Loading...
HomeMy WebLinkAboutM&R North Fork Properties, Inc M& R SOUTHOLD PROPERTIES LLC 1050 WATERVIEW DRIVE SOUTHOLD NEW YORK 11971 July 14, 2019 Southold Town Trustees, We are writing this letter to request a letter of non jurisdiction for the vacant property located at Lot# 56 of Cedar Beach Park in the Town of Southold. Suffolk County Tax Map#1000-90-3-4. We are proposing the erection of a residential structure in the near future. Plans and survey have been forwarded to your office from Brett Kehl reference the proposed site. We grant permission for any Southold Town Trustee to enter and exit the property at any time for any purpose related to this correspondence. Please fmd an enclosed check for$50.00 as well as the notice of formation for LLC. Thank you in advance. We can be contacted at the following phone numbers: Mark Schill 516-924-4606 Roman S. Wilinski 631-484-0161 Sincerely, r Mark Schill Roman S. Wilinski J UL Cron /oCc�7 Un-� _ �� � UL 16 20 MTownS e� jGU C✓d A�ru15f_/ c9 n 50-666/214 &R NORTH FORK PROPERTIES INC. ; 104.0 �� 1050 WATERVIEW DR. SOUTHOLD,NY 11971 . ?iSr -/ Aur' 2 ,. 4 #'uaq C�� ���+ Tas'1 II�C� 1` $ �"C• .�----^'-• - Heat Reactive Ink OBQ ZZ NP 1:0 2 140666 7I: 05000460013112 1040 M & R NORTH FORK PROPERTIES„ INC. An incorporation meeting was held on the 8t' day of April, 2016 at the offices of Tomao and Marangas , 193 Griffing Avenue, Riverhead, NY 11903 Present were Mark Schill and Roman S. Wilinski. At the meeting the following resolutions were agreed upon: Resolved: the corporation will issue one hundred (100) shares of stock. Fifty (50) Shares will be issued to Roman S. Wilinski [Certificate Number 1] and Fifty Shares (50) will be issued to Mark Schill [certificate Number 2] Resolved: the officers were elected as follows: President: Mark Schill Secretary/Treasurer: Roman S. Wilinski The meeting was thereafter concluded Dated April 8, 2016 . y o Q ECC AVE JUL 1 6 2020 Soufholo Town Board of Trustees b E E + D .� + SURVEY OF: JUL1 6 2Q20 PROPERTY LOCATED AT BAYVIEW U LAND N/F LOT No. 56 AS SHOWN ON PHYLLIS R MAP OF CEDAR BEACH PARK \ MAUS FILED: DECEMBER 20. 1927: FILE No. 9 SoulboidTown VACANT TOWN OF SOUTHOLD Boar of Trustees SUFFOLK COUNTY. NEW YORK PaLE�p \ S.C.T.M. # 1000-90-3-4 LAND N/F AREA = 24.915 SF. 0.57 ACRES TOTAL. -LOT 23.156 SF. UPLAND AREAS 28°11'00"E / PAUL a1 �,s GILMAN SCALE: 1'=40 42.74' RESIDENCE NOTE: THE EXISTENCE OF RIGHT OF WAYS. ` \ WETLANDS AND/OR EASEMENTS OF RECORD A PROPOSED 9'1 DRIVEWAY S 60°20'30"E \\ IF ANY. NOT SHOWN ARE NOT GUARANTEED. 63.00' f► �l ON O• TEST \ PROP.VA SWATS TNA MOLE ELEVATIONS REFER TO 1988 NAVD FILO MEAN IFN IREATMOWT SISTER q +a_ 641 EL 10.0 ELEVATIONS SHOWN THUS H++ w.12PO LUKDR�IOKROTO09 / PROPOSED COVERAGE: SANITARY LOW E�-N IEVELERS .IPE HOUSE 2.500 SF. PROP.SM EACH OISTIRI WITH ►p cN OVCN WALK F'•P� �p < GARAGE 528 SF. SIDE- TRERCG EXTIArLOOILTE eg TOTAL = 3028 SF. mKKOOLLES TaEaumFarER "c ?+ y� �p WELL TOTAL TOTAL PROPOSED COVERAGE 23.156/3.028 13.08% aw PRP.FunmE ms p 9/., K,\ PROPOSED SYSTEM CALCULATIONS: h 4 EIPAN9mx TRvcH Bao .• +ems y+y p HOUSE ROOF AREA = 2.150 SF. 43 <<t+ 2y k 4 ON 2150. X0.17 = 365.5 SF O�p4'�r 365 / 42.2 = 8.6 VERTICAL FT vytiG y +40 �g ►p +¢� op w OF 8' DIA LEACHING POOL REO'❑ �0� a� �q0�Q m d�y��° y� o ' dp ZONE vv 1 8' DIA X 4' DEPTH 8 J O ,�, ►• SQFc 4 ` 4+ 1 8' DIA X 5' DEPTH STORM DRAIN POOLS Q S. ;9 ay3 ►9 FrMA �4+� PROPOSED SYSTEM CALCULATIONS: 1ry sr y 4eF iSee OnG�r GARAGE ROOF AREA - 528 SF. %K t �sb �� 528 SF. X 0.17 = 89.8 SFO 89.8 / 42.2 = 2.1 VERTICAL FT OF p 8' DIA LEACHING POOL REO'D �� ►` SO �' +'� �Oy� �� 1 8' DIA X 3' DEPTH STORM DRAIN POOL n ► O y ZONE R-40 TIDAL A9WETLANDS DARY ► �/A+� F ADDED Ely PROPSSFD SOUTHOLD TOWN TRUSTEES RETAINING N 27°44'55"W �% WALL 16.72' ? euDN ' j TEST HOLE DATA ►� ]NOT TO SCALE] N 62°50'42"W —8 BY:MCOONALD GED SCIENCE 4/24/2018 38.62' S 73°12.53"W OL DARK BROWN LOAM N 87°02'03"W I. 36.47' 38.67' SM PALE BROWN FINE 3' TO COARSE SAND ML STILL WA TER $p BROWN FINE SANG UNAUTHORIZED ALTERATION P ADDITION TO THIS 9AVEY S A VIOLATION •. LAKE . 8'9' SURVEYED BY: OF S==S==7789 OF THE NEW YORK STATE EOCATION LAK COPIES OFTM SURVEY N&P NOT WAF30 ME LAND SURVEYORS 07® SP NATER IN BROWN PAUL BARYLSKI LAND SURVEYING OR EMBOSSED SEAL SHALL MDT BE CONSIDERED TO BEA VALID TRUE Capt'. FINE SAND GUARANTEES OR COITO ATONS tN=ATEO HDEON SHALL RUR ONLY TO PATCHOGUE NY 11772 THE POISON FOR WHOM THE DOVEY IS PREPARED•AM ON HIS ff]IALF TO !T' THE TITLE COKPANY.GOVFAK1ffMAL AGENCY AMD LENDaS INSTITUTION PHONE 631-294-6985 LISTED TIX�����P �roTE>� COMMENTS:WATER SURFACE 8.9'GUARANFAX 631-627-3186 Ol9TIT TRIN9 OR�OONT OWNERS. AODITIDNAL BELOW SURFACE PAULBARYLSKIRaYAHOO.COM 3773 SEPTEMBER 13. 2019 SURVEY OF: PROPERTY LOCATED AT BAYVIEW LAND N/F LOT No. 56 AS SHOWN ON PHYLLIS R MAP OF CEDAR BEACH PARK \ FILED: DECEMBER 20. 1927: FILE No. 90 +2m VACANT / TOWN OF SOUTHOLD \ SUFFOLK COUNTY. NEW YORK \ POLE+'Lt S.C.T.M. # 1000-90-3-4 LAND N/F AREA = 24.915 SF. 0.57 ACRES TOTAL. LOT 23.156 SF. UPLAND AREAPAUL \ 28°11'00"E SCALE: 1"=40' ti + GILMAN ~+ 42.74' ++ RESIDENCE NOTE: THE EXISTENCE OF RIGHT OF WAYS. WETLANDS AND/OR EASEMENTS OF RECORD p' DR/VEWAD S 60°20'30"E +m®� IF ANY. NOT SHOWN ARE NOT GUARANTEED. +m? d 63.00' DW �O' TEST \ PROP.I/A OWATS TANK V+m A 99 co HOLE ELEVATIONS REFER TO 1988 N A V D FUJI CLEAN CEN-S TREATMENT SYSTEM tim CoA h' EL 10.0 m \ ;� ti � +m c F ELEVATIONS SHOWN THUS +++ 12x 12 W/PDB-/2 RISER AND F��?�F Fo�mv �� 0? R� Ro? \ PROPOSED COVERAGE: ROTO-FLOW 3050-4 LEVELERS S Q�OQ / PIPE H 0 U S E 2.500 S F. PROP.SANITARY DISTRIBUTION P'�' ryDWCV \ CH SIDE- ��v,�'� GARAGE 528 S F. TRENCHES.EACH 40'LONG WITHELJEN TOTAL = 3028 SF. B 9 MODULES XTILE SAND FILTER Fc ar 6��'� 46 J WELL N 6,O TOTAL PROPOSED COVERAGE = 23.156/3.028 = 13.08% \ 2 PROP.FUTURE 50X ro �� A NTRY 299 97, lY\ PROPOSED SYSTEM CALCULATIONS: ��V��� EXPANSION TRENCH °`� ,9e V4- Al m P'F°Fo 4- q HOUSE ROOF AREA = 2.150 SF. m '° yE^Po a DW 2150. X 0.17 = 365.5 S F p�p�'�� rAR 'se +m' F<. �F"�s�y �S 365 / 42.2 = 8.6 VERTICAL FT vptip Q,�A� ,aA �, a0 ,� se' ®m FEMA OF 8' DIA LEACHING POOL REO'D oQ o+' `goo se rr 9,F< m QQ��g�+0 °° h� ZONE 'X• 1 8' DIA X 4' DEPTH Q� 1 8' DIA X 5' DEPTH STORM DRAIN POOLS ^� �? $5 A m ., FEMA PROPOSED SYSTEM CALCULATIONS: �ACV r7fOs �p Ap �@e 'epF EO 6 0 hNE A C'J�' GARAGE ROOF AREA = 528 SF. �. �o�` �s�O °o°s ya �F`~ q Al 528 SF. X0.17 = 89.8 SF `l' o���� a> �F�OA o� F° DW O �pti�Q �ti 89.8 / 42.2 = .2.1 VERTICAL FT OF 20J ,y, ftiosF s c,? � 8' DIA LEACHING POOL REO'D < '�c° 1 8' DIA X 3' DEPTH STORM DRAIN POOL ZONE R-40 TIDAL WETLANDS BOUNDARY AS FLAGGED BY ��' PROPOSED _ f SOUTHOLD TOWN TRUSTEES RETAINING N 27°44'55"W N e WALL 16.72' ? �B�FFER i TEST HOLE DATA l p. RF i —�/ (NOT TO SCALE) BY: MCDONALD GED SCIENCE DEC 9 2019 N 62°50'42"W �— 4/24/2018 a _ 3 8.6 2 S 73o12'53"W OL DARK BROWN LOAM -- N 87°02'03"W I' , s 3 8.6 7 - - --- - - 36.47' SM PALE BROWN FINE 3' TO COARSE SAND ML 4' S TILL W A T E R Sp BROWN FINE SAND UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATIONL A K E OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. SURVEYED COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED SP WATER IN BROWN PAUL B A R Y L S K I LAND SURVEYING OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. FINE SAND GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TOI�. PATCH 0 G U E NY 11772 THE PERSON FOR WHOM THE SURVEY IS PREPARED.AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION PHONE 631-294-6965 i LISTED HEREON.AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. COMMENTS: WATER ENCOUNTERED 8.3' FAX 631-627-3186 GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL BELOW SURFACE INSTITUTIONS OR SUBSEGUEW OWNERS _ PAULBARYLSKIoYAH00.COM 3773 SEPTEMBER 13. 2019 �j• s' 1s' 0'-4}• s-2�• -5• 7'-s•�7'-6• ins wmNAT o1)L REMI)IDR tmE ACCQSAVCE ml THE nATm m IN Ems mn on smcen6. 13"1 1• �2,- 3•_, •_3}• 4'_2• -2. _'�� O tAAf1VE✓E Yf1I0H0fF66IDDffOIgtSIEN1Y D1IDe570N1(WCN HLDESIGN ASSOCIA m9emi a wrNaedn•ewa • • dere SOuftliNeNYdz 11971 E,Mot&a4®oplm4ne D Au.IF19I�l A�W� C•M1I Atwdclu LLC• DACADziebi LLC (2)19iY fl>j L0.UNL4 OTHFRISE NOIm ; ANDERSEN 3-ANDERSEN 3•ANDERSEN 3•ANDERSEN 1W285z SM iWt852 gr 1Y265z SM TY2e52 Them d=gs and tpeeMeaHont hduding the „ag RISY ALL DIIIEM OS ktea 0.design and arrangements roprBeen ted (z)t-3/P.9-t/x•LM. HERE 110 OF El AMIDEN thsTeF,,art the property of KEHL DESIGN 4,-'• IBI:-IP,tIN 005 N Nall. ASSOCIATES,U.C.No part thereof Shell be 0 51' eoplad.disdoeed to others or used In connection 0 It any Mork or project other than for which Jgg they how been prepared without written content. m f F I NM*PRM FIE BFm 4 c is m LZ LL �od J1110 X 9}"F.J.16•De�COVERED PORCH COVERED PORCH T REV.1lEzosxl6utluL DINETTE I 92DEM OEMTED 11-25-19 o N x bS DEFRare It R � � � 9DaNf P ? s,� NOT FOR SLINE OF6 ECOND ANDERSEN ANDERSEN ANDERSEN ANDERSEN g� CONSTRUCTION FLOOR -- T11288 3 11 3 X266% 5662 FRENCHWDOD 12080-4 USE UNLESS to Jva's\r-a.•+\c-r(s) (2)1-3/e.u-t/z'LK CERTIFIED BY A � 71 I '� PROFESSIONAL ENGINEER • q.4'-32• 0'-54• i4-- KITCHEN '-C N Z 1 VEFM FIREPLACE OPMO SaE N N N { A N I FARni xElalr Arm g x SPE CATIONS WITH OWNER, c" d uAaoNRr nREPtACE b z — -- VMW HUM WE I�� WrrHGREAT' O DINING ROOM ALL DWENSWNS -J 1 N�GEWH is PFx. Q O I i:1 NY CODE. O 0 , PRWme alrlsme AN _ As PER lar.NDE S t 0 0 O c DEC 9 2019 yWj m � N . n 1 C•m, � ;. L , .. ------- Fml OPEMNO'If1 _,. UTILITY RN. GUEST j ^ ROOM R a�HtWCltg SDUPm N w� ' ' A,6,� PROPERTIES T�' g F� •-W A'-er'. 4• E7Fc „ IFDAIED Im TIE=1 no�E SIA mill. •W+ I I ALL WXGS AE W ff 1 Y DEN MEDIA ROOM ~ I4Rt3Ct -1' - LAKESIDE DRIVE f AREA No (z)IKA tY Lx utL4 BEDROOM xeeo UNDER �2. otxo>tn SOU PHOLD,NY 11971 1 MUDROOM• * 5ro 1Bam ,� o 101R1ou�OdAS SCTM#1000-90-03-04 S� I�I FOYER v 31• -s•— —a'-e�' 7S -to• TIE zm5NmNAW ORA WING TITLE-- MT LAUNDRY E 2016 INFORM ROOM k ' �' &"MIT x 1-3 6� ; "=-COVERED a m FIRST FLOOR PLAN ❑ n ❑ 1680-aaeO-1680 b PORCH Aimsn°Ei°n �. ,is. •L x 1-3/4-.2-1 Eft. • — ——2——— - ''1--- _,• ©D�'IANMT 20111 IE1L TIM A59!>atTES LM ALL I=PLANS ANI EIEVA110S ARE MO SID SA7 RN AM M MWElff 6 MWD MM 1 NI BIS MTM BE� t a .1a ui Ftd_ 2 ,-3 4t a-t z �K EE MRMM WW FILO MU W 7E RI1SS HOBS DF E S M!MUM F 96YL tHiY NL •�., ARCHWAY ANDERSEN i7i'ANDERSEN WEf�I MMMTDL AALLL D ARE SNE PR(�W OF RSD EQHA9S FORMIR ASM ND LIBSINS ND M 9 RlR UM I�'9i�E FW FED FR IE ATW2652 ANDERSEN ANDERSEN OW 10 MM TW2652 TW2652 1W2652 � t TW2442 iW2442 —S 103E OF.9Q1 ASSODAILS,UG 71E RRiR 10 BIND OILY ONE SIA7ICRAE FROM TIEg !liDfM 18DIBD 09Ba96 AID 0t IID06 US W01�111�IIS WI� PLANS 6 DCDM DI0119YELY 1011E BIYFR,NM NUB PROOF OF R RM RINUT AMM®AS MW W T1Fg RADS. T— MY Doa ASSEMBLY IS Ampta oe of tlrox dnnige does not a lDla¢e the*t0 buk titltal tiro tt lhoriYatian MARCH 29 tote of rood gotal ilg agmd%NA Be Salfeli County Dept of Redm k*n Tm�0 p E 0 l 0 WDm o o�ma,ta DBS,FEIK etc. VW4 a Do6�min alp Io�eols 0 ad 1?29-ots � '-7 �j egmltbs ptbr to eaDatnldklL W._ 7-1, CHECKED ETY; DESIGN CRITERIA AND CONSTRUCTION TO MEET OR EXCEED ALL REQUIREMENTS OF THE RB >`2'-41• )'-6' V-e' �L�• _yJ�'_7b—�j•_�• _3�._ _3._,�. 2015 INTERNATIONAL RESIDENTIAL CODE UPDATED THE 2018 UNIFORM CODE SUPPLEMENT. AS AN ALTERNATIVE TO THE INTERNATIONAL BUILDING CODE THE FOLLOWING STANDARDS ARE PERMITTED SUBJECT TO THE LIMITATIONS OF THE THIS CODE AND THE LIMITATIONS HEREIN. I O� WHERE ENGINEERED DESIGN IS USED IN CONJUNCTION WITH g' 2' t'-,Dy 7'-t�' THESE STANDARDS, THE DESIGN SHALL COMPLY WITH THE INTERNATIONAL BUILDING CODE 1 •- r FIRST FLOOR PLAN 601- - FIRST FLOOR PLAN 1. AFdcPA WOOD FRAMED CONSTRUCTION MANUAL(WFGM) 2051 SQ FT LIVING SPACE 2.AISI STANDARD FOR COLD-FORMED STEEL FRAMING- 99 SQ FT COVERED FRONT ENTRY PRESCRIPTIVE METHOD FOR ONE-AND TWO FAMILY DWELLINGS(AISIS-230) 0KWtDE2GNAS5063A78,uc 350 SQ FT REAR COVERED PORCH SCALE:1W-1'-0• 3. ICC STANDARDS ON THE DESIGN AND CONSTRUCTION OF LOG STRUCTURES(ICC400) RIDGE VENT ©MIMIT 2019 IM)L DESM AMMIM LLC,ALL FLOOR RANG AND ESAIM ARE 2x5 RIDGE BEAM PROTECTED NO FD)DIA CWMff UW.RANG MAY NOT EE REPR07110ED WW 12 MM AM IMUAWL ALL PULS AND DE MS ARE TIE SOLE PRW M1Y OF 6� XBL DW AGSOOATES UG TIE MIT M IUD ONLY CK SIN=FROM 1IM 12 RAMS 6 UMM EXQM9RY M)ME 9MfBC MRH MfRMPI PROOF OF RRDIAZ (1)1-%"x 11-W LVL RIDGE BEAM Acapfmao of these dlasige does rat alholiit Mie r4h1 to Its IrRllatt Den aatllaimtkn dh KEHL DESIGN ASSOCIATES, uc of lord puff*Wici,4 md1 m%f(c&(body Dept of Hm191 Sake,Tan&M5 INK dam. ..I" . ———————————— ————————————— I-— , D�6n v DEC RMA e(e Yeiy d caldMam coda and lequiellelb vb ad ,2 agaldesprlor mlxrotruc6aL PO.BG116)s pnae:lslgaxi-iti GAF CAMELOT 12 souftd0ewyok 11911 Uld zbrdf(OopW&j INSTALLATION AS00PER MANU FACTURES ACTURES SPECS I —15.5 I e'p, RED CEDAR SHINGLE ROOF DESIGN CRITERIA AND CONSTRUCTION TO MEET OR EXCEED 2x HANGERS cc 9A•COX ROOF SHEATHING ALL REQUIREMENTS OF THE 2015 INTERNATIONAL RESIDENTIAL 4(n'COX ROOF SHEATHING -4—= HANGERS CODE UPDATED WITH THE 2016 UNIFORM CODE SUPPLEMENT. x�N o.0 Acxexe uc.r� oAcnmame.uc 200-16'oe RAFTERS CE&WATER SHEILD AS AN ALTERNATIVE TO THE INTERNATIONAL BUILDING CODE „ 2x4/2xfi R-30 INSULATION 2x10-15'cc RAFTERS THE FOLLOWING STANDARDS ARE PERMITTED SUBJECT TO THE OWNERSHIP&m”of umuK ICE&WATER SHETLD STRONG BACKj LIMITATIONS OF THE THIS CODE AND THE LJMITATIONS HEREIN. These drowInge and cpeeiNoatlons Including the x5-16 x WHERE ENGINEERED DESIGN IS USED IN CONJUNCTION WITH Ideas,dwign and orralgsrnwnts represented e'FASCIA THESE STANDARDS, THE DESIGN SHALL COMPLY WITH THE ��are_the property �y f KEHL DESIGN be a vs INTERNATIONAL BUILDING CODE P� In connection mrvOOWS TO BE SET AT 7'-5' 1. AFdcPA WOOD FRAMED CONSTRUCTION MANUAL WFCM with any or project otherto others or�Nn for which ( ) they have been prepared without written consent. 2x8 RAFTER LEDGER MASTER BEDROOM Fmm-LOFT 2.AISI STANDARD FOR COLD-FORMED STEEL FRAMING- 2x8-16'cc RAFTERS o 'w PRESCRIPTIVE METHOD FOR ONE-AND TWO FAMILY rte• W COX ROOF SHEATHING In •I I DWEWNGS(AISIS-230) "- 19 ICE&WATER SHEILD 1` WI40 x 11-7/8'-16'as OAK FLOOR SLOG STRUCTURES(ICC400)NDARDS ON THE DESIGN AND CONSTRUCTION OF NOT FOR 3t 12- 3/4'COX SUB FLOOR R-30 INSULATION R-19 INSULATION CONSTRUCTION TJI580 X14' j FLOOR SYSTEM 16•oc USE UNLESS—B'FASCIA CERTIFIED BY A B'FASCIA—� 0'-1D}• 12'VENTED SOFFIT(SEE DETAIL) PROFESSIONAL HURRICANE (3)1J"x 11a'LVL GIRDER STRAPPING DOUBLE 2zB PLATE 2x6-16'cc WALL STUDS ENGINEER 1/2'COX SHEATHING 8•z6'AZEK BEADED WAINSCOTING4P DINING ROOM R-19 INSULATION 15•FELT I PACK OUT&WRAP GIRDER AND FALSE GIRDER I M40 x 14'-16•x •I 6x6 POST PACED OUT AND WRAPPED w/914TRIM OAK FLOOR FOYER 2z6 PLATE CDX SUB FLOOR 1-1/6'FlBERSTRONG RIM BOARD ELEVATION SCHEDULE r X 6•TREX DECKING (AS PER MFG.SPECS.) WORK NOTES: 4'PC.SLAB W/6X6 WWM. 2X10 ACO BOX BEAM WRAPPED WITH AZEK WI40 x 14'FLOOR SYSTEM 16'oa ON COMPACT FILL V.I.F.FlMSH FLOOR 1428' (4)2X12 AGO BOX BEAM PACKED OUT AND WRAPPED WITH AZEK 2X1°AGO FLOOR JOISTS 16'oa. SILL (2)1Px M R-19 INSULATION 14'LVL BOX BEAM W 12 x 30 STEEL BEAERMI°EA TERMITE -SILL SEAL TCP OF FOUNDATION 1274 FINAL GRADE FINAL CR 12'SOMA TUBE W/8•x18 ANCHOR BOLT DAMP PROOFING OF 11.99' NEW CLEW RLL 4 x 4 STEEL BOX OF BOTTOM (2)#4 VERTICAL REBAR TUBE :i'MN ON —8'x18•ANCHOR BOLTS MAX.8'-0'oc GIRDER 11.83' 1'-4'x 2'-s• I e'PC FOUNDATION WITH SONA TUBE PIER ON VERTICAL REBAR m 4'-O'OC. 24•x 24•x 12'CONCRETE FOOTING 24'x 12'CONCRETE FOOTING 4'-0'x 4'-O'x 1'-0' AND WITH(4)195 REBAR L.W. WITH(4)#5 REBAR LW. OONC.Fro.WITH#5 R®AR OTED ON°FROUNDARON DETAIZONTAL REBAR L FLOOD ELEVATION B.0' NEW CLEAN FILL SPACED EQUALLY,AND#5 NEW CLEAN FILL SPACED EQUALLY,AND#5 CRAWL SPACE s•oc.EA1aL WAY(TMP') ? CRAWL SPACE REBAR 24'OC.S.W. REBAR 24'OC.S.W. TOP OF SLAB 8.27' MIN 3'-0'BELOW FINAL GRADE MIN 3'-0•BELOW FINAL GRADE NEW CLEAN FILL NEW CLEAN FILL L 2x4 KEY WAY BOTTOM OF SLAB e.1' GRADE(VERIFY PRIOR TO CONSTRUC110N) CROSS S E C T I 0 N /-� 24•x 12•CONCRETE FOOTING (VA F.)APPROX.BOTTOM OF FOOLING 4.74' A WITH(4)#5 REBAR L.W. SCALE: 1- L r-On O 24•NTH 2(4)#5 CONCRETE FOOTING FLW.NG SP REBAR Q24"OC.S.W.UALLY.AND� SPACED EQUALLY,AND#5 MIN S-O'BELOW FINAL GRADE �---y �— —iREBAR 24"M S.W. g I I I D� -H 0. i j '1 1 3500 PSI CDNC. zxs ACQ 15- 1 3300�P5 GONG i GENERATOR I 6xe/toxt0 WVA1•J I BC I I I 8%8/10X10 1VIaA. 2X8 ACO UNITS I I UNITS I z JOISTPROPERTIES GIRDER 4`I DEC 9 2019 L—J L—J 10'GONG WALL 1 - 1 12'CONCRETE Fl 2X6 ACQ NEW CLEAN LAKESIDE DRIVE CONIC, PAD FOR GENERATOR CONIC. PAD FOR AC UNITS SONA LUBE BOTTOM GIRDER FILL SOUTHOLD,NY 11971 MIN.3'-O'BELOW FINAL GRADE &LtI_J SCTM#1000-90-03-04 12•CONCRETE Fl CONFl 12' CRETE SONA TUBE.BOTTOM SONA TUBE.BOTTOM DRAWING TITLE*. NOTE: BUTTRESSES TO MIN.3'-O'BELOW MIN.3'-O'BELOW LOCATED NEAR OF OF FINAL GRADE FINAL GRADE ELEVATION SCHEDULE RETAINING WALL AND AT 16' RjAlOjlJyALL RAINING WALLWALL CROSS SECTION INTERVALS ALONG THE ALONG THE WALE STAIR FRAMING 8'X6'TREX TOP RAIL 7BST HOLE DATA HOUSE BY Md)ONALD OEOSCENCE IEX RAS ME M PURNEI1 ff ME MW AD AM x 1u�IY ff THE STONE CAP 4X4 ACO POST a^��1e om FADEmw Nm sm B mm mm IFAIBENR ELM FINISH FLOOR HEIGHT 14.28' #s REBAR 12'x MOM MTERUM EXmrtWIffM0 ZU MY ALL EACH WAY NEW CLEAN4 RED Mf1u6 AID OIFIt'im6 ND ff$BEY IEEE Lm R30 Fn lE ELEVATION SCHEDULE FILL 8'X 6'TREX DECKING EL=X.X' DL9BIIRMM&1A59AFSIMILIMFMDMMMIt TOMMm TOP OF FOUNDATION 12.74' 2X6 ACO FLOOR JOIST 12' uf�11110 Maus AD a 1111111313 NO M MINIM Wr CLEAN GRAVEL 1.25'-2• OL DARK BROWN LOAM FaMY AO MM AS EM 1D ME V.I.F.FlNISH FLOOR ,428' TOP OF BLUESTONE CAP 12.16'�— 1• WEED BARRIER TE FINISH GRADE 11.99' NEW CLEAN 'O' sM MARCH 29 2018 TOP OF FOUNDATION 1274' \\ FINAL GRADE 11.99' BASE O F RETAINING FILL I. 4X4 ACO POST ----3' PALE BROWN FINE TO COARSE SAND a BOTTOM OF ORDER 11'83' WALL ELEVATIONS RETAINING ' 4x4 POST ANCHOR _ML_4' DRAWN '°ze-2oi5 WALLCRAWL SPACE 6X6 ACQ NEW FINAL GRADE 6.0' r RETAINING WALL BOK X8 ACQ HECKEn 13Y` FLOOD ELEVATION alY EXISTING GRADE 5.0' -- 6 --L.. _ RETAINING WALL SP BROWN FINE SAND RB JS REBAR 12'oc. .� 8'x18 ANCHOR BOLT = SHEET NUMBER: TOP OF SLAB 6.27' EACH WAY z' �e GM OF SLAB 6.1' WA1 WMIVIBSfJMOTING GRADE 3.0' —j 12*C NBEEBFIIIEEDD 8'3' A302 r 05 REBAR 12'x FINE SAND 1.7' s10RTWAY (V.I.F.)APPROX BOTTOM OF FOOTING 4.74' (8`g REBAR MIN.3'-O'BELOW - L G WAY FINAL GRADE SP WATER IN BROWN FINE SAND RAINING WALL AND AND BUTTRESS CROSS SECTION RETAINING WALL RETAINING WALL DETAILS STAIRS DETAIL COMMENTS: WATER ENCOUNTERED 8.3' BELOW SURFACE � 7■Sr •f� 1�� K � , 7TH r xx r� 'J *tel � ��.,, j � /�� %y� ✓. a Y. +,Y �, ;� AM w , i L ,w �, R� T j' � ��w� `�f..., ! •i �'� t a `t . �- r ,�� rw - I � � # � � 1 `` .. �.�. _ ,,r _ .. yy+ f' � , ., s � � 6 ' - .,..",, ..may R :. �' "e +.. '�z 1I.C'r `^' � ,. ��r� `� - .y ��+�,.. � .`tA ,�� _ �'Yom, _f t:''�^ .� t y � x i w•wry i{�[�I � F 7 S �QJ}Y3 J }-�. 'I�`#w � � 1.�^� j�. �ri`� ��f f 1 Jj� '�; ��� -! f r ,� ���� 7' .. � � Gi I �f. '�i"rig��w ;P- l ��r y� A�jr ' .� /! � � <'i` a �� ~�- 1 * � . r � l�' C' _ _ _ ���y- �cf •�. t. - _ 'lrt '_ _ �. yK� f- .AAs-,,, _ - _ - _ - •inq,'�. �� � - i � .' '.� '��. ,tr.�` ...',t�_.,W7AI' _ � a�9Y.�I'ii�����.f��lti•';�!�.T,J�4�I�..,• c a\�+:�C ej {�t / ♦ A / N G 6 T TOMOF ' Sd/nIO1J t w e3 ♦ O `.a1.T w 1] A NI 1 O �qi w a M Z7 e sw V 7 A Arr + z W 0" Z •�./ a1 i4 nw - 6 (-15 1 1M ' s Q ,7µq s s P w • / 12 ft --------------- IONMOF. St 1\ A SIXJn10L)'� 13 ,.d. O CEDq a ` R POINT - y P o 7gN1OF8M110tO ,w + n w A P 2Sis WEST � � i CFC fa 0 1 R LAKE m - ° a, m "� SO1R11 u1. N.117 4WW DR. /:1 W. LAKE �.!! '11Mc) 161> 1B 12W) 25 20 1 b 1B 20 Tf 22 z9 a r 5 e Yyy/��� A b '.9.1 . 't b d $ :2 ] HOG r � �.. NECK SAY >�gl r +oa.or ----- - - --- COUNTY OF SUFFOLK © N SOUTHOLD SECTION a. n==='-' ,o,.„., =-7— as NOTICE 09( Real Property Tax Sernce ncy r .. .. WIP, r: L z s Michael J.Domino,President OF SOUTyo • -,tTown Hall Annex ,`Q l0 • 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams 0� COUNTYFax(631) 765-6641 ,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only . Coastal Erosion Permit Application Wetland Permit Application 9 2019 Administrative Permit /Received 1 _- - � Received Application: �Z'�•�� '.'s i/ Received Fee: $ ?-SO. Completed Application: IZ•l�•� Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): ,3.ZO LWRP Consistency Assessment F rm Sent: DAC Referral Sent: 12-IT-4 ate of Inspection: i g' Receipt of CAC Report: Technical Review: Public Hearing Held: ],, I Resolution: Owner(s) Legal Name of Property (as shown on Deed): /�D/''�� FCA U S -LMailing Address: 1060 14/0 1 P �� 0 I ,y� ( � q 1 Phone Number:-0 (C 1 q 9A G' Suffolk County Tax Map Number: 1000 - q Property Location: SO(-) aV P r &el �C (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): Mailing Address: Phone Number: 500 Lakeside Drive Southold NY 11971 SCTM 1000-90-3-4 1. Construct a new 2 story family dwelling with a 1650 sq ft.floor plan. The basement will be a 3'11"crawl space. Construct a 528 sq ft detached garage with a concrete floor. A new I/A septic system will be installed on the property. 2. A reinforced 115' conctete wall will be installed along the wetland side of the property. The wall will be 7'x4". The wall will be 41"above grade. Natural stone will be installed on the face of the wall,with a Bluestone cap. A 4' planting bed will be in the front of the wall. (see attached drawing) 3. Wood stairs will be 6'wide with 5-8"steps on the wetland side of the wall. 6-3'Sonotubes 3' below grade will be used to support the steps. ACQ treated lumber will be used for the framing and cedar for the treads and railings. The landing will be 6"x6"ACQ treated lumber with Bluestone gravel in the middle. (see attached drawing) 4. Deck and Stairs Construct a 35'x10' deck attached to the house. 7-24"x24"x12" concrete footings will be poured, 12" round concrete Sonotubes will be used to support the deck and stairs. ACQ treated lumber will be used for the framing and cedar for the decking and stairs and railings 5. Clean fill will be brought in for behind the new retaining wall and the new I/A septic system, approx 400yards of fill. 6. Generator pad will be 4"x5'x4' poured concrete. Air conditioner pad will be 4"x5'x15' poured concrete 7. Gutters and all leaders will be attached to the new drywells. 8. Driveway and walkways The driveway will be approx. 1200sq ft with RCA for the base and bluestone gravel. Pavers will be used for the250sq ft walkway the base will be RCA and pavers will sit on 1"of sand. 9. Pool and Patio The pool will be24'x35'concrete/gunite material. The patio will be Bluestone set on a 4"concrete slab approx. 950sq ft. planting beds will be along the top edge of the retaining wall and patio. Board of Trustees Applj' tion 11 GENERAL DATA Land Area (in square feet): (7- 11 q )S Area Zoning: Previous use of property: f Yl Intended use of property: e \ ILA Covenants and Restrictions on property? Yes �No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? /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 ___L,No If"Yes", please provide copy of decision. Will this project require ny 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? V_. No ' - Yes If yes, provide explanation: Project Description (use attachments if necessary): C o aahA� - %L 'l 11,k)PA I X/,K_Q, cy--) VO C CIO+ e Board of Trustees Apple tion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: VYi Area of wetlands on lot: 13900 square feet Percent coverage of lot: Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated?_�_Q 0_cubic yards How much material will be filled? Iv cubic yards Depth of which material will be removed or deposited: _ feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: yni 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): 617.20 Appendix B Sliort 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: Q Project Location(describe,and attach a location map): Brief Description of Proposed Action: Cons car as �s��1e, ) C)-Soo s - �y P�o Name of Applicant or Sponsor: Telephone: 5/� _ � coo Mn C ` E-Mail:i ` IC6 '-,'s 0 f Address: City/P State: Zip Code: o yA-1,1W N� 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO I 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: ❑ 1 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? acres i 4. Check all land uses that occur on,adjoining and near the proposed action. E]Urban El Rural(non-agriculture) ❑Industrial E]Commercial [91 esidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Pagel of 4 ' 1 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? 6. is the proposed action consistent with the predominant character of the existing built or natural O YES landscape? ❑ 7. Is the site of the proposed action located in,or does it �om,a state listed Critical Environmental Area? NO YES If Yes,identify:��-ry (C r p k ❑ 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? AO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: Tl ❑ LIP 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? Vr ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Ideptify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: [Shoreline ❑Forest ❑Agri cultural/grasslands ❑Early mid-successional [Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ 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-point sources? NO ES If Yes, ❑ a.Will stuini water discharges flow to adjacent.properties? NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff andto drains)? If Yes,bri fly describ : ❑NO WES 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: ❑ Iffl 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: ❑ 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: k a d( 2A, I) 1tR Pn®l- Date: Signature: z 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 Elregulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 Q No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 1 l. 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 mayor 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. r EICheck 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. EICheck 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 4 Board of Trustees Appli ':ion AFFIDAVIT N O k�,Ll ' c S ' BEING DULY SWORN DEPOSES ANDA FIRMS 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 of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF CJ� eL an b" , 20 1!�__ Not Public g"P o Nawy Messer' troraav`. Notary Puhlic,State of New Xock No 01ME 6177256 ., aueuo 1 Qualified in Suffolk County `M;4yi y y Commission Expires 11]jlM APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pumpse of this form is to provide information which can alert the town of ssible conflicts of interest and allow it to take whatever action is necessary to avoid same. i YOUR NAME (Last nam6,fust name,giiddle 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.) r 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 even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)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 G� Submitted this, ` _day of 20 Signature •� Print Name Form TS I Towri 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 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-. supportink 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# /0 '9 PROJECT NAME 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: NJ i - -6-TW A Location of action: � �s Site acreage: 5 Present land use: y—a c-ou- T \ard Present zoning classification: 1� y 2. If an application.for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: ` �y (a) Name of applicant: �a,Y\L (b) Mailing address: J O E)O (k)ake/rVl P1w (c) Telephone number: Area Code( ' (�� a� Q(O O( (d) Application number,if any: N/ Will the action be ' ectly undertaken,require funding; or approval by a state or federal agency? Yes ❑ No 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 LWRP Section III=Pol' es Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No MNot 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 R NoNot 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 —.Policies Pages S through 16 for evaluation criteria Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III =Polici s Pages 16 through 21 for evaluation criteria ZYes ❑ No El Not Applicable 0 . 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 N - '<Lpplicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LVW Section III — Policies Pages 32 through 34 for evaluation criteria. Yes No Not'Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wZApplicable ee LVW Section III—Policies; Pages 34 through 38 for evaluation criteria. F] Yes El No PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the.Town of Southold. See LWRP Section III=Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye❑ No N Not Applicable Attach additional sheets if necessary WORKING COAST POUCIES 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 F1 No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town water See LVVRP Section III-Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes 1:1 No Not Applicable ` Attach additional sheets if necessary Policy 12. Protect agriculturallands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No U Not Applicable r Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. 'See LWRP Section III—Policies; P ges 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable l PREPARED BY TITLE DATE