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HomeMy WebLinkAboutTR-10782 Y Glenn Goldsmith,President ��o��SOfFD(,�cOGy Town Hall Annex A.Nicholas Krupski,Vice President o 54375 Route 25 0 Eric Sepenoski ,a P.O.Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Elizabeth Peeples l �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: ;�mpleted in field by: Cole Environme tal Services on behalf of THE MICHAEL E. & CHERYLYN R. FOSS JOINT REVOCABLE TRUST requests a Wetland Permit to demolish existing two-story dwelling with porch, paved driveway and chain link fence; abandon existing sanitary system and install an I/A OWTS system landward of proposed new two-story approximately 56'x37' dwelling with an 11'x5' front porch, a 38'x10' covered rear porch, and 18'x12' open patio; construct a 24'x22' detached garage with 8'x11' open air covered walk between the garage and dwelling; install exterior basement stairs on west side of dwelling and two basement egresses on east side; install a 22'x10' swimming pool, pool drywell, pool equipment area, and pool enclosure fencing with gates; install A/C units and a generator; install a pervious driveway; and install gutters to leaders to drywells to contain roof runoff. Located: 775 Hill Road, Southold. SCTM# 1000-70-4- 27 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 Type of Application: �Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: Present Were: G. Goldsmith >c N. Krupski ��E. Sepenoski L. Gillooly Ix�E. Peeples +15.11 WEST HILL ROAD +15.19 +15.30 +15.24 +15.07 +14.98 S 68'53'50" E 130.00' -4 E - - - - - ®CAN15.0 7 5.0 - - - 15.2 - - - - - -- 4.9- - -1 - - - OH OH 110., OH OH OH-/- OH OH OH OH OH -U. OH OH FOUND \ I FOUND A MONUMENT -`- - PIPE / 582.95' 153+ , I +15.13I 15.0 % +15.4 \ TITLE No.: 563-S-15882 ,,YY +14.3 14.5 14.6 +141 CERTIFICATIONS: MICHAEL E. & CHERYLYN R. FOSS, as Trustees of the Michael E. and 0) Cherylyn R. Foss Joint Revocable Trust 00 I ABSTRACTS, INCORPORATED a O FIRST AMERICAN TITLE INSURANCE COMPANY 0 T- NOTES: N 1. LOT AREA = 22,198 SQ. FT. 0 +13.s I I+13.8 +13.6 �13.8 UPLAND LOT AREA = 19,013 SQ. FT. 2. PROPERTY APPEARS AS LOT 6 ON A CERTAIN MAP ENTITLED "MAP OF CALVES NECK" FILED FEBRUARY 15, 1972 AS MAP No. 5673. 3. ELEVATIONS REFER TO NAVD 1988 °D I I13.7 N 00 13.5 I m 4. SUBSURFACE AND ENVIRONMENTAL CONDITIONS WERE NOT EXAMINED OR T 13.3 13'' - CONSIDERED AS PART OF THIS SURVEY. ' T 200F OVER 13.3 X X 16.4' 16.2' I o.9'E 5. FLOOR ELEVATIONS ARE APPROXIMATE, FLOOR ELEVATIONS DEPICTED ARE 3.FLOOR ELEV: MEASURED ADJACENT TO THE BUILDING ENTRANCE UNLESS OTHERWISE 0 1s.14 �` INDICATED. +12.1 13.2 I 13. so FLOOR 1E 833. z4.2 6. THE LOCATIONS OF UNDERGROUND UTILITIES HAVE NOT BEEN EXAMINED AS PART OF THiS SURV--Y. SURFACE EVIDENCE FOUND WHiLE GARAGE 1 1/2 STORY N CONDUCTING THE SURVEY IS SHOWN. fE 11.7 DWELLING " D.9'W #775 LOT 0 LOT The offsets or dimensions shown from structures to the property lines are for a specific purpose and use,and therefore,are not 5 Z 7 intended to guide in the erection of fences,walls,pools,patios,additions to buildings and any other construction. I FLOOR ELEV: 11 7 X 23.8' +14.98 33 5' 1 1.4' + Subsurface and environmental conditions were not examined or considered as a part of this survey. 1 1.9 10.6 a o ;p 11.9 Easements,Rights-of-Way of record,if any,are not shown,unless otherwise noted. A/C 3 Property corner monuments were not placed as a part of this survey,unless otherwise noted. UNIT a Certifications on this survey signify that the survey was prepared in accordance with the current existing Code of Practice for Land X +11.2 14.2' GATE x 0 Surveys adopted by the New York State Association of Professional Land Surveyors,Inc.The certification is limited to persons for r- whom the survey is prepared,to the title company,to the governmental agency,and to the lending institution listed on this 11.4 11.3 CHAIN LIDK FENCE co survey. +11.1 +10.8 Said certifications indicated hereon are not transferable. z r +9.3 I FE (V 0.7'E W a� 7.7 N +7.7 +9.3 >R Ad O \ r a +8.7 � +B.t O +7.4 N I WALL ' Date Revision -1. Z .4 0.2W Tax Ma : DISTRICT 1000 SECTION 70 BLOCK 4 LOT 27 _ 1W L5 +5.2 3.1 +5.2 WOOD WALK - _ +4.9- - WALL +4.9 0.3'E r GRAVEL WALK WOOD BULKH 4.97 PIN-N- -A- CL E ON LINE 4.29 EAD BW 0.67 IBW -5.°' 4.30 I LAND SURVEYORS LLP BW -4.60 4.24.6 N 62'22' W -4.864.23 _ +- .9 9Q" BW 457 4.25 +-s.t +-s.1 + (TIE w �u- 41 55 VETERANS HIGHWAY, SUITE I I 63 1 .648.9273 -6.1 +LINEA LONG BULK+1000 44' BW -a.,5 BW i93 RONKONKOMA, NEWYORK 1 1779 WWW.PLSLI.COM s.s +-6.a - -F-5.2 O 2024 PINNACLE LAND SURVEYORS LLR +-5.7 _ _ +-4.4 BOUNDARY & 3 53.°°' _ TOPOGRAPHIC SURVEY SITUATE I ^ J0`OKEY CR _ EEK SO UTH O LD f r _ I TOWN OF SOUTHOLD SUFFOLK COUNTY NY € � I N 63'32' laAR 1 2 2025 s 0°' I ?I Date Unauthorized a r addition to this survey is a violation 57 yy "' i�=-�I J U LY 17 2024 of Sectlo New York State Education Law § I 40. _ - Scale 20' -� - Sheet No. 1of1 �' es�og6 VIEW: Project No. Co es earing the land surveyor's 240195 emboss e 4,4 shall not be considered to be a e and valid copy SITITATE SOUT'HOLD THIS PROJECT IS IN COMPLIANCE WITH 2O20 RESIDENTIAL CODE OF NEW YORK STATE. TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-70-4-27 2-'�"«�B°" �' SCALE 1"=20' 9-28' C AT LOT AREA := 22,198 sq. ft. 2'-1 " 2'-8 1 " CHAMBER Volume(gal) ARCHITECT I Sedimentation Chamber 397 UPLAND AREA = 19,013 Sq. t. _ 2 Anaerobic Filtration Chamber 396 ECIRCULATION 3 Aerobic Contact Filtration Chamber 181 AIR LIFT PUMP SINFECTION 4 Storage Chamber 90 CYLINDER(OPTIONAL) Disinfection Chamber 6 TEST HOLE DATA 4•INLET PI ^ s\ / "OUTLET% Total Volume 1069 REVISIONS D E S C R I P T 1 0 N (TEST HOLE DUG BY SUFFOLK COUNTY SOiL EVALUATIONS ON FEB. 22 2025 /EL 15.0' 0, pV �A �JA SPECIFICATIONS PU I / / ! © Anaerobic Media PP/PE Filling Rate 32% B, \ `` Board Type Aerobic Media PVC/PP/PE FillingRate 17% BROWN LEAN CLAY R SILT W/SAND(CL&ML) +15.11 W,q jF ENT Aerobic Media PP/PE Filling Rate 55% R INLET a (2) AIR uFT PUMP Blower 2.8 cfm 3.3' \ ___1 <0 Tank FRP BROWN SANDY SILT(ML) 217 VENTILATION— 0 Piping PVC/PP/PE 4.4' PIPE Access Covers Plastic/Cast Iron '- PALE BROWN SILTY SAND(SM) 5.3' y14.6 2"NR INTAKE Disinfectant(Optional) Chlorine Tablets PALE.8ROWN FINE`SAND(SP) \ +15.19 RECIRCULATiON PI "FLOW BAFFLE � / PALjPOWN SILTY SAND(SM) FEW SILT _ - FLOW OPENING(TYP. (CLEANING OPENING) B QV PLAN VIEW \ \ \�\ \ 15.0 PALE BROWN FINE SAKI)(SP) cAT� \ \ v 68' , +15.30 /iLJ/J SINFECTION C 15.0 3�So++ RpVFC) 18"MANHOLE(TYP 18'MANHOLE(TYP 24"MANHOLE(TYP CYLINDER (OPTIONAL) 4'MANHOLE OPENING PALE BROWN FINE TO COURSE SAID (SW) \ Iy\ ^ - 15.3+ "' �� 15.2 +15.24 +4 PeR pIt EL 0.1' 14.9' \ \ - -- TYPE WATER PALE BROWN FINE TO COURSE SAND(SW) \\ \ - -- F CONTAC MT EDIA IN �\ \ 17.0' (p 5.43r n \a\ ��+1\.91O000, +15.07 I �"✓�C P Re O AY \ \\ _ P71� ® ECIRCULATION THIS SITE PLAN HAS BEEN PREPARED �°oe,q 4jr yY N Ex 7 \a, +14.98 0- pO ^ q ASSEMBLY USING THE INFORMATION FROM THE of F, cb Q a / EX, G I / SURVEY OF PINNACLE LAND SURVEYORS PRO Oy�' C¢p�0{� V +t50 °'\� LLP DATED JULY 17 2024, UPDATED Ilk Po/c�1pk0 ? y T, Q ' S �> P ©� �', �(© DULY 29, 2024 - ROTO� �i RS7k ?' ',stio �\^�\ \ \ OBIC MEDIA UPLAND L 0 T AREA - 19,013 s t. coo `ow sgp�oy / ° R� x�, o �, O q f ?•D"'�G GOSO� D �x 4At� / y FOR D�jD �j +15. \ j \ ATION ASSEMBLY CID EXISTING IMPERVIOUS LOT COVERAGE ,yy�FR�F / r +14.376 DESCRIPTION AREA % LOT COVERAGE � coy ` �yc� / ° ° t. w \ SECTION A-A VIEW SECTION B-B VIEW HOUSE Z',164.37 sq. ft. t 1.3% ,ecp�ol p b�4 aVo O 14.1 f / 8 '9N 3 I� PORCHES 142.6 sq. ft. 0.8% o o�q o +1 / D' .0 S � 11 FUJI CLEAN CEN-7 TREATMENT SYSTEM PAVED DRIVEWAY t o73.5 sq. ft. 5.6% /MPRpVFO R�yR l ° ° q1'I : '' �':.'... ��/ �¢ 14.6 Ij (NOT SCALE) ' �° %o / f Ue4/c F / :::: :pRpp�s:::::::':'.'. �� w3Q TOTAL 3,380.47 sq. ft. 17.7% Wg rFR c�H 13.8 .a :::::':F'rglP:''. '... :' oaf Q UPLAND LOT AREA = 19,013 sq. ft. rs .. .:� �� W EXISTING IMPERVIOUS LOT COVERAGE , DESCRIPTION AREA % LOT COVERAGE g+ 12k9 ?3, / a'::'::':::':':.. ... .'.?° ^ ALARM/CONTROL PANEL CONTROL PANEL MOUNTED \ pOpD/q Nk yo,o• '''''''''. .. �.�.,.�.....'.'.'.'.'.'.'.'.•.'.'.'.•.•.•.�`r^. '.'.... E. �/ MDL#1041972 CONTROLER A" ON 4"X4" PRESSURE O < D x 4' l JtQ MFG BY SJE RHOMBUS TREATED WOOD POSTS HOUSE 2202 sq. ft. 11.5% ` 13.2 �`` �/ ':::::::: ::::: 13.6 AIR BLOWER FRONT PORCH 57 s ft. 0.3% ':•:•:•:•:•:•:•:•:•:• :•.•:•: ::. r�.. . .:........•.•.•.•.•.•..." �... g 4iy C, q / :.:.:.:.'.'.'.'.'.'.'.'.'.'.'. '.'. ( ,Uo�� G INSULATED WEATHER 'w....... .. 0 q'"Wg0 s RESISTANT BLOWER ?: ;.�.;•.1:3 .:.:..:.:.:.:..//::;:::\„ 43.�. SPQR yFO�C ENCLOSURE O ;:, J FCC �Vr �H TO DETACHED GARAGE 528 sq. ft. 2.8% p/F / � � o eF 0 COVERED LINK 88 sq. ft. 0.5% NF ...................:.............. `� e•o ys �.® COVERED PORCH W HOT TUB 380 sq. ft. 2.0% 11 9 . .. / yo C FoR R� q� F (� z OPEN PATIO W STEPS 280 sq. ft. r m r�::::::::::::::: I� 'l -AIR LINE TO 20' ,• / FUJICLEAN OWiS ^ POOL W COPING 220 sq. ft. 1.2% �o F11.2P o%0 �l Mp'T Uj •� R M° Dr BFFF"f '�0• . '/ pVF� TOTAL 3,755 sq. ft. 19.7% N �� 0.` / \°y 2.0 '' ' ?%'o• i�yo y PUe4/C• ELECTRICAL SUPPLY 7.7 ,v° ( \� p r1' O 6f��pOVsf I V,4� TO BLOWER ReNee T° 11.4 W o /FR /�Roi�so�yo LLl DRAINAGE SYSTEM CALCULATIONS: f 7.7 �,/ 70. n0 ti m US ELECTRICAL SUPPLY TO FUJI BOX OWTS //) 0 •;-11.� 11.3 0' `� �NF11.7+ yo(,FfD Fo� SPLICE BOX V / ROOF AREA: 3,755 sq. ft. �'�' \ 11.9 0 , u 3,755 sq. ft. X 0.17 = 638.35 cu. ft. Qom, CONTROL PANEL & BLOWER J 638.35 cu. ft. / 42.2 = 15.12 vortical ft. of 4' dia. leaching pool required + 9 3 +10.8 aN� O PROVIDE (4) 8' dia. X 4' high STORM DRAIN POOL `\ " ! TO aeZR� � (NOr TO SOMA) NOTE: ALL ROOF AREAS TO BE PIPED TO DRYWELLS 5.4 0 PROVIDE 3'-0" COLLAR AROUND EACH DRYWELL OF CLEAN BANK RUN `\ o O n_ -` AERATOR MOUNTING CASTING O +5.2 +9.3 PROPOSED 8' DNA. X 4' DEEP DRYWEL.LS ARE SHOWN THUS: Q- - - 0 wok/Mq� + 8 7 0 ELECT. CONDUIT PROPOSED 8' DNA. X 4' DEEP DRYWEL.L FOR POOL ARE SHOWN THUS: O- - - o,Noy°,�Ffe N OWTS WIRING PER MFGR. ' Gi 120V AC, 10, 60 HZ, 15-AMP POWER SUPPLY LL LEGEND: + 5.2 #12-2 AWG WiTH GND IN 1" PVC CONDUIT 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM +- 9 +6.1 + FUJI CLEAN HARDWIRE EXISTING ELEVATIONS ARE SHOWN THUS: +-s1 74 E� CONTROL SERVICE OWTS iNN F.FL. - FIRST FLOOR +-6.1 t PANEL PANEL G.FL. - GARAGE FLOOR 4.9 WA�-L ELECTRIC SERVICE 0•ZW AIR BLOWER COiECTION MINIMUM LEACHING SYSTEM FOR 5-6 BEDROOM HOUSE IS 400 sq ft SIDEWALL AREA. `% 3.1 2 LEACHING POOLS (8' DIA. x WDEEP) 6.1 NOTE: BURIED ELECTRICAL POWER CONDUITS \ ` SHALL BE MIN. 24' BELOW GRADE - GROUND ROD �v [Ex] PROPOSED FUTURE 50% EXPANSION 8 DIA X 8 DEEP LEACHING POOL `� \ Q PROPOSED 8' DIA X 8' DEEP LEACHING POOL ` 6.5+ � ` ` ELECTRIC ONE LINE DIAGRAM I 7 2025 r kl A R 000 PROPOSED FUJI CLEAN CEN-7 6.4/ + TREATMENT SYSTEM / y, 6.2 At 13 PROPOSED 12"xt 2" POLYLOK DISTRIBUTION BOX / 633 -5.7 I SLIUtheId-own 2. ALL NEIGHBORING PROPERTIES WITHIN 150' OF PROPERTY LINES / •h�a� 53��pry �� +-4.4 4 8�����tTnlstees HAVE PUBLIC WATER. \ 24"0 COMPONENTS THIS ACCESS ONLY PROPOSED SEPTIC S STEM DETAIL Al'Y / A:) Aj5 20"0 HDPE SECURE HEAVY COVER BY POLYLOC (NOT TO SCALE) 3. THERE ARE NO WELLS WITHIN 150 OF PROPERTY LINES. 63.32, \v/ Spry +-4!1 20" SALT' SCREEN BY POLYLOC (TYP.) 4. SEPTIC SYSTEM DESIGNED FOR UP TO 6 BEDROOMS. HOUSE 12 x 12 POLYLOK D-BOX 400 O �'Y ` ELEV. 15.0, _/ W PDB-12 RISER AND FINISHED GRADE / FINISH GRADE Charles M . Thomas ELEV. 13.6' ROTO-FLOW 3'J50-4 LEVELERS ELEV. 14.3' CLEANOUT TO GRADE WITH LOCKING COVER TOP EL 13.0' 1' MIN. a r c h I 1} ei L' l} APPROVED PIP s" COVER NY 11947 (631) 721-7993 T 12 83 I/A OW`rS TANK rn INVER min. PITCH 1/4'/1' LEACHING PO BOX 877 JAMESPORT, INV. EL 12.63' FUJI CLEAN CEN-7 ELEV. �'A�LEY GAP �= 3' CLEAN TREATMENT SYSTEM SAND INVERT INV.EL 12.17 • o COLLAR ELEV. 12.37' ELEV. 12,47' " 8.5- �• �8.5b� "ZIv PROJECT P PROPOSED SITE PLAN SKETCH BOT. EL 7.5' BOT. EL. 8.5' 6' MINIMUM PENETRATION HIGHEST EXPECTED GROUND WATER INTO A VIRGIN STRATA ELEV. 1.1' OF SAND AND GRAVEL GROUND WATER PER TEST HOLE 1 SCALE: 1: 20 FUJI CLEAN CEN-7 I/A OWTS SYSTEM - (NOTES) TREATMENT SYSTEM 1. MINIMUM I/A OWTS SYSTEM CAPACITIES FOR 6 BEDROOM HOUSE IS 660 GPD. "�'� 6 BEDROOM HOUSE, SINGLE FAMILY DWELLING - 660 GALLONS PER DAY USE FUJI CLEAN CEN-7 TREATMENT SYSTEM RATED FOR 700 GPD. SITE L PLAN USE: (1) FUJI CLEAN CEN-7 TREATMENT SYSTEM a 700 GALLONS PER DAY 2. A 1OFT MIN. DISTANCE BETWEEN I/A SYSTEM AND HOUSE SHALL BE MAINTAINED 3. ALL JOINTS SHALL BE SEALED SO TANK IS WATER TIGHT. 4. INSTALLER MUST HOLD A CURRENT LIQUID WASTE LICENSE PURSUANT TO CHAPTER 563 ARTICLE VII Wr H ENDORSEMENT J. LEACHING GALLEYS (4) 5. %A SYSTEM MUST BE REGISTERED WITH THE SUFFOLK COUNTY BOARD OF HEALTH IN CCORCANCE TO ARTICLE 19. 1. MINIMUM LEACHING SYSTEM FOR 5-6 BEDROOM HOUSE IS 400 sq ft SIDEWALL AREA. 6. OWNER 1 ALL EXECUTED OdcP CONTRACT WITH THE MAINTENANCE PROVIDER AS PER 9. 4 LEACHING GALLEYS;4.0' DEEP (8.5' LONG X 4.75' WIDE) 7. VENT I/'A WITH A MIN 2" DIA PIPE TO THE EXTERIOR SIDE OF RESIDENCE AND TERMINATE 18 2. LEACHING GALLEYS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE (OR EQUAL) INCHES ABOVE GRADE WITH A CARBON FILTERED DEVICE LOCATED 3 FT FROM ANY WINDOW LEACHING STRUCTURES, SOLID DOMES AND/OR SLABS. OR DOOR. 3. ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL). B. ELECTRICAL CONTROLS SHALL BE MOUNTED ON THE SIDE OF THE RESIDENCE IN VIEW OF THE DATE: 2/26/25 SYSTEM 4. A 10' min. DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE MAINTAINED. 9. PANEL SHA�LLnMEET (NEMA) 4x SPECIFICATIONS. 5. AN 8' min. DISTANCE BETWEEN ALL LEACHING GALLEYS AND OWTS TANK SHALL BE MAINTAINED. 10.CONDUIT SHALL HAVE APPROPRIATE SEALS TO PREVENT GAS AND MOISTURE FROM PROJECT No. REACHING THE CONTROL PANEL DRAWING BY. MC 11.SYSTEM SHALL BE EQUIPPED WiTH A FUNCTIONING WARNING SYSTEM WHICH WILL ACTNAT AUDIBLE AND VISUAL ALARMS THAT CAN BE READILY SEEN AND HEARD BY CHK BY. OCCUPANTS OF THE RESIDENCE SERVED. 12.AERATOR AND OPERATING COMPONENTS SHALL BE ACCESSIBLE AND SERVICEABLE FROM DWG No. 1 ACCESS OPENINGS. 1 -O O 1 OF 1 THESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS, AS INSTRUMENTS OF SERVICE, ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBLICATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED. REUSE, REPRODUCTION OR PUBLICATION BY ANY METHOD, IN WHOLE OR IN PART, IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT. TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT.VISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS. THIS PROJECT IS IN COMPLIANCE NTH 2O20 RESIDENTIAL CODE OF NEW YORK STATE. w a ARCHITECT / iiiiiii Hill illilil III \ / \ REVISIONS DESCRIPT ION / \ / / \ / IIIIIIIIIII ill Hill 1111 Hill 1 11 1 1 1 1 1 11 1 1 1 1 111 ill 1111 1 1 1 \ 1.0. PLATE HEIGHT \ T.O. WINDOWS 28410 28410 -- - - -- \ 00 to wTR o2s 1 M A I p 1 q 12 2025 � / T.O. SECOND FLOOR STANDING SEAM METAL \ / ROOF 7 T.O. PLATE HEIGHT \ ! .vn / BEAD BOARD HEADER T.O. WINDOWS TE10 I ( o ( b 28410 2052 2052 30410 28410 28410 TEMP TEMP co W 30211p0 I Li0 y TE T.O. FIRST FLOOR ( I'— O 0 I-- n �- - W Q SIDE YARD SETBACK SIDE YARD SETBACK O 0 Q W (� z E FRONT ELEVATION Ld � 1 SCALE: 1/4" = 1'-0" _J cc LIJ LJ / \ \ 0 0 I I I H 1 11 1 1 11 1 11 1 1 11 1 ;1 1 1 11 1 11 1 1 11 1 1 \ O f— / \ 0 / \ ® \ / A 21 T.O. PLATE HEIGHT \ T.O. WINDOWS \ = 28410 28410 0 \ Co OD / M11111 11 Hill Ill co \ / C 2 WTTR 026 \ / SANDING SEAM lmi� T.O. SECOND FLOOR \ Charles M . Thomas / ROOF \ T.O. PLATE HEIGHT \ a/ r C h I t e C +_ l / \ PO BOX 877 JAMESPORT, NY 11947 (631) 727-7993 30410 TEMP _ T.O. WINDOWS o� IPROJECT o I 28410 28410 28410 28410 30410 28410 28410 TEMP TEMP TEMP TEMP 2052 2052 TEMP TEMP ao 30210 TEMP PROPOSED ELEVATIONS T.O. FIRST FLOOR I 15'-0" A 23'-0" 3/10/25 SIDE YARD SETBACK SIDE YARD SETBACK PROJECT No. DRAWING BY. MC CHK BY. E FRONT ELEVATION WITH GARAGE DWG No. 00 1 SCALE: 1/4" = 1'-0" 1 OF s ITHESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS, AS INSTRUMENTS OF SERVICE, ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBLICATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED. REUSE, REPRODUCTION OR PUBLICATION BY ANY METHOD, IN WHOLE OR IN PART, IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT. TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT.VISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS. THIS PROJECT IS IN COMPLIANCE WITH 2O20 RESIDENTIAL CODE OF NEW YORK STATE. t ARCHITECT REVISIONS D E S C R I PT I ON T.O. PLATE HEIGHT A 21 T.O. WINDOWS T.O. LOW PLATE HEIGHT b 24 10 1 0 o I i� n I �r T.O. SECOND FLOOR - 24 10 r T.O. PLATE HEIGHT . .... .... n^ q P Ii T.O. WINDOWS MAR 1 2 2025 � i O 0 2446 2446 2446 I T.O. FIRST FLOOR ui 0 Y CLOPLAY O.H. DOORS CLOPLAY O.H. DOORS AS SELECTED PER OWNER AS SELECTED PER OWNER o z 0 E SIDE ELEVATION ui Q o Q 0 � Q z W ry C) z < - o o z � cn 0 o � Z o � I- 0 LL V) A 21 T.O. PLATE HEIGHT T.O. WINDOWS Ell i 1 o 00 i� T.O. SECOND FLOOR 24 10 T.O. PLATE HEIGHT Charles M . Thomas T.O. WINDOWS a r C Il I t e C t PO BOX 877 JAMESPORT, NY 11947 (631) 727-El 7993 o PROJECT I O O I 24510 24510 T.O. FIRST FLOOR PROPOSED ELEVATIONS DATE: 3/10/25 PROJECT No. DRAWING BY. MC CHK BY. E SIDE ELEVATION DWG No. 4 SCALE: 1/4" = 1'-O" a 002 M70 2OF 5 THESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS, AS INSTRUMENTS OF SERVICE, ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBLICATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED. REUSE, REPRODUCTION OR PUBLICATION BY ANY METHOD, IN WHOLE OR IN PART, IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT. TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT,VISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS. THIS PROJECT IS IN COMPLIANCE NTH 2020 RESIDENTIAL CODE OF NEW YORK STATE. a` Y t E b � r ARCHITECT 4k \ REVISIONS D E S C R I P T ION / T.O. PLATE HEIGHT T.O. WINDOWS \ MAR 1 2 2025 � on \ Id \ _ / T.O. SECOND FLOOR T.O. PLATE HEIGHT T.O. WINDOWS \ \ o 2456 2456 I o - to � T.O. FIRST FLOOR - I E- � }- —7 w PROPOSED Z LAP POOL I OC) O Q �y W I 23'-0" z 21'-0" LLJ E REAR ELEVATION Q ui 5 SCALE: 1/4" = 1'—O" a I z Ln 0 0- � Z Oly- I— a_ D 0 0 UL U) Charles M . Thomas a r c h i t e c t PO BOX 877 JAMESPORT, NY 11947 (631) 727-7993 PROJECT PROPOSED ELEVATIONS DATE: 3/10/25 PROJECT No. DRAWING BY. MC CHK BY. DWG No. W403m 3OF 5 THESE DRAWINGS AND ACCOMPANY�NG SPECIFICATIONS, AS INSTRUMENTS OF SERVICE, ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBLICATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED. REUSE, REPRODUCTION OR PUBLICATION BY ANY METHOD, IN WHOLE OR IN PART, IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT. TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT.VISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS. iLL!i 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management Photo Sheet Michael &Cheri Foss 775 Hill Road Southold, NY 11971 SUM NO: 1000-070.00-04.00-027.000 PHOTO 1—AERIAL(FACING NORTH) a . IN ��(( 9 _ 5yT yfI jig If www.ColeEnvironmentalServices.com iCES 425 Montauk Highway " East Quogue, NY 11942 Environmental Consulting (631) 369-9445 Wetland Project Management PHOTO 2—AERIAL(FACING EAST) dN 1p y- 7 Ail xt µ yw� PHOTO 3—GROUND LEVEL(FACING SOUTH) ■ i l�l www.ColeEnvironmentalServices.com 425 Montauk Highway — East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management PHOTO 4—GROUND LEVEL(FACING NORTH) r p■ i 11 PHOTO 5—GROUND LEVEL(FACING NORTH) www.ColeEnvironmentalServices.com 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management PHOTO 6—GROUND LEVEL(FACING EAST) ow' e� M ;rhfl;�LY: PHOTO 7—GROUND LEVEL(FACING WEST) �y •4,1y�T�..r..d,n".s+�' I r1 4 tf A'f �'' U(r t-� � .�7+���I? TR f Y'tr www.Co[eEnvironmentalServices.com Y � Slt o-zrw ,: � �\�\�` aEeaEe tto.I>m ,,•: a ;�, �. l :. '.^?a,�, r., sec NO xm 15t! a ��` A \ v� ewtwl we � ,. 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S° m _aa.. .,i°` '� •' 7z ,p? ,. .--. ...- �.. _ � �,.,.M`k•...�����, .° ��\�� ���c ,\'�\ �i �\.�`��t' �fi��1 yl � -aat&�a ,;f �� f �'� r o. rrn..x lee }.• -.. 77 COUNTY OF SUFFOLK U _ _ Real P-peny li D xe.liency uurte.9re Kxe•v�a s.z v w w osmenoawnsaan 070 p "`�---•-- _-^-- �" _-- ..,.... Qtl w... ,m ram. -,u+i t,wr e.wr xtmm,m,a.,+,wcsrw A `.' aarthan OFFICE LOCATION: " MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: May 12, 2025 Re: LWRP Coastal Consistency Review for THE MICHAEL E. & CHERYLYN R. FOSS JOINT REVOCABLE TRUST SCTM# 1000-70-4-27 Cole Environmental Services on behalf of THE MICHAEL E. & CHERYLYN R. FOSS JOINT REVOCABLE TRUST requests a Wetland Permit to demolish existing two-story dwelling with porch, paved driveway and chain link fence; abandon existing sanitary system and install an I/A OWTS system landward of proposed new two-story approximately 56'x37' dwelling with an 1 Vx5 front porch, a 38'x10' covered rear porch, and 18'x12' open patio; construct a 24'x22' detached garage with 8'x11' open air covered walk between the garage and dwelling; install exterior basement stairs on west side of dwelling and two basement egresses on east side; install a 22'x10' swimming pool, pool drywell, pool equipment area, and pool enclosure fencing with gates; install A/C units and a generator; install a pervious driveway; and install gutters to leaders to drywells to contain roof runoff. Located: 775 Hill Road, Southold. SCTM# 1000-70-4-27 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 action is CONSISTENT with LWRP Policies and, therefore, CONSISTENT with the LWRP. 1. Reduce turf area against the water body. A native plant, non-fertilized vegetated buffer is recommended to further policy 6. , 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 f "� !.� Glenn Goldsmith,President �` '�Q� �f�'r , Town Hall Annex °���`� 5 2 A.Nicholas Firupski,Vice President s ,`�, j f �lll + P.O.Box 54375 Route to 2 Eric Sepenoski " Southold,New York 11971 Liz Gillooly Elizabeth Pee les c ` �, � Telephone (631) 765-1892 P "ityI - ;c Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only , E G E B V E Coastal Erosion Permit Application Wetland Permit Application l" Administrative Permit MAR 7 2025 Am endment/Transfer/Extens io ^Received Application: Received Fee: $�- �� Southold Town TInemomplete- SEQRAopletedApplication: Board of Trustees Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): - LWRP Consistency Ass ssment Form Sent: CAC Referral Sent: /J PY / _Date of Inspection: Receipt of CAC Repo t: __Technical Review; _ _Public Hearing Held: Resolution: r Owner(s) Legal Name of Property (as shown on Deed): The Michael E.and Cherylyn R. Foss Joint Revocable Trust Mailing Address: 42 South Ash Street, Denver,CO 80246 Phone Number: 310.365.6102(Cheri) 720.454.9313(Mike) Suffolk County Tax Map Number: 1000 - 070.00-04.00-027.000 Property Location: 775 Hill Road,Southold, NY 11971 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Cole Environmental Services _ Mailing Address: 425 Montauk Highway, East Quogue, NY 11942 Phone Number: �631 369-9445 Email: info@ColeEnvironmentalServices.com C G•�c� Sew�- . PPP 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management Project Description Michael &Cheri Foss 775 Hill Road Southold, NY 11971 SCTM NO:1000-070.00-04.00-027.000 Proposed new construction. Existing structures to be removed, including 2-story 2,164.37 square foot house, 142.6 square foot porch, 1,073.5 square foot paved driveway, and chain link fence. Existing sanitary system to be abandoned as per SCDHS specifications. Proposed 2-story approximately 56'X 37' residence with 24'x 22'detached garage and 11'x 8'covered link between the two. Exterior basement stairs on west side of house,egresses on east. 11'x 5' front porch,38'x 10' covered rear porch, 18'x 12'open patio,and 22'x 10' pool. Pervious driveway. I/A sanitary system in front yard. 8'x 4'drywells for pool and roof runoff. www.ColeEn-�ironmentalServices.cc•n ­_'Zoard of Trustees Applicat tea' GENERAL DATA Land Area(in square feet): 22,198 Area Zoning: R-40 Previous use of property: Residential Intended use of property: Residential Covenants and Restrictions on property? Yes �No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _aYes Jallo 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. VJA4his project reqF9 any demolition as per Town Code or as determined by the Building Dept.? Yes I I No Does the structure(s) on property have a valid Certificate of Occupancy? _Yes F_No Prior permits/approvals for site improvements: Agency Date NYSDEC 11/25/24 Town of Southold Septic Permit 1/17/1991 Town of Southold Building Permit 6/11/1973 ❑ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? Iy I NoE Yes If yes,provide explanation: Project Description (use attachments if necessary): Please see attached project description. J 'Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To create a new, functional residence Area of wetlands on lot: 0 _ square feet Percent coverage of lot: 17.7 % Closest distance between nearest existing structure and upland edge of wetlands: 54 feet Closest distance between nearest proposed structure and upland edge of wetlands: — 60 feet Does the project involve excavation or filling? ❑ No ✓Z_Yes If yes,how much material will be excavated? 338 cubic yards How much material will be filled? 343 cubic yards Depth of which material will be removed or deposited: 10 feet Proposed slope throughout the area of operations: 3.4% Manner in which material will be removed or deposited: Typical construction equipment to be used for excavating and depositing. Excavated material to be used for backfilling. 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): Please see attached project description. r � . • i - 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 Name of Action or Project: Foss House Project Location(describe,and attach a location map): 775 Hill Road, Southold, NY 11971 Brief Description of Proposed Action: Please see attached project description. Name of Applicant or Sponsor: Telephone: 631-369-9445 Cole Environmental Services E-Mail: info@ColeEnvironmentalServices.com Address: 425 Montauk Highway City/PO: State: Zip Code: East Quogue NY 11942 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: ❑ NYSDEC Letter of NJ, SCDHS, Town Building 3.a.Total acreage of the site of the proposed action? 0.5 acres b.Total acreage to be physically disturbed? U.L0 acres C.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 00.5 acres 4. Cher 1 land us at occur on,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial Residential (suburban) Forest ❑Agriculture HAquatic QOther(specify): Parkland Page 1. of 4 i 5. Is the proposed action, NO YES NIA a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural 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: Peco1]c BaY and Environs,RegLt ator_V T dalLWetland$.._A_re_a. ❑ 7 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 1/✓ 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:_ ❑ 0 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water:`__ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: New I/A sanitary system ❑ to be installed. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? " b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO 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\vaterbody? ✓ Y If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. ntify the typic bitat types that occ n,or are likely to be found on t10roject 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 animal,or associated habitats, listed NO YES by the State or Federal government as threatened or endangered? Bats 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 If Yes, ❑ a a.Will storm water discharges flow to adjacent properties? ©NO DYES b. Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes,briefly describe: NO V-S Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO LYES 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 YES solid waste management facility? If Yes,describe: __ _____ ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: _ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Chris Cole,Cole Environmental Services . Applicant/sponsor name: Date:03/04/25 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 I 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 I. Will the proposed action create a material conflictwith an adopted land use plan or zoning regulations? ❑ C] 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? ❑ ❑ 5. Will the proposed action result in an adverse change in the existing level of traffic or 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 ❑ ❑ 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, El ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ I ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 406 ' No,or Moderate small to large impact impact may may occur occur 10. W ill the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 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 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management Project Description Michael &Cheri Foss 775 Hill Road Southold, NY 11971 SUM NO: 1000-070.00-04.00-027.000 Proposed new construction. Existing structures to be removed, including 2-story 2,164.37 square foot house;142.6 square foot porch, 1,073.5 square foot paved driveway, and chain link fence. Existing sanitary system to be abandoned as per SCDHS specifications. Proposed 2-story approximately 56'X 37' residence with 24'x 22' detached garage and 11'x 8' covered link between the two. Exterior basement stairs on west side of house, egresses on east. 11'x 5' front porch,38'x 10'covered rear porch, 18'x 12'open patio, and 22'x 10' pool. Pervious driveway. I/A sanitary system in front yard. 8'x 4'drywells for pool and roof runoff. www.ColeEn•fironmentaI Services.ca:n APPLICANUAGENUREPRESENTATWE TRANSACTIONAL DISCLOSURE FORM The Town Hof Southold's Code of Et}tics prohibits conflicts of interest on the part.of town-offims and employees The purpose of this form is to provide information which can alert the town of possible conflicts of Interest and allow itdo take whatever action is necessary to avoid same. YOUR NAME: 9-Q � m e I , �� e (Last name,first name,.rpiddle 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 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'I'awn of Southold? "Relationship"includes by blood,nrarriage,.or business interest-"Business interest"means a business, including apartnership,in which the town officer or,empl'ayee has;even a partial ownership o.'f(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 applicattt/agentlrepresentative)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);. 13)the legd'or'beneficial.owner,of any interest in a,non-corporate entity(where the applicant is corporation); C)on officer,director,partner,oremployee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted t isk1dgarC" ' 20 J SignaturePrint NameWt Form TS l APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The`Town'of Sotithold's Code of Ethics oh iliits'conflicts of interest on the namt of-town officers itnd employees Tiie nuraoso of this form is'to provide information which can alert the town ofnoesible`eh'Ada of mteresGand allow it'ta take whatever acuomms necessary,,to avoid.same. CHERYLYN R.FOSS,MEMBER OF THE MICHAEL E.AND,CHERYLYN,R.FOSS JOINT REVOCABLE TRUST YOUR NAME: . ._ (Last name,first name,griddle 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 X Change of Zone Coastal Erosion Approval of plat Mooring _ Exemption,from plat or official map Planning Other (lf"Other'',name the activity.) Do you personally(or'through your company,#,,Use,sibling,patient,or cfiild)have a rclad6nship with anyaEfiecr oretnployee of the T;iy6, Southold? "Relationship"includes by:blood,Mairiage,or business-iWtesL"Business interest"means a business, including apartnership,in:which the loii*n.offieci or a.mployee teas even ti patiial otvnersttipof(or einploytncpl by)�t.comporation. in which the townofficer.or:employee`owns'mortrthan 56/oof the shares. YES NO ^ - If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Sout o d.: AJ Title or position of that person., Describe the relationship between yottr$elf(the apolic.dagent/representative)and the town officer or employee.Either check : the appropr:iate;line A)thriugfi;D)and/or describe m thespace prove e . The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)rilie'ownecgf greater_than 5°lo'of the stiam 's of the corporate stock of the applicattt (when the appltcttmtt is -corporation). B)the,legal or ieneficia!ovine[of any interest in a`aton-corporate entity(when the applicant ispot a corporation); ` C),anofficer,director,:;partner,or einployee of'tieopplicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th' / day of 1144gh 209 Signature Print Name Form TS 1 e .'ard of Trustees Appli.cat AUTHORIZATION (Where the applicant is not the owner) I/We, CHERYLYN R. FOSS,MEMBER OF THE MICHAEL E.AND CHERYLYN R.FOSS JOINT REVOCABLE TRUST owners of the property identified as SCTM# 1000- ___ 070.00-04.00-027.000 in the town of SOUTHOLD New York,hereby authorizes COLE ENVIRONMENTAL SERVICES 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 Property Owner' ignature l sfi SWORN TO BEFORE ME THIS, _. [ . DAY OF: (�� _ 20.2 S Axj ANN @uC o Public ORADO 019014May 19.2027 )ard of Trustees Applicat,,` AFFIDAVIT CHERYLYN R.FOSS,MEMBER OF THE MICHAEL E.AND CHERYLYN R.FOSS JOINT REVOCABLE TRUST 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. Signature of Property Owner Signature of P perty Owner S WORN TO BEFORE ME THIS.- ._ _DAY OF SOPHIA BRANN NOTARY PUBLIC STATE OF COLORADO NOTA"y ID 20234019014 W Commisslon N ublic _ Expires May 19,2027 ,ard of Trustees Applicat AUTHORIZATION (Where the applicant is not the owner) MICHAEL E.FOSS,MEMBER OF THE MICHAEL E.AND CHERYLYN R.FOSS JOINT REVOCABLE TRUST I/We, , owners of the property identified as SCTM# 1000- 070.00-04.00-027.000 ,in the town of souTHOLD -;,New York,hereby authorizes COLE ENVIRONMENTAL SERVICES 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 Property Owner's S' ature Sfi SWORN TO BEFORE ME THIS DAY OF,; ILt,Y+RC.} -_- ,;20 ZS ._ SOPHIA BRANN - NOTARY PUBLIC ublic STATE OF COLORADO NOTARY ID 20234019014 My Commission Expires May 19,2027 '-,ard of Trustees Applicat,` AFFIDAVIT MICHAEL E.FOSS,MEMBER OF THE MICHAEL E.AND CHERYLYN R.FOSS JOINT REVOCABLE TRUST BEING DULY SWORN DEPOSES AND AFFIRMS THATHE/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. Signature of Property Owner Signature of P erty Owner SWORN TO BEFORE ME THIS ! DAY OF 20�_, SOPHIA BRANN NOTARY PUBLIC STATE OF COLORADO NOTARY ID$0234018014 Public ary My Commlwlm Expires May 10,2027 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Rrrohibit's conflicts of interest on the part ci tow officers rind emoloveeL 11wournose:of 'this form is to provide information which can alert the town ofposstble conflicts'of interest and allow it to take whatever action is necessaivto avoid same. YOUR NAME: MICHAEL E.FOSS,MEMBER OF THE MICHAEL E.AND CHERYLYN.R.FOSS JOINT REVOCABLE TRUST _.. (Last name,first name,.rpiddle initial,unless you are applying irithe 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 Trustin X Variance Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map " Planning Other (If"Other'',name the activity.) Do you persoi ally(o'rthrougli youi company,spouse;sibling,parent,or child)have•a relationship avith any officer or:dtnployec of the Tow`n`of:Southold? "Relationship"includes by blood,marnage,or°busmess ipterest="I3usnie5s interest"means a business, including a partnership;in which the town officer or cmptoyee has even a;partial ownership°of(or:employmept by)`a;corpora tion` inwhich the own_off cer;o'r employee'owns mo e.than.5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship W ween yourself(the applicantkgetlt/representative)and the town officer or employee.Either check the appropriati,line A)through"D)and/or describe m lhespace provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A);tlie owner;of grea(erahan 5'%.of the sl ares_of the corporate stock of the applicant (when the apphcant.is iicorporation), B)the legahor:"beneficia16, er:of any interest inanon-corporate entity, (when the applicant isnot a corporation); officer,director;;partner,or,employee.of.tlie applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP .. Submitted this day Qf Mett 20 K Signature Print Name Form TS1 1 Board of Trustees Applies, -.on PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS APPLICATION NAME & SCTM#: NAME: �- 3 q STATE OF NEW YORK COUNTY OF SUFFOLK , residing at , being duly sworn, deposes and says that on the day of , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office located at ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Signature Sworn to before me this Day of 720 Notary Public NU' TILt Ulm HtA 'KING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: THE MICHAEL E. & CHERYLYN R. FOSS JOINT REVOCABLE TRUST SUBJECT OF PUBLIC HEARING: For a Wetland Permit to demolish existing two-story dwelling with porch, paved driveway and chain link fence; abandon existing sanitary system and install an I/A OWTS system landward of proposed new two-story approximately 56'x37' dwelling with an 11'x5' front porch, a 38'x10' covered rear porch, and 18'x12' open patio; construct a 24'x22' detached garage with 8'x11' open air covered walk between the garage and dwelling; install exterior basement stairs on west side of dwelling and two basement egresses on east side; install a 22'x10' swimming pool, pool drywell, pool equipment area, and pool enclosure fencing with gates; install A/C units and a generator; install a pervious driveway; and install gutters to leaders to drywells to contain roof runoff. Located: 775 Hill Road, Southold. SCTM# 1000-70-4-27 TIME & DATE OF PUBLIC HEARING: Wednesday, May 14, 2025 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 e Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I. 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# 1000 _70. _4-27 PROJECT NAME Foss House The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑✓ I. 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: Please see attached project description. Location of action: 775 Hill Road,Southold, NY 11971 Site acreage: 0.5 Present land use: Residential Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name Of applicant: Cole Environmental Services on behalf of The Michael E.and Cherylyn R.Foss Joint Revocable Trust (b) Mailing address: 425 Montuak Highway,East Quogue, NY 11942 (c) Telephone number: 631_369-9445 Will the action be directly undertaken,requite funding,or approval by a state or federal agency? Yes ❑ No❑✓ If yes,which state or federal agency? _ C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ZYes ❑ No ❑-Not Applicable Proposed construction is In keeping with the character of,the community and maximlzes distance to the wetlands Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria Z Yes 0 No ❑ Not Applicable A The proposed site is currently developed with a single family residence. 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 17 Yes ❑ No ❑ Not Applicable The proposed construction was designed to keep the existing tree in the rear yard. The project is in keeping with the character of the community and maximizes distance to the wetlands to the greatest extent possible. 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 ❑ Not Applicable The existing bulkhead protects the property from erosion and flooding. The proposed residence will be further landward than the current house, further protecting the structure and minimizing loss of life and structure. Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑✓ Yes ❑ No ❑Not Applicable Proposed drywells will collect roof runoff. An I/A system is proposed in the front yard,helping to reduce nitrogen and protect water quality. 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 17 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 ✓❑ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No ❑✓ 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. ❑ Yell ] No❑✓ Not Applicable Attach additional sheets if necessary 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 0 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 LVVRP Section M—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No ✓❑ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No ✓❑ Not Applicable PREPARED BY Chris Cole TITLE Agent DATE 03/04/25 i 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management Project Description Michael&Cheri Foss 775 Hill Road Southold, NY 11971 SCTM NO: 1000-070.00-04.00-027.000 Proposed new construction. Existing structures to be removed,including 2-story 2,164.37 square foot house, 142.6 square foot porch, 1,073.5 square foot paved driveway, and chain link fence. Existing sanitary system to be abandoned as per SCDHS specifications. Proposed 2-story approximately 56'X 37' residence with 24'x 22'detached garage and 11'x 8'covered link between the two. Exterior basement stairs on west side of house, egresses on east. 11'x 5' front porch,.38'x 10' covered rear porch, 18'x 12'open patio, and 22'x 10' pool. Pervious driveway. I/A sanitary system in front yard. 8'x 4'drywells for pool and roof runoff. www.ColeEn• iron mentalServices.co•n 425 Montauk Highway East Quogue, NY 11942 Environmental Consulting (631)369-9445 Wetland Project Management Town of Southold Board of Trustees 54375 Main Road EcUr 11 �/]�/� P.O. Box 1179 ISLLS�LJI t1 V LIL; Southold, NY 11971 MAR' - 7 72Le 5 Re: Foss House Michael &Cherylyn Foss 775 Hill Road ScE�ftTic►rwn Bcl�o���c3fcT�tmges Southold, NY 11971 SUM NO: 1000-07000-0400-027000 To Whom It May Concern, Our clients, Michael&Cherylyn Foss, are looking to add an addition to the existing residence as well as covered porches,and remove existing structures. Please see enclosed the following items: 1. , Check#3841 made payable to Town of Southold in-the amount of$1,100.00 2. 4x Original Application with attached Project Description 3. 4x SEAF with attached Project Description 4. 4x Affidavit,Authorization, &Applicant Transactional Disclosure Form for Michael E. Foss 5. 4x Affidavit,Authorization, &Applicant Transactional Disclosure Form for Cherylyn R. Foss 6. 4x LWRP with attached Project Description 7. 4x Survey by Pinnacle Land Surveyors dated 7/17/24 8. 4x Project Plans by architect, Charles M.Thomas,dated 2/26/25 9. 4x Photo Sheet 10. 1x Trust Agreement Should you need anything further, please let me know. ® C E U E Sincerely, LIAR - 7 2025 vw/~ Summer Looney Southold Town Info@ColeE,uvironmentalServices.(;)m Board of Trustees Cole Environmental Services, Inc. w NW.ColeEnvironmenta Services.com