 Street HALLS CREEK DRIVE Hamlet MATTITUCK SCTM 1000 Section 116 Block 7 Lot(s) 2 Lot Size50,257 SQ FT Zone A-C I (WE) APPEAL THE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED 08.03.21 BASED ON SURVEY/SITE PLAN DATED 06.23.21 Owner(s): THOMAS ANNICQ Mailing Address: 100 HUDSON STREET,APT 8D, NEW YORK, NY 10023 Telephone: 617.834.5141 Fax: Email: T.ANNICQ@GMAIL.COM NOTE:In addition to the aboveplease complete below if application is signed by applicant's attorney,agent,architect, builder,contract vendee,etc.and name of person who agent represents: Name of Representative: COLE ENVIRONMENTAL SERVICES for(X)Owner( )Other: Address: 425 MONTAUK HIGHWAY, EAST QUOGUE, NY 11942 Telephone: 631.369.9445 Fax: Email: KATE@COLEENVIRONMENTALSERVICES.COM Please check to specify who you wish correspondence to be mailer!to,from the above names: ( )Applicant/Owner(s), ())Authorized Representative, ( )Other Name/Address below: WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED 06.23.21 and DENIED AN APPLICATION DATED 08.29.21 FOR: (X)Building Permit ( )Certificate of Occupancy ( )Pre-Certificate of Occupancy ( )Change of Use ( )Permit for As-Built Construction ( ) Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by numbers.Do not quote the code.) 280-15 Article: III Section: Subsection: Type of Appeal. An Appeal is made for: ()o A Variance to the Zoning Code or Zoning Map. ( )A Variance due to lack of access required by New York Town Law- Section 280-A. ( )Interpretation of the Town Code,Article Section ( )Reversal or Other A prior appeal( )has, (X)has not been made at any time with respect to this property,UNDER Appeal No(s). Year(s). . (Please be sure to research before completing this question or call our officefor assistance) Name of Owner: ZBA File# REASONS FOR APPEAL,(I'Icase-bc.spec0c;,[KI[!I/IOt1ll1 SJ1C'C/,S tllay J1e 16SC[I)VJIJt l3KLI7alY'!'8 signature 116IC0 i eeP 1:An undesirable change will,not;be produced in the CHAT ACTER;of the neighbor.or a detriment to nearby properties if granted,because: OTHER PROPERTIES IN THE NEIGHBORHOOD HAVE�POOLS IN`THE'SIDEYARD. THE PROPOSED POOL AND PATIO ONLY' SLIGHTLY ENCROACH INTO THE SIDE YARD,WHICH AFFECTS,NEITHER THE CHARACTER OF-THE NEIGHBORHOOD, NOR CAUSES A DETRIMENT TO ANY NEARBY PROPERTIES. ADDITIONALLY,'THE PROPOSED LOCATION WOULD RELESS VISMBLE.,FROMNEW SUFFOLK AVE,GIVING PASSERBY AMORE UNADULTERATED VIEW OF THE CREEK. 2..The;beuefit sought by the applicant CANNOT be achieved by solve titethod-'feasible forthe applicant,to pursue, other°than an,area variance,because: THE TOWN*OF SOUTHOLD TRUSTEES REQUIRE A 50'BUFFER FROM.A POOL. THE WETLANDS ON THE PROPERTY CREATE-A DIFFICULTY IN MEETING THE.CODE. ADDITIONALLY,THE P.ROPERTY'BORDERS ON I OF THE ONLY UNADULTERATED AREAS OF SPAR7INA-PAT ENS/ -ALTERNIFLORA. FOR THE HEALTH'OFTHE WETLANDS&WATERWAY,IT IS.IMPbRTANT T,0 MAINTAIN AS MUCH.OFA BUFFER AS POSSIBLE. THE.-PROPOSED LOCATIONWAS CHOSEN AS IT DOES NOT NEGATIVELY AFFECT THE NEIGHORHOOD;IT MINIMALLY£NCROACHES'INTO THE' SIDE YARD,.KEEPS DEVELOPMENT FURTHER'AWAY-F.ROWTHE WETLANDS AS OPPOSED TO PROPOSING THE POOL FULLY.IN THE REAR;YARD, AND PROVIDES AN UNADULTERATED-VIEW OF THE CREEK FOR,PASSERSBY ON NEW SUFFOLK AVE. - 3.Tlie amount'ofreliefregmted is not substantial because: THE`PROPOSED POOLAND PATIO ONLY MINIMALLY ENCROACH ONIHE`SIDE'YARD. THE-'PROP.SOED-PLAN IS INKEEPING WITH THE NEIGHBORHOOD. 4.The variance will NOT have,an adverse effector impact on the physical or environmental conditions in the. neighborhood or district because: 'THE PROPOSED LOCATION OF THE POOL AND,PATIO IS TO HELP MINIMIZE ANY ADVERSE.EFFECTS ON THE ENVIRONMENT AND MAINTAIN.A PRISTINE VIEW OF THE CREEK. S..Nas Lhe allegged,difticulty been self=.created? ( }'Yes,or f)4 No.,Why:. . TOWN`OF.SO.UTHOLF TRUSTEES BUFFERS CANNOT BE MAINTAINED IF THE POOL-IS PROPOSED IN TWE'REAR'YARD. ' Are.there any.Covenants:or Restrictions-concerning this.land? {x}.No { ; Yes(please firnish a•copy) . 'Phis'is.the.MINIMUM:that is,necessary and adequate,and'.attliesame time,preserve and protect the character of the neighborhood and the health,safety,and-welfite-of the community: b0l U Signature of Appl-i a- iorized Agent, . ( (Agent must subdiit«YfiRen,Authorization fioin Odner): SWOrn toaietbre'nie this^1/ day, SHEILA M.LYONS Notary.Public,State of New York No.49811525 t]ualilied in Nassau County Ccmmissfon.Expires Apri122, 3 Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) l �iyta a o )�,l//(A residing at 30 s- PAUs_(kt%G, (print property owner's name) (Mailing Address) COLE ENVIRONMENTAL SERVICES do hereby authorize (Agent) to apply for variance(s)on my behalf from the Southold Zoning Board of Appeals. (Owner's Signature) Trtom,K5 -A/dNl6R (Print Owner's Name) FORM Ido. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town.Hall . Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29856 Date: 11/19/03 THIS CERTIFIES that the building ADDITION Location of Property: 305 HALLS CREEK DR MATTITUCK (HOUSE N0.) (STREET) (HAMLET) County Tax Map No. 473889 Section 116 Block 7 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit• heretofore filed in this office dated JULY 9, 2003 pursuant 'to which Building Permit No. 29555-Z dated JULY 9, 2.003 was issued, and conforms to .all of. the requirements of the applicable provisions of the law. The occupancy for, which,, this certificate isissued is DECK AND GAZEBO 'ADDITION TO AN EXISTING ONE FAMILY DWELLING. AS APPLIED FOR. The certificate is issued to STUART D & HELEN D GLASS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT 'OF EMALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. X1766,88 11/03/03 PLUMBERS CERTIFICATION DATED N/A' ut size Signature Rev: 1/81 FORM NO. 4' TOWN OF SOUTHOLD BUILDING DEPARTMENT. Office of the Building Inspector Town Hall . Southold, N.Y. UPDATED CERTIFICATE OF OCCUPANCY No: Z-30873 Date% 04/21/05 THIS CERTIFIES that the building ADDITION Location of Property: 305 HALLS CREEK DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 116 Block 7 Lot 2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 9, 2003 pursuant to which Building Permit No. 29555-Z dated JULY .9, 20 03 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK ADDITION TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (NOTE• THIS UPDATES' COZ-29856 DATED 11/19/03 REMOVING GAZEBO FROM CERTIFICATE OF OCCUPANCY AS IT WAS NOT CONSTRUCTED AT THAT TIME) The certificate is issued to STUART D & HELEN D GLASS _(OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A. ELECTRICAL CERTIFICATE NO. 1176688 11/03/03 PLUMBERS CERTIFICATION DATED 'N/A Au o ize Signature Rev. 1/81 FORM NO'. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office, of the Building Inspector Town .Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No. Z-24799 Date DECEMBER 13, 1996 THIS CERTIFIES that, the building NEW DWELLING Location of Property ' 305 HALLS CREEK DR. MATTITUCK, N.X. House No. Street Hamlet County •TaxMap. No. 1000 Section 116 Block 7 Lot -2 Subdivision Filed Map No. Lot No. . conforms substantially to the Application 'for' Building Permit heretofore filed in this office dated APRIL 22, 1996 pureuant to which Building Permit No. 23410-Z dated My 6, 1996 was issued-,• and conforms to all of the requ-irements of the applicable provisions of the law.. The occupancy for which- this certificate is 'issued is ONE FAMILY DWELLING WITH ATTACHED GARAGE & BEAR DECK •AS APPLIED FOR. The certificate is issued to STUART GLASS _ (owner) of the. aforesaid.building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-96-0017=DSC.. 30 1996 ELECTRICAL INSPECTION CERT. #13685 - DEC. 4, 1996 PLUMBERS CERTIFICATION DATED DEC. 9, 1996-CHARLES SANDERS_ Bui ding inspector Rev. 1/81 ��g11�FO1�•��G Town of Southold 10/30/2018 P.O.Box 1179 . ;o ' 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 40010 Date: 10/30/2018 THIS CERTHIES that the building RESIDENTIAL ALTERATION Location of Property: 305 Halls Creek Dr,Mattituck SCTM#: 473889 Sec/Block/Lot: 116.-7-2 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 1/5/2018 pursuant to which Building Permit No. 42301 dated 1/17/2018 was issued,and conforms to Al of the,requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: alterations to existing one family dwelling as applied for. The certificate is issued to Lavaud,Floriane of the aforesaid.building.' SUFFOLK COUNTY DEPARTMENT OF 13EALTH APPROVAL ELECT-RECAI CERWMCATE N®. 42301 6/7/2018 . PLUMBERS CERTIFICATION DATED 6/19/2018 JERes Williams f - Signature APPLICANT'S PROJECT DESCRIPTION APPLICANT•COLE ENV.SERVICES ON BEHALF OF THOMAS ANNICQ DATE PREPARED: 01- 2,0 -2j 1.For Demolition of Existing Building Areas Please describe areas being removed: H. New Construction Areas(New Dwelling or New Additions/Extensions): Dimensions of first floor extension: Dimensions of new second floor: Dimensions of floor above second level: Height(from finished ground to top of ridge): Is basement or lowest floor area being constructed?If yes,please provide height(above ground) measured from natural existing grade to first floor: III.Proposed Construction Description(Alterations or Structural Changes) (Attach extra sheet if necessary).Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: Number of Floors and Changes WITH Alterations: IV. Calculations of building areas and lot coverage(from surveyor): Existing square footage of buildings on your property: 2,205 SQUARE FEET Proposed increase of building coverage: 675 SQUARE FEET Square footage of your lot: 50,257.88 SQUARE FEET Percentage of coverage of your lot by building area: 8%EXISTING V.Purpose of New Construction: TO INSTALL A POOL AND PATIO VI.Please describe the land contours(flat,slope %,heavily wooded, marsh area,etc.)on your land and how it relates to the difficulty in meeting the code requirement(s): THE EXISTING WETLANDS ON THE PROPERTY CREATE DIFFICULTY TY IN MEETING TH TR 1STE S' CODE REQUIREMENT SINCE IT IS NOT POSSIBLE TO MAINTAIN A 50'SETBACK FOR THE POOL AND PATIO. THE PROPOSED LOCATION MAXIMIZES THE DISTANCE BETWEEN THE POOL/PATIO AND THE WETLAND LINE. ADDITIONALLY,THE AREA IN THE REAR YARD IS SIGNIFICANTLY MORE SLOPED THAN THE AREA IN THE SIDE YARD. Please submit 8 sets of photos,labeled to show different angles of yard areas after staking corners for new construction,and photos of building area to be altered with yard view. 4/2012 QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A.. Is the subject premises listed on the real estate market for sale? Yes X No B. Are there any proposals to change or alter land contours? X No Yes please explain on attached sheet. C. 1.)Are there areas that contain sand or wetland grasses? YES 2.)Are those areas shown on the survey submitted with this application? YES 3.) Is the property bulk headed between the wetlands area and the upland building area? NO 4.)If your property contains wetlands or pond areas, have you contacted the Office of the Town trustees for its determination of jurisdiction? YES Please confirm status of your inquiry or application with the Trustees: and if issued, please attach copies of permit with conditions and approved survey.WE WERE ADVISED TO APPLY TO THE Z bA . PRIOR TO APPLYING TO THE TRUSTEES. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? NO. E. Are there any patios, concrete barriers, bulkheads or fences that exist that are not shown on the survey that you are submitting? NO. Please show area of the structures on a diagram if any exist or state none on the above line. F.- Do you have any construction taking place at-this time concerning your premises? No If yes, please submit a copy of your building permit and survey as approved by the Building Department and please describe: G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking, please apply to the Building Department to either obtain them or to obtain an Amended Notice of Disapproval. H. Do you or any co-owner also own other land adjoining or close to this parcel? NO. If yes, please label the proximity of your lands on your survey. I. Please list present use or operations conducted at this parcel EXISTING SINGLE FAMILY RESIDENCE and the proposed use SAME WITH POOL (ex: existing single family, proposed: same with garage, pool or other) 09.30.21 Authorized signature and Date F s e e THOMAS ANNICQ 305 HALLS CREEK DRIVE MATTITUCK, NY 11952 SCTM NO: 1000-11600-0700-002000 AERIAL FACING EAST 305 HALLS " }. CREEK DRIVE 4 SUFFOLK COUNTY GIS 2020 AERIAL FACING NORTH y Yen Nro'� ✓.'!6l IU4lSL � �yY -..Y" ♦ 3 vc ��i' luix� �., THOMAS ANNICQ 305 HALLS CREEK DRIVE MATTITUCK, NY 11952 SCTM NO: 1000-11600-0700-002000 AERIAL FACING NORTH N 7✓ AERIAL FACING NORTHEAST �rt AW frralY ♦" r THOMAS ANNICQ 305 HALLS CREEK DRIVE MATTITUCK, NY 11952 SCTM NO: 1000-11600-0700-002000 FACING EAST FACING SOUTHEAST �I Y s _�K l: A H R� Cole Environment er�:ices •• 111 •11 1 11 11 111 w j � y Ad.5 APPLICAt .NT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM t}told's Code at'E hics prohibits conflicts of interest on the part of town officers find etittilove s.Ti►c nut The Town of Sou °hose of this fdrin s to° r6vide infort iattot teittch can all the town of" ossible conflicts of interest and allow ttto tnkc whatever acuotLts IteCCSSS1rY t0�V(liCl Battle. YOUR NAME: -11i OM A 1; Avn/r c (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.1f so,indicate the other person's or company's name.) NAME_ OF APPLICATION: (Check all that apply.) Building X Tax grievance X_ Trustee Y Variance 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,shouse,sibling,parent,or child)lt;tvu a retilionshij7 with"IV oliiccr or employee of the-Town of Southold? "Rehdionship"includes by blood,al•Triage,or business interest°'Business int4re,Vt means a business, including a partnership,in which the town oflicer or cmplUyee h:ts even partial o�vncrship of(or e►nployn7cnt hy)xt cot7)aration in which the town officer or employ ee owns 11,61-a 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 ar position of that person ----------� IDescribe the.relationship between yourself(the applicant/ttgent/representative)and the town officer or employee.Either check the appropriate line A)thf-oul h 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)ilio owner of greater than 5°,of the shares of the corporate stock of the applicant (when the applicant is a corporation); l3)the legal or beneficial owner of any interest in a non-corporate entity(whenDENNIS W COLE applicant is not a corporation); _.______yC)an ofrccr,director,partner.,or dm of lite applicant;or NOTARY PUBLIC,STATE OF NEW YORK D)the actual applicant. Registration No. 01006317241 Qualified in Suffolk County Co ion Expires December 29,20 R DESCRIPT ION OF RELATIONSHIP Submitted this I. day of 201_1 Signature Print Name wet! )corm TS l r AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the hart of town officers and emolovees.The purpose of this form is to tirovide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME : RUMMEL, KATE (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance X Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest" means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee. Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(cheek all that apply) A)the owner of greater that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSMP Submitted this of SEPT ,20 21 Signature Print Name KATE RUMMEL SURVEY Off" PROPERTY LOTS 31 - MAP OF HARBOR VIEW AT MATTITUCK �- FILED:AUGUST21 , 1987-MAP#:8377 SITUATE `0. 0 MATTITUCK '0 o ��, TOWN OF SOUTHOLD 0 k SUFFOLK COUNTY, N.Y. -TAX MAP NO.: 1000-1 16.00-07.00-002.000 c Y f( LOT AREA: 50,257.88 S.F. (1.1 53 ACRES) (v Y �� UPLAND AREA:27,450.47 S.F. (0.360 ACRE) co DATE SURVEYED:JULY 14, 2020. PROPOSED POOL: MAR. 24, 2021 R LOT 32 REVISED:JUNE 23, 2021 �� a u ^ S87°07'50" W1 PROPOSLD POOL EQUIP.&DRY :I.L -ELEVATIONS REFER TO NAVD88 '� °�JW m °NONE FEN, FLAG. IV �' 4l WAL 0.1' ;d�W ON�NE 0.3'S 3'CHAIN LINK FENCE 1�2 10 FEN. 0,36 q'`f• 2 'N j .31,7.31 EXISTING UPLAND LOT COVERAGE: �0 o MON, ND. RESIDENCE:2,205 S.F. OR 8.0% n r ASP \ (p I j i j WITH HLOD KCU AY J� F'R4�F bJt L1 r�OL FENCE Re I } j j 1 Prc� 40G, f I N + PROPOSED 0 J l 9x29 P06L �j 1 j,l 1•L� 0) O _) LL( �' U 0.Jrf A. ii '-.CELLA,,' ` I 1 ° d O z/ ENTRAN t >. ,� .__ TIDAL WETLAND BOUNDARYAS , ( •R. \/ - i�ROPOSE'O STEP'ifvG1STONE� •�""y. DELINEATED BY COLE I Y �n RAGE / t ENVIRONMENTAL,MAY 13,2020 0�!(�� f,, v Q 0 q ��P / N L=18 p2 m Y /� RRGnG1.;,CDrD (W)i ADDTIO<;J j j SHORE LINE OF CREEK----. V� 3+ ?? U u N (Q ( u j f Q Q I 12.7 �" U V /y Co i 1.Ox8.2_ n m D / I 01- W WINX O 0 Z w U)� p OO "� /` i FLAG- ff I `r Q. Z'O 0 Ur D• 3.5 �� 11 3.5 3 / gyp {, / LOT 3 !Ll Nz ' n N lL w 4 Q /' / 1 r` z + ROOFOy 3,5 ■� Q ^� 4 ENTRY ER m 1° N SOF me IV` CO Q m N V ' J F,AG f MARSH AREA ' 1. �✓• 1 1.Ox i 0.9 35.7 ,, y Z \ 'a ® Oli BOX WIND.ft ( (� I - �t �' 1 0 iw s _ ..� 0 l 2 c..., FL<r, AG-, f Q �0OvX eC�Jb, \--.._ \ u v '} `. i d 'a �_ \\\ I 0.3'Nj ®�0990 ff MON. D. / II MON.FN D. l !I I ADJACENTASPHALT 16 1A 12 ' 3 ~ 361 .67 BLOCK CURB DRIVE YWI TH LINE IO fl 6 14 2 ' PIPE ^U SET N870075011W ANGELO JOSEPH CECERE LOT 30 PROFESSIONAL LAND SURVEYOR 1 n IT, LEr,AL NUMS; N'> 1.COPYhi^HT 2014 A.G LAND L:JRV':YING FILL'ALL.F"!GN'`ftF'iEf<:'iD. ry' 2 UNAM+!CCr,17.EDAI:CCPA7101JCRAOCJ�IONTO'THIS,'UFV[.Y'tJrhPFtiARINGALICFN'E:E.DLA`C)SU.P':C'ICf,�"-'':AI.I:g AllOI.F,TIONC>SEC(I�N'7709. N1 f (•„* _UBD'VIGIO rZ.O _.V ORX•u`,ATE_G:10 a'7U.V LAVJ. •j I N j�/��tM N(��1^�� 30NLY GOteNDA'tY3Ufi'EV NJ.?S WtTH'?ic'.3Ui\•FiOT:;[nf5C:':OCOliEP,L ghE.GENU:NECf!�E AID CCRNiitTCOFc50FlN_SUKrEYOTt.^i ORIr,.,1;iAL'.V^.PI; 1 - A--* �' 11�1�8.1� ��� 7 iy �,'7. ; P LC A.NU G)"'-N �N G rER7FICATIONSCNTHISN.OUND.4RYSU.IVLY`.1AFSil.Nzr/T}.A7'tiLIAl-A'AS?REPANCD!4AC:COhCP.,14CEWfCFTF1EC'URF:-' Ei04'NGCGDEC"PRA,:MT S - �.. FGR L�•hD;iURb'EY0,17OF*;'ED BYTHE NEJYORISSTAT'EA5.00LgT:CN Or F'P,OFE3SIONAL LAND EUkVEYOfu,i'rC.THFrEFTiPic RON i5 LWITE°TC PER:/NZ I JA .-•_ �•� � FOR Vh IOh1THE 501J�+7.ARY5UK�EY�WP L'PREP:.FiF C.?O'IH(i'IT.'LC':v'\:P:NY,T"O THE GOV=RNA1Eh?ALAtiCFlt"`Y,.tup TOTHc LENJNGIti5T17UTI�JN LI.r.TEJGN J i; }p�� {pyy s�,�.� j(�� f��* qq,,� THiS BCVNOAfY(:;:JHVEV 4vli'. I ® ,�Ul 1VEY NM'Mj--PLA,1 PLANNING 5:'1E CGK?li'1•.✓.^G>iS HEREIN/u^E NO i TFANS F'cRAEL'c' j •, _ --✓ - .,J- Y s" THE LOCATION OF UNDERGROUND'^d-RCJ04ENTS OR ENCROA,CH.n;ENTS ARE NOT ALWAYS KNOWN AND CiTEN MUS BE ESTIMATED- NIUNDFNGROUN - :!.1AF:0\'ERSENI'n.:.F ENCRO:.GHI.+.'cNTS EY.I.9T UR A:tE EHO'J;N.THE Ikr ygVEhfENI'S CR ENCROACHM:;NTS ARE WOT COVEC'.EO TsY TN:>SUCtV�Y 77 S. COLEMAN ROA® CENTEREACI-I` NY�'`I:.i 7���� 4 T T'HE CFF.C'S tOH DttAENSICNS;SHO'JJN H.REON FRO4ITHE`..'.'F<_Y^JRES TO THE RROFER'1Y L!NCS AJ-1E FOR A:,FEC!FIC PJB OSE AND L;�E A ND"liEREFORC L V - 1- . �I - 7. - - AP.E\OT 1NMNDE13TO!�U7DE TIDE EF:ECi'ION OF FENCES.RE''AINiNG'A'ALL,POOLS,PFT)OSF'I.ANIINi3 AieCA'S,AMATIONS TO BUILCINGS,AND ANY nT1ENTIYE O L�.p 80 - _-P�y L� QqM�J I� t.,.t � OF CONSTRU:TION. HO,NE:,63 .846�s✓++/,Jf, 't�. E.ONLYSUFNE( BEA.%1NG7HE>.KERSE1.MCISEECSEAL SHOW CBEREUEDUF"7SWrE„TNCFT'F!ANEPA306.::[DSEAL COPIES h1AYCONTAIN Feet " j�.-,r' UNALI-lIORMaDAND UW:Er'_'CTASLE N.1001MCATIONS.OCLETIONS.ACCITiON<.AND CHANGES. F +� 3.PROPERPYCORNER,.IONUNIENFWERTNOT SET AC,PAR T OF THS ELIRVEY UNLESS OT'1ERPnSENO TE7 rel, C.. =: EMAIL: AJCs246(95OPTONLINE.NET ..ALL EAs:F:FnzvrsllEFCRTo .Eu , (Four. SCALE: 1 INCH = 40 FEET AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval,use variance, area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: COLE ENVIRONMENTAL SERVICES ON BEHALF OF THOMAS ANNICQ 2. Address of Applicant: 425 MONTAUK HIGHWAY, EAST QUOGUE, NY 11942 3. Name of Land Owner(if other than Applicant): THOMAS ANNICQ 4. Address of Land Owner: 305 HALLS CREEK DRIVE, MATTITUCK, NY 11952 5. Description of Proposed Project:9'x29' IN-GROUND POOL WITH SURROUNDING PATIO 6. Location of Property: (road and Tax map number)305 HALLS CREEK[)RIVE, MATTITUCK,-NY 11952 SCTM NO.: 1000-11600-0700-002000 7. Is the parcel within 500 feet of a farm operation? { } Yes ¢C} No 8. Is this parcel actively farmed? { } Yes {X} No 9. Name and addresses of any owner(s) of land within the agricultural district containing active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff, it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937)or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS 1. 2. 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) 447�k 10 04 21 Signature of Applicant Date Note: 1. The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2. Comments returned to the local Board will be taken into consideration as part as the overall review of this application. 3. Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. .rya TOUVW®F SOUTH®LD PROPERTY RECO 3 I as �aoil, MI. , STREETr VILLAGE` DIST. 'SUB. LOT w, aL.r -�-�: y• „ '��6 q ,.m �."��`I"" „ ��''.����, ir�,..,� (��F,:.�.�.,�a qq , �, I�' �;;�"Ay 1 � ,-, ([ (f''` r �, q 6� �..�:.�:... t p d� FORMER,OWNER N E CR.1010 d $ W TYPE OF BUILDING �i•,.Lt!,,,� '.t �„i+<k.,1��: iIl f � "', 'u—) Len�r� i RES: SEAS. VL. +-:,. a FARM COMM. LAND vq IMP. TOTALDATE REMARKS 1:"i �,'_.� i� e�^}f #s e�� a e�J Cm" dl�` fl� t�3°� !"!'IPi(A 7t.7 Leo-!�il, o ! r; +. ::)t Cay k f 1 c l' 6} 1� "L 1469 i " ��7�1. i 1"P P l3 �a� ��3 - �� ,• i . ! r ; + }'J`'! 5 t.✓� _ ��::...,-'�—` -'`.�' 7' 't t _.� /"t * /& / 4� �1V,P ,+C��1J7t"'1 i o 4..C../+"��"� tn„'tr s i.=-' t'/"�"=Y u°I'3 , ."P 4 b f�*,,;(�'. 1 3 el,,�;• . u^^� `ic2c>c� .. ✓ �' � / Jf J( `�'' F3 qc� — --- loo I O on /1 /.' FRONTAGE ON WATER; TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL IFF V3 M M Bonding Wire connected to all hardware MAIN WASTE FILTER HAIR&LINT CATCHER P P DRAIN PUMP SKIMMER MIN LT R SAPAF T WATER LINE 2"REFURN TO INLET LIGHT MAIN DRAIN 29' PIPING SCHEMATIC 2"PIPE ^ *^� IrcnnwGj �r .3coN"Nuous REHAR MAI N MESATWOC `�• 6W MLE BnZD- DRAIN R BOND BFN° - YERVAETE ��,..-n rf�i 2'COPING ,;;. A WAR I �if.,.l ?rn <�. I 7 mnx � —II•I1' � •. MAME Du» v�> ' . .I,• II,I,� .: LIGHT I II Ili;ii!I a I'll" 11 ii— 2�-1" TO :IiI I ie ro 3G' 5'-0" Ill Ij I;i °r- (Typ) RADIUS Complies With: *1H3 Z0 IIIIII III! . , ' ° Section R326 of the 2020 Residential TD24PADWS-S EOWEND _ I`IIII II'�I g-.RADIUS-DEPENDtv"JEs,1� - .:` Illl lt�_I�Il l+` � NEW Code of New York BsaD,� LIGHT FlUN'DrXTURE TOBOX� 4, �,� CDNCREZE -° �a .!!I1 �iil IIiI'I= UGW NICH Residential Section N1103-12 (R403.12) Re �'� ry �•_ ��1� �� r✓ � 6'fhVW - P..^ 11'.�i'li I IIIII� ill II Pools and Permanent Residential Spas IIhIIIII`'•IIIIII�I Ii iil ' lk �� - - P LIGHT PIT DETAILS r— i'+;� u� Section R326.4 Barriers LIGHT NICHE DETAILS (NTS) G Z ;_�_4• Section R326.5—R326.6.5 Entrapment Avoidance North Fork Pool Care Annicq #4 STEEL REINFORCED JMain Rd. 305 Halls Creek DEPTH <5'-0" >5'-0" Mattituck, NY 11952 Mattituck, NY HORIZONTAL 10" O.C. .10"O.C. VERTICAL 10" O.C.: 15" O.Q. POOLTYPE:9x29 Gunite SCALE: NTS .12" O.C. e.w. OR. 12" O.C: e.w. OR JAMES DEERKOSKI, P.E. FLOOR MESH.EQUIVALENT MESH EQUIVALENT 260 DEER DRIVE DATE: 12/8/2021 MATTITUK, NEW YORK 11952. DRAWING NUMBER _ . 1 OF 2 .rw,q>_ `;�: 'sS.sTPk�,�7^;! r+T' •l,'..,: r'J�:'-,--�-'- " Yom•-s+�--�f./r_'`°—�--� � � - � ,. - ��,'�-� "`:�''�,<•Y�'+. � �"'�--„ -e"�,.+'C`� i � }A ,.ytr.z t,'�� t`'� r'1..���.�'''.�tr r���r�s`~ � �b' - /Coo:' �,7%_t':t-' "U�!.; ��na,�: ;i'�µ.�h •`se•",•t,;�.C.y _ ;�SS'e.+tr t'�,�K-' + .y ..v. r'. ,'.�'��,..-%�'� o°°�. �!r.�..-._,�_•��-�''"�c�` ,,z�t,a �,x L �,tY /"%(^� � "H r�7..•.,t v••c�;8 3. `l' 1 1. , _ t'�;^"- "--'"";��Yy �+�•'"V;y'+,�-t.^.' ram-Ji`'2 „d ,a.;`-.:o'"`. a•._ctw�'w;*- �'�4=Gfk rti+.�:��%O- Ei � , � �w= a`y'f•�t�r"��7'.,'-,�� .�4� .S4�3�- w! ..7�,,.�� ,:;`'�,'.t•-'�'T� _�q�r:�.M`x '.n i'�i.*.'Xa7 fl r-s,:Fy;"Y �`�s(�r ,����w<_. 1 +:,r ys�F•w ,�'�.i t a�t��z;��i' c-�... .ire.� . -'' � ���"`'{.s'' 's1� _ + ��'V 4w ,r( '�+'� ='1.�h. - + •,r' COLOR ^fir 1.�`t.''"�s..':. t:i'�'L �. �7 _ ,�-�,n'� S-•"p �,��t t 'ss 'm ,. ., SO qS��}i{4y��}Ha�o-e d � ,� ® .j'�Y,._a'y�`;, k: e � ,J.+ •S � I � r TRIM . �4fij;"�'t-"r`.+r�a?„�,?;'^a\rid�'Y�'av{rdY�!,e�:.;,.�,.-r.•-.,«'a;;a,.•-55�;,;, .{...°7Ft,�"+.�.., .�. ly �1 { , =mss <�"�`d'i ��+':i..e,.'`n. .t�abyp•. ,+" �•s.�:., iti;,t.-:= I a/—•.- f _A 44S M. Bldg. 0 i / f Foundation B FC. : Bath , Dinette . -3 -Q FULLYy BasemenCRAW L Floors Kit.f0 SLAB � f ! �✓'d',•�LWc�/� Extension t' - �., • �. 1` ' Ext. Walls �nterior-Finish L.R. Extension // X 3 = Fire Place Heat D.R. l ,, atio 7 — Woodstove BR. Porch p Dormer Fin. B. Deck S-2,,6C5�z '5 -'-�� ��� . Zf /2, Attic f - � Rooms 1st Floor �� f Garage tD yr.5":� A z,:�— �. Driveway Rooms 2nd Floor — 1 Pool ,-' a1 .p9 7 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 snaking 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", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 SCTMN 116 _ 7 _ 3.2 The Application has been submitted to(check appropriate response): Town Board 0 Planning Dept. 0 Building Dept. 0 Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital 0 construction,planning activity, agency regulation,land transaction) (b) Financial assistance(e.g. grant, loan, subsidy) (c) Permit, approval,license,certification: Nature and extent of action: PROJECT PROPOSED POOL AND PATIO PARTIALLY IN THE SIDE YARD Location of action: 305 HALLS CREEK DRIVE, MATTITUCK, NY 11952 Site acreage: 1.15 ACRES Present land use: RESIDENTIAL Present zoning classification: PC 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: COLE ENVIRONMENTAL SERVICES ON BEHALF OF THOMAS ANNICQ (b) Mailing address: 425 MONTAUK HIGHWAY, EAST QUOGUE, NY 11942 (c) Telephone number: Area Code( ) 631.369.9445 (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes 0 No❑ If yes,which state or federal agency? NYSDEC A LETTER OF NO-JURISDICTION WAS ISSUED BY THE NYSDEC FOR THE UPLAND. 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. X]Yes [:] No [:] Not Applicable THE PROPOSED POOL AND PATIO LOCATION MINIMIZES ANY ADVERSE EFFECTS BY MAXIMIZING THE SPACE BETWEEN THE STRUCTURE AND THE WETLAND AREA. ADDITIONALLY,THE PROPOSED LOCATION OF THE POOL AND PATIO MAKE THE STRUCTURE LESS VISIBLE FROM NEW SUFFOLK AVE. THIS PROTECTS AND MAINTAINS THE PRISTINE VIEW OF THE WATERWAY. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVV" Section III—Policies Pages 3 through 6 for evaluation criteria 11 Yes 11 No El Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ® Yes Q No Q Not Applicable THE PROPOSED LOCATION FOR THE POOL AND PATIO MAKE THE POOL LESS VISIBLE FROM NEW SUFFOLK AVE. THIS PROTECTS THE PRISTINE VIEW OF THE CREEK FOR PASSERSBY ON NEW SUFFOLK AVE. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria 0 Yes 0 No ® 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 0 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. 0 Yes [] No 0 Not Applicable THE PROPOSED LOCATION OF THE POOL AND PATIO MAXIMIZE THE AREA BETWEEN THE STRUCTURE AND THE WETLANDS, WHICH HELPS TO MINMIZE ANY ADVERSE EFFECTS, AND,THEREFORE, HELP PROTECT THE QUALITY OF THE ECOSYSTEM. ADDITIONALLY,THE PROPOSED LOCATION IS SIGNIFICANTLY LESS SLOPED THAN THE REAR YARD, WHICH WOULD HELP TO REDUCE RUNOFF. 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 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 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. ❑ YesO No® Not Applicable 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. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 11, Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. © Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 12, Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. [] Yes ❑ No® Not Applicable Attach additional sheets if necessary Policy 13.. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. 0 Yes ❑ No ® Not Applicable Created on 512510511:20 AM 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing 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: HALLS CREEK POOL Project Location(describe,and attach a location map): 305 HALLS CREEK DRIVE, MATTITUCK, NY 11952 Brief Description of Proposed Action: PROPOSED 9'X 29' POOL WITH SURROUNDING PATIO Name of Applicant or Sponsor: Telephone: 631.369.9445 COLE ENVIRONMENTAL SERVICES ON BEHALF OF THOMAS ANNICQ E-Mail: KATE C LEENVIRONMENTA ERVICE OM Address: 425 MONTAUK HIGHWAY City/PO: State: Zip Code: EAST QUOGUE NY 11942 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 X 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: TOWN OF SOUTHOLD BUILDING DEPT,TOWN OF SOUTHOLD TRUSTEES X 3.a.Total acreage of the site of the proposed action? 1.15 acres b.Total acreage to be physically disturbed? .01 acres C.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.15 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑ Commercial EXResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic IX Other(specify): WETLANDS p Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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: PECONIC BAY AND ENVIRONS. DESIGNATED BY SUFFOLK COUNTY TO PROTECT X PUBLIC HEALTH,WATER,VEGETATION,AND SCENIC BEAUTY 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Doe's 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: X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: X 11.Will the proposed action connect to existing wastewater utilities? NO I YES If No,describe method for providing wastewater treatment: X 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b.Is the proposed action located in an archeological sensitive area? X 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X 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: M Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional M Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 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? KI NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO M YES PROPPSED DRYWELL FOR POOL 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: X 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: X 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: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE KATE RUMME,AGENT,COLE ENVIRONMENTAL SERVICES 09.30.21 Applicant/sponsor� Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the 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? 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 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above, and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. 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