HomeMy WebLinkAboutMennicken, Charles & Jill Glenn Goldsmith,President r➢�O�� COG Town Hall Annex
A.Nicholas Krupski,Vice President 54375 Route 25
Eric Sepenoski P.O.Box 1179
Liz Gillooly �y • �,�� Southold,NY 11971
Elizabeth Peeples � aJ Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: q 1l`l2Y Completed in field by: G . Go 1A 5m)4'
Twin Forks Permitting on behalf of CHARLES PARDEE &JILL MENNICKEN requests a Pre-
Application Site Visit in regards to an expansion of existing screened porch on seaward side of
dwelling; minor remodel of dwelling; one-story addition on landward side of dwelling. Located:
6760 Peconic Bay Boulevard, Laurel. SCTM# 1000-126-11-3.1
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound ✓Bay
Part of Town Code proposed work falls under: c/Chapt. 275 Chapt. 111 other
Type of Application: Wetland oastal Erosion Amendment
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No Not Applicable
Info needed/Modifications/Conditions/Etc.:
_c�.-.f1G�eG5,a= slosl '1'uCT �i7•TT C S ' �-C1—�'n��� �11
wig ►<, �e�,c lc�.r
Present Were: ✓ G. G dsmith y/N. Kr ski /E. Sepenoski
L. Gillooly ✓ E. Peeples
S.C.T.M.# DISTRICT 1000 SECTION 126 BLOCK 11 LOT 3. 1
#R-24-0587
DWELLING 20.8 LATERAL 3 INLEr PORT OUTLET SOLVENT WELDED TO 4"
WORKSHOP 20.8 ADAPTER ALL PORTS LONG STUB OF 4"SCHEDULE 40
ARE 4"OPENINGS PIPE CONNECTED TO FUJI 4" SDR 35
(TYP) CLEAN CEN UNIT(TYP) ITCH 1/87FT
GRADE 19.5 GRADE (19.0) /P GRADE 5% MAX EL(19.0)
C/0 TO GRADE INVII TAB DIST INV17.26
DWELLING INV18.95 INV17.36 BOX EL17.43
WORKSHOP INV 18.24 INV17.66 INV17.1 (1) EACH
SDR35 4"SDR 35 8'0x12'DEEP
PITCH 14"/FT X PITCH 1/8"/FT LEACHING O
POOL 0 O
000000
EL 12.77
EL11.4
FUJI CEN5
HIGHEST EXPECT. GROUND WATER EL 1.5
SANITARY INVERTS
COVER w
TO GR E MIN. iv`' FINSHED GRPLE
IPE
SDR 36 PVC PIPE OR EOLVV.
PITCHED 1f8•PER FT.MIN. MI
INLET SANITARY NOTES
® ® ® ® 1.THE OWTS INSTALLER SHALL HOLD AN ENDORSEMENT FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH.
® ® ® ® 2.AN EXECUTED OPERATION AND MAINTENANCE CONTRACT BETWEEN THE MAINTENENANCE PROVIDER AND THE
® ® ® ® SHALL BE PROVIDED TO THE SCDHS
" ® ® ® ® M ® 3.PROVIDE A 2'VENT PIPE FROM THE OWTS TO THE DWELLING AND CONNECT TO THE SANITARY VENTING WITHIN THE HOUSE
THE VENT PIPE SHALL BE PITCHED TOWARD THE OATS SO ANY LIQUID WILL DRAIN TOWARD THE OWTS
® ® ® ® ® 4.AN EFFLUENT FILTER SHALL BE INSTALLED UNDER THE ACCESS COVER OF THE CEN5 UNIT ON THE OUTLET PIPE
C�
3 d PAN Rounrow4rER PROPOSED SEPTIC SYSTEM UP TO 4 BEDROOMS
SANITARY DESIGN BY:
0)FUJICLEAN CEN5 500 GPD(OWTS) RICHARD M. MATO A.I.A.
(1)LEACHING POOLS 8'xl2'DEEP PO BOX 2284
LEACHING POOL I 0)EXPANSION LEACHING POOLS AQUEBOGUE NY 11931
NTS 022.45" PHONE: (631)523-5879
18 021.65" EMAIL: RMATOARCH TECT@GMAIL.COM
ELEV. 19.7 11NLET,
/ 7 OUTLETS
. I .
OL oaM fd2o.65" BRED ARC
0_8' S( hrir
SM LOAMY SAND 2.V 1115 LIGHT COVER#3009C Q�
U P BROWN BOX ACCEPTS: �\ �A�O M.
19 I MON. 1 FINE-MED. TOP VIEW HEAVY COVER#3017-C20 Q O
0 0\\^�O y G5�Q SID GRATE #3017-G20 y"t
SAND 6"TALL RISER#3009
` 23.55" �12"TALL RISER#3009-R12
SW PALE
MEDIUM I II NDCAP TYPE 1
�t L BROWN o • LEVELING DEVICESAND
04186 yOQ
NO WATER 17' M TF OF
HIGHES7EXP.WATER EL 1.5 CIO 2"INCREMENT, ;,-: r" �° BOX SEAL,
/�+ K.WOYCHUK LS TYP. r� POLYLOK SEAL RICHARD M.MATO A.I.A.NYS LISC#041861
A`J JUNE 1,2015 3!�','1.i,.
\ I / m o\ #3001 TYPAOPLCSTYR
Q lit, 1� EL 18.9 M EA GRAVELILEVEL LEVELING PAPACTED D
1 D�1c�O ���� AGO \ DRAIN ; `\ WOLYLOK 20"DPE FRONT/SIDE VIEW
� Q\ \ AAATERIAL-HOPE
/1�1� DISTRIBUTION BOX PolYlok DETAILS
BLUESTONE G BL ::::
/U. DRIVEWAYkm
1 2f ... "....N� \
MO N \ NO PROPOSED GAS SERVICE y C^� Q
OR INGROUND TANK '��'�����.�••��� ' o CHAMBER Volume(gal)
� ` Sedimentation Chamber 198
\ \\ o ® Anaerobic Filtration Chamber 198
EL 19.7
/ "'A
(3 Aerobic Contact Filtration Chamber 95
�
GAVEL `N LAND N/F OF GRADE Clarification Chamber 44
-4s- - ......:::., LOUISVALENTE \ ff>�
Disinfection Chamber 4
gqNNSUNG SANITARY 3 \ \12"
\\ Q• \ (T6BEABANDONEDAND ZZ•, ::G;". ` Total Volume 540
r .,
"L+ \ CIffiLLED WITH CLEA /
COARSE SAND. 1SSµ0P:•::•:. \ �.
°:'. WD20;a.::: :. \ -18
ExIS NG / / .,/• SPECIFICATIONS
J ELCC.3ERVICET000NTROLPAN / a•:::.F�
CONTROLPMCL ANDAIR PUMP � •�•�4a 'jOw ` GROUND �` � Anaerobic Media PP/PE
PUMP
19 B 06• 24'
\\ ELEC CANDAIR SUPPLY HOSE TO OWTS / - EL 2 \` Board Type Aerobic Media PVC/PP/PE
U rscHio PVC VENT PIPE / i AIR HOSE AND Aerobic Media PP/PE
\\ \� 8'Oxl2'DEEP �I �4\ U.P. ELECTRICAL SUPPLY
\ c� 5 LP B \ ?ice \ TP TREATMENT UNIT Blower 2.8 cfm
\ \1N 4jti NLE 1 w \ Tank FRP
A I \ FUJIMAC'AIR PUMP ON PRECAST CONCRETE PAD
Piping PVC/PP/PE
\��/1 _^- D.P. 5 00 E NTS
19. CEN5 Access Covers Plastic/Cast Iron
\ \ t \�\ " Z �\ 1\\m Disinfectant(Optional) Chlorine Tablets
Cr
LAND N/F OF \mac ,�\ MN\ EXP \\\ANDREW HOLFELDER \\ ��` \\r/ CFujiClean U01 I'L"
\ \ E 18 \ a'\ \\ BR• CQS P DWELLING ELECTRICAL PANEL 'Toward Clean Water... SCUM BAFFLE B
\ S
ts. PRO ppRGH .,�•
P. GH \ GOVEREO�41' z`71$ 2•�4
P REO9 \ \ 29'EXIsj, 9'3x r4AIN ECIRCULATION
\ C, x32• o 7V VER eRFaKER AIR LIFT PUMP
DRAINAGE CALCULATION \��)\ gx6oE�?-\ L 19 EL 19.5 \ Ex`Sj{ �� ISINFECTION
80 , N,IN CYLINDER(OPTIONAL)
DWELLING W/COVERED PORCH: 2668 SQ.FT. a°INLET PI a°OUTLET PIPE
i
2668 x 0.766=443Cf REQUIRED \ $ PROP. 1� i,.t1.,. �,r:,ttf f! CIRCUIT
\ 1S1F�t4 i;if,t ,T1il':6 m $ BRFAKER AL A
(2)8'DIA x 6'DEEP DRYWELL=537cf PROVIDED �� 001110 ,I';:I ::::w z 1� 11' 30AMP L
a-4•
rmlcAL SILT \ P FAR DEDICATED
SCREEN SECTION G' .2•,,;__
\ �w'•" >5011�n�(�E':;,':'a,13• 9z I ECTRICAL SERVICE ro
pV , F(v`,; m HYDROACTION CONTROL PANEL
\ P PROP INS ii1 '.j 112SN LING: :1: ;;; N EFFLUENT
GEOTEXiILE FABRIC AIR LIFT PUMP
SUPPORT POSTS GP ;: .#6 . VER INLET BAFF
WOOD OR METAL \ L20.8 ` ' PA 10 COV)Mg-D
\ Xlgj• >..FF,., PO 1 WOdD 1.1E \�
FLOW DIRECTION E R ..• .38FOC sPA�E [t: jOREN'A S700{i
pVs•
rGP
T VJI�F. 90x6af`1 CONTROL RECIRCULATION PIPE FLOW BAFFLEi
3/4"AIR INTAKE
EXCAVATED AND axe . :...;ic::ii;!r;; iiiii : iiii I �' ,1s BACKFlUED TRENCH '::: ..
EX g \ N: a .`, ! ; PRpp, l I i EL 1ss �p>N / PANEL
EXISTING GROUND FLOW OPENING(TYP.) (CLEANING OPENING)
jORE BNICON riR XcAF / B
PLAN VIEW
y(�S.
�g 9' J
.19
P 000 S1pOP 20"ACCESS COVER 20"ACCESS COVER 20"ACCESS COVER DISINFECTION
IPROooM N 3gyT t JQ CYLINDER(OPTIONAL)
1.6'E (TYP) (TYP) (TYP)
UNR 16
J��3 27 EXISTING SANITARY \ �S' �/ 1 M16 \IFS TO BE ABANDONED
\ I \ AND BACKFILLED 2.4E y\�
1 \ W/CLEAN COARSE SAND. // / N' �� COVER
\ EL 18.4 PLUG
(THREADED, SIXMRE _ a'
N - V ..
Installation Guidance FujiClean Schedule 40 P/C 90-Degree Inlet Adapter '� \ \ DEC�OE /// /// 1"1 ``�,P TE
1.The FuijlClean 80-Degree Inlet Adapter has(4)openings(3)inlets and(1)outlet All ofthese will accept standard �ft�yfgAP`` O CONCRETE BASE
k7 16. 7 lOO
schedule 40 fittings. / DECK CLEANOUT Box
2.The top of the inlet adapter has a 6"opening that can be fitted with a 6"SDR dserpipe and cap as a dean out. / \ / / ADAPTER ADAPTER
CLEANOUT
3.Any unused entry ports on the FujiClean Inlet adapter shall be capped with a 4"schedule 40 adapter&plug,or a Schedule 40 slip
cep that is solvent welded to a short stub of pipe inserted and solvent welded into the adapter port.
N
4.The lateral entryaria ter shall be secured to the Fu iCleem unit using a 4'Ion stubof4"schedule 40 \ /-a 03 ��• m 3oDEOREE FlTTINO
P 1 9 9 pipe that is solvent welded 8 2'
into the adapter outlet end end FujiClean Inlet so that the adapter fits Hush on the FujiClean unit. \
5.The installer shall ensure that the soil beneath the adapter is bacdlted and compacted sufficientyto support the bottom of \ \ EL 18.2 //v / �ar O
the adapter and prevent any settling orstmin on the adapter or FujiClean unit. \ \ �/ / h' O so CD
It ® 4'-9"
6.Metalfltt F /
ings,pipe,end ceps are NOT to be used for of the adapter. �,9/ ��
7.Must Install a cleanout to grade in accordance with the'STANDARDS FOR APPROVAL OF PLANS AND CONSTRUCTION FOR \\ \\ LqGq (OV/ �N
SEWAGE DISPOSAL SYSTEMS FOR OTHER THAN SINGLE-FAMILY RESIDENCES"and the"STANDARDS FOR APPROVAL I \ 7 / a� �O FLOW
OF PLANS AND CONSTRUCTION FOR SEWAGE DISPOSAL SYSTEMS FOR SINGLE-FAMILYRESIDENCES" / / / Q`�d`
8.The following are instructions on how to make a solvent weld forattaching piping to the FujiClean lateral entry adapter. \ / ����' SEtiVFR LINE
1.Square pipe ends,chamfer and remove all dirt. 18- / Y / O?O YYY CLEANOUT DETAIL
2.Check dry fit of pipe and fitting.Pipe should easily go 1r9 on the way into the fitting.If pipe bottoms,it should be snug. I \ �pQ. Ply NTS
3.Use a suitable applicator at least'%the size of the pipe diameter.Forlarger size pipe systems,urea natural
bristle brush or railer,
4.Clean pipe and fitting with a listed primer(Do not use printer anADS pipe and fittings.Use Clear Clamorony!) I^ ( O S E CT I 0 N A-A V I E W
5.Apply liberal coat of cement to pipe to the depth of the socket;leave no unmated surface. 18� 7
6.Apply a thin coat of cement to the inside of the filing;avoid puddling of cement. 17
Puddling can cause weakening and premature failure of pipe mfitting.Apply a second coat of cement to the pipe. G7
7.Assemble parts QUICKLY.Cement must be fluid If cement surface has dried,rarest both parts. 16-'
8 Push pipe FULLY into fitting using a%turning motion until pipe bottoms. \
B.Hold pipe and fitting together for 30 seconds to prevent pipe push-out-longer at low temperatures.Wipe oft excess, D\� THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
10.Allow 15 minutes for good handling strength and 2 hours cure time at temperatures above 60 degrees
Fahrenheit before pressure testing up to 180 psi.Longer cure times may be required at temperatures below 60 degrees V ZONED R-40 LOCATIONS SHOWN ARE FROM FIELD OBSERVA TONS
Fahrenheit or with pipe above 3 inches.DO NOT TEST WITH AIR. /•t`�. NON-CONFORMING LOT AND OR DATA OBTAINED FROM OTHERS.
NOTE:The set up/cure time is dependent on several factors.The pipe size,socket fit,emblem temperature, \v1
relative humidity,solvent cement used and the system operating pressure should all be considered when determining set up cure limes. NAVD88
� AREA: 32,975.28 SQ.FT. or 0.76 ACRES ELEVATION DATUM: ----------___
ALL MATERIALS SCHEDULE 40 PVC(TYP) T UNAUTHORIZED ALTERATION OR A00177ON TO THIS SURVEY IS A WOLA77ON OF SECTION 7209 OF THE NEW YORK STATE EDUCAT70N LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
6"SCHEDU LE 40 END CAP CLEAN OUT M UST BE IN STALLED TO PROVIDE ACCESS TO THE e ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 77TLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON
ADAPTER&PLUG(TYP)CLEANOUT TO GRADE ADAPTER FROM ABOVE(TYP) LISTED HEREON, AND TO THE ASSIGNEES OF 774E LENDING INS77TU77ON, GUARANTEES ARE NOT TRANSFERABLE.
d THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
TOP VIEW(TYP) NOT JNTENDEL TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD177ONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUC7URES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE IiME OF SURVEY
6"SDR 35 PVC RISER
PIPING EXTE DED EXTRA INLET a SURVEY OF: CESCRIBED PROPERTY CERTIFIED TO: CHARLES PARDEE'
LENGTH VARIES(TYP) CAPPED VIA
4"SCHEDULE MAP OF:
ADAPTER&PLUG
OR CAP CrYP) Q FILED:
SIDE VIEW(TYP) SITUATED AT: LAUREL
i
EXTRA INLET TOWN OF: SOU7HOLD CAPPED VIA KENNETH M WOYCHUK LAND SURVEYING, PLLC
4'SCHEDULE40 SUFFOLK COUNTY, NEW YORK
ADAPTER& LUG Professional Land Surveying and Design
INLETADAPTER
NTS INLET VIEW(TYP) REVISED 06-03-24 P.O. Box 153 Aquebogue, New York 11931
CREVISED 05-73-24 FILE # 224-41 SCALE: 7"=30' DATE: MARCH 29, 2024 PHONE (631)298-1588 FAX (631) 298-1588
N.Y.S. LISC. NO. 050882
GFA CALCULATIONS SITE DATA
LOCATION. APE: PROPHi7Y:M973M SF 0.76.c
PROPEATYi 32,975.29SF
BUODABIEPPAPa17Y. 30,497.18 SF 0.0).c
(180=,)GFAPERMEITEP.49A495F STIMkTUDAREACIF IOA004/- a=. � f!„''
- - - r - - - - - OWTI G III.NLOR. 1,779.E GROUNDDBTURIANCE W ru
F7a5TI 0M.FLOOR-- WESW DB51 fl services
® 15T TOTAL• 298M WMNG AMA LOYCOVERAGfi
HOUSE 1.779.6 SF WWW.mehdealanseNicea-corn
.FLOORDEMCh. -26923E
2 .FLOOR DEMO: -W&9 SF SOUTH LANDING, 2&O 5F phone:
% TOrALD}MO: -WB.ISF SOLMIPORCW III SF (631)"B.UM
ifr.FIOORADDmON: 661.55F NORTH POROI+ .2&017 small:
NEW2NRS.ROOW 9062 SF OVfDOORSHOa+HL• 46.0 sF mMiaef@mchdealgnservicea.com
i DEfATCHED DECK 2M6 SF
TOTAL GFA.3".0 SF BULMEAD DECK 12925E
ACCESfORYBUIIDING 395.7IF
a WATCHED GARAGE 4=0 SP
TOTAL- 2=1 EF IOS%
MI I III= Q STORM WATER MANAGEMENT DETAILS TDB „M Imp
XX MASNROON4 -2639 SP
an4�n IDCATIOW SF ARM-700%RUNOFF AT DRYWELL DRYWEU. SOUTH LANUNQ -ffi.05F
PROPOSED rRAINPERHOUR PRO19DD CAPACrrc.
PC.OR SF SM CF MW&,Vdp 507CF NORTH PDRO3. fF
TOTAL• -M3199 SF -f.t%
PROPO—_— T- •—-—•—_—•—-— evsP[I IITCD_RAN 0n n R68UM SOUIIi SUNPOS M+ AREA LOTCOVEIME Q W 44
02 IF
1}a1DRIDl1. N.W.ADDMOM 30a9 SP ESE
.}aD uCT®.v6W IAtyl lo6a SI�IYl6 NaE�1 ry W 6Y W Bp® uJ
SOUTH IANIDO4W 23.0 5F 1
/ 0.garr9.u.a,.a.vw.•Aw.rooauwr0.. NORTH PORCH. 4152 SP ` �J
. 4.®maa.c�av�nrtTxmaamaecmnnnwwrxnKSFaI
EamvcoGneEarmsanlmrnss�c.une.u�t�wOsrmnma TOTAL, 1AM75F 39%
4 PNRQIaLt®IFlI1l61W+®I/m 61PRmAmMdcr YQlN®aM
. \ fewSPllillwoleCrMmamiO Mflf. V r1y
1 WAUATM:
/ A}PEWa11gCOCN.o»�t�amlapxunzmo<umnmeunarct COMODf®TOrALe 9,9315E 13L%M M
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DRY WELLS TO BE IC KIN' 4N W6 PAOOg DBOUNDS. 6URVEYOR: KLMlWV/OfUK � � � /►
EXISTING AWAY FROM HOUM gwma.ROuum-- w.aEST. MARCH 29,2024
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f '\ 2ND.FIJhOR / (EXISTING TO BE DEMOILISHED) REPLACED WITH VA sEPn W r
EXISTING BALCONY TOP V
PLAG POLE Z
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,O EXISTING\, DECK SUNROOM ADDITION
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SCALE: SEE PLAN
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RMEXISTINQ C H
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SCALE: SEE PLAN
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SCALE: 1/8" = 11-011
Charles Pardee &Jill Mennicken
6760 Peconic Bay Blvd, Laurel
SCTM No. 1000-126-11-3.1
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Charles Pardee & Jill Mennicken
6760 Peconic Bay Blvd, Laurel
SCTM No. 1000-126-11-3.1
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Charles Pardee &Jill Mennicken
6760 Peconic Bay Blvd, Laurel
SCTM No. 1000-126-11-3.1
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Photograph 5) View looking west along the south property line at the non-turf Photograph 6) View looking east along the south property line at the non-turf
buffer between the two bulkheads on the property. buffer between the two bulkheads on the property.
Charles Pardee & Jill Mennicken
6760 Peconic Bay Blvd, Laurel
SCTM No. 1000-126-11-3.1
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turf buffer between the two bulkheads on the property. turf buffer between the two bulkheads on the property and the adjacent
properties to the east of the subject lot.
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From: Nunemaker,Amanda Amanda.Nunemaker@town.southold.ny.us
Subject: RE:6760 Peconic bay blvd
Date: June 26,2024 at 9:24 AM
To: Lisa Poyer lisa@twinforkspermits.com
Hi Lisa,
As long as the first floor remains intact (not gutted and exterior sheathing to remain) other
than the minor alterations shown on the plans, this would not be deemed a demolition.
Do you want me to return the application as all zoning complies or do you want me to shred
it?
From: Lisa Poyer<lisa@twinforkspermits.com>
Sent: Wednesday, June 26, 2024 9:01 AM
To: Nunemaker, Amanda <Amanda.Nunemaker@town.southold.ny.us>
Subject: 6760 Peconic bay blvd
Amanda
Attached is the revised set of plans for the pending denial review. I wanted to email this to
you first before printing a hard copy and dropping off. Let me know if this is acceptable and
if the work will fall below the 50% demo rule. I will get you an official hard copy. Thanks.
Lisa
ATTENTION: This email came from an external source. Do not open attachments or click
on links from unknown senders or unexpected emails.
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TWIN
FORKS 288 E. Montauk Highway
PERMITS Hampton Bays, NY 11946
631-644-5998
info@twinforkspermits.com
August 29,2024
-Via Email-
Glenn Goldsmith,President
Southold Town Trustees D
54375 Main Road
PO Box 1179
Southold,NY 11971 AUG 2 9 202 '
RE: Wetland Permit Pre Application Inspection Request
Owner: Charles Pardee&Jill Mennicken d 1
Situate: 6760 Peconic Bay Blvd.,Laurel,NY 11948
SCTM No. 1000-126.-11-3.1
Dear Mr. Goldsmith:
Please view this letter as a formal request for a pre-inspection request for the above referenced property.
The owner is looking to do a modest expansion of the screened porch on the seaward side of the residence,
a minor remodel of the residence and a one story addition on the landward side of the residence.
The proposed project will consist of the following:remodeling the existing 1-1/2 story residence;
reconstruction and small enlargement(91.9 sq. Ft. addition)on the seaward side of the residence with the
existing wetland setback at 76.4'with the new addition at 74'; small addition on the first floor on the
landward side of the residence at 300.3 sq. ft.;reconstruction and addition to the second floor of the
residence where existing second floor is 608.9 sq. ft. increasing to 906.2 sq. ft an increase of 297.3 sq. ft.
The project will also include the installation of an I/A septic system. All proposed work to the residence
will be conducted landward of a functional bulkhead and landward of erosion control silt fencing. The
proposed residence additions will be landward of the neighboring properties pier line. The Town Building
Department has reviewed the application and project and the project is NOT deemed a demolition.
The owner has submitted the inspection fee in the amount of$150.00 directly to the Trustee office. If you
would please place this application on the schedule for the September 11,2024 inspection and let me know
the window of inspection time so that I may meet you at the property. Thank you.
Sincerely,
Lisa Poyer
Principal Planner
Board of Trustees Applicz� .won
AUTHORIZATION
(Where the applicant is not the owner)
Me, 'Charles Pardee&Jill Mennicken
:owners of the property identified as SCTM# 1000- 1000-126-11-3.1 in the town of
Southold(Laurel) New York, hereby authorizes
Lisa Poyer,Twin Forks Permits 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.
Pro erty Owner's Signature roperty Owner's Signature
SWORN TO BEFORE ME THIS DAY OF�7 1 A LAr_,20 a-1
Dayline Cin Iron
NOTARYPLtBLIC,STi1TF OF NFW YORK
Registration No.OIC16442796
Oto,.�,Pub11C Qualirrcd in SUtrotk County
""' Commission F.xpires I0/17/2026
Board of Trustees Application
AFFIDAVIT.
Charles Parties&Jill Mennicken BEING DULY SWORN
:DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN
.ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT
ALL WORK WILL BE.DONE IN THE MANNER SET FORTH 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.
01 A .
Sig4ature of Property Owner ignature of Property Owner
9
SWORN TO BEFORE ME THIS 0.DAY OF -D11 U 20c
Dayline Cintron
NOTARY PUBLIC,STATE OF NEW YORR
Registration No.01C16442786
Qualified in Suffolk County
Lary Public Commission Expires 1,011.7/2026
APPLICANUAGENUREPRESENTATM
TRANSACTIONAL DISCLOSURE FORM
e T o So o d° C M
e o tli ibits co '�, re+ o f , o 0 oe e T es e u e o
:.... ..-.. .
s • . i. t e° fo' at'on.
j��i?cdaiei►to rivaid'snme. .
YOURNAME: Charles Pardee&Jill Mennicken
(Last lame,first name,apiddle initial,unless you are applying iii 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 X
Variance Trustee X
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? "Reliu(ionsw includes by blood,ei*6inge,or business interest"Business interesf''mearis a business,
including aparti eiship,.in which the town officer or employee It .even a partial'ownership of(or employment by)a'coiporotiori
,in which the toy h.officer ar employee owns more than 5%,of c shams.
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 applicanttageat/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 orbencfeialowner of any interest in a non-corporate entity(When the
applicant is not a corporation);
C)an officer,director,partner,of employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
• •:Submitted is day of 20
Signature
PrintNatne Charles Pardee&Ji ennicken
Form TS I
1
APPLICANT/AGENT/REPRESENrATIVE
TRANSACTIONAL DISCLOSURZ FORM
f: o eYN
owe
YOURNAME: . t O 2S— ��� �r �itJV!!(1,
(Last game, name,middle initial,unless you are applying fd"name of
someone also 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)
'fax grievance _- Building r..
Variance _ Trustee X
Change of Zone _ Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
pf"Other",name the activity.)
Doyouj rsfln..kl
o iy:{or throughyour.company,spquse,sititin ,p har:chit. linesa itud�ins{1ip!�vlt artyoffae rorempls�yee
of'the' soatl�old?
"Relattanship mcltides:liy,blood,rharriag .brl�u G striisier st "Busutcs terost'; Means abusinass,
Including a pardneisliip;•iri vt+hich the'iott offiFer or.'employ
ee leas even a partialawnerslilP af,'tor enplonadt?by)a caiiparptYa
in which tho tovn;oRicr:or employee cttivns;marg ttiEitt %oftho 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/agenttrepresentative)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 ofgreater than rob ofilte,sltara of the•coxpGiate stack ctfthe apPllcpttt
;(wben the ttppiicant is a 4.0wrc►ogn);
B)the legal or bencfiuiai oluner of any:tntecost in a noit-coiporate.eMit (wheu:tbs
applicant'is not,tt corpoiation);
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONS141P
Submitted th s ( day of .. 20
PnntN , LrSq f1'
Form TS 1