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Home My WebLink AboutAntunovich, Richard & Anne Glenn Goldsmith,President QF S®(/,� Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ®� ®� � ® P.O.Box 1179 Eric Sepenoski ! f Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � �� Fax(631) 765-6641 Cou V,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 21, 2024 Ural Talgat, RA, RLA 436 7th Street Greenport, NY 11944 RE: RICHARD &ANNE ANTUNOVICH 1845 EAST GILLETTE DRIVE, EAST MARION SCTM# 1000-38-4-26 Dear Mr. Talgat: The Southold Town Board of Trustees reviewed the site plans prepared by Ural Talgat, Architect, last dated November 1, 2023 and determined that the proposed construction of a proposed second floor addition and new covered entry onto existing dwelling is out of the 100 foot Wetland jurisdictional area under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary, or within 100' landward from the edge of vegetated wetlands, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. This determination is not a determination from any other agency. Sincerely, Glenn Goldsmith, President GG:ec Glenn Goldsmith,President ®F S®U�� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route P.O. Box 1179 Eric Sepenoski J8 Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 c®U ,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NON-JURISDICTION INSPECTION DATE OF INSPECTION: `� Z INSPECTED BY. Ch. 275 Ch. 111 COMMENTS: � c nn NOW OR FORMERLY GARDINERS BAY COMPANY v < � O m m EX I ST I NC7 FIRST FLOOR < EXTERIOR OUTDOOR �n LOT COVERAGE TABLE DEC,< (2-75 sf) W < SITE AREA TOTAL: 10,000 sf _Z STRUCTURES EXISTING PERCENTAGE PROPOSED PERCENTAGE I� NEW SECOND FLOOR RESIDENCE: 1,480 sf 14.5 % 1,450 sf 14.5 916 A- FIRST FLOOR DECiG: 2"75 sf 2.75 % 2"75 sf 2.-15 016 ADDITION sf) CO OVER O sf O 0/063 sf 0.63 OVER EX I ST I NCB FIRST 51/0 EXISTING FLOOR (1 ,48o sf) TOTAL 1,155 sf 1-7.5 % 1,515 sf 15.15 510, 1 STORY 3 BEDROOM VAS FLOOR AREA CALCULATIONS RESIDENCE roftvoint No. 1845 SITE AREA TOTAL: 10,000 sf STRUCTURES EXISTING PROPOSED Koad Residence let floor: 1,480 sf 1,480 sf (� 10, Residence 2nd floor: 0 sf 1450 sf PRINCIPAL PRINCIPAL TOTAL 1,450 sf 2,a60 sf STRUCTURE STRUCTURE SIDE YARD EXISTING SIDE YARD SETBACK ATTACHED SETSAGK < 1 CAR GARAGE PROPOSED NEW GoVERED ENTRY MAX GROSS FLOOR, AREA I PORGH (6 5 sf) SITE AREA TOTAL: 10,000 sf ~ AI loveable gross floor area: 2, 100 sf m � � Q� < _ Q N Existing gross floor area: 1,480 sf per N Q Proposed dross floor area: 2,1�60 sf < v _ z < N O N v 00 , Proposed building Id in area total :: 2 �6 0 sf oa- N � � Y_ 1H p g ' IL 0 z w O < } — Proposed building area increase: 860 sf, 40.15% O ly O } � DAEA SCTM # 1000-38.-4-26 - gt PROPERTY: 1845 East Gillette DirJ) _ ?x ADDRESS East Marion NY 119,39 ` JAN 18 OWNER: Anne Antunovich 202 pavement edge Richard A Antunovich Sol 86 Inlet View Path __ P^ordofTrusf:ces East Moriches, NY 11940 SITE: 10,000 sf = 0.229 ac East rive ZONING: R-40 Residential SURVEYOR: Michael W. Minto, LSPC 87 Woodview Lane Centereach, New York 11720 License # 050871 DATED 1 / 9 / 2021 Fill AN I U1 10VI R E 40% N W.0 Ro SCALE : 1 /8"=V-011 EAST MARION, NEW YORK DATE: 9-27-2023 REVISED DATE: 11-1-2023 �P't TAzc �10. U RAL TALGAT ARCHITECT 436 7th STREET GREENPORT, NEW YORK 11944 Z BA APPLICATION ;. (631)477-8963 / / / 6ARASE TWO DE K STORY HOUSE ORIENT HARBOR r � EDGE OF WETLANDS POOL I IGH WATER �J LINE PROJECT PROPERTY i, I n � I r n I I m m 11 EG 10.4' 43.5' DECK 34.4' �— DE OK I — -------- Two TWO I ONE STORY STORY STORY I HOUSE IS' HOUSE HOUSE I IOZ Cleaves Point I \ I r——————--- -- Road L———————— — J _ I m I 15.2' m EXISTING \ cv BULKHEAD \ TWO East Gillette Drive STORY HOUSE \ DECK (V N — 2q' m 28.8' I I \ DECK 22' TWO Cleaves TWO STORY Point \ STORY DECK I HOUSE o a d HOUSE DECK I I I \ f \ N N N \ A I"m" 'm 'I' U N V I H R E I N EAST MARION, NEW YORK DATE: 11-1-2023 JQt'LTA`O9y''� ORAL TALGAT INOEIGH 'BOR'HOOD wpo" LAIME ARCHITECT SCALE: 1 "-30'-0" 436 7th STREET 02403 yo� GREENPORT, NEW YORK 11944 Z BA APPLICATION (631)477-8963 i THE EXISTENCE OF RIGHTS OF WAY UNAUTHORIZED ALTERATION OR ADDITION DRAWN MM. CHECKED MM I DATE JAN. 2021 DRAWING i JOB N0, 20-1195 AND/OR EASEMENTS OF RECORD IF TO THIS SURVEY IS A VIOLATION OF ANY, NOT SHOWN ARE NOT SECTION 7209 OF THE NEW YORK STATE GUARANTEED. EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING Area 1 IO OOO S.f. THE LAND SURVEYOR'S INKED SEAL OR Premises known as: EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. # 1845 East Gillette Drive, East Marion GUARANTEES INDICATED HEREON SHALL RUN 7�EEnvONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND ptTO THE ASSIGNEES OF THE LENDING INSTI— D 4 TUTION. GUARANTEES ARE NOT TRANSFERABLE. 6 I I Southold Town of Trustees s 0 �o V13% 00 �z dn�ewoy s A !O c 2 o °66j, ' do 'O. �r o a oo qg fI i- c 055 01 N��y PEA W O ` 0 Rc2s 00, es 0 sFOC�N 7S��J Survey of Lot 82 D Certified to: MAP OF MARION MANOR ABSTRACTS, INCORPORATED MAP N0. 2038 FIRST AMERICAN TITLE INSURANCE COMPANY situate at RICHARD ANTUNOVICH AND ANNE ANTUNOVICH East Marion NEWREZ LLC ISAOA/ATIMA Town of Southold, Suffolk County, New York Michael W. Min to, L.S.P. C. District 1000 Section 38 Block 4 Lot 26 LICENSED PROFESSIONAL LAND SURVEYOR NEW YORK STATE LICENSE NUMBER 050871 Scale 1 "= 20' Surveyed August 13, 2020 87 Woodview Lane Updated January 9, 2021 Centereach, N.Y. 11720 GRAPHIC SCALE PHONE/FAX: (631) 580-1202 20 0 10 20 40 801 CELLULAR: (631) 766-9714 W EMAIL: mikemintolspc®gmail.com ( IN FEET ) 1 inch = 20 ft. Ural Talgat RA, RLA Architect and Landscape Architect 436 7eh Street Greenport NY, 11944 January 16, 2024 Board of Town Trustees Town of Southold Town Hall, 53095 Main Road P.O. Box 728 Southold New York 11971 ERE ORe: Antunovich Residence JAN 18 1845 East Gillette Dr. East Marion, NY 11939 Southold Town SCTM# 1000-38-4-26 bwofTrustees Dear Trustees: Enclosed please find two Site Plan drawings, Trustees Application and a check for$50, for the property referenced above. The proposed construction is greater than 100 feet from the edge of wetlands; we are therefore requesting a letter of non jurisdiction from the Board of Trustees. If you have any questions, please do not hesitate to call us. Sincerely, Ural Talgat <N r: Glenn Goldsmith President . . -<: y.. Town:Ha Annex .: ... :a �. 54375 Route 25 A:'Nicholas Krupski,Vice President' :;x�:''... P.O.Box 1179. : • Eric Se enosln..- }" ... r p ,; .. _. .... Southold,New York 11971 .. L :. ;: - e 1 � .: ..'4... . T lephone(637) 765=1892 z Gillooly.: �: �':: .. .... ', � . . ...._ Elizabeth Peeples:. :. . B®AR,D OF T®WIo1 TRUSTEES ...... .. ... ..... ... .... .....'_.. TOWN OF SOUTHOZ,D .:....... :.: - - -.This Section For®Ilice Ube Only. Coastal Erosion'PermitA plication Wetland Permit Application_ • Administrative Permit... 9 .: ' ... .:'......:. 'Amendment/Transfer/Extension'. .... . ..'..:..... .: :: ..:: Received Application:-- - JdN : : Received Fee:, ::. -Com feted A licatibri:::.:. p pP s old Towq- Incom lete::;....: ..:.::.'.... .: P SEQRA Classification: Type I Type II :::Unlisted:': Negative Dec: Positive Dec:.:.::� _- Lead Agency Determination Date:. . Coordination:(date sent):.. LWRP Consistency Assessment Form Sent:::_..::.:.:.:'.:::::.:':....,„r:>.'......: CAC Referral Sent::. ._. Date of Inspection: Receipt of CAC Report: Technical Review: :. Public Hearing Held:.__;: Resolution: Ovvrier s Legal Name of pro e as shown on Deed)-:J.Richard-A.:Anfuho" i ti-&:Anne:Antunovich: O g PAY ( Mailing Address:.::86anlet View Path;.fast Moriches,:NY 1:19�4p:' 631 A- 95 323:1 Phone. um er:. :....'.::.:......".:::::::: :'::. :..5uffolk County Tax Map Number: 1000-:38-t}4=26:::.:':.:::.:::::.:.::. Property Location:'1845. East.:Gillette Drive,:.East Nfanon;::NY. eet orth o_ .' leaves Roint Road:.:.:.:. w. If necessa roti ide LILCO Pole4, distance to cross streets--and location rY,P ' ) :.. AGENT(If applicable) g 436 7t Mailin 'Address:....:. G�eenporf; NY.:11944.:::: Phone Number:: 6:3�-47:78963 Email:;Ur 9.@h al5 dtmail:cbm Board of Trustees Aipplication GENERAL DATA 10,000.sf........................ .. ..... .... Land Area(in square feet)::,._ Area Zoning::..R-40. ....... ............ Previous use of property:. Residence-Single Family Sin le Family Residence - Intended use of property:..:. g . Covenants and Restrictions on n Yes ✓ .-.No property? 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 J�No If"Yes", please provide copy of decision. �his project re%arq 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_D_No Prior permits/approvals for site improvements: Agency Date Southold Building Department. BR945270 As Built 10/1/20.. ...-_. Southold ZBA #1229..-2/27L69..................... ❑ No prior permits/approvals for site improvements. Has any permitlapproval ever been revoked or suspended by a governmental agency? FV No ❑ Yes If yes, provide explanation:...... ..... . . .... .... . Project Description use attachments if necess Add a second story .to the existing.one.-story. single family residence with existing attached garage. Eoard of Trustees Application WETLAND/TkeStikk LANDS APPLICATION DATA -stor AM .second story._to the existing one Purpose of the proposed operations: single family, residence-with-existing attached, ........... Area of wetlands on lot: . ...square feet Percent coverage of o. % 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?. cubic yards Ho* much material will be filledT. ..... ... ....... cubicyards Depth of which material will be removed or deposited: 0. feet Proposed slope throughout the area of operations: 0% Mariner in whichmaterial will be removed or deposited: Bobcat 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): none ....................... .......... .................... ....... ............................... .......... ............. 1 Board of Trust ees _'plication AFFIDAVIT Richard A. Antunovich and Anne Antunovich BEING DULY SWORN _ DEPOSES 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 of Property Owner N of Property Owner Richard A. Antunovich Anne Antunovich SWORN TO BEFORE ME THIS k+ DAY OF %VO 'Mb� �.24 2� KERRI L. WILLIAMS Notary Public-State of New York nA"%V AFIZ No.01W16431958 ry vy/ Qualified in Suffolk County Notary Pu 4blic My Commission Expires 0418/2026 Board of Trustees _,plication AUTHORIZATION (Where the applicant is not the owner) I/We, Richard A. Antunovich and Anne Antunovich owners of the property identified as SCTM# 1000-38-04-26 _in the town of I ` Southold ,New York, hereby authorizes Ural Talgat to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. Property Owner's Signature 4PrortyOwner's Signature Richard A. Antunovich Anne Antunovich SWORN TO BEFORE ME THIS�1�+ DAY OF '/ ( Vft r- ,.20� KERRI L. WILLIAMS ` Notary Public-State of New York _ No.01 WI6431958 Notary Public Qualified in Suffolk County y My Commission Expires 04/18/2026 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code.of Ethics prohibits conflicts of interest:onthe parttoftown titficers and:em-ogees.The puro-se of :this form is to provide information which.can alert•thetown of possible conflicts of interest and.allow`it to take.whateveraction'is necessary to auaid same: YOUR NAME: AntunOVlCh, Anne (Last name,first name,*iddle initial,unless you are applyingin the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ✓ Change 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.chile))'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:busirress, 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 56%of the shares. YES NOS. 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/replesentative)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): f1A)the owner of greater than 5%of the shares of the corporate stock o f the applicant. _n (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity.(whenthe 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 // Signature Print N me nne Antu vie Forin TS I APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold',Code of Ethics DtQhibit§conflicts of:interest on.the art Ftown officers and em to es.The purooseof ;this form is to provide information'which can alert the town of passible conflicts of interest and allow it to take whatever action is necessary to avoid same, YOUR NAME: Antunovich, Richard A. (Last name,first name,ipiddle 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.) I NAME OF APPLICATION: (Check all that apply.) Tax grievance Buildiing 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 persorally.(or through•your company,spouse;sibling,pare)tt;or child)have a relationship;with any officer or employee of the Town of Southold? "Relationship"includessby blood, marriage,or business`interesL"Business interest"means,a business, including a partnership,in which the town officer or employee,has even a.partial ownership of(or employmenrby)a corporation in which the town officer or employee owns more than-5%of the s ayes. 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,o'r child is(check all that apply): _nA)the owner of greater than 5%of the shares of the corporate stock o(the applicant -E (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corpora"te 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 yt,,,dafo AhO 1,1� o 2 Signature Print Name,Richard A.Antunovich Form TS 1 AP PLICAIVTIAGE1`T'7MEPRESENT'ATIV E TRANSACTIONAL DISCLOSURE FORM The Town of5outtsol8'.sCodeofEthics:Qrohibits<ooriflictstifinteces oothe:paitoffowii=a ceisanoempltiirees:The Mmose-of :this form is'ttr:nroyide inforniatioir which.cari:siert tlie:town.:of dtrssilife conflicts ofiriteiesCariii allow it to take:whatever ac6oci is. necessaty:to:aydid.same YOURNAME:.. _ Talgat, Ural (Last name,first name,iriddle initial,unless you are applying_in.the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ✓ Change of Zane 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:cornpany,spouse;sibling;-piiiint or.child)haw- a relationsliip:with any officee:or#mp[dyse. of the Town o£Southold? `'Relation§hip"includeitby:blood;:.ittart agei-fWbusiriessiartetest:"Business iittemsC'meanss:.business, including a.partnership,:in=which the town officer or empioyce has even a_pac tial ownership of(or employment by.)a corporation in which the lq*Woffieer or employee owns more th6h.3 7a of-tlie shares. YES . �. NO ......... ✓ .....:.I. 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/agentfrepresentative)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): —EJA the owner of er than 5 Mi oifthe shares of the co 6 c raicstockofthe licmt P� � app�. -.:. Y: E[ when the `( applrcant is a sotporairbn); > B)the legal or beneficial owner of any interest in a non-coiporafe:entiiy.(*bin=the -E applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th'>`(/ d �� 20 . Signature. Print Name.Ural.Talgat Fonn TS I 617.20 Appendix B Short Environmental Assessment Form Instruetions..f�r:Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification..- Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. ........................ Part t-Project and Sponsor Information i Name of Action or Project: Antunovich Residence Project Location(describe,and attach a location map): 1845 East Gillette, East Marion, NY ..................I:..........:....: ..__. ..:..:_.::, Brief Description of Proposed Action. Add a second story to the exisiting one-story,family residence with existing attached garage: Name of Applicant or Sponsor: Telephone:63'�- 9rJ-3231_ Richard A. Antunovich & Anne Antunovich E-Mail: arg a7380@gmail.com... Address: . . 86 Inlet View Path City1P0:. State: Zip Code: East Moriches NY 11940 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, 'NO,..,. .YES.:_ administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. Iflno,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: J. Southold Town Building Permit, Southhold Town ZBA 3.a Total acreage of the site of the proposed action? Q23 .. acres b.Total acreage to be physically disturbed? n..n.Q1Q...... ...acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.23 acres 4. Che 11 land uspQ4at occur on,adjoining an ar the prop action. Urban L_IRural(non-agriculture) Industrial Commercial ❑✓ Residential(suburban) Forest ❑Agriculture Aquatic QOther(specify): Parkland Page I of 4 ' y 5. is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ RV ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑� ❑ NO YES 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? Fill 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: ❑ NO YES 8. a. Will the proposed action result in a substantial increase in traffic above present levels? ❑ ❑ b. Are public transportation services available at or near the site of the proposed action? c. Are any pedestrian accommodations or bicycle routes avl ilable on or near the site of the proposed Elaction? 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: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water. ❑ F 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatm I t: ❑ 0 I 12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES which is listed on the National or State Register of Historic Places,or that has been determined by the ❑ ❑ Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places? b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑ archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory? 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? W ❑ 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: rna, Page 2 of 3 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 ❑✓ Suburban 15. Does the site of the proposed action contain any species of ani'maI,or associated habitats,listed by the State or NO YES Federal government as threatened or endangered? ❑ ❑ 16. Is the project site located in the 100-year flood plan? NO YES 17. Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ R] a. Will storm water discharges flow to adjacent properties? I RI Li b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? ❑ �✓ If Yes,briefly describe: , Gutters,leaders to catch basins. 18. Does the proposed action include construction or other activities that would result in the impoundment of water NO,.. YES or other liquids(e.g.,retention pond,waste lagoon,dam)? If Yes,explain the purpose and size of the impoundment: ❑ i 1-9. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste NO YES management facility? If Yes,describe: ❑ ❑ 20.Has the site of the proposed action or an adjoining property bei n the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponso�am : Ural Talgat Date: / Signature: Title:Architect PRINT FORM Page; of Agency Use Only IIf applicable! Project Date: Short Environmental Assessment Form Part 2 -Impact Assessment Part 2 is to be completed by the Lead Agency. 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 t large a o a e impact impact ma y a Y may occur occur 1. Will the proposed action create a material conflict with an'adopted land use plan or zoning regulations? ❑ El- 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)? S. Will the proposed action result in an adverse change in tha existing level of traffic or El ❑ 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 El 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? ❑ El 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑ waterbodies,groundwater,air quality,flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? ❑ ❑ PRINT FORM Pagel of2 SEAF 2019 Agen Use Onl [If a livable] Project• Date: Short Environmental Assessment Form Part 3 Determination of Significance 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 iimpact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting, probability of occurring,duration,irreversibility,geographic scope and magnitude. Also consider the potential for short= term,long-term and cumulative impacts. i ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date 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 FORM Page 2 of Town of Southold LWRP CONSISTENCY ASSESSMENT FORM. A. INSTR[JCTIONS L All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold-Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. i 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. roposeci:..:act'ion:..;will.:be.:evaluated- .as:..to:.dts_:si�ijficant ._.p beneficial::aiiE&adverse:&Mcts:.:uyoni 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. :Thas; each. answer-n ust .be exnlained.in detail;1istm :both:.supportin n non sUggon ting::facts: If an action cannot be certified as consistent with the LWRP policy standards and conditions,:it.shall:not:be::utiilertakezi:. 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. E. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 38 26 PROJECT NAME_Antunovich Residence The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑✓ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑- (b). Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Add a.second.story.to.the.exisiting one-story.family residence with.existing.attached garage.................. J � Location of action: 1845 East Gillette Drive, East Marion, NY Site acreage: 0.23 Acres Present land use:..Residental Present zoning classification:-.R-4o 2. If an application for the proposed action has been.filed with the Town of Southold agency, the following information shall be provided: r: 1c Riechard A Antunovich and Anne Antunovich ( ) Name-of.a lant RP (b) Mailing address: 86 Inlet View Path, East Moriches, NY 11940 ........ (c) Telephone number: (631)4953231_: .. .. Will the action be directly 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. i 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 LVVRP 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 L II Section III—Policies Pages 3 through 6 for evaluation criteria 0 Yes E] No R1 Not Applicable There are no historic or archeological structures on property. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria IV Yes 0:No Not Applicable Building structure is in keeping in style and scale of neighboring structures: ...._. ........................ .... _._..__.. .._._. Attach additional sheets if necessary I NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LV;" Section III—Policies Pages S through 16 for evaluation criteria 0: Yes a No.5:Not Applicable Attach additonal sheets i.f ne.... ..ces....s.._ary _ : _ :... ........... ................................ .........................._......_...... .........._._ _......__._.........:_........... ._ ' 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 - F-1 Yes E_No ONot 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 Fv ,Not Applicable J 1 No development will take place in the"protected"or"natural indigenous environment". .. Attach additional sheets ifnecessary Policy 7. Protect and improve air quality in the 'Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. Yes No n✓ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and'w"tes. See LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. .Yes D N® 1 Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies;Pages 38 through 46 for evaluation criteria. Ye _] No 0 Not Applicable No.mbl.ic land involved. Littoral access unimpeded. ........... ..... Attach additional sheets if necessary i WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑.Yes :❑ No ❑✓ Not Applicable Attach additional sheets if necessary- Policy 11. Promote sustainable use of Paving 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 0 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 ❑ NOR] Not Applicable There.are:no a0g0tural.larids on.site. ........... ............ ............:.. .. .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 ❑ NOW] Not Applicable PREPARED 13Y Ural Talgat .. .. .. ...TITLE-.Architect: ..... ............. DATE 1/16/2024 _ saw c:- •vich —#11, view looking • • • t r6 ' '{y N: . 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