Loading...
HomeMy WebLinkAboutTR-10307A Glenn Goldsmith, President ®F so// Town Hall Annex A. Nicholas Krupski,Vice President ,`®� ®�® 54375 Route 25 Eric Se enoski P.O. Box 1179 p Southold, New York 11971 Liz Gillooly � Telephone(631) 765-1892 Elizabeth Peeples ® �® Fax(631) 765-6641 ®u BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE #2181 C Date: September 27, 2024 THIS CERTIFIES that the removal of existing deck and installation of a new 12.4' x 40.9' deck with railing and two sets of stairs; and the pruning of several trees, At 1400 West Creek Avenue, Cutchogue Suffolk County Tax Map#1000-110-1-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January 24, 2023 pursuant to which Trustees Administrative Permit#10307A Dated February 15, 2023,was issued,and Amended on September 18, 2024, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the removal of existing deck and installation of a new 12.4' x 40.9' deck with railing and two sets of stairs; and the pruning of several trees. The certificate is issued to Maryellen Dugan&David Wagner owners of the aforesaid property. 411:1- —4J" Authorized Signature Glenn Goldsmith, President ®F S®��� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples ® �® Fax(631) 765-6641 C®U0,�' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 24, 2024 Maryellen Dugan & David Wagner 950 Mill Road Bryn Mawr, PA 19010 RE: 1400 WEST CREEK AVENUE, CUTCHOGUE SCTM#: 1000-110-1-4 Dear Mr. Wagner & Ms. Dugan: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 18, 2024: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#10307A for a 12.4' x 40.9' deck; and as depicted on the site plan prepared by Joseph Fischetti, P.E., received on September 3, 2024, and stamped approved on September 18, 2024. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Glenn Goldsmith, President Board of Trustees September 3,2024 Southold Town Hall Annex Board of Trustees 54375 Main Road P.O. Box 1179 Southold,NY 11971 RE: Address: 1400 West Creek Ave S/B/L: 110.4-4 Owner:. David Wagner and Maryellen Dugan Permit No.: 10307A To Whom It May Concern: I am submitting this letter to request an Administrative Amendment with the Board of Trustees for the above-referenced permit. The referenced permit is for a new deck. The proposed deck dimensions were 12'4"by 37'10". As shown in the attached drawing,the as-built deck dimensions are 12'4"by 40'9': The deck is complete and has been inspected and approved by both the building department and the Trustees. I hope you find this letter satisfactory. If you have any questions or need additional information, please contact me at 215 356-3806. Sincerely, David Wagner VE CEIVE EP. 3 2024 SOa I MW Tom WWgThx*ft Glenn Goldsmith, President ``�� Sfl % Town Hall Annex ski, Vice President ��v 54375 Route 25 A. Nicholas Kru p � � P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone (631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 HOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed When project complete, call for compliance inspection; Glenn Goldsmith,President ®� sou Town Hall Annex A. Nicholas Krupski,Vice President � ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly es9 Telephone (631) 765-1892 Elizabeth Peeples ® y® Fax(631) 765-6641 &V Nil, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10307A Date of Receipt of Application: January 24, 2023 Applicant: Maryellen Dugan & David Wagner SCTM#: 1000-110-1-4 Project Location: 1400 West Creek Avenue, Cutchogue Date of Resolution/Issuance: February 15, 2023 Date of Expiration: February 15, 2025 Reviewed by: A. Nicholas Krupski, Trustee Project Description: Remove existing deck and install new 12'4"x37'10" deck with railing and two sets of stairs; and to prune several trees. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated August 20, 2021, and stamped approved on February 15, 2023; and site plan of Joseph Fischetti, P.E., dated January 10, 2023, and stamped approved on February 15, 2023. Special Conditions: To establish and perpetually maintain a 20' non-turf buffer along the landward edge of tidal wetlands; no trees on the western side of house to be pruned. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 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. � K� . A Nicholas Krupski, Vice-President Board of Trustees S.C.T.M. N0. DISTRICT: 1000 SECTION: 110 BLOCK: 1 LOT(S): 4 MONU.P. T�T DIRT OR/VF�gY SUNSET PATH % (33' PRIVATE RD.) oR\JEwP� ' ICOPPER PIPE OI9'S S 88051'20°E GRPJE� / 221.91' 2 I j _ / j PROPOSED J O j j OUTDOOR SHOWVR 0 >L I I BNFFENON/R/RF I m l 1 1 4'x5' y Z�NEI = {1 /'100' 1� 1eTBACK l GRAVEL I I I DRIVEWAY 1 WOOD o k l 83• I STOOP ��\ I C � � 1 1 11 Y 55. EXI tED E OF22.5 ILAWN I �l� 1 6 BW5.4 EG EL I m o SI NG 1 B .4 33 ,S.F. 1 , 60'111 6.2; i� / 1 > TIMBE IWAL I I 4.9' I Dr TLV 0 TW 7.3 1 1 I B1BW 7.2 1 ~ I I x > W 59 1 I 10.1 I w x Y. 1 I I I > CATWALK 4'1 FO TPATH I 1 I zo I �sl FLOAT RAMP x n I / �o a p� x X//x x x / j I WOOD ti 1 STY FIRM. 1 BRICK WALK a 0o I I x /x xyX9>x x/� X 1� DECK U N DWELLING oA \ o AREA 20' LANDWARD OF I x x x X/ w 1 I W 10 #1400 w WETLAND BOUDNARY TO BE \ x Z 1 1N 12.1 �_� •1.+�A ��d q tl Y REVEGETATED USING NATIVE SPECIES. \ x I I� of 10.2'; \o0 0-®E tl� V �d X x \\ I � I I of \ 6.2 .'80ARD OF a �3tJSTEES x x \ \ z i 1\ z'I 5.0' 120.4' \ \ o I o \ \ I \ U.P. m \\ o TOWN, �F SC)UTFi�L� o j 22.5' ry N I cm w \\ \1 O II \\ \\ 1\ \ \\ 24.3' 58..3� I� A 1 a / W \ \ N \ 1 STY Ds"'!T �j Y��.YI�"• 1� 20z: cd \ FRAME CONC, od' \ O O \ \ \ '- \ GARAGE APRON / IN \\ 111 \\ / LANDWARD EDGE OF TIDAL 5\ V' \ \ 0� \1 \ i,,.T \ \ WETLANDS, NDS,FLAGGED BY \--\ 1 \\ �` O , \ \ \ d1 / COLE ENVIRONMENTAL SERVICES \ \ / \ JUNE 10,2021 \ \ \\ . \ \\ \ \ \ n1 GRAVEL DRIVEWAY �' •— ��'-� \ \ \ ,r; yRON POST Q/L PIPE OyL ` � \ REBAR W/CAP 3.8'S N 88°20'40"W\ 245.45' LAND N/F OF FEMA MAP#36103CO163H W1260OLLC THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOCA17ONS SHOWN ARE FROM FIELD OBSERVATIONS UPLAND AREA: 30,303 SQ.FT. or 0.69 ACRES AND OR DATA OBTAINED FROM OTHERS. WETLAND AREA: 2,095 SQ.FT. or 0.05 ACRES TOWN OF SOUTHOLD AREA: 32,398 SQ.FT, or 0.74 ACRES ELEVATION DATUM: NAVD88--- LOT COVERAGE UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLAT70N OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY (BASED ON 30,303 S.F.) MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID ]RUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY/S PREPARED AND ON HIS BEHALF TO THE TIRE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION DWELLING W/DECK & FRONT PATIO: 2233 S.F. LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE BRICK WALKS: 180 S.F. NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADD177ONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS BOAT HOUSE & DECK: 283 S.F. AND/OR SUBSURFACE STRUEiURES RECORDED OR UNRECORDED ARE NOT GUARANTI=ED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY TOTAL EXISTING COVERAGE: 2696 S.F. or 8.9% SURVEYOF:DESCRIBED PROPERTY \EOFNElyy CERTIFIED TO:DAVID WAGNER; MAP OF: H M woy 0 MARYELLEN DUGAN; PROPOSED OUTDOOR SHOWER: 20 S.F. TOTAL PROPOSED COVERAGE: 2716 S.F. or 9.0% FILED: FIDELITY NATIONAL TITLE INSURANCE COMPANY; Y a F SITUATED AT:CUTCHOGUE Of MARYELLEN DUGAN; O n � TOWN OF:CUTCHOGUE Iv SUFFOLK COUNTY, NEW YORK �S` 050882 �, KENNETH M WOYCHUK LAND SURVEYING, PLLC F Professional Land Surveying and Design REVISED 08-20-21 P.O. Box 153 Aquebogue, New York 11931 UPDATED 07-15-21 FILE #220-149 SCALE:1"=30' DATE: NOV. 2, 2020 N.Y.S. LISC. NO. 050882 PHONE (631)298-1588 FAX (631) 298-1588 PT�.1-A =77- Ld O 44 P4 P4 _ ----- _ a. w w o --_ _____ _•_ _._ _ C) fill Jill I Jul 4t �r�'Drrr"",f'rr{r rw''�'�Nr1rr•+..,crrrc,�`'.'�rsNh!;'./1<5,rrrrr-�''S,'rrf�,'.r,'rrrr�/'1�.r.rr•/;•ri'�rrr.s'1'/strM/./<jfrrrrr�',/<r�rrN:.•^!r.S,rrr``r l.'�'�`NNt.1r.._�.'rrrr`rrr-S5'r'r•_`e/'fS.rr'r_�.-/'i,^•fCfr,','�r%'rr4rrr 1'.�'�<rrrr•_�',:',.'rr,rr/�•iJ�r'%' rNr!,.•�l'-�,_jrCrCrr/�_,'jrr„Nrr•_•/r rs'rrr_'-'r+tNr,..,....,.rrrrrs/''rr•ri./;q.r''r�rf.,C.�-!''i;Nvrj .S'`rrfc�-'rtS1r.”,''�rrrrss,.•r'?/:�ri!"f. �rSrrr�.��''rr r'SNrrrr/r•'frrrr.':''rN-/h S/,'f,rrrf.._�/r.�'frCr,_�s•'rrrrM.f,rrrc�crS r_'•'Ntrry1r/ • WEST ELEVATION_ SCALE: 1/4" = 1-0'1 r.r;rr[r`s��frrr'v•S�r'crC�>'/��•'rrrrn••/•.rcrrr'r',''StNirr,f..''_rrrcrr•'1.is'ru�rr_��.f�:iS'r�-/t','hrr{'-.,<',.'rrrcrrr✓''rs,'lrNru._�/.'!r.rrrr.•Sj°rrh�f�.�."'`crfr���h'�'Ji$sNrj UJ -uw.-s--_�__-_..�-«_�_..--,_+•w--.ms..._.+s++.-�-.s_•u-s_.«_..__-.n'+_._r...:-...t.f._�r.na,...-•+_-t_.�.-.-.�_._r_...•-.S-_.-u_....._.".I�rw_.N-_t_„_r"1�—,._w:_-- w_,-.•_t._-_=m...r-+«r_rw.._q-.:.+',...��—. uj LU CQ O o co Z co 0 n c”) U) 0 CO uj U) LL M ----------- --- ----- DRAWN BY: JF 1/10/2023 ti-S is SCALE: SEE PLAN ..... ..... ...... ------ ;.e C; SHEET NO: NORTH ELEVATION SOUTH ELEVATION- ))3 Liz SCALE: 1/4" V-0" SCALE: 1/4" V-0" u LE u 'I-. W U � 9 W rw O w � � z w � � P4uw O g Q. W w o C) x zoz EXISTING �j ~ V 23 U� 1'-O" LEDGER BOARD TO BE FASTENDED n TO BUILDING WITH TIMBERLOK® SELF-COUNTERSINKING SCREWS i I }}ja•�� BY OLYMPIC MANUFACTURING I (2 SCREWS @ 32"O.C.) i p Ito U ' Z - ia L ' u x `1 w -0 W i V N I X N /1 z m i o i zIr-� z � 6X6 ACQ POST uJ CD 16"X16"PIER I J " _ N MIN.3'BELOW GRADE to LCA (TYPICAL) ' v' O 0 O C� _ O Z co (3)2X10 ACQ GIRDER (3)2X10 ACQ GIRDER -" (3)2X10 ACQ GIRDER (3)2X10 ACQ GIRDER i i 7 ; ` �� --------------------- ` � i -------------`-� �� rte^^ n ' w V J \� 1'-0" 8-il/ 8'-11Y? i 8-11/:a 8i-11/zn � LL O 37'-10"' w CL DRAWN BY: JF FOUNDATION PLAN SCALE: 1/4" = 1'-0" 1/10/2023 '44 °�' '`� �"•� SCALE: SEE PLAN / SHEET NO: ^•.� [t z f �`e�l,` Ali # �f A Alf L /� 6� `t EXISTING HOUSE W Lij U � rw O e v p w W W 37'-10" I t/1 -I 1'-o' 0 Fq F•-� PROPOSED DECK EXISTING TO BE DEOMOISHED AND RE-BUILT I Q O m , FLOOR PLAN SCALE: 1/4" = 1'-0" lu �-� W (�\ Z z ° zLo U J X O N to z00co LDma U) 0 = co RAILING (TYPICAL) W a: 0 co cnU- PPROVED B --� 0 0 M BOARD OF RUSTS :S I a _ 5L4 DECKING TOWN OF SOUTHC LD DBL 2X8 ACQ DJ @16"OC pop EXIST. DATE ,S ----(� — (3: 2X10 ACQ a , ,1 _ G_iRDER ' 2X8 ACQ LEDGER BD. FLASHED,ANCHORED 00 — --- (TYPICAL) 6 _ DRAWN BY: JF 6X6 ACQ ---- 0ST 1/10/2023 • .p °� EXIST. •o a �.. �. •A; :.� _ SCALE: SEE PLAN h a. pb 16"X16" CONIC. ` m o.e•_4 PIERR g � .:g , �,,.; r. �� � ��, SHEET N O 4 •� •4 t t.•, A CROSS SECTION A NM p 2 3 SCALE: 3/8" = 1'-0" A,J"1..sill ,. SK WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS WF Or � / 4'A GIRDER DECKING DECKING 4'DIA.MAXIMUM EXTERIOR W WALL DECK JOIST DECK)01ST 1/2"DIAMETER LAG SCREWS, CONTINUOUS PUSHING.EXTENDED THROUGH-BOLTS WITH WASHERS PAST JOIST HANGERS,CAULKED TO (2)1/2"GALV.OR S.S. OR 5"LEDGERLOK SCREWS PREVENT WATER INTRUSION LEDGER �Oln CARRIAGE BOLTS WITH GIRDER m ♦ W O AND JOIST FLUSH ON TOP ..yL. RIM BOARD CAUI.KTO PREVENT WATER SIMPSON CBS WASHERS AND NUTS INTRUSION LEDGER AND ANCHOR DECKING 1/2"DIA.EXPANSION BOLTS, 1•�'�a JOIST FLUSH ON TOP v EPDXY OR ADHESIVE(PER r••tCONCRETEtl. ►,• POST w x"111 JOIST 1-S/8`MIN.FLOOR 'MIN MANUFACTUREINSTRUCTIONS) d, •� PIER DECK/PORCH RAILING w/�sVASHERT AND NUTS 5"MAX. DECK JOISTS -.-e.r bECKING "MIN. ►,�.:•�� �,• DECKING DECKING Q f�--1 a a'•••' JOIST HANGER •• �• r•, ,� ,� el DECK JOISTS �•f.� 2%ACQ LEDGER BOARD FOUNDATION WALL •�.�,� r_rJ• a' ji•� BLOCKFOUNDATION •►:NOTE: 'r•• DECK 101ST DECK)01ST RAILING W FOUNDATION j •�: TO BE FILLED WITH ���, JOIST HANGER POST WALT. •�Ar�• GROUT AT ANCHOR �j!�� 2X AGO,LEDGER BOARD V • w LOCATIONS O — DMZ HOLD-DOWN 'r'VVL�JJ1, GIRDER GIRDER 0.1M BOARD SIMPSON D LEDGER BOARD TO RIM BOARD DETAIL LEDGER BOARD TO FOUNDATION WALL DETAIL (MIN.2X8) DECKING Iry—•�1 2"MIN �r O O THROUGH-BOLTS u 5'MAX. DECK JOIST O THROUGH-BOLTS SHALL HAVE A DIAMETER OF 1/2".PILOT HOLES FOR THROUGH-BOLTS 2'MIN. SHALL BE 17/32"TO 9/16"IN DIAMETER,THROUGH-BOLTS REQUIRE WASHERS AT THE BOLT HEAD AND NUT. SIMPSON CC SIMPSON CBS R)1/2"GALV. WITH/S.S. 2X BLOCKING AT EACH POST O EXPANSION AND ADHESIVE ANCHORS CARRIAGE BOLTS ATTACHED WITH 10d THREADED ANCHOR ANCHOR WASHERS AND NUTS NAILS TOP AND BOTTOM 12"OC STAGGER FASTENERS UTE APPROVED EXPANSION OR ADHESIVE ANCHORS WHEN ATTACHING A LEDGER BOARD POSE CONCRETE IN 2 ROWS TO A CONCRETE OR SOLID MASONRY WALL AS SHOWN IN LEDGER DETAIL.EXPANSION PIER POST-TO-DECK CONNECTION AND ADHESIVE ANCHOR BOLTS SHALL HAVE A DIAMETER OF 1/2'.MINIMUM SPACING AND 2"MIN. 5-1/2"MIN.FOR 2X8 EMBEDMENT LENGTH SHALL BE PER THE MANUFACTURERY RECOMENDATIONS.ALL O O ® 6-1/2"MIN,FOR 2X10 ANCHORS MUST HAVE WASHERS V 5'MAX. 7.1/2'MIN.FOR 2X12 O ® OLAG SCREWS 3/4'MIN. LAG SCREWS SHALL HAVE A DIAMETER OF 1/2`.UG SCREWS SHALL HAVE PILOT HOLES L-b-MIN. LEDGER L LAG SCREW.THROUGH BOLT, DRILLED WITH 5/16"DIAMETER HOLES.ALL LAGS SHALL BE INSTALLED WITH WASHERS. 4'MAX' OR ANCHOR WITH WASHER LAGBOL75 SHALL HAVE 1-1/2'UNTHREADED SHANK.LENGTH MUTT PENETRATE BEYOND RIM BOARD A MINIMUM 1/2".LAG SCREWS AND WASHERS MUST BE GALVANIZED O0.S.S. CONCRETE LEDGERLOK SCREWS PIER LEDGEkLOK SCREWS SHALL BE A MINIMUM LENGTH OF 5".LEDGERLOK SCREWS SHALL NOT 4'DIA.MAXIMUM BE USED FOR MASONRY,CONCRETE,BRICK VENEER,STUCCO,SIDING,OR RIGID FOAM LEDGER BOARD FASTENER SPACING AND CLEARANCES INSULATION, BOT OMSHALLEBEAMINIMVM DISTANCE Of 3-3/4°FROM ENDS AND 1.3/4" FROM TOP ANDDBOTTOM EDGES. 24"X24"X12"CONC.FTG. HANDRAIL NOTES: T BELOW GRADE All required handrails shall be of one of the following types (ALT.,BIGFOOT FOOTING) or provided equivalent graspability. Z 1).Type I.Handrails with circular cross section shalt have an outside diameter of at least 1-1/4 inches and not greater 36"MIN. than 2 Inches-If the handrail Is not circular It shall have a perimeter dimension of at least 4 inches and not greater than 6-1/4 inches with a maximum cross section of FLOOR SHEATHING NAILING AT 1/2'DIAMETER LAG SCREWS. ATTACH TO I-JOIST 1/2'DIAMETER LAG SCREWS. dimension of 2-1/4 inches. 6'MAXIMUM ON CENTER TO THROUGHBOLTSWITH WASHERS WITH A MINIMUM THROUGH BOLTS WITH WASHERS , JOISTS WITH HOLD DOWN OR 5'LEDGERLOK SCREWS SIMPSON DTT2Z HOLD-DOWN OF(19)ed NAILS OR 5'LEDGERLOK SCREWS SIMPSON DTT7,Z HOLD-DOWN 2).Type 11.Handrails with a perimeter greater than 6-1/4 Inches shall provide graspable finger recess area on bothUj sides of the profile.The finger recess shall begin with a STAIR RAILING t 1 • • • _ s s distance of 3/4 Inch measured vertically from the tallest SOLID SAWN DECK 1 1 1 JOISTS DECK 1 1 portion of the profile and achieve a depth of at least 5/16 , FLOOR JOISTS JOIST. 1 1 •. JOIST 1 1 inch within 7/8 inch below the widest portion of the 1 1 s profile.The required depth shall continue for at least 3/8 1.1/2'SPACE inch to a level that is not less than 1.3/4 Inches below the THREADEDPEDUP ROD MAY BE SLOPEDTHREAUP ROD MAYBE tallest portion of the profile.The minimum width of the MINIMUM SLOPED UP TO 1:12 MINIMUM 2X6X36' SLOPED UP TO 1:72 LAWAY FROM THE HOUSE ATTATCHED TO JOIST AWAY FROM THE HOUSE handrail above the recess shall be 1-1/4 inches to a GIRDER UVEB WITH(16)10d NAILS GIRDER maximum of 2.3/4 inches.Edges shall have a minimum HANDRAILS JOIST HANGER AND CLINCH JOIST HANGER radius of 0.01 inches. ,—= W W Q) Z lOd THREADED NAIL OR BALUSTERS L�M70 WOOD SCREWS. �•a � a--F• LATERAL LOAD DEVICE WITH JOISTS PARALLEL TO DECK JOISTS (PROVIDE IN (2) LOCATIONS IN DECK) 16"OC EQUAL OR GREATER THAN 3'LONG. STAGGERED IN 2 ROWS OPEN BALUSTER ATTACHED TO WALL z Z Lo • HANDRAIL CONNECTION W ❑ N ALL HANDRAILS SHALL BE CONTINUOUS THE FULL LENGTH —/� ' O_jO If BEAM IS CONSTRUCTED WITH 3 MEMBERS (2)THREADED NAILS OR SCREWS AT EACH ENDO OF THE STAIRS. HANDGRIP PORTION OF ALL HANDRAILS V, Z �•�/'� CD 6 FT.MIN.EXTENT OF BLOCKING ATTATCHED OUTSIDE MFMB FR TO THE SPLICE END:SPLICES SHALL BE LOCATED ONLY OVER SHALL NOT BE LESS THAN 1-1/4'NOR MORE THAN 2-IN ,� W T INSIDE MEMBERAS SHOWN. INTERIOR POSTS CROSS SECTIONAL DIMENSION,OR THE SHAPE SHALL PROVIDE AN EQUIVALENT GRIPPING SURFACE O r �\ ATTACH BLOCKING TO DECK WITH 1/2'DIAMETER UG SCREWS. _ 10d NAILS AT 4'O.C.STAGGERED THROUGH-BOLTS WITH WASHERS BEAM ASSEMBLY DETAIL V) co ❑ OR 5"LEDGERLOK SCREWS SIMPSON DTT2Z HOLD-DOWN U) ^' O ^ ' W LJ.. U)atfrer t1/ DECK 1 1 STAIR TREAD U_ • JOIST 1 1 I I RIM BOARD O THREADED ROD MAY BE MINIMUM I-1/2"THICK FLOOR JOISTS SLOPED UP TO HE STRINGER /\ ^ BLOCKING.BLOCKS MUST (SOLID OR WOOD-I) AWAY FROM THE HOUSE Q3 L.L FILL BAY AND FR SNUGLY JOIST HANGER GIRDER JOIST 0 GIRDER/HFADER STRINGER TO DECK/PORCH CONNECTION LATERAL LOAD DEVICE WITH JOISTS PERPENDICULARTO DECK JOISTS (PROVIDE IN (2) LOCATIONS IN DECK) SPLICED JOISTS OVER HEADER/GIRDER DRAWN BY: )F CLIMATIC AND GEOGRAPHIC DESIGN CRITERIA CONNECT TY-DOWN ANCHORS TO EACH JOIST GROUND WIND SEISMIC FROST WINTER ICE SHIELD FLOOD NAILING SCHEDULE 1�1��2�23 SNOW SPEED DESIGN WEATHERING LINE TERMITE DECAY DESIGN UNDERLAYMENT NAIL NAIL LOAD (MPH) CATEGORY DEPTH TEMP. REQUIRED HAZARDS JOINT DESCRIPTION QTY SPACING NOTES STRINGER JOIST TO: 4-Ed COMMOI, PER TOE ®16" C MODERATE SLIGHT TO SILL,TOP PLATE OR GIRDER JOIST NAIL (2)THRU. 20PSF 130 B SEVERE 3Fr. TO HEAVY MODERATE 11 NONE BRIDGING 2-Ed COMMOI, EACH TOE BOLTS 1 SCALE: SEE PLAN TO JOIST END NAIL BLOCKING EACH TOE ANCHOR ,0 1 TO JOIST 2-Ed COMMONEND NAIL WOOD JOIST ANCHOR PIER •' O 16"TREAD 1). ALL FRAMING,CONSTRUCTION,COMPLIANCE TO BE PER 2015 IRC,20T6 NYS UNIFORM SUPPLEMENT BLOCKING TO: 3.16dCOMMOI, EACH TOE a� SILL OR TOP PLATE BLOCK NAIL 1 "'.-'4 •. . LEDGER STRIP EACH FACE GIRDERMEADER • , 4 SHEET N O 2). ALL FRAMING MATERIAL TO BE#1 AC PRESSURE TREATED LUMBER. 3-16d COMMO :;4 CONIC.SLAB �q• a Q TO BEAM JOIST NAIL (AS REQ.) ti WOOD JOIST JOIST ON LEDGER PER TOE "�.• •''•'+ 3). ALL FASTENERS,HANGERS.AND ANCHORS TO BE GALVANIZED OR STAINLESS STEEL TO BEAM 3-ad COMMo JOIST NAIL .' ) � 8-di.. f• ti DECK PIER BAND JOIST PER END 3,-0„ CONIC. •� V! PER PUN 3-16d COMMO p• P1E0. 4). ALL PIERS AND FOOTINGS TO BE 3 FOOT BELOW GRADE. TO JOIST Jo1rr NAIL FLUSH JOISTS WITH HEADER/GIRDER _ BAND JOIST TO: PER 2-]6d COMMO TOE NAIL _ 5). ALL JOISTS TO BE BLOCKED OVER GIRDERS AND AS SPECIFIED. SILL OR TOP PLATE FOOT ALL JOISTS CONNECTED TO A FLUSH HEADER TO BE SUPPORTED WITH a:' (s' 4'.+ THE PROPER STEEL CONNECTOR. •:gI, x f 6). FLASH ALONG HOUSE WALL,OVER LEDGER WITH MIN.10"FLASHING. IF ABLE,SET FIR JOISTS APROX.1/4"HIGHER THAN LVL HEADERS """" M.r TO ALLOW FOR SHRINKAGE. �j i) , JTI g�1FF04 .,. , Glucin-voldsmith,President p�� _G Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 CO _ Eric Sepenoski P.O.Box 1179 Liz Gillooly �-'A • �� Southold,NY 11971 O Elizabeth Peeples l �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: z l3 is Completed in field by: d'yf'� MARYELLEN DUGAN & DAVID WAGNER request an Administrative Permit to remove existing deck and install new 12'4"x37'10" deck with railing and two sets of stairs; and to prune several trees. Located: 1400 West Creek Avenue, Cutchogue. SCTM#: 1000- 110-1-4 Typ"f area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type ,of Application: Wetland Coastal Erosion Amendment ✓Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No ---�N of Applicable Info needed/Modifications/Conditions/Etc.: Oti�t oy-, Ajew aWW S d W i ZO r J4-�'�v WrAA tf rk hc)va be- P01V4 Present Were: G. Goldsmith ✓ N. Krupski E. Sepenoski L. Gillooly E. Peeples • to a "} •� �r � t� �+ ~ 't�• ,wl ` t >:. lit If •�. e .10 . /frig + ► i. � i'.. 7 !• \ .41 .,. 'moi•. •�, s- { '• '•:'Y. .. a 4IR ` "47 A r • n r' w t •r ,'t +r t�• ��' � .t �.,�i'y'�'.r Jj&4.; "3 t" �`s.c t5.. Y .�w �('Y.;,?,,r.'�..�p� �d �t �_ !.' 4`� .�,- i's�x`:• ?'�''� ♦ Hary�;��ti �% tp`,•`,• %'y J - W •� •,yf \!V F� '� yah`� J � `Y�yr f s� / 1 .2 'tib•• {'•�"'t!`r r, Y� 3i,•y�����,�'Sl .1 ' S , �� i•;,1 •V.. � nom• _ +'•y - y 3 � t 4 ,4 � ; l a S r1 � :s• •i .� •'•3 ':.•j��.` f �",•1 . �.•• r ♦ til � #�• , � '�¢�N ', _.. ,, �t-�$w - i : • rfM-�. , • ••. tet • .J� ins .� '! � ,L��,+�}i ';�� � �+ X ` Jr ''+ •fit•^�=•s:!�� 54 JAI yet,,.! ..'" `' .. ..:�,:�•.�. -r �� + ' yam, fJ :,Z�� M` S,yr� a.Il f •a �, �. . s ' e a -t" ! .r `SC��„��,fir• f�.°„ j'' 1 _ �'t`\. ?� � •\7„$' _••, WA 44 V. `• / 1 • • ! .�- `S P `fir•• aw 40 s. J •7! 40 lk 416 �S• mss'.!, Apwt 1 1 F F •S• l tf it. L � � . �,�4 r- `I •••yY t '14 ��'Y Vt f�+ s�� � •. +��/'.• �='11 i 14, VOW KVolk 1 -sy �Y A w. L x^ � J tl i ► •b►o ,�/{� •r• ^ � .r '� ,.,t' ,-a.. 7 4' '1•�,oma` r �'� b � �." 74 WWI Lb Al, L)eck Looking tast, October 2022 �• �. .r moi. ` ,t � ' _ • ,�`.� �� 's: � ��` •'•. .i� ...4\C. � ,�__. �,. Y� e./ �...s �•�I�' t/' ' 4" �i.,/L t �a � � fly _ 'e � � .��y`Y; •. .. `! 1 �• �" � �� ,.�1A/��� �,� - �7� � . -off •. \ �JQ, � , y���� `�` �G/ A� 4a 14 �il`��.i:�• ii r\ •\\ .,� 1�� t'��.• �'h� r >�°°p,1`rt �°` �" '• ,l,�ti!' iw 1,4 .. �v.r"�, ,'lr .:;�$4��;yo •Y` r;.S,:J'•��' L4 t`i..+S_. :� ,1� V •'} �t '�I �} � "^K �.� y ,.4. Ar Y f - .. . - _� .. � ♦1. .tom. a ,s �� ,� •- _ „ ��'.:. \'.. dJf •�_� T��r.is 1'+ ��!"-.n .s-•w � a.,�- �$' ,,Y r 11.E � _�,, �'.. `,� _- ^11'-y_ I.L. ,� -�y�1��� •. �`�M+�' I � -•_R �. 4. � •✓ '� �''� _l �•� - w d- /Ps \- ;� ,�K. ` .- a �i TTT _ F .' JvAF ?' 4c f4 je, 40 ,- / [ �? ��'� Q4` Y � - JI -.� � �iy-:i- J:.L ���~a ten. ° � � - �• �,-� 1. .loom s •f f te ~ ' / ` •`M, Y� '. , xtj MM M ;, �, ��f -t,� JLC' 1•; r •�'�� a;���'T�t+fie _ is+Y ,i•r'� sw t • ��i �yr�-•�,..,� , �� �; �,�:''i"•vim+' �� `.ct t 1 dL - f� .01 Nft lie � �_ �`�l�;•• �r.'�' t� ~���"'��"`i�.�-.�`� >�l" '"'►�'�'� `W, <- ate.. t`K,�r i►' � ."1` �' ,�!� �r+ �;�..':�S�.l� ` � � •.' � air 1,. - f J- ' M.TGHLINE r '1 3� + yTa \ N•° '0 0%?� °° M1ry P..d : `Et [, _ �; roR ocL No t ,R,..""L��q, aD A ty •°4F a" i +�T'..,+at�,..�, t` .� '� �rt'R ..r•��S' 7 M. .r � ... � ,�'/ {{ /�� P � � .a/ .sr–� ,� O V '� ve ,f�✓a,. X61 ,• � ,e � a P `?sW R n int d 4i,% ,peri .e ♦ 3:. .r 1A 9; • "M1� ``. � �% �,�'t ��f�'.'r•��/ a2�``,fid N� 4'�,y} < $��e '� a'� 9 a �'� �4` � A" `.. " 21 i y R , e� .�✓ su y ,a t.: swwrr�ssFu.l / i +� ' 1}' •�`�.��� j ,.� �� ��� Y� ���ff//�y //'� \ i a��}�'\_^she. \ '�� +� t �• iV ,s.ae, :a"�"'rv •::: �""'7'" 0s'11'� ��r`A `!,?`\y' M1 \`� �'\ KaNna� a� O]Hq FOR PCl NO IUpC p139 , { q r rf � I>•s-��1 :a1 � � FVR PCL NO ^ ' IFn J (J 9EE SEC NO R '4r, ' • 'y_`x+clm '>_`-1 a_� I as K I 2 _.y+C+� 1•aK �'A.l.�.'d.�� .moi FPiFF+MINr Ta.MEI!'N'tl .1 ( f 'i BEE YG.N0,11 t ;�.` c .. . .....>,..�.�.a.. ._w. _ -..,.,•� ..s. >, CWNTYOFSUFFOLK N NOTICE E �.I' ,.I<IN, ,000 SECTION NO p Hr�_— "��^'�— -- �•• O '•' —_ _— •� .zlRu v. heel P-p,,tyl—S—i.,Ag—y 1MMBEIE£.MTFMV,CN wLE ae v ��.. NMa `" ELF BouTNosu 17 Q N o ....,_ H.....w ,.» ---- .tee..,.,,, u,l M �•.e;•--•- e. MaIHOIR MNR7&FearaN mnE P s 1 ncwE Rxa+xl. 3 SOUTyolo coun ,� MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: February 13, 2023 Re: LWRP Coastal Consistency Review for of MARYELLEN DUGAN & DAVID WAGNER SCTM#: 1000-110-1-4 MARYELLEN DUGAN & DAVID WAGNER request an Administrative Permit to remove existing deck and install new 12'4"x37'10" deck with railing and two sets of stairs, and to prune several trees. Located: 1400 West Creek Avenue, Cutchogue. SCTM#: 1000-110-1-4 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 as-builts are INCONSISTENT with LWRP Policy 6.3 and, therefore, INCONSISTENT with the LWRP. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The as-built structure (deck)was constructed without a Board of Trustee review or permit. A Wetlands Permit 10028 for the existing deck was not found in Town records. In a 2021 permit for the property,the deck was not mentioned. A 20'wide non-turf but revegetated buffer landward of the tidal wetland was specified in the permit. The attached photos do not correlate to the survey; therefore,the location of the trees in relation to the buffer and house is unknown. The purpose of removing the trees has not been specified. The removal of the trees is recommended as INCONSISTENT with Policy 6. A proposed outdoor shower is shown on the submitted survey. There is no drain. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Honorable Lori Hulse, Attorney Glenn Goldsmith, President ®F Sig Town Hall Annex ® A. Nicholas Krupski,Vice President �® �® 54375 Route 25P.O. Box 1179 Eric Sepenoski ALSouthold, New York 11971 Liz Gillooly Elizabeth Peeples � ® � Telephone(631) 765-1892 a Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension Received Application- 1,24.23Received Fee: $ 1000, — Completed Application: �•aS�?-?> Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: oordination:(date sent): - ',I , LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: 2.7.20 JAN 2 4 2023 Receipt of CAC Report: Technical Review: Public Hearing Held: Z-is. 63oartf of}iusrtr;� Resolution: -_ Owners Legal Name of Property as shown on Deed : �aOY1V XLe—IM Mailing Address: 5?.y ZV/Cc / '4v r/ ,4AZ Xf ✓, / fly/0 Phone Number- Suffolk County Tax Map Number: 1000 - ��fj �� ��• (j(> �' ® T> (Zl�t� Property Location:© Ale, (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): a Mailing Address: Phone Number: Emaik-�� Board of Trustees Applici on GENERAL DATA Land Area(in square feet): 3 4 �7 Area Zoning: /'C ,E_S IP !, Previous use of property: Intended use of property: Covenants and Restrictions on property? _X—Yes No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? V/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 No If"Yes", please provide copy of decision. Will this project requir any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure (s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description (use attachments if necessary): PROJECT DESCRIPTION Wagner / Dugan Residence 1400 West Creek Ave, Cutchogue Deck Remove existing deck and install new deck per the attached plans. S-T1,s 3�7`/0 Tree Pruning Prune several trees within the 100-foot zone per the attached photos. WETf A ND/TRUSTEE LANDS APPLICAT—N DATA Purpose of the proposed operations: ,,,d/eAl 41et_-, gLd V10, Area of wetlands on lot;._r--e ,�TAc,� ^ square feet Percent coverage of lots:–� ,���N�G % Closest distance between nearest existing structure and upland edge of wetlands:, A/_4410feet Closest.distance between nearest proposed structure and upland edge of wetlands.^/¢. ..d feet. Does the project involve excavation or filling? No Yes If yes, how much material will be excavated?2-7— cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations;_ -z Irt T xc�j-O Manner in which material will be _removed or deposited: f,/,p�o �.o�►i��✓ 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): � J 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete 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: �' �✓� T C�? k- v.( C GNB vt Project Location(describe,and attach a location map): Brief Description of Proposed Action: N/mfApppPcant or :/��'h� Telephone.-2/j,-3r-6 ?"0 ✓�� �/ E-Mail: Address: �. City/PO: State, Zip Code: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources th ❑ 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: ❑ �eJs'G.2/r1/G /t-�il�•G�' �� ��GI� 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned &- or controlled by the applicant or project sponsor? .N�'C� acres 4. Check all land uses t at occur on,adjoining and near the proposed action. ❑Urban ural(non-agriculture) ❑Industrial ❑Commercial_�esidential(suburban) >9vorest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/ a. A permitted use under the zoning regulations? El F-1b. Consistent with the adopted comprehensive plan? ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? [:T 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: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b. Are public transportation service(s)available at or near the site of the proposed action? ❑ 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: A14 El El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: / El1 1.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO ES Places? b.Is the proposed action located in an archeological sensitive area? ❑ 13.a. Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YE wetlands or other waterbodies regulated by a federal,state or local agency? b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 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: Shoreline Forest ❑Agricultural/grasslands ❑Early mid-successional Wetland ❑Urban uburban 15.Does the site of the proposed action contain any species of animal,or associated habitats, listed NO YVES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-po' t sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? NO ❑YES b. Will storm water discharges be directed to established conveyance systems(run ff and storm drains)? If Yes,briefly describe: NO AYES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO J YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO A'YES completed)for hazardous waste? If Yes,describe: Vf ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE THE BEST OF MY KNOWLEDGE App I icant/sponsor name: jQV149 1,/m �✓/�� Date:—, 7/7z--3 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 El ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? R E 3. Will the proposed action impair the character or quality of the existing community? FI El 4. Will the proposed action have an impact on the environmental characteristics that caused the El 1:1establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ 1:1affect 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? E 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 F] Elproblems? 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. F] Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. F] Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of Board of Trustees Applic, _,Lon AFFIDAVIT c`� i- /lid ✓� BEING DULY SWORN DEPOS S AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ,ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO'ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature e er Signature of Pr tyoZer f Pro SWORN TO BEFORE ME THIS ?sb8 DAY OF WbVLM bjA , 202_ Notary P lic I :;•,nmonwealth of Pennsylvania-Notary Seal SARAH M TAYLOR-Notary Public Philadelphia County My Commission Expires January 17,2025 Commission Number 1274115 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: /D � 'r `- s� 9ldl C . t/ (Last name,first name,.�aiddle initial,unless you a applying to the ame of someone else or other entity,such as a company.If so,indicate,the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or 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 ven a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%oft shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of��ACj/�° 200 3 Signature Print Name7z' •-s ,,q •�/�✓�� Form TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its si fgru icant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM#%/19- OD - a94 00 - 9dlt-. OdJ 2 PROJECT NAME�-,/,� �i,.�..i���y�� /��G.i f/17 -k -17r11 /1 L✓i�✓� The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance(e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: ►, cl/?,.D Location of action: �a g e , e�T'At e Site acreage: Present land use: �s��-�, t- Present zoning classification: .�'�S/�*,�"�'iA e- 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:✓/�/1-5<el-/ -, A,/r9�' (b) Mailing address: 9S'O,,1e1Z 4m , 4,7,, ✓ Az-l/1 , AX 12PO (c) Telephone number: Area Code( ) '�!,/J'- (d) Application number, if any: A)l� Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes F-1Ns� If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ No><Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LMW Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ 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 ❑ No�k,Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria F-1Yes 1-1No ;sPNot 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 1:1No�Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not-Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ N(�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 ❑ NA 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. ❑ Yel—I N�Not Applicable Attach additional sheets if necessary WORKING COAST POLIES Policy 10. Protect Southold's water-dependent uses and promote sitingof new water-dependent uses in suitable locations. See LWRP Section III–Policies; Pages 47 through 56'for evaluation criteria. ❑"Yes ❑ Nqg 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 ❑ N0_5�_Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of'energy and mineral resources. See LWRP Section III–Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY . ,C✓d/�� �G�� TITLE e !hl�--y DATE W/ 3 —r