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TR-10563A
Glenn Goldsmith, President ®� s®�/�� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski l6 Southold, New York 11971 Liz Gillooly Elizabeth Peeples � � � Telephone(631) 765-1892 Fax(631) 765-6641 COUflf�,� BOARD 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 '/2 constructed When project complete, call for compliance inspection; Glenn Goldsmith, President _`�®� s®l/�� Town Hall Annex A. Nicholas Krupski,Vice President ®�v ®�® 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®UfVT`l,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10563A Date of Receipt of Application: April 2, 2024 Applicant: Barbara Pagano SCTM#: 1000-37-4-9 Project Location: 2435 Cedar Lane, East Marion Date of ResolutionlIssuance: May 16, 2024 Date of Expiration: May 15, 2027 Reviewed by: Board of Trustees Project Description: Replace the existing 16'x28.10' irregularly shaped seaward side deck with steps to ground in-place; replace existing 10.8'x17.11' front entry deck in-place with full length stairs to ground; replace existing 8.7'xl8.9' masonry patio with new surface in-place; install a 4'x4' enclosed outdoor shower on patio; along east wall replace existing sliding door with 6.8' tall by 5' wide slider and three windows; along south wall replace one existing window with new; replace west wall entry door with new 6.8'x3' door. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Nicholas J. Mazzaferro, P.E., received on April 2, 2024, and stamped approved on May 15, 2024. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is n t a determination from any other agency. 1 41,e� P,P6�X Glenn Goldsmith, President Board of Trustees s HOLD TRUSTEIES OUT 105 L3 A lssued .Tlo. -96"a�loc►f4 Qa a� �o Da#e SO15 /ay Addr�SS ay35 Ce.�a� Lanc , Eat Ma�;on THIS' NOTICE WlIIST 9E DI�t64YED DURING CONSTRUCTION TOWN TRUSTEES OFFICE ,TOWN OF SOlJ7'IOLD SOUTFiOLDB N.SFa 11971 TEL.; 765.9892 T ROOF DRAINAGE CALCULATION: m SURVEY OF PROPERTY ROOF AREA= 1319 S.F. (1319 S.F.) '(21'/HOUR)-224 CUBIC FEET REQUIRED a LOTS 34 & PIO LOT 33 - MAP OF ' PROVIDE MINIMUM(1)8'DIAM.X 6'DEEP DRYWELL OR EQUIVALENT. o N LOT COVERAGE: N GARDINERIS BAY ESTATES•, S.Ec 2 RESIDENCE: 1,319S.F. FILED: SEPT. 23, 1927- MAP#:275 DECKS: 670 S.F. ck SITUATE TOTAL: 1,988 S.F.OR 27.1% - EAST MARION :h M TOWN OF SOUTHOLD .' P/O LOT 133 SUFFOLK COUNTY, N.Y. --- - - y'` W °"` N63052' O"E 132.00 TAX MAP NO.: 1000-0.3700-04400-009000 °x °" OH O.S' ONUN>~';r, _ LOT AREA: 7,336.76 S.F. (0.168 ACRES) °"''-°" °N �I- —+ P/O LOT 133 DATE SURVEYED: SEPT. 8, 2022 I a f° -Q-�H `" ( o PROPOSED DRYWELL:NOV.29,2022 1 > ♦ � �' qg� 11,1 o ❑A c'UNIT N o LOT COVERAGE:DEC.23,2022 l+l ASPHALT DR � 36 5 _ o �° r n g I Z NEYVAY cwuy 40.8' M O � N g 8J 0 20 40 �j'� do 26.3r 7.4 two .S .$ STORY ° O ►-� Feet I Imo+ �°oo y FAME °° > m °o RESlD SCALE: 1 INCH = 20 FEET ° W N ENCI~ .a1 LOT 134 0 E o ^' *2435 °1 � 01 o UI i4, 0 X D T N OF 24.7' O i t: In 365 c Z �yz+ m PROPOSED ti E x 0 I CONC 0 R�1 E PAIOO ` °RYWELL o° I w O e ' '= f' O/L 0.31 p 1.2'S 0.6'S O C. WAL.L O.9'S c 24'wIDE S63°52' O"W �� gOr 130.00 D , PRIVATE ' •Of RIGHT OF WAY , LOT 135 ° E u I � c LEGAL NOTES: 1.COPYRIGHT 2019 AJC LAND Sl1Fi4MS'er I S PLLC.ALL RIGHTS RESERVED. ' 2.UNAUTHORIZED ALTERATION 04ADDMON TO THIS SURVEY MAP BEARING A LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209. I'n SU&DIVISION 2.OF M_W YORK STtf E EDUCATION LAW. 3.ONLY BOUNDARY SURVEY MAP.1�VITH THE SURVEYOR'S EMBOSSED SEAS ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL WORK \\(/ ..L AND SURVEYING PLLC ANDOPINION. U _�.,..:.: :.;j.. 4.CERTIFICATIONS ON TFi1S 80UA`niyfyY SURVEY MAP SIGNIFYniATTHE MAP\HAS PREPARED IN ACCORDANCE WITTI THE CURRENT E7(ISnNG CODE OFPRACTICE J .. -, .•_:` FOR LAND SURVEYS ADOPTED �fiE NEWYORK STATEASSOCIATION OF PROFESSIONAL LAND 5URVEYORS,FNC.THF CERTIFICATION IS LIMITED TO PERSONS LAUD. SURYEYIIIC & PLl�tltiiil�iC FORYYHOMTHEBOUNDARYSURVEYMAPISPREPAFiaED,TOTHETITLE COMPANY,70 THE GOVERNMENTALAGENCY.AND TO THE LENDING INSTITUTION USTEDON THIS BOUNDARY5VF{VEY MAP. ...3'+-.;..,., :,...�.,�;;•i�:K.; ,. r_�`': a,; .,�_, !iIHECERTIFICA -ID ICRMNA5,SNOTTRANSFERABLE C IIIt.LUGAIIONOF'UNOFiF1GRC`tiD ! V RE ALWAYS KNOWN AN TBEESTIMATFD.IF UND APR ^JA �•L� RO EMENTSO EN NOT DOFTEN MUS ANY UNDERG�1'Q 2 2024 N I f M E HAI' 77..;5 "CO MAl1i`ROAD 'CENT REAL ROVLAtLN'IS'OR NCROAC SEXLST OR ARE SHOV�TV,niE IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY TH155UfiVEY. . , E k `' NY 'I 1720 7.THI:OF1°SETS IOR DIMENSIONS!SH°WN HEREON FROM THE STRUCTURES TO THE PROPERTY LINES ARE FORASPECIFlC PURPOSE AND ANDTHEREFORE �-V+ ARE NOrf IN I ENDED TO GUIDE TH WALLS.POOLS.OF FENCES.RETAINING WALL POOLS.PATIOS PLANTItiG AREAS,ADDITIONS TO BUILDINGS,AND AW OTHERTYPE PHONE: 63 73 OF CONS FRUGnON. e.ONLY SURVEYS SEARINGTHL M1yCtRS EM13OSSW SEAL SHOULD BE RELIED UPON SINCE OTHER THAN LMB6SSLDS9ALCOPIES MAY CON TAIIJ,t Southold Town L' UNAUTHORIZED AND UNDEIECTALLE MODIFICATIONS,DELETIONS,ADDITIONS,AND CHANGES. EMAIL: AJC246@OPTONLINE.NET 9.PROPERTY CORNERMONUMEM'SWERENOTSETASPARTOFTHIS SURVEY UNLESS OTHERWISE NOTED. Board of (CuSteeS j IO.ALL MEASUREMENTS REFERTOUS.SURVEY FOOT. t CJ I: �I 5 GENERAL NOTES_ •rok, ,�,? ,4 '�'a s.v i:�r7`a s. ""' ;(s}-N::S.: .L':�� F<;grS'(�. •< �,.,., r..ee. ,'rm I L THEWFORMATION WITHAL THSSET GFWNSIRUMONDOWMENIS LR RELAIM'IOBASIC DESIGN PERVIE IBCAIVS CODES-MOAS USTED BELOW OCIXIPANCY CIASSIHCAMN RESmFNIALMIENTAND FRAMING DETAILS.THEY AREINTENDDASACONSIINCtIONAID,NOT ASASU65'RRRE ADI AWACEM M07, M9MMUM1FOR GENERALLY ACCEPTED GOOD BUDDINO PRACTICOAND COMPiIANCEWITHCURREIMTORK 1 RIDGGTOAAPTFAASSEMBLY: OCCOPANTLOAO WA A(DN. ALUMINUM MR MOISTURE MMTANI STATEBMLMNGMMMEMIERAI-CONTWUC10RISRESPONM MFORPROVM=SFANDARD I-VCX20 GALIGESFRAPSHALLREATTACHEDTO EACH PAIR OFRAFMOI MACWNDANCE APPD. 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AMRSM CALWORK7OCOMPLYWITH2O17NE8. , - # ISSUE/REVISION DATE A MSIALLSMOKE OETEL701SAND CMRONMONOIODEDERT:TOTS THROUGHOUTAS PER THE MC& ,}f",,-�E .'`� .'k° ,;"'. -. �"� a:s'• �q`y.' #¢�}',Y,,rr,,€��'„ �•"+ '•1+� ALLIGES70 RES)AW50HSTRONG TIMOR EQUIVALENT NYSCODE ..^v. L. .?'1r rM` :l�G«ti /� AL.FRMMMIGiMFASlE4EDMWNFORMANCEWML Southold Town s' v ',` �.- J I: -.,�>v.' " ,: •, ,. ,:•. .fi �a,�"' e�.,srr. �€ ReCCODE-2020 1 FOR PERMIT 01104/24 `• .+^,�:.q;. .�,'a ,r .c,r. !?, r. .'`,:. i7,+aa - "`p, s`"O,r TABLERBp23(1I•GENERAL .. .-* ,:'' a 1 PAONOE�'TYPEXSHEEMOCKFIRESTOWNGATI"MIDGMUMDIBTMICFSFORNON T Board o�Trustees ACCESSIBLE ARFAB. i TBSDfSIGNCOMPUES WRH7HE ZO20 HC EHEROYWDEASAPR6C18PRVEDBiGP1 2 USESIMPSON t1AAIMM ANDANCHORSWITH ZNMAXTRIPM PROIFCRVECOA7MG FOR CONTACT 7AeLETOTO25(9)-FItAUI1NG-ROOF 2 2. UMDEMONWT6IRUCRONSHALLCOMPLYVMSEMONR402OFTHE2WSIBC. 3, RS7AWITHLL 1•CO2 DETECTOR INAD61TIONTOSMDKEAIARN6 PER FLOOR PERSPECa609.1A_=Q BC+HYSSUPPLEUQEMALDLSIGN- UR4DSPEEO IS 190 MPH & 01=DED-MW WAUSPPLFDARASUM LREMkM"ONODE TNEPoILOLYMOfLFM@FESAflE 4. RSHAMBEYMCONFRACTUR5 RESPONSIBILRYTOASCFRTA/LALL PREVAILING PROCEDURES /� q MCLWEO-NOOF/1YAL15/FLOORS/B7LSET4ENM/FOVNDJIRON+VEINRLA710N. INCLWMG STORAGE ANOTOBElMMES,PROTECTION OFOS71NM WORK 70 RIMMACLS5 y� y , va ;'., ' OF �etp J TOWORKARM HOURS OF PERMITMED WORK,ANABARIUMOPWATERAND ELECTRIC POWER AND . '• 1. ALLUMMCOPHATIMAMFk=MMMNSFDRMSPARWULARLOCATONINCRDERTDEKMHIE '•y ,_ ice uYv'Hy- av,. .+t -�c�.�� J.�• .rvlti+"�Ma3 Y' IQ THEWORKINACARFFULANDOROMLVMMNMWFTHYRELFASTPOSSIBLEOISnMUNCETOTHE - 5, MMCOMRACMSKA MAIHTHENETBSJMARRUrRABM70 =ESANDSM&W S RWFFRAMING: PERz020IBC-CHAPIERB 1 1 NEW FILTOBECWMOFORGAIROMATFRW-CONIRACTORTUVEMPYE)GSIDIG SOIL CONDITIONS 7ENIPORAr4LYDBWNNMMWMMPERFOMNOTHEWORKASREQWRFD, WAl1EMMING: PEL2001SC-CHAPMO ,(� DRAWN BY: FRIOBTO ML MUMANDADO ADMTMNALMAS RMEM B. MIHECOURMOFC01SWWCRON.AWNDMGNEXA575LWLICHDISAGF=WrTL7WATAS FLCORFRAUM PM2Lp-M1W-CHAPTMS N.J.MAZZAFERRO,P.E. KS 2 COMPACIIDNOFNsWRLLSHALLBEATIEWSWPROMROEMM(PNRASMD898ANDASEMI INDICATWON7N6EDRAWUNGS,7HECONMACIDRSWALL-STOPWORKANDNO71PY7WDMGNEitR MG,ROOFSHFATH PER20201BC-CHAPTERS D3lrTiT),COMPAIT7NESO1LAT12"LOTS(7YPICJU.).CONRMCMRTD HAVERLLIE'IED BYA ORTHEO MEERIMMBMATELY,SHOIAD HE FA&TO FOLDWTNS PROCEOUREAPIDCOMINUE CBLINGSHFATHIN4 P0120201BC-dMPIFRB LROFFSSIONALAGMCYFORWMPACRON. WORK,HESHAILASSUMEALLRMPOFLSIBIUMANDLIARMAR151NQUEREFRONL FLOG SH EAUGNC PER20WIBC-CHAPTERS � PROFESSIONAL ENGINEER DATE: 1TDORSHFATIRHQe PFA202DIBC-L1IAPTHF5 ( < O 01104/24 P.O.BOX 67,GREENPORT NY,11944 SCALE: 516.457.5596 EMAIL:nw_lirt@msn.com 1/8--1I-T ' $�Fp �O 051Q°'� �� RESIDENTIAL SHEET NO: ` l AROFESS101A '� 2435 CEDAR LANEf SEAL G�r� EAST MARION,NY 11939 11 , r- — — — — — — — — —, r- — — — — — — — — — , r. IL-. — — — — — — — — — — — — i 1 50% OF DECK STRUCTURE TO REMAIN - FOUNDATION FRAMING I t \ I t \ i I \ L I \ ! ( EXISTING DECK FOUNDATION \\ "l 1 \ L- -I i TO REMAIN \ I \ I \ \ i REPLACE DECK BOARDS IN-KIND \ B I \ I \ r i \ REPAIR MASONRY SURFACE AS REQ. 9-0 '� EXISTING PATIO EXISTING BASEMENT APR - 2 2024 Southold Town Board of Trustees DECK BOARDS REPLACED IN-KIND W/ EXISTING SUPPORTS. REPAIR FRAMING AS REQUIRED. 50% OF DECK FRAMING I I o I AND FOUNDATION TO REMAIN i exa Aca Posr I ° SCTM#1000-37-4-9 i ® W/ LOWW GRADE PIER 3'BELOW I # ISSUE/REVISION DATE I (TYPICAL) i z I 1 FOR PERMIT 01104/24 — — — — — _ 2 REVISED =1124 NO WORK REQUIRED ON EXISTING g I" 7'-II 3/4' T-II 3/4' BUILDING FOUNDATION 17' III= 3 -c� NfW yo 4 N.J.MA7IAFERRO,P.E. DRAWN 9Y: KS v ° f 9 PROFESSIONAL ENGINEER DATE:01/04124 R P.O.BOX 67,GREENPORT NY,119" SCALE: EXISTING FOUNDATION PLAN PROPOSED FOUNDATION PLAN, 516.457.5596 EMAIL:mazaQm Dnmcom 18-1 1-0" SCALE: 1/8"=1'-0" SCALE: I/8"=1'-0" 3 �`+` No 0570�'� • p ��' RESIDENTIAL_ SHEET No: AR°�ESs1o�P~ 24.35 CEDAR LANE ��� EAST MARION,NY 11939 SE 28'-10" + 12' m EXISTING DECK TO REMAIN REPLACE EXISTING DECK BOARDS AND RAILINGS 50%OF DECK ELEMENTS TO REMAIN EX STING DECK EXISTING DECK' s 31'-10• 7'-5• 6- 9- 6'-9' 6'-9" 1. :4'1-2* 1APPROVED BY BOARD OF TRUSTEES INSTALL-(4)6'-O'x6'8' EX.MASONRY 'TOWN OF SOUTHOLD REMOVED RAISED INSTALL NEW WINDOW ANDERSEN SLIDERS a RAISED PATIO F IN EXISTING OPENING FLOOR IN THIS AREA c'Li AR4l(4'-0"WIDE) g NEW OUTDOOR DATE n/I LIVING ROOM DINING ROOM DINING ROOM SHOWER LIVING ROOM box MASONRY s 'o RAISED PATIO NEW ;,+ 3'X3' 14RN13T WSTAIRCASE RA L RAILING m " I— r WALL ( fl LANDING LO LO 4 NEW CLOSET N CH 40 iv INSTALL 2-2"XIO'HEADER -- NEW POCKET 8'-7" 8 4'WIDE CLOSET DOOR DOOR MIN.32" L BALCONY ABOVE EX.BEDROOM BEDROOM No.2 BEDROOM No-I FIREPLACE No_2 `� EX.BEDRI-V FIREPLACE No.I — — _REMOVE DOOR (BALCONY IS 8'-6°AFF) n-- f I NOTE: ALL WINDOWS AND DOORS 7' 4 WASHER DRYER NEW CLOSET TO BE ANDERSEN A400 DEMO STAIRCASE 3n ENERGYSERIES -RA RATED LOW E GLASS KITCHEN EX BATH � NEW 3--0- RENOVATED KITCHEN ® C � � � � U BA O ALTERED ENTRY DOOR 0 o o i APR 2 00 2024 ILM ALF-0 ENTRY DECK BA ENTRY DECK SOUtfIOICI Town 6 STEPS SC •M#400037 `_Jofi Trustees i EX.DECK # ISSUE!REVISION DATE REPLACE EXISTING DECK BOARDS 8 RAILINGS b SHED LOWER DECK EX�ETIDNG 50%OF DECK ELEMENTS TO REMAIN FOR PERMIT 01/04/24 TO REMAIN OUTDOOR EXIST. SHOWER OUTDOOR 2 REVISED 02121/24 SHOWER --------------------- ------- - 3 ------------------------------- 0 E Y ------------------------------- '� D.p 4 ------------------------------- 5. `� - � N.J.MAZZAFERRO,P.E. DRAW KSSev: PROFESSIONAL ENGINEER DATE: ® 01104124 it: P.O.BOX 57,GREENPORT NY,11944 SCALE: EXISTING FIRST FLOOR PLAN PROPOSED FIRST FLOOR PLAN W 516.457.5596 EMAIL•maa fin@msn.com 1/8"=1•_G• SCALE: I/8"=1'-0" SCALE: I/8"=1'-0" A10, p��tl �� RESIDENTIAL SHEET NO: OFESsv� 2435 CEDAR LANE A�2 EAST MARION,NY 11939 f'1 OPEN TO BELOW NEW WALL-INTERIOR 2X4 STUDS--- NEW STAIRCASE 3"X3' 14R-13T W/RAILING NEW CLOSET C STAIR HALL EX.STAIR HALL BEDROOM NO.4 EX.BEDROOM BEDROOM No.3 CHIMNEY EX.BEDROOM cxlrw NO____4 No, 3 a RE BATHROOM ED BAT�I DEMO STAIRCASE 00 9. F(31 OPEN TO BELOW INSTALL NEW WINDOW IN EXISTING OPENING-A21 C E 11(1 APR - 22024 Southold Town Board of Trustees EXISTING SECOND FLOOR PLAN PROPOSED SECOND FLOOR PLAN SCTM#1000-374-9 SCALE: 1/8"=1'-0" SCALE: 1/8"=l'-0" # ISSUE/REVISION DATE 1 FORPERMIT 01/04/24 2 OF iV yy O 3 Y 4 9 F� N.J.MAZZAFERRO,P.E. oRn KKSS BY: ' PROFESSIONAL ENGINEER DATE: J ® p — 01/04/24 P.O.BOX 57,GREENPORT NY,11944 SCALE: _ 516A57.5M6 EMAIL•maz Urt@msn.com VW=1'-0° C� 05-10 ' ���' RESIDENTIAL SHEET NO: SI00A� 2435 CEDAR LANE /��� EAST MARION,NY 11939 M SEA TREX COMPOSITE TOP RAIL POST CAP INFILL(TYP) " . POST SLEEVE CABLE RAIL TREX REUSE EXISTINb COMPOSITE TOE RAIL POST SKIRT ti 12 — —— 5/4X6 TREX COMPOSITE DECKING J EXISTING DECK RAILING AND DECKING EXISTING SCALE: NTS 12 `rl/ST/ 6 c b 2XI0 RIDGE NEW DECK BOARDS&RAILINGS L] 2X8 RR @I6°OC RAILING P EXISTING EXIST. )@16°O.C. SHED NEW 112 RENOVATED ❑ ao (3)2X8 GIRDER (STING BATH BATH ' 2X8 LEDGER w 6X6 ACO POST FLASHED REPAIR FRAMING NEW — IL°DIA. .' AS REQUIRED CLOSET --- CONC. n a_ 50%TO REMAIN PIER EXISTING REUSE EXISTING SISTER 2X8s W/EX.STUDS EXISTING 1 EXISTING SECTION A ® E c E SCALE: NTS EXISTING EXISTING r APR - 2 2024 SCTM# 1000-37-4-9 EXISTING Southold Town ° s # ISSUE/REVISION DATE a Board of Trustees 1 FOR PERMIT 01/04I24 SECTION B 2 REVISED OMW4 SCALE: NTS p N�NV 3 y 4 �cn N.J.MAZZAFERRO,P.E. DRA KKSS BY: PROFESSIONAL ENGINEER DATE'��4 O P.O.BOX 57,GREENPORT NY,kl SCALE: 516A57.5596 EMAILm pn uQmsn.cpm NTS RESIDENTIAL SHEET NO, 2435 CEDAR LANE EAST MARION, NY 11939 SE L N ;E 4 v' E 4-1 FRONT ELEVATION ® E C E (STRUCTURE REMAIN AS EXISTING) SCALE: 1/4"=V-0" APR - 2 2024 SCTM#1000-37-4-9 # ISSUE J REVISION DATE Southold Town Board of Trustees FOR PERMIT o1/04/2a 2 ` - OF N _ 4 � DRAWN BY: N.J.MAZZAFERRO,P.E. KS PROFESSIONAL ENGINEER DATE: 01/04/24 ® j 1. P.O.BOX 57,GREENPORT NY,11944 SCALE. t; 516.457.5596 EMAIL max IinQmsn,c0m moo, M0 051109y �a,�' RESIDENTIAL SHEET NO: SIO�A�'k. 2435 CEDAR LANE /►�5 EAST MARION,NY 11939 /''�► SEAL i � 1 3 1 J14 1 J12 11/4 TUB LAV Wa 2VD FLOOR (�R 7 co.1 a 341 111441 3 1114 1?/4 11/4 1�/2 11/4 1�/2 4KIffT. MV UV DISH SHOWER WASHERWASHER ISMOOR 3"f.A.1 11/4 41 C.O. 311 2 11144241 2 3 4 4"U TO TRAP HOUSE SFp r��X lsT//VG .. , STEIy RISER DIAGRAM SCALE: NTS SCTM#1000-374-9 # ISSUE I REVISION DATE �------� 1 FOR PERMIT 01/04/24 2 p0 � 3 Qc � P� �o� fif9 4 o_ fv g• >cr N.J.MAZZAFERRO,P.E. DRA KS8Y: -01 o e PROFESSIONAL ENGINEER DATE: CD� �O ?•f 01IM24 117d�. r k1 P.O.BOX 57,GREENPORT MY.11944 SCALE - 516.467.5596 EMAIL:mazjtn@msn.com NTS �o, ®S'o�y RESIDENTIAL SHEET NO: 2435 CEDAR LANE �c EAST MARION, NY 11939 Al V Glenn Goldsmith,President ®F S®�/�� Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski 8 l Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � a� Fax(631) 765-6641 c®Um,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10563A Date of Receipt of Application: April 2, 2024 Applicant: Barbara Pagano SCTM#: 1000-37-4-9 Project Location: 2435 Cedar Lane, East Marion Date of Resolution/Issuance: May 15, 2024 Date of Expiration: May 15, 2027 Reviewed by: Board of Trustees Project Description: Replace the existing 16'x28.10' irregularly shaped seaward side deck with steps to ground in-place; replace existing 10.8'x17.11' front entry deck in-place with full length stairs to ground; replace existing 8.7'x18.9' masonry patio with new surface in-place; install a.4'x4' enclosed outdoor shower on patio; along east wall replace existing sliding door with 6.8' tall by 5' wide slider and three windows; along south wall replace one existing window with new; replace west wall entry door with new 6.8'x3' door. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Nicholas J. Mazzaferro, P.E., received on April 2, 2024, and stamped approved on May 15, 2024. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is n t a determination from any other agency. Glenn Goldsmith, President Board of Trustees S -HOLD . TRUSTEES 0 . T No. IssuedTO �a�bc►r� Po4��o Date- 5/15 /ay� Addressa43s C."air I-ArNe. , E4�' Mv�r:on THIS. NOTICE MAST BE DIOLAYED DURING CONSTRUCTION 7°OiNfJ TRUSTEES OFFICEoT@.{nIN1 OF SAUTH'06D SOUTWOLDo N.Y. 11971 TEL.: 765-1892 Glenn Goldsmith,President r S0 Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ®� ®�® P.O. Box 1179 Eric Sepenoski lxi Southold,New York 11971 Liz Gillooly G Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 c®UNTI,� BOARD 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 1 st day of construction % constructed When project complete, call for compliance inspection; � �gyFFO[�-c Glenn Goldsmith,Pre"s'ident ����. OGy� Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 0 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Elizabeth Peeples �Ol �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees nn,,�..,, Field Inspection Report Date/Time: 7 � d�UyCompleted infield by: l' BARBARA PAGANO requests an Administrative Permit to replace the existing 16'x28.10' irregularly shaped seaward side deck with steps to ground in-place; replace existing 10.8'x17.11' front entry deck in-place with full length stairs to ground; replace existing 8.7'x18.9' masonry patio with new surface in-place; install a 4'x4' enclosed outdoor shower on patio; along east wall replace existing sliding door with 6.8' tall by 5' wide slider and three windows; along south wall replace one existing window with new; replace west wall entry door with new 6.8'x3' door. Located: 2435 Cedar Lane, East Marion. SCTM# 1000-37-4-9 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Typ of Application: Wetland Coastal Erosion Amendment 7Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly E. Peeples YAIU 'P-�Aa-s- IA- '0 l w: r Existing Rear Deck— Looking West '-U wwtl � `�� N'J/bMfWYI.-„'�"�"'�mfi7�`A"•'.7 b j a Existing Rear Deck Surface to be Replaced — Looking North 1 �N \ j. r Existing Masonry Patio to be Resurfaced — Looking West _f Existing Masonry Patio New Outdoor Shower Location— Looking East 2 i Doors & Windows to be Replaced i� ,i '.1 Existing Deck Railing to be Replaced 3 �w T North Side - Existing to Remain 4 a Front Entry View— Looking East A Front Entry View— Looking North (Deck to be Resurfaced) 5 t1FFOL TRUSTEES " SUPERVISOR John M.Bredemeyer,M,President Henry P.Sm{th,vice President SCOW L.HARRIS Albert L Kr%sld,Jr. • Town Han John L.Bednosld,Jr. �Pl � `1►�� 53095 Main Road John B.Tuthill P.O.Box 1179 Telephone(516)765-1892 BOARD OF TOWN TRUSTEES Southold,New York 11971 Fax(sid)765-1823 Town OF SOUTHOLD May 3, 1991 John Parrott 18-75 CPL Kennedy St. #1-G Bayside, New York 11360 RE: SCT14 #1000-37-4-9 Dear Mr. Parrott: The following action was taken by the Board of Town Trustees during its regular meeting held on May 2, 1991: RESOLVED ghat the Town Trustees APPROVE the request fora waiver for a deck attached to the dwelling located at Cedar Lame, East Marion. Please return to the Building Department for a determination on the need for any other permits which may be required for this project. Very truly yours, 4 #*AM ;?O�-W John M. Bredemeyer, TIT President, Board of Town Trustees JMB:jt cc: Bldg. Dept. CAC File FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20220 Date SEPTMMER 16, 1991 THIS CERTIFIES that the building ADDITION Location of Property 235 G`8D_AR LP�NE _ _EAST MAi2TONr N.Y. House No. Street Hamlet County Tax Nap No. 1000 Section 37 Black 4 Lot 9 Subdivision Filed Map No.� Lot No. conforms substantially to the Application for Building hermit heretofore filed in this office dated JULY 2, 1991 pursuant to which Building' Permit No. 20143-2 dated _ SEA 16, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is WOOD DECK ADDITION TO D SEING AS BUILT & TO YHA CMTDITIONS APPEAL ##4044, The certificate is issued to Wi1xim, AILWw & JOH'N PARROTT (owners) ' of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO.----H-022028 - MAY 10, 1991 PLUMBERS CERTIFICATION DATED _ N/A j or Building Inspector Rev. 1/81 • jtate Uepartr, , it of i_nviortmenta[ Gonservatio; 0=-5UNY, Stony Brook, New York 11790-2356 : . Qa`ro I- DATE: /I _ --75 GPI.- K01ndy G r ._ M r' 1- 7�830� 1'i:on:as C..toning /d'04u t -O comatissioner 10 + Dear 5� M M"ov\ A review has been mane of your proposal to: OY� � C'j- -J tyK6&-r dec*S7 a s er -rhe. survey by Root (dic vav% Ivy I dotted T 1 W 17 q 5eTM '11 /000 - 37- Y -q Based-on-•the informa-t-ion you have submitted, the New York State Department of Env' onmental Conservation has determined that the parcel. _,y�oject is: Greater than 300' from inventoried tidal wetlands. ,,f Landward of a substantial man--made structure ,bGJ� ��Q(A greater than 100 ' in length which was constructei5 prior to 9 20 7 . Landward of the 10' above mean sea level elevation contour on a gradual, natural slope. Landward of the topographic crest of a bluff, cliff or dune which is greater than 10' in elevation above mean sea level. Therefore, no permit is required under the Tidal Wetlands Act (Article 25 of the Environmental Conservation Law) . Please be advised, howevert that no construction, sedimentation or disturbance of any kind may take place seaward of the 101 contour or topographic, crest without a permit;. 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 in this area as a result of your project. Such precautions may include providing adequate work area between the 10' contour or topographic crest and , tha project (i.e_ a is ' to 206 wide construction area) or erection of a temporary fence, barrier, or hay _ bale berm. Please note that any additional Pork, or modification to the project as described, may require authorigation by. this Department. Please contact this office if such are contemplated. Please be further advised that this letter does' not relieve you of the responsibility of obtaining an,y.. neceseary permits or approvals from other agencies. - '~° Vey truly yo s, AL 5 a Deputy Regional Permit ,Administrator - `�=- TOWN,C,7 SOU thO O :_ . FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-20068 Date JULY 111 1991 THIS CERTIFIES that the building ADDITION & ALTEMTION Location of Property 2435 CEDAR LAND EAST MARION, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 37 Block 4 Lot 9 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 25, 1991 pursuant to which Building Permit No. 19691-Z dated MARCH 5, 1991 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION & ALTERATION TO EXISTING ONE FA TLY DWM=KG AS APPLIED FOR. The certificate is issued to WILLIA' , AILEEEN& JOHN PARROTT (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-022332 - MAY 29, 1991 PLUMBERS CERTIFICATION DATED N/A /Building Inspector Rev. 1/81 Relgbu mauox !t� m-nm y- maa,a m-zo-n Q.•""i 4lZ M n '+ f 'd.a _�� iS1_- �e. •' `4 P s f --- / d E` �F' R' F• ¢`t ^ A y?�, a 4t p (� i,L DnY,nEw Es, i � m ' z ✓ ky�_^°____-___ y a mnwln "e"L zz .i a� sPMs PorW E� � _�_ A ) -----' _'_ __"__ mp�c NOTICE COUNTY OF SUFFOLK © E 1OP SOUTHOLD SECTION NO b, ^ RealProperty Tax Service Agency Y E �� ------ -- -- -- -- b Counlr�ppmRMAUC.NY„B0, 037 z,Hmu a �• —__— u. --.-- ....uw�..--nn-- ..,a iti PROPERTY M P p• w, „ .... ,',Hq n�W ,pin xo 1D00 AP OFFICE LOCATION: � SOUTyQ MAILING ADDRESS: Town Hall Annex '`� l0 P.O.Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) cis Southold,NY 11971 apt Telephone: 631 765-1938 COU LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: May 14, 2024 Re: LWRP Coastal Consistency Review for BARBARA PAGANO SCTM# 1000-37-4-9 BARBARA PAGANO requests an Administrative Permit to replace the existing 16'x28.10' irregularly shaped seaward side deck with steps to ground in-place; replace existing 10.8'xl7.11' front entry deck in-place with full length stairs to ground; replace existing 8.7'xl8.9' masonry patio with new surface in-place; install a 4'x4' enclosed outdoor shower on patio; along east wall replace existing sliding door with 6.8'tall by 5'wide slider and three windows; along south wall replace one existing window with new; replace west wall entry door with new 6.8'xT door. Located: 2435 Cedar Lane, East Marion. SCTM# 1000-37-4-9 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-built structures are INCONSISTENT with LWRP Policies and with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 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 structures were constructed without a Wetlands Permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Honorable Lori Hulse, Attorney Glenn Goldsmith,President so Town Hall Annex A. Nicholas Krupski,Vice President ®� ®T 54375 Route 25 ® P.O.Box 1179 Eric Sepenoski FSouthold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples T,aui,663 -6641 E 0 BOARD OF TOWN TRUSTEESAPR ' 2 2024 TOWN OF SOUTHOLD own This Section For Office Use Only Board of Trustees Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Exte sion Received Application: q4Q oZ Received Fee: $ ?J Completed Application: Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: S��O oZ CAC Referral Sent:�ll fn_. Date of Inspection: T� Receipt of CAC Report: Technical Review: Public Hearing.Held: Resolution: Owner(s) Legal Name of Property (as shown on Deed): d � � �' �✓aTIC � Mailing Address: -Lk-V: ccav v \Vm WW c � � �r Q Phone Number: Suffolk County Tax Map Number: 1000 - ��' Ll G1, Property Location: kk,�C, (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Email: )ard of Trustees Applicatii' GENERAL DATA Land Area(in square feet): 19 � \� Area Zoning: O Previous use of property: ` &rAM o \-i&;;-t t• C Intended use of property: S z Covenants and Restrictions on property? Yes No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? A—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 require 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?--X—Yes No Prior permits/approvals for site improvements: A en Date \ M al�l Cz - (0 VA� us, d V�� 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): � � 2435 Cedar Lane, East Marion, NY 11939 1000-37-4-9 Project Description Details: 1—Rear Deck—Replace existing deck surface in-kind. Deck is 16'-0"feet wide and 28'-10" long with an angled south side. Deck size to remain the same as existing. Replace foundation and framing only as needed for structural safety. Deck railing to be replaced with code compliant system as selected by owner-all sides. 2—Front Entry Deck—Replace existing deck surface and staircase in-kind. Deck is 10'-8"feet wide and 17'-11" long. Staircase to be full length of entry deck. Deck size to remain the same as existing. Replace foundation and framing only as needed for structural safety. Deck and Stair railing to be installed as needed for code compliance as selected by owner—south side and stairs. 3—Masonry Patio- Replace existing masonry patio surface with new surface treatment. Patio is 8'-7"feet wide and 18'-9" long. Patio to remain in same location and the same size.Add new outdoor shower on patio-shower to be enclosed and 4'-0"X 4'-0". 4—Front Glazing- Replace east wall existing sliding door (1 ea.) and windows (3ea.)with new Anderson 400 Series Energy Efficient sliding doors(4ea). Doors to be 6'-8"tall by 5'-0"wide. Existing headers to remain in place. Replace existing south wall window (1 ea.)with new Anderson 400 Series Energy Efficient window(1 ea.). Window to be the same size as existing. Existing header to remain in place. No new structural openings required. 5-Entry Door- Replace west wall entry door(1 ea.) with new Energy Efficient doors (1 ea). Door to be 6'-8"tall by 3'-0" wide. Existing header to remain in place. No new structural openings required. :bard of Trustees Applicatk WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: l�. , - 1 ��"' Alf, f"ter: dA-- " UQ\A tl� �—o toy? ��.�, �,. � �� Q'A ute- oc Q�Z% Area of wetlands on lot: 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? 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: Manner in which material will be removed or deposited: 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): V3 r a s 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I 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 'RM�0&-j Ck '�km U Ii'v Name of Action or Project: �dA-cam Ce-"'.� Avyc'`^ Project Location(describe,and attach a location map): Brief Description of Proposed Action: all Name q4Applicant or Sponsor: Telephone: CL�Q do<r"" ye" F!tiV E-Mail: av rr vw V�f,(ck o,J- Address: CZ v- �r City/PO: VS_..(X State: Ny Zi��� �'J' N'V"A I 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ ,_ ,Vc,�& ko Wlmk�� 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 d or controlled by the applicant or project sponsor? a acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) []]ndustrial ❑CommercialResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ❑ b. Consistent with the adopted comprehensive plan? r7:i 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 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: � El 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ® i ❑ b.Are public transportation service(s)available at or near the site of the proposed action? rV1 ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? L❑-J 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: ❑ L 11.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 YES ,Places? [Z" ❑ 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: 4 �4 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 [R 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 YES If Yes, frJ ❑ a.Will storm water discharges flow to adjacent properties? ❑NO []YES b. Will storm water discharges be directed to established conveyance systems(runoff 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 I 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: D/1, ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applican sponsor nam Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur l. 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? 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 F-1 El establishment of a Critical Environmental Area(CEAV 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? F 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, ❑ Elwaterbodies,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 ❑ 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. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 `oard of Trustees Applicati' AFFIDAVIT ® Qt tsx r, r--) BEING DULY SWORN DEPOSES AND AFFIRMS HAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH 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. gnature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF &h- , 20 No ary Public JENNA KOCKENMEISTER qN.0,TARY PUBLIC,STATE OF NEW YORK N0.01K06402096 QUALIFIED IN SUFFOLK COUNTY MMISSION EXPIRES DECEMBER 23 2027 r APPLICANUAGENU/REPRESENTA.TIVE TRANSACTIONAL DISCLOSURE.FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puruose of the 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' ��'� � � ��� (Last na rst name, fiddle 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 Zone i 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,rrlarriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES _ NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the Owner of greater than 5116 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 P' 24-1 S igna e PrinWrE t Name v �• .. Form TS 1 Y 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 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- 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# 0J - - PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. N 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: gg 4�- � ����.. '����,�,��° ,�� �-�������5 -• �v�L Gam!1�,5 --s- 99 Location of action: Q`r � nfL �' `�t y Site acreage: o 'k s-lr�e-�� Present land use: ��L e e `/ Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: l a (a) Name of applicant: � i (b) Mailing address: '�.`J V t'L,(- 7.+G'VyQt (c) Telephone number: Area Code( ) (0 51' 'VI ` l 00 (d) Application number,if any: lA Will the action be directly undertaken,/require funding, or approval by a state or federal agency? Yes 1-1 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 F'�;' Not Applicable �1 C" AA Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Section III—Policies Pages 3 through 6 for evaluation criteria tvq Yes ❑ No J& 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 IV Not Applicable j Y 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 Yes ❑ No�K Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III --Policies Pages 16 through 21 for evaluation criteria 19 Yes ❑ No NNot 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 [:] 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 wastes. See LVPRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes ❑ No PS 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.Yeo No 0 Not Applicable Attach additional sheets if necessary l WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. Yes ❑ No � Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. tsa_Yes ❑ No*Z 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. XYes ❑ No N Not Applicable �l 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. [XYes ❑ No �RNot Applicable PREPARED BY �; ��� l r'� TITLE ,��,,-;W C. \r DATE � �