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HomeMy WebLinkAboutTR-10290A Glenn Goldsmith, President ® X\)T so(j� Town Hall Annex A. Nicholas Krupski,Vice President ® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Jr Southold, New York 11971 Liz Gillooly G ® � Telephone(631) 765-1892 Elizabeth Peeples �® v Fax(631) 765-6641 AA 60 NTI, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1999C Date: January 18, 2023 THIS CERTIFIES that the existing 15'11"x7'6" deck with 3' wide stairs and 3'11"x9'4"front porch with 5' wide stairs; At 270 Park Avenue Extension, Mattituck; Suffolk County Tax Map#1000-123-8-27 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January- 3,2023 pursuant to which Trustees Administrative Permit# 10290A Dated January 18,2023, 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 existing 15'11"x7'6" deck with 3' wide stairs and 3'11"x9'4"front porch with 5' wide stairs. The certificate is issued to Michael Giacone owner of the aforesaid property. Authorized Signature r ZEN DESIGN 1250 EVERGREEN DRIVE P • CUTCHOGUE,NY 11935 * . �} •r PHONE:631513.6589 x w ' c i 1 These plans m copyrighted!ane wo are subject to copyright .. • protection am t ectural W neer Sec.704 of the Copnignt AW ns a 17 U.S.O.as emonded December 1990 and k— • NcIch,in .d Nb. hot11Copyright Protection the as 11t o-a The prehec.,r.Includes but la oat limited of the es an rano as wall as the err�ngemant and oompasltbn of apeUs and abments of •. . design Under such protection,una,thcalzee u of these plans, ♦ eras work or home represented,can legally result In the cessation or s ', y (__• , { con stmOlon or aWillnip being sebed and/or monetary m . . Z wY♦ ' copensatlon to ZEN DESIGN LLC a ♦ # NO. ISSUE DATE �' t' r j 01 TRUSTEES APPLICATION 04.14.22 l s 02 DEC APPLICATION 05.29.22 03 TRUSTEES APPLICATION#2 12.04.22 • k e a • g FtED AR? -4 E.NIC Ily 46 tier N O • �♦ � �� r s4 04442' • i TF O F N,r- y Pat • GIACONE RESIDENCE 270 PARK AVE EXT ` • MATTITUCK,NY 11952 • i SCTM#1000-123$27 ` PROJECTr SCALE: ♦ '��h DATE: 12.04.22 i DRAWN BY: Z.E.N. t• _ s ` AREA MAP AM-1 PHOTO LOCATION KEY r DEEP HOLE (GARDINER'S CREEK) ZEN DESIGN 1250 EVERGREEN DRIVE CUTCHOGUE,NY 11935 PHONE:631513.6589 RIGHT OF WAY These plans em copyrighted and are subled to copyright protedlon as an'are hitedural work'antler Sec.102 d the Copyright Act,17 U.S.O.as amended December 1990 and known as Architectural World Copyright Pratxtion Act of 1990.The protection Includes but Is not limited to the overall form as wall as the arrengement antl oompesitlon d spades and enrtrenn d design.Under such prolmdon,unauthorized use d these plan, .wee o.•„@ work or home represented,ten legally result In the ceasation of construdlon or buildings being sell ad and/or monetary compensation to ZEN DESIGN LLC. s. NO. ISSUE DATE 01 TRUSTEES APPLICATION 04.14.22 02 DEC APPLICATION 05.29.22 03 TRUSTEES APPLICATION#2 12.04.22 GREAT PECONIC BAY 41ERE A R cy i E N/ V q ' i M i NG r - i �N 1 t w X444 #' I�Fr�7t tff f O F N E � � ytt r.: �.. � ✓ 'j 'f „ . i1 I t19� him t 1 , `T a '. � '_—^—�.• ,yam GIACONE RESIDENCE 270 PARK AVE EXT MATTITUCK,NY 11952 SCTM#1000-123-8-27 SCALE: PANORAMA 1�%HOTO 1 - FACING EAST FROM PARK AVE EX7. DATE: 12.04.22 1 PHOTO TAKEN MAY 2,2022 DRAWN BY: Z.E.N. SITE PHOTOS 1 P-1 PHOTO LOCATION KEY JDEEP HOLE (GARDINEWS CREEK) ZEN DESIGN 1250 EVERGREEN DRIVE CUTCHOGUE,NY 11935 PHONE:63L513.6589 RIGHT O1 WAY These plans are copyrlghletland aresub(act Mcopyrign[ Protection as an'am= work'under Sec.]02&the Copyright Act,17 u"O.es amended December 1990 and l—,n as Architectural Worire Copydgirt Protection Act of 1990.The pmteetlan Ind udes but Is not limited to the omrall form as well as the arrangement and composition of spaces and elements of design.UrMer such protection,unauthorized use of Mese plain, .ware.ma work or home mpr®entad,can legally result in the cessation of construction or buildings being seized and/or monetary compensation to ZEN DESIGN LLC. NO. ISSUE DATE 01 TRUSTEES APPLICATION 04.14.22 - 02 DEC APPLICATION 05.29.22 03 TRUSTEES APPLICATION#2 12.04.22 GREATPECONICBAY All ED ARC �` n r� 04442' P� 4TF y0 f" OF N E`!'! .. �� GIACONE RESIDENCE 270 PARK AVE EXT MATTITUCK,NY 11952 SCTM#1000-123-&27 SCALE: PANORAMA PHOTO 2 - FACING WEST FROM REAR OF HOUSE DATE: 12.04.22 2 PHOTO TAKEN MARCH 26,2022 DRAWN BY: SITE PHOTO 2 P-2 ZEN DESIGN 1250 EVERGREEN DRIVE CUTCHOGUE, NY 11935 PHONE: 631.513.6589 3 A-1 NOTES: .---------------------------------------------------------------------------- • ALL FRAMING IS PRESSURE TREATED. • METAL JOIST HANGERS OR STRAPPING , AT EACH JOIST CONNECTION. These plans are copyrighted and are subject to copyright ' protection as an"architectural work"under Sec.102 of the i -- -- STRINGERS i - Copyright Act,17 U.S.O.as amended December 1990 and known -- -- 2X6 SUPPORT JOISTS WITH 00 as Architectural Works Copyright Protection Act of 1990.The 2X6 RIM JOIST ABOVE EXISTING DECK STEPS protection Includes but Is not limited to the overall form as well i as the arrangement and composition of spaces and elements of --2x6 RIM JOIST ' design.Under such protection,unauthorized use of these plans, iILIi work or home represented,can legally result In the cessation of 4x4 WOAD POSTS construction or buildings being seized and/or monetary ' compensation to ZEN DESIGN LLC. 2x6 SUPPORT JOISTS i REAR DECK i - .---BLOCK BRIDGING BETWEEN JOISTS NO. ISSUE DATE 2x6 WOOD JOISTS 16"O.C. ------------- - - LINE OF EXISTING DECK 7'-6"x 15'-11" 01 TRUSTEES APPLICATION 04.14.22 2x6 LEDGER 02 DEC APPLICATION 05.29.22 � r --HOUSE ABOVE ON 6x6 WOOD POSTSAW, T71 03 TRUSTEES APPLICATION #2 12 04.22 '- ----------------------------------- - • G,,1D1EC FR ING PLAN CALE:V,-1'•0" Ga\7 ", — EXISTING SINGLE STORY FRAME RESIDENCE-UNCHANGED (�FtED ARC E.NIC, ATF N Z 4x4 PRESSURE TREATED sq��oF4ry �o�� POST ON 4x4 WET ANCHOR 2 BASE.ON 8"DIA SONOTUBE q-1 PIER WITH(3)#4 VERTICAL -- ,. BARS ON 24248 FOOTING i — WITH(2)#4 BARS IN EACH 2x8 P.T. LEDGER ' DIRECTION-MIN 36" BELOW LINE OF AS BUILT FRONT PORCH I 5 d i GRADE. 4'-O"x 4'-0" ;-i FRONT 4 COMPOSITE a v e _ i i I I M r_L__,DECKING N Q O r--i_ � i i PORCH i ; -=- L—� �T L----J ------ r=---=---=---= l i ------ --- _____ GIACONE RESIDENCE --- � P.T. STRINGERS 270 PARK AVE EXT � r ------------- -- MATTITUCK, NY 11952 12 DIA.SONOTUBE-36 MIN r BELOW GRADE.— ------ SCTM# 1000-123-8-27 4'-41/2" 4f-4f' 5'-0„ 4'-4„ 3'-71/2" SCALE: 1/4" = 1'-0" PORCH FRAMING PLA 1 AS BUILT PORCH & EXISTING DECK PLAN DATE: 12.04.22 SCALE:3J4" 1'-0" SCALE:1/4"-1'-0" DRAWN BY: Z.E.N. AP; R VL- Y DECK AND PORCH BOARD OF 1 RUSTEES PLANS TOWN OF SOUTHOLD DATE �-_ . �PDi I JAN 3 --- Board of Trjsfices AN V NZ!I= FRONT PORCH REPLACING _ -:__µ. -_ � EXITING-BU UNDER -` BUILTBUILDING �_.S t. C€rtr _._.. 4 E .l i....:_.€_2.1... _ . . PERMIT#44748 _ x #„- _ __ _ ._ ___._ ._ �.__. _._ __..._ ZEN DESIGN E I E j i E 1 £ �E E E 1 � x � '```� '.,. .;...;.-.::� ::r:'; ;',.'.:..;:: .'_ '.w:c......xw:;.,�ia✓'..r..:�'�_..r:a.:�::.'."c,i'.':� '.:. '. =m...cf:c..Z;-:.:'_:.w._:-:...�-i�.'c::.:.=i:=:T"a�.::...':":.:=i.:`w'^.-:,c:. l .~ .._~ _::::;:-::.m.x.:: s.c:v..:•;._n...r._.�:.:._..z.:..._r:_:.:..:;::'^a:•�.:.:;....•:acc-��:_„_._„�c.•.._.•'_c:.�t•__.'.�:._r�..��_r�?�r.;.:.:cr__-=�=.=.=^_�=i: Glenn Goldsmith,President ®��®g S®U��® Town Hall Annex A. Nicholas Krupski,Vice President �® P.O. Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly G � Telephone(631) 765-1892 Elizabeth Peeples ® y® Fax(631) 765-6641 C®UfdTV,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10290A Date of Receipt of Application: January 3, 2023 Applicant: Michael Giacone SCTM#: 1000-123-8-27 Project Location: 270 Park Avenue Extension, Mattituck Date of Resolution/Issuance: January 18, 2023 Date of Expiration: January 18, 2025 Reviewed by: Glenn Goldsmith, President Project Description: For the as-built 15'11"x7'6" deck with 3' wide stairs and 3'11"x9'4" front porch with 5' wide stairs. 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 Zackery E. Nicholson, RA, dated December 4, 2022, and stamped approved on January 18, 2023. 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. Glenn Goldsmith, President Board of Trustees Glenn Goldsmith,President �� eaGya - .Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 0 Eric Sepenoski ? P.O.Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Elizabeth Peeples d �a '' p ��� Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 1/11/23 Completed in field by: 49, (2,11stniA Zackery E. Nicholson, AIA on behalf of MICHAEL GIACONE requests an Administrative Permit for the as-built 15'11"x7'6" deck with T wide stairs and 3'11"x9'4" front porch with 5' wide stairs. Located: 270 Park Avenue Extension, Mattituck. SCTM#: 1000-123-8- 27 Typ of area to be impacted: nSaltwater Wetland Freshwater Wetland Sound ✓ Bay Part of Town Code proposed work falls under: ZChapt.275 Chapt. 111 other Typp 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.: SNcG;o,',� }oc'v10"cA 05 6u i 1+ Present Were: .� G. Goldsmith N. Krupski E. Sepenoski L. Gillooly E. Peeples 5 U RV EY Of LOT 3 N AS SHOWN ON A CERTAIN SUBDIVISION MAP ENTITLED"MAP OF MARRATOOKA POINT' FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY MARCH 19, 1972 AS MAP NO. 331 �A� VY 51TUATE : MATTITUCK DEEP HOLE TOWN : 50UTHOLD ��AR�iNER's) CPEEK 5 U F FOLK COUNTY, NY FLOAT SURVEYED 08-OG-2018 SUFFOLK COUNTY TAX # 1000 - 123 - 8 - 27 ,`q E C.-E_I V CERTIFIED T0: - ; _ 3 JAN 20? Michael J. Giacone Nicholas A. Giacone _-•-Fidelity National National Title Insurance Services, LLC —BOG— scunr ov Town Board of Trustees 7` BOG— S5503311 OG•-- S55°33' 1 711E ___5G. 151 _POST -__- fE�INE ALONG OBSERVED IIIGH WATE � 0 O RIT OF AVENUE A.K.A. sand roadway ±➢ C)Z (�S1 Z=SC>(J)q 0 � z a rn�0 rnZ=rn � _ rn O �rn O POLE ➢c.�r `�G?70 O FRA�F 0➢➢ ➢C10 070 N 5T0 35.7 OOH 0 ZI MEO FY rnrn O rt�rn��� P pN PILFS �0 I.. '(1 U1 -` —� 0 \Y O 24.2' V c -n J PRPMe Ul 5�2�\ F N` 'Unauthorized alteration n addition 's a survey � FCO N I`/ `5' Y ® 4Ct�I map bearing o section land surveyor's 2,of iso lT /'�p nT P QFjI violation of section 'York sub-division2, of the � GREAT r 1 G.EL./ �°® New'York Sloie Education Law.' t� �7`�� "Only copies from the original of this survey marked with an original of the land surveyor's �d stomped seal shall be considered to be valid true f� copies' � y 'Certifications Indicated hereon signify that this survey was prepared in accordance with the ex- isting Code of Practice for Land Surveys adopted by the New York Slate Association of Professional ' ..l Land Surveyors. Said certifications shall run only „•�C�jL S02 2 la the person for whom the survey Is prepared. �} S� and on his behalf to the title company,governmen- :?yO LANG fol agency and lending institution listed hereon•and yam., to the assignees of the lending Institution. Cerlifica- •"'-"t•!�.':'Xt~'G tions ore not transferable to additional institutions NOTES: e MONUMENT FOUND JOHN OHN C o E M LE R5 LAND 5 U RVEYO R G. EAST MAIN STREET" N.Y.S. LIC. NO. 50202 Area = 11 ,20G Scl. Ft. RIVERHEAD, N.Y. 1 1901 OFFICE: G3 1 -3G9-8288 Area = 0.2G Acres GRAPHIC SCALE 1"= 30' resurvey@optonllne.net 1 S-135 OFFICE LOCATION: A AILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 ®��' ��� Southold,NY 11971 (cor.Main Rd.&Youngs Ave.) r Southold,NY Telephone:631765-1938 www.southoldtownny.gov 5 .� PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICD LWRP Coordinator Date: Januay 17,2023 ' Re: LWRP Coastal Consistency Review for of MICHAEL GIACONE SCTM# 1000-123-8-27 Zackery E. Nicholson, AIA on behalf of MICHAEL GIACONE requests an Administrative Permit for the as-built 15'11"x7'6" deck with 3' wide stairs and 3'1.1"x9'4,".front porch with 5' wide stairs. Located: 270 Park Avenue Extension, Mattituck. T4 M4; 1000-123 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with LWRP Policy 6.3 and therefore, INCONSISTENT with the LWRP. . 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. .1. The as-built structures were constructed without Board of Trustee review or permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Glenn Goldsmith,President ®�Sa�f�" Town Hall Annex �1� A. Nicholas Krupski,Vice President e,� l® . 54375 Route 25P.O. Box 1179 Eric Sepenoski Jt Southold, New York 11971 Liz GilloG Q.. Telephone(631) 765-1892 Elizabeth Peeples ��- Fax(631) 765-6641 Ot BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application 1;s_ Wetland Permit Application 3.,��; ___...._- ! Administrative Permit � ~ �LAmendment/Transfer/Extension Z JAN 3 2023 tEmpleted Rceived Application:ceived Feer:$ �,0V 44 Application:. Boardof7^,sloes Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: - �oordination:(date sent): LWRP Consistency Assessment Form Sent: AC Referral Sent: _ Date of Inspection: Receipt of CAC Report: '�TTechnical Review: ✓ Public Hearing Held: •� ' Resolution: Owner(s) Legal Name of Property (as shown on Deed): Michael Giacone Mailing Address: 25 Westphal Drive - Delmar, NY 12054 Phone Number: 518.265.5490 Suffolk County Tax Map Number: 1000 - 123 - 8 - 27 Property Location,. 270 Park Ave Ext - Mattituck, NY 11952 (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Zackery E. Nicholson - AIA Mailing Address: 1250 Evergreen Drive - Cutchogue, NY 11935 Phone Number;_ _631.513.6589 =____ _Email;_ ZENicholson.Arch@agmaii.com Board of Trustees Applic .on GENERAL.DATA Land Area(in square feet): 11,207 SF Area Zoning: _ R-40 Previous use of property:: Seasonal Dwelling _ Intended use of property:- Seasonal_Dwelling 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 Certificate of Compliance for Existing Deck Does the structure(s) on property have a valid Certificate of Occupancy? Yes X No Prior permits/approvals for site improvements: Agency Date Building Department 2-28-20 PB#44748 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): This application is for a Certificate of Compliance. The deck shown in plans is existing. We are seeking to acquire an as built permit for what was constructed in order to close out Building Permit#44748. See Description next page for Front Porch. x�srt�a� peuC is I�'~I x_ -& wl 3-C) WIDE Sees Project Description: Under Building Permit#44748. The existing front porch (4'-0"x 4'-0") was in a state of structural disrepair and for safety reasons was removed in the Summer of 2020. To provide access to the house a new front porch has been constructed (3'-11"x 9'-4") with a 5'wide staircase for access. The main porch &stairway were replaced in the same location. The new porch was expanded to the side to provide a safer entry into the home. The new porch and stair did not change the setback distance for the front yard. Board of Trustees Appli& '.on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Acquire Certificate of Occupancy for deck in order to close out Building Permit#44748. Approval of Front Porch replaced under Building Permit #44748. Area of wetlands on lot:. 3105 square feet Wetlands on North side of property across the road. Percent coverage of lot: 27.7 % Closest distance between nearest existing structure and upland edge of wetlands: 48' feet Closest distance between nearest proposed structure and upland edge of wetlands: 48' feet Does the project involve excavation or filling? X -No _ Yes If yes,how much material will be excavated? NA cubic yards How much material will be filled? NA cubic yards Depth of which material will be removed or deposited: NA feet Proposed slope throughout the area of operations: NA Manner in which,material will be removed or deposited: - NA 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 operation has no affect on the wetlands or tidal waters of the town. it ,M 617.20 Appendix B Short Environmental Assessment Form instructions for Cornoieting Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete 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: Project Location(describe,and attach a location map):- 270 Park Ave Ext - Mattituck, NY 11952 SCTN: 1000-123-8-27 Brief Description of Proposed Action: Certificate of Compliance for an as built deck. Approval for Front Porch replaced under Building Permit #44748. Name of Applicant or Sponsor:- Telephone: 631.513.6589 Zackery E. Nicholson - AIA E-Mail: ZENicholson.Arch@gmaii.com Address:_ 1250 Evergreen Drive City/PO: - State: Zip Code: Cutchogue New York 11935 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: Certificate of Compliance 3.a.Total acreage of the site of the proposed action? .257 acres b.Total acreage to be physically disturbed? .007 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? .257 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban [:]Rural(non-agriculture) [::]Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO _ YES . N/A a. A permitted use under the zoning regulations? ❑. "[;X�J' b.Consistent with the adopted comprehensive plan? ❑ L_^_I 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? M-1 FRI 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental A:iea?-- NO -YES If Yes,identify: S. a.Will the proposed action result in a substantial increase in traffic above present levels? - 'NO-- : YES ❑. b.Are public transportation service(s)available at or near the site of the proposed action? 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: - _ - N/A Q ❑ 10, Will the proposed action connect to ani existing public/private"water supply? NO YES If No,describe method for providing potable water:,._ _ _ _ _N/A .Fy' EJ I I.-Will the proposed action connect to existing wastewater utilities? NO- YES If No,describe method for.providing wastewater treatment: _ N/A a ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? -❑ I3.a.Does any portion of the site of the proposed action,or lands adjoining ttie proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? FYI 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: ❑X- 14. Identify the typical habitat types-that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline El Forest ❑Agricultural/grasslands ❑Early mid-successional [Xf 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? a 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: NO ❑YES 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: — L-"i El 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: - - _ o M- ,20. ,20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or- NO YES completed)for hazardous waste? If Yes,describe: _ _ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Zackery E. Nicholson - AIA Date:: - 12.04.22 Signature:= �= — Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of thefollowing 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 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? Q 3. Will the proposed action impair the character or quality of the existing community? (y El 4. Will the proposed action have an impact on the environmental characteristics that caused the ("j n establishment of a Critical Environmental Area(CEA)? - I 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? F1 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate 1771 reasonably available energy conservation or renewable energy-opportunities? ❑ 7. Will the proposed action impact existing: y j a.public/private water supplies? l-"I b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? MR El 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 FV7 problems? u 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-tern,long-term and cumulative impacts. Check this box if you have determined,-based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold--Board of Trustees -Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) -_ PRINT ___ __ 4 _ Page 4 of 4 Board of Trustees Application AFFIDAVIT Michael J. Giacone BEING DULY SWORN DEPOSES AND AFFIRMS THAT HEYSHE 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 TOVrN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature Property Owner Signature of Property Owner SWORN TO BEFORE ML THIS DAY OF . 20 clN o tax} ISlic 6aiifiedinRensselaer County Reg.No.OILY,5,07 55 commission Expire! (I Oq Board of Trustees Application AUTHORIZATION (inhere the applicant is not the owner) I/We, Michael J. Giacdne owners of the property identified'as SCTM# 1000- 123-8-27 in the town of iyldiiiiuGli New York.,hereby authorizes Zackery E. Nicholson'- AIA to act as my agent and handle all necessary u-brk involved with the application process for permit(s) from the Southold Town Board of Trustees for this pro arty. Property Owner's Signature �. Property Owner's Signature SWOR-1,4 'CO BEFORE ME THIS �� DAY OF .PJ��''e`�`�.__..._..__.^w 2UA _..._ otary Public heryl A.;Lyon .NotbryPublic,State b(New.York Qualified in Rensselaer O rity .•R�;.�:OtlXrSi� �3.• ,��pmritiselo0 Exp#es_, ti APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE]FORM The:fown oBouthold's Code of Ethics prohibits conflicts of interest on the part of town ofTicek and etntilovees.'ftie6ijrose.o.` ihis form is to provide'infnrnuriiotr.which`can alert the foivn of1?ossihle conflicts of interest acid_alioiv.it tri iake.iihati;vci actinn'is necessalyto avoid same: YOUR NAME: Giacone, Michael J. (Last name,first name,gtiddle 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 grievanceBuilding Variance Trustee X Change of Zone _ Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Othee',.name the activity.).,_ ---------- Do you 1,ersoitally for through your company,spouse,sibling,parepil,or child)have a relationship'With a'ny offici ero eriliiId-yee of the'l,ok%h of:SClitliold? "Relationship"includes by blood,ntlrriage;.or business interest."Busihess interest"intimi,,,id blisiiicss, including a partnership.in which the town off icer or employee hits e'en a partial owi orship of(or enlplowncnt,by).a C(trporarion in which the town offiear 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 ofperson 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 heckthe appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): ________A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or'beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); _C)an officer,director,partner,or employee of the applicant;or the actual applicant. DESCRIPTION OF RELATIONSHIP AA Submitted t s - f 2,0e' Signattiie Print Name Al Form TS I Board of Trustees Application AFFIDAVIT Nicholas A. Giacone BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH INTHIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TO'%N OF SOUT14OLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED, IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUsTFES 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. Signature of Property 4Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF 20Z3 -- Notary PAlic 0"A-Lon Notaty;Ptiblic;State ot.�tt:w York QuafifiedinRensselaer Coun't'y feioAl Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Nicholas A. Giacone owners of the property identified as SCTM# 1000 123-8-27 in the town of Mattituck New York, hereby authorizes Zackery E. Nicholson - AIA to act as my agent and handle all necessary work involved with the application process for pen-nit(s) from the Southold Town Board of Trustees for this property, V Property Owner's Signature Property Owner's Signature SWOF,N TO BEFORE ME THIS DAY OF _ W w 20 93 r �- otary Pu is Cheryl A.Lyon Notary.Public,Stale of Now York Qualified in Rensselaer County Reg:.No.0.t Ltg079955 Commission ftjres� ai 3 I � � APPLICANT/AGE NT/REPRESEN'TATIVE TRANSACTIONAL DISCLOSURE FORM The Town ref 5onthoid's Code 01711hics,prohibits conflicts"of.inferest.on the part aftowii ofTiceis iiid emiila4ees.`ffie.purjiosc of.. this form is_to provide informadow.whicti ruin alertlfie conflicts ofintceesl and nllti�v-if taiake:iatiatevGr actirrn.ia necessary to avoid Same. - YOURNAME: Giacone, Nicholas A. (Last name,first name,ipiddle.initial,unless you are applying)n 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.) Tau:grievance Building Variance Trustee X Change of Zoner_ Coastal Erosion Approval of plat Mooring _ Exemption from plat or official map Planning _T Other (If"Other",name the activity.)._ _ _._ ....,._.._... ))n you persanally(or through your company,spouse,sibling,parent,or child)have it relationship widi-any officer or einployce of the Town of Shu:hold? "Relationship"inclu6s by blood,marriage,to business interest."Business'intcrest"ir(cams'a liusirtuss. including a partnership,in which the town 6111cer or cmplayee has even a parted ownership ol"or en(t�loyntc,nt by),,(cprjwation, in which the.t6wrt offlc r or employee pwns:more than,51"'o of the shares. YES ; NO X If you answered"YES",complete the balance of this forth 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 tier spouse,sibling,parent,or child is(check all that apply): the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); 13}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 the actual applicant. DESCRIPTION Or RELATIONSHIP G Submitted this day of 1200_ Signature Print Name _ �(� Form TS 1 G 01 v Town of Southold LWRP CONSISTENCY ASSESSMENT FORINT A. INSTRUCTIONS L All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse,effects upon.the coastal.area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in-,detail, listing both supporting and non- supgorting 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# 1000 - 8 - 123 - 27 PROJECT NAME Giacone Residence The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees I 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: Q Nature and extent of action: Acquire a Certificate of Compliance an existing Rear yard deck that was constructed prior to work completed under builder permit#44748. CoC required inorder to aquire a CO for the house and close out Building Permit#44748. Under Building Permit#44748 The main porch &stairway were replaced in the same location.The new porch was expanded to the side to provide a safer entry into the home. The new porch and stair did not change the setback distance for the front yard. i Location of action,-.270 Park.Ave,,Ext Site acreage: •257 Present land use: Seasonal Residential Dwelling Present zoning classification:_ R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Zackery E. Nicholson - AIA (b) Mailing address:.__1 250 Evergreen_Drive--_Cutchogue, NY 11935 (c) Telephone number:Area Code( ) 631.513.6589 (d) Application number,if airy:- / Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes 0, No n If yes,which state or federal:aggncy? 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. a Yes a No n Not Applicable _Project-uses_material_that maintain'the existing community character and does not change any open .-space. The existing infrastructure is continued to be used resulting in an efficient-use. The existing use of the coastal location is unchanged and there is no additional development on the site. There for there is no adverse impact. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria Yes Q No 0 Not Applicable 1 This site is not in-a historic druistrict, nor is there any archaeological resources located on the site. Attach additional sheets if necessary Policy 3. . Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWR.P Section III—Policies Pages 6 through 7 for evaluation criteria X❑ Yes.❑ No ❑ Not Applicable This project maintains the visual quality of the neighborhood through the use of similar materials for the deck and.- maintaining the primary residential structure as it currently exists. 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 t--' Yes ❑ No ❑ Not Applicable This project improves the resilience-of the frontporch from potential flooding. The project does not impact the property conditions there for does not affect the:aspects.for erosion..The project does not involve any work within the wetland_ s or the tidal zone therefore preserving the natural resources of the site.---- Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable The project does not'affect the water quality of the Town of.Southold. Nor does it-affect the water supply. 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. —E] Q Not Applicable . Yes No NotAApplicable This project does not affect any coastal and wildlife habitats. The project does not have any affects on the existing wetlands of the site. 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❑X Not Applicable The project does not involve or impact the air quality of the site. 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. D Yes 0 No 0 Not Applicable The project does not involve solid or hazardous waste. 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. Yel:] No 0 Not Applicable The project does not involve any public access s to coastal waters, public lands and public resources. Attach additional sheets if necessary WORKING COAST POLfil-.'',S } 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 ❑X Not Applicable The project does not involve any water dependent uses. 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 M—Policies; Pages 57 through 62 for evaluation criteria. LX1 Yes ❑ No ❑ Not Applicable This project maintains the sustainable use of marine and town waters by minimizing the construction work. The deteriorating rear deck is being replaced in kind with minimal expansion. The front porch was replaced to provide safe access to the house. All this work will not affect existing marine resources. 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 0 Not Applicable This project does not affect agricultural lands. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑. No 0 Not Applicable This project does not affect energy or mineral resources. PREPARED BY Zackery E. Nicholson - AIA TITLE Agent DATE 12.04.22 R9vapnB 09-12W 0600 �'�'� ^� SEE SEG NO 115 SEE SEC ND 1tE SEE SEC NO 115 —z 0 xiat.mW _ m> Obt60 FOR PCL NO n 4 Ocq Off, I H rfsTcfo a 0-0J SEE SEC NO 21 r� of "g + — •� Fq a:1.4 2 +""`c g 16210) I 15-08-0W 2 rr411 Bt.26I � 5 0 OT A. S m�, o '\ 2 J E OR. o- ~ I 0 9 w O SI 12 p tT3P 2 , 11M. 4 y t w 29 - ♦ 8., 0 10 1A9(c I 1 0609 "I FOR PCL NO E n "s 2 w M1, d�rrn d2 BA(c7 \°' 10n(cl 1.eA(c) 11 1 SEE SEC NO t.t 0 c in E EB 28A(c) 22OS001 33. 0 °4 45 r 6016 M 22 O 20;lN°1 0 ^ SZ. t ORFFK ,59A 'o GENtER to 15,�e to r r 21r` z' e`��� zB C °n.z .p �� zt� r'1 ✓ o Q�// z3„ ri E022 _�„u'`— I) a � w 3 � t'1l ,•. ,�nwu � 5 m`.,Q• � a] bm .b 09 � 44 dP ` ~ 46 40 �. 1d0 1 •� �Y/ l�Ot3 fie .13 C 47P�� ' teNl 8 1 Z,a 4Ea 2.r ton° ¢ a1P11, �I n // S3 bO' tt.t g 22 t0 pµc3 ` ii ♦fi 01 T j2t P11 PO's ' S �' H x Lim i fid 202 til SS '1� _ _ E 40 0 ttfi5 yt3 425, stu, O,jO� 30 ttO 54 p n tT2r m �W tgµol ' a 45 t to 25 tz? �rr., V-0 52t1 n yt stc2 /Y��.. \E BpY Ja,a ,. M1°+ ay GGNIG GRET pE •ase,- ,// 5 6 (21) __°w__ NOTICE "ci^r°a COUNTY OF SUFFOLK © K 0s 30UTHOLO SECTION NO Property Tax Service Agency v ery E _ -- _— _— coumvc e.Nr got M r ucLo. 123 N c.rr it writha • r.. ,mer.. __r__ sr.o...w--,w-- /'� car A rN xrt na 1000 PROPERTY MAP