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HomeMy WebLinkAboutCierach Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) j/yam— Kevin Cierach owners of the property identified as SCTM# 1000- 115-17-3 _ in the town of Mattituck New York, hereby authorizes W. Jonathan Fabb _ _ 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. zt� L Property Owner's Signature Property Owner's Signature Kevin Cierach SWORN TO BEFORE ME THIS �27th v_DAY OF June _ 20 25 (2�Q� L".4,21 Notary Public NWary Public, State of New York No O'ID14635190-Suffolk County C=OIMR'i�:�losl Expires Oct.31,20.24 r Glenn Goldsmith,President ��O��S�FfO(kcOGy� i_ r Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 0 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �A • 0`� 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: Completed in field by: ig. Go)) So,,A Richard Lark, Esq. on behalf of KEVIN CIERACH requests a Wetland Permit for the as- built 59.6'x37' three-story dwelling with garage under and attached wrap-around raised decking consisting of a 10.2'x33.8' raised deck with ±3.6'x18' steps and landing to ground, and ±7'x8' raised deck with steps down to on-grade brick landing; modify the height of the as-built three-story dwelling to become a two-story dwelling by adding,fill and retaining walls around existing foundation consisting of: along east foundation wall place 23 cubic yards of fill in a 34' long area to raise the elevation to 3' above current grade, and add 28 cubic yards of fill in a.21' long area to raise the elevation to 6' above current grade; along west foundation wall place 1 cubic yard of fill in a 59' long area to raise the elevation to 6 inches above current grade; along north foundation wall construct a 10' high by 20' long retaining wall and add 78 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade; along south foundation wall construct a 10' high by 34' long retaining wall and add 104 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade. Located: 4500 Deep Hole Drive, Mattituck. SCTM# 1000-115-17-3 Typ 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.: OQ rodro-Zn r<e ovalBs Present Were: /G. Goldsmith ✓N. Krupski ✓E. Sepenoski ./ L. Gillooly ✓E. Peeples .ems 3 ' I_ I I OVA Ua 17 1 'r m 11 a a ILVARML11111,51161 rCONCRETE HEADWALL II II EDGE OF PAVEMENT II j -DRAIN PIPE SURVEY OF PROPERTY II SITUATE II EDGE OF PAVEMENT NEW SUFFOLK AVENUE " DRAIN GRATE MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK M o I S.C. TAX No. 1000- 1 15- 17-03 SCALE 1 "=30' M JUNE 309 2023 g MARCH 6, 2024 UPDATE MAP & MAY 11, 2024 AMEND MAP d .a OCTOBER 18, 2024 ADD GRADE PLAN CALC. & PROP. WALLS Q' I NOVEMBER 15, 2024 REVISE MAP 18.1' FINISHED FIRST FLOOR JANUARY 21 2025 REVISE MAP (1 I a FEBRUARY 26, 2025 REVISE MAP N/0/F 16.7' CELLAR CEILING AREA = 56,419 sq. ft. a1 z 1 CURB STREET GRADE OPPOSITE HOUSE 1.295 ac. o MELCHIORE PALMI N NTERI I NOTES: & ATHENA PALMINTERI d o1 iv o o AVERAGE FINISHED GRADE AROUND HOUSE 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM z 1.4' 1 2 CELLAR FLOOR TO CEILING EXISTING ELEVATIONS ARE SHOWN THUS:xx.x 1� $ 88.41'00" E HAIN N E 132,26' I F.FL. - FIRST FLOOR ONC. MON. to N C.FL. - CELLAR FLOOR 1 sET LArH z Ui 2. THE DIFFERENCE IN GRADE BETWEEN THE FRONT YARD IPOST do RAIL FENCE 1 I ' <5 6.2' 1 1 CELLAR FLOOR AND THE REAR YARD IS 10, 2 STORY HOUSE & CELLAR SECTION 0 i I th I (NOT TO SCALE) ml o I LOT COVERAGE I I I DESCRIPTION AREA % LOT COVERAGE SEPTIC SYSTEM STANCES I o (FOR MAIN HOUSE) 2 STORY HOUSE & 2,517 sq. ft. 4.5% --}- ----- I O GARAGE UNDER DECK COVER HOUSE CORNER"A" HOUSE CORNER"B" I I 453 DECK 450 sq. ft. 0.8% SEPTIC TANK 1 104 sq IN 0 1 PROPANE I O OUTLET COVER 12' 55' 1 SIDE YARD 1 TANKS 19-6' 2 STORY FRAME CESSPOOL 1 725 sq. ft. t.3% 18' 6s' 1-1/2 STORY ACCESSORY GARAGE I COVER 1 FRAME1 STORY STUCCO 565 s CESSPOOL I I jWooD STEPS I ACCRY b, I ACCESSORY BUILDING q. ft. 1.0% COVER 2 21' 58' 1 1 do LANDING I GARAGE M I 23.5 •5gAABOVE GRADE TOTAL 4,257 sq. ft. 7.6% 303' 20.4' 1 GROSS FLOOR AREA e WATERLINE fN SEWER MAIN HOUSE 3,719 sq. ft. 6.6% I I LINE ,1' I I w f w I o I I 1 p o 9 4p 1 p N o 0 1 1 p69n ' 2 STORY HOUSE U ' CELLAR GRADE CALCULATIONS I 0 I F SEPTIC jTANK 18.4' 3.1' I WOOD STEP � SCALE 1/8"=1' W 1 1 p I m g I & DECK .F Qi i z MASONRY'EDGING ;= I F-I -jr' M W 50.0' 1 � 1 N 40 � o I1 u Mi f z 1st FLOOR EL. 18.1' 3 Y I W I If 1 < � i di O L'i TOP FOUNDATION 11 EX. GRADE EL 15.8' 0.1 i' 6% i � i3 o o oE- �a Ui W 100 I I 1 3 1 a � wao w 1 I j f9 ^' FOUNDATION a, EL 12.3' A I B I 1 I PROPOSED GRADE PLANE ry PROPOSED FILL BOTTOM OF WINDOWS EL. 10.1' 126 s ft.' EXISTING GRADE PLANE WATER VALVE WATER LINE !' 45.3' �/1 F-i W►- q M 37.0' --_ - / ti `o FCAAT�I A jinPOj�05ED1FIk2 sq.ft. / M <d o� WATER METER - t0.2' 3ti.2' WHOM/z 00AREA AIR CONO 1 p O ti 21 4' 34 CE LAR FL00 EL 6.2' UNIT 1 w W z 1 aY g� 1 O =- PROPOSED FILL 59' TOTALUP PROPOSED FILL (nix 0 ' o o S m ~5 VOLUME = 25 cu.yds. q• y � "�� m W I Z y TOTAL FOUNDATION FOUNDATION WALL 650 s ft. O VOLUME = 23 cu.yds. ox a o r7 NOV�o OO U Nl d, H ' Q' W �Q `Ot .Y 1 t0 F 4 li .O a s AIR COND 1 � w �W 6 I SEPTIC TANK s' UNIT r u N n 3q, v I � CONC. COVER co0D µ O0S"ND s o v Q t1S LEACHING A I a a EL 18.1' POOL 251.9 HOUSE ADS GPS ' w� 1st FLOOR CONC. COVER z I c`d -) I :; 0 b I c� TOP FOUNDATION r0 1 ,d1 �` rvntW EX. GRADE777-777771 EL 15.8' LEACHING d x POOL 1 ' i I IIi t I1 -0m /F? m PROPOSED FILL ad LLJ VOLUME IGyd.o g m EL 12.3' pU I II" I 1ci PROPOSED GRADE PLANE OF3 6 ; I o j N 1 F a EXISTING FILL 590 sG ft. EL 10.1' DRAIN GRATE c� I 3 II- 1 I -tO FOUNDATION WALL AREA 1 Ennz F EXISTING GRADE PLANE zo CELLAR FLOOR EL 6.2' 0 I wN 59' TOTAL / m 1 t;,' z m I I I TOTAL FOUNDATION WALL AREA 650 sq. ft. / 8 8 coI p j 1 �a WEST FOUNDATION WALL o o IIOI w d 100 1 1 0=) n 1061 I CATCH BASIN _O I I j 5 1 1 st FLOOR EL 18.1' j 11 j 1 EX. GRADE TOP FOUNDATION MAIL BOX O 1 I I I EL 15.8' I I 1 p STONE PILLAR Z 1 I I I PROPOSED FILL 55 ft. si q I j L FOUNDATI N WALL 0D 1 I -J w 1 01 EL 12.3' VOIORN �0 1 11 I FOUNDATION PROPOSED GRADE PLANE BELGUW BLOCK GRP 1 i I I w 1 b EXISTING FILL 112 sq. ft. EL 10.1' APRON 1 - 1 xZ l o 1 OVERHEAD DOOR OVERHEAD DOOR Q FOUNDATION WALL AREA EXISTING GRADE PLANE ELGIAN BLOCK CURB I �� I # ro o� I Coe � 1 1 N 1 � M tc I- I 10' CELLAR FLOOR 10' 4' 16' POST & RAIL FENCE EL 6.2'1 I o STONE PILLAR I I O 1 1 47' TOTAL 4r I I i I I i O TOTAL FOUNDATION WALL AREA = 407 sq. ft. VOLUME5M FILLyds. IRREGULAR WIRE CE N NORTH FOUNDATION WALL SET LATH I N 88.41'00" W I I ' m 142.09' 0° N/0/F I 1 WILLIAM ALLAY MACOMBER, Jr. 18 1 I o OF a f /'J°�A & JESSICA SIDLAUSRAS (P .... . �' I c=i A�� 9Z• 1 I I 1st FLOOR W I I TOP FOUNDATION . ( r i nW EX. GRADE EL 15.8' 2�. p w j $� I �pEGEII t: PROP05M FILL 113 sq ft. m `�iO�f�Oi•' S 467 •• - ,��0 0 1 F I �R FOUNDATI HALL AREA PROPOSED ;4A •� . •. Lim. No. 50467 1 I EL 12.3' PROPOSED GRADE PLANE M A R 2 4 2025 EXISTING FILL 136 sq. ft. EL 10.1' i i i I FOUNDATION WALL AREA ij OVERHEAD DOOR DOOR m EXISTING GRADE PLANE Nathan Taft Corwin III , � ; 1 - w 1 I I B0�OfId Town TRtStCeS CELLAR FLOOR 21' 47' TOTAL 4' 12' 10' M EL. 6.2' Land Surveyor I I TOTAL FOUNDATION WALL AREA = 407 sq. ft. PROP05ED FILL VOLUME - 104 cu.yds. 1 I SOUTH FOUNDATION WALL I 1 Successor To: Stanley J. Isaksen, Jr. L.S. I I EXISTING QrZ,gM PLANE CALCULATION, PROP05ED GRADE PLANE CALCULATIONt TOTAL FILL NEEDED = 234 em Joseph A. Ingegno L.S. 1 y I 1 AVERAC7E GRADE ELEVATIONSs AVERAGE GRADE ELEVATION5i sc� Title Surveys - Subdivisions - Site Plans - Construction Layout W 00 gUIXH� 1 EA5 FOUNDATION WTION ALL, O sq.+f��x I6'=101 sq.ft. EAST FOUNDATION HALLL((34'X 3')'+(211X 6'))t225 sq.ft. 5011 rl FOUNDATION HALL: qS+3')/2 X 21'-131 ft. 5OUT14 FOUNDATION HALLS (10'X 25'=250 ft. PHONE (631)727-2090 Fax (631)727-1727 �T FOUNDATION HALL qS'X 5g'=560 sq.ft, HEST FOUNDATION HALL, IO'x 5g'=5go sq,ft, OFFICES LOCATED AT MAILING ADDRESS TOTA-s "115 sq.ft. TOTALi 1,225 sq.ft. DUG CANAL LEADING PERIME`I�OF BUILDIN6, 202 sq.ft. PERIMETER of OUILDIN6. 202 sq.ft. 1586 Main Road P.O. Box 16 q'p DEEP HOLE CREEK GR HT ADE PLANE HE16 , 'Tq5 sq.ft./202 = IS ft. 6ZADE PLANE HEI6HT, 1,225 sq.ft./202 - 6.1 ft. Jamesport, New York 11947 Jamesport, New York 11947 FIN15HEO FLOOR 15 5.0'ABOVE GRADE PLANE FINISHED FLOOR 15 5.5'ABOVE 6RADE PLANE PHOTOS OF CIERACH PROPERTY ( SCTM #1000-115-17 -3) The attached photos of the Cierach single-family dwelling show the house foundation where the proposed fill, is to be placed; for the purpose of raising the ; grade plane level to allow this single-family dwelling to be classified as a 2-story building under the New York State Building Code . The calculations showing the location and the amount of fill to be placed around the foundation are; shown on the Survey of Property prepared by Nathan Taft Corwin III , Land Surveyor, last amended February 20, 2025, as "2 story House Cellar Grade Calculations" . r r C i Ak - 1 r 1 y -r .vI'• YpIA����`� +'X .� ��C•• ��+rt .}���4 } '�R t 1 t 2f:� :}, � , R _ • t S- �� y � w�o. 1 M � ,., Ilia - w 1 r � xe I Aj r -�• _ —45 #3 �.- '�•'' Kevin Cierach aY >a w, Y� � �o• _�� ;� Single-family dwelling South & east foundation walls & rear yard .. _. Taken 2/25/2025 ._K N l ' B , , 7 .y F fl' \ -3 Cn \ O F-h I-'- %,J♦�t _..ter.^��5��� R . '. N W CD Ln Oy '.. Lk h..K� p• 'nR, w -k _ ,•-.. _ ., x {s�xh;R� } " a, �.�.�' �. .'i4i -".y.��� -ktiE'' 3,:� � � ,r;- �d-- a� r .. N d N N r • n� f , awl 71 w.•ti. N O I C7 \ wNw N c- I— C) s - � a { r _ WV IAIU i4l A ai r r ' ;a Ar• ..w t r �` •J .. - ear",: ,--. f' ,., �z:�:�'.�j•- '!',e� � !`!4% _ 'fry✓ sy 1"1! x h" �•'�` - , i. - - Kevin Cierach dwelling Single family East foundation wall _ 2 5 Taken /2 /2025 i W ��' _:.-=�-•.'_ 'Yip 1,..- l`' �"; .,;�..'; ..,._ I z _ n �-7 Z Ul .- �' - (D rt �.Q H n '• o:� G W N — \ o rt C cn O S2 - 1 ;i q�AA4 4 • J ft �lir•��.4Ys Q�i. ,1 hYta�YeF A. - ,.. ea,,s`1; +� .�"• �p' 3'4_`t,,� r � �"Cts-/AT,�jt' i� V1 .:� �_�#J�\.,. ���#. � `�✓,f t� 1� �� ��,.,,t ka+rr•y\� a\:��ta�� ��-{�,�,p .. �i{.� a�.'!�r' 1� r i w•j5! �r � v � �y 't 4� `�4 yfi'; ,���y�Ie,a.y:��' � ', •s!a�;, .�ti.,;:• �1��r.,/ ,y2�` 1>,"'± i' F_ � r:. �'y.l� ry �': � Ik. _ r ♦ � @, \ S �"d � i i "< �1�"n• "!•r�'� �° 1 �yyy�"§eee'� �t; 't '�" � r i'. °s: r 1� � t t i ti 6� f�l ( � 'Y �• i� � � p�� �'. �'� � `��'A �,JriG ? ��I '��,p'a�� v't a ��ti' 1t � of.�� (�1` ��,t"' ;4p � � 1 • .� � �' s ;- {! • �S�hl fsl� �A� Y Q..� �,1Z\f i • YIs [.,... 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S •^.. - - _ - ` #9 , Kevin Cierach ' Southeast corner of property -" at 4500 Deep Hole Drive Mattituck, New York showing 14 z, set lath at southeast corner of property Taken 2/25/2025 ' IIII IIIII III III IIIII IIII��IIII I�II . �IIIIIIIIIUI SUFFOLR- COUNTY CLERIC RECORDS OFFICE ' RECORDING PAGE Type of, Instzument; DECLARATION Recorded: 07/17/2008 . Number-of Pages• -3 At: .09:25:07 AM Receipt Number 08-0068347 ' LIBER: ' 'D00012558 PAGE: 278 - District: Section: Block: Lot: 1000. 115..00 17.00 003.000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $9.00 NO Handling $5.00 NO COE $5.00 NO NYS SRCHG $15.00 NO TP-584 $0:00 NO Notation $0.00 No - Cert.Copies $15.00 NO RPT $30.00 NO Fees Paid $79.00 THIS PAGE IS A PART 'OF THE INSTRUMM THIS IS NOT .A BILL Judith A. Pascale County Clerk,, S-tiffolk County ;. : Number of pages RECORDED :GGS Jul 17 G'::25:Ur Am Judit•h..A. Pascale This document will.be public CLERK OF SL�FFCILK CGLIhITY record. Please remove al-I 'L D00012558 Social Security Numbersg prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps . 3 FEFS. Page Filing'Fee Mortgage Amt.. . 1. .Basic Tax Handling 5. 00 2. Additional Tax TP-584 T Sub Total Spec./Assit. Notation / or . EA-52 17 (County). Sub Total Spec./Add. EA-5217 (State) TOT. MTG. TAX Dual Town Dual County R.P.T.S.A. - Held for Appointment Comm. of Ed. 5. 00 . Transfer Tax t • Mansion Tax Affidavit The property covered by this mortgage is or will be improved by a one or two NYS Surcharge 15.. 00 family dwelling only. Sub Total YES or NO -Other Grand Total 7ti If NO, see appropriate tax clause on . page# of this I me t. 4 Dis 1000 11500 1700 003000 5 Community,Preservation Fund Real Pro. P T S Consideration Amount $ Tax-Sere R_ SFL Agenc, 17�1UL-08 CPF Tax Due $ Verificati Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land ' CUhU � TD DP TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 1.1901 Co. Name' www.suffo[kcountyny.gov/clerk Title# This page forms`part of the attached made by: (SPECIFY TYPE-OF INSTRUMENT.) The premises herein is situated in SUFFOLK COUNTY, NEW,YDt12K. TO In the TOWN of &X4 "1 C) In the VILLAGE . or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) EXHIBIT f DECLARATION THIS DECLARA ON, dated--(a day of. Mom/ ,200AL, is made (hereinafter the"Declarant"), whose address is "an WITNESSETH WHEREAS,the Declarant is the owner of certain real property located in the Town of Southold,County of Suffolk, State of New York(Tax Map#1000, Section 115,Block 17,Lot 3),which real property is more particularly described in' Exhibit A annexed hereto(hereinafter referred to as the"Property");and WHI;REAS,the Property is situated in or adjacent to regulated freshwater wetlands MT-16 of the Mattituck quadrangle,which have been inventoried and mapped by the New.York State Department of Environmental.Conservation (hereinafter"Department"),pursuant to'Environmental Conservation-Law(hereinafter"ECL")Article 24(also known as the"Freshwater Wetlands Act')and Part 664 of Title 6 of the New York Code of Rules and Regulations(hereinafter"6 NYCIW);and WHEREAS, various activities conducted both in and adjacent to freshwater wetlands are regulated by the Department pursuant to ECL Article 24 and Part 663 of 6 NYCRR and require written authorization from the Department prior to being conducted; NOW,THEREFORE,in recognition of the Department's jurisdiction as set forth above,it is the responsibility of a party having any right,title,or interest in the Property,to obtain from the Department or any successor organization, a current description of all activities which are regulated pursuant to ECL Article 24 and Part 663 of.6 NYCRR,and to obtain written authorization•from the Department prior to such regulated activities being conducted on the Property. Regulated activities include;but are not limited to clearing of vegetation; application of chemicals; excavation;grading and filling; and erection of any structures. By. STATE OF NEW YORK ) ss. COUNTY OF cr "C ) On,the t'o day of in the year 200 4 .before me,the undersigned, a Notary Public in and for said state,personally appeared M 0 Ge ra-mL ,personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name'is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity,and that by his signature on the instrument,the person or entity.upon behalf of which the person acted;executed the instrument. NOTARY PUBLIC JAMT V 7ENVART NOTARY IPUBLI6, 9teAte ol'New Yofk Wo. 52-46633485 Qualified iri Suffolk'County a Commission Expires Nov_3o,20/(y 1. . _ paid by the party of cicDnd part,'does hereby grant and release unto the party of the second part,the,heirs or, successors and assig, th4 party of the second part forever, ALL that certain plot,'piece parcel of land, with the buildings and improvements thereon erected, situate, lying and being ift at Mattituck, Town of Southold, -Suffolk County; New York, more particularly bounded and described'as follows: BEGINNING. at a point on the easterly side of the.easterly. branch of Deep Hole.Drive (as altered in 1967) 354.34 feet southerly along said easterly side of Deep Hole Drive with the southerly side of New Suffolk Avenue from said point of beginning. RUNNING THENCE.along land now or formerly of' Howard B. and Mary Larson south 88 degrees 41 minutes 00 seconds east 132.26 feet to the Map of Harbor View at Mattituck; THENCE along said map the following two- courses; 1) south 0 degrees 12 minutes •20 seconds east 331.31. feet; 2) south 0 degrees 33 minutes 40 seconds .east 78.80 feet to land now or formerly of William A. and Judith Macomber; THENCE along last mentioned land.north 88' degrees 41 minutes .00 seconds west 142.09 feet to said easterly side of Deep -Hole Drive; THENCE along said easterly side north 1 degree 19 minutes 00 seconds east 410.00 'fee- to the point or place of BEGINNING. BEING AND INTENDED TO BE the same. premises conveyed -by deed dated 7/12/91 and- recorded 7/26/91 in the Suffolk County Clerk's office a,an Liber 11305 Cp 525. 1 a r ? l MAOOIE F.VAVRICA,P.E .. � X 817E rnrosw sea�41'oo'E X�•`� +rouwow.nn+m n+nnwN -.�iA`_, �.% WAYIr°AdOeRYAti0+1 VICINITY-MAPy o 1Doo 2000 1 SCALE_:1"=1,000 SCALE:1"=1000 � 12 _ SITE INFORMATION G SITE: 4500 DEEP HOLE DRIVE /. 1 MATRTUCK,NY 11852 RET,NINO WALL,, SIN; 1 0 0 0 4 16-17-3 GROSS LOT AREA: .55,725 SF(1-270 ACRES) OF NEW INC G NIULTI•LfVEL ' f}; �1OOIN RAIBEDDEC; ^•, �. • ) w000 sr'Eps AS-BUILT MEASUREMENTS fJp,044Y5`. STRUCTURE A B SEPTIC-TANK eEPTICTANK 12-0'- 6V-V BANITARYLEACM,OPOOLM2 LEACHING POOL I "1W-W ee:o•,. SANITARY LEACHING POOL#1 .LEACHING POOL 2 81'-0• 65'-0• . \ ` 9 • {5000EEPHbLE DRN�. MATn711QH,NY 11r6!' a e � � � � SANITARY SYSTEM , l A643UILT PLANS DID &GIiAVEI_J. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES' RFV (( �• APPROVAL OF CONSTRUCTED WORKS FOR ASINOLE'FAMILY RESIDENCE r �1 0�1LTANKI9LOCATEOINBASEMENT. l__,�� l ` Date ..61m2a H.S.-Ref No. ,...:••,,.R70.G7oo71. _ OVERALL 2.THERE ARE NO ON91TE DRAINAGIE STRUCTURES. Nae\41'p0'W ` \1 I I \ SITE PLAN The sewage disposal and water supply facilities at this location have been pp������(A� SANITARY AS-BUILT PLAN inspected and/or ceddied by this Department or other agencies and found BISTAIED FROM WILLIAM R SIMMONS SCALE:1"0 50' to be satisfactory FORA MAXIMUM OF 4 BEDROOMS. C- DATED a161a7 �� �,�*����� _ 0 - 50 100ib�'�P,4, -�—�— KC SCALE:1"=SW CRAIO KNEPPER,P.E.,CHIEF Office of Wastewater Management ! TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE:March 27,2024 RENEWED:November 8,2024 AMENDED:November 8,20Z4 AMENDED:December 23,2024 TO: Kevin Cierach . 1280.Jockey Creek Drive Southold,NY 11971 Please.take notice that your application dated March 20,2024: For permit:-to legalize an"as built"single-family dwelling an"as built"accessory stucco building for storage use and an"as built"accessory garage for storage use only at: Location of property: 4500 Deep Dole Drive,Mattituck,.NY -.County Tax Map No. 1000—Section 115 Block 17 Lot 3 Is returned herewith and disapproved on the following grounds: The"as built".single-family dwelling on this conforming 56,419 sq ft lot in the R 40 District,is not permitted pursuant to the Bulk Schedule which requires a rear yard setback of 50 feet The survey indicates a rear yard setback of 35.2 feet. . In addition,the"as built"accessory stucco building for storage use and the"as built"'accessory garage are not permitted pursuant to Section 280-15,which states lots measuring40 000=59 999 sq.ft. shall have a minimum rear yard setback of 15 feet. The accessory*stucco building has a rear setback of 3.1 feet and the access=garage is partially located in.the side.yard This Notice of Disapproval has been amended to reflect the letter received from Lark&Folts on December 23, 2024. Authorized Sign re Note to Applicant:Any change or deviation to the above referenced application may require furtlier review by the.Southold Town Building Department. CC: file,Z.B.A. 1E1T 3 �\\' `•,R ` 6EE SEO NO iW , \ `, \� '��� L��\\ \3` \�\ \ ��'. `• V t0.000 �'N _ SNTCM _ f .. .. \. .... .-.J ,\:_ ..._ '83: �,A! r+,� ���a\���� \\�� �� 2.� �C...�-Y� �.• RD~_ { 4 \�i��� \\.\�:'' ,,� _. 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'� �^\•4'., �r 'I +a i n r� :s ter+ \• ° �,�'m';;<°Vw"a wc�•,Nxe '••�°•`r•""""""""`o,a• r� - ^,•. ' COUNTY OF SUFFOLK© r{once --- --- '""—" 'O--'--'---- .. O �,'wr —�— M.., �,u:t� :mo.,c,rAAemacr..,t+rtrwr 4osaivamr,Faaarat+tm'c•`a+wr�u•aKnv,x ornAux^r,aaaav+T rosou.4 rcoa or R®r RE,E o-_u•..10r n,.e. wUTxoto seCTIM N yRcal ProperryTax Senice Agency E �-- - W 116 "o ssrx_--•-- ."` —- - �• ---- ..,s,. (217 x.e. ., v�mwc v nc --'— S sseAr�Aavcr �� OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold, NY 11971 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: June 3, 2025 Re: LWRP Coastal Consistency Review for KEVIN CIERACH SCTM# 1000-115-17-3 Richard Lark, Esq. on behalf of KEVIN CIERACH requests a Wetland Permit for the as-built 59.6'x37' three-story dwelling with garage under and attached wrap-around raised decking consisting of a 10.2'x33.8' raised deck with ±3.6'x18' steps and landing to ground, and ±7'x8' raised deck with steps down to on-grade brick landing; modify the height of the as- built three-story dwelling to become a two-story dwelling by adding fill and retaining walls around existing foundation consisting of: along east foundation wall place 23 cubic yards of fill in a 34' long area to raise the elevation to 3' above current grade, and add 28 cubic yards of fill in a 21' long area to raise the elevation to 6' above current grade; along west foundation wall place 1 cubic yard of fill in a 59' long area to raise the elevation to 6 inches above current grade; along north foundation wall construct a 10' high by 20' long retaining wall and add 78 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade; along south foundation wall construct a 10' high by 34' long retaining wall and add 104 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade. Located: 4500 Deep Hole Drive, Mattituck. SCTM# 1000-115-17-3 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 the LWRP. 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 /o l LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No.(631)734-6807 RICHARD F.LARK Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com May 8, 2025 Elizabeth Cantrell, Sr. Clerk Typist Board of Trustees Town of Southold 54375 Main Road - P.O. Box 1179 Southold, NY 11971 RE: Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) Dear Ms. Cantrell: Pursuant to your request, I am enclosing an Authorization of Kevin Cierach authorizing me to act as his agent before the Southold Town Board of Trustees . If there is anything else you need, do not hesitate to contact me. Very truly yours, Richard F. Lark RFL/pl Enclosure and of Trustees Applicati AUTHORIZATION (Where the applicant is not the owner) I/ g,-, . Kevin Cierach.. owners of the property identified as SCTM# 1000-_ 115-17-3 in the town of Mattituck ; New York, hereby authorizes Richard F. Lark 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 Signature Kevin Cierach SWORN TO BEFORE ME THIS_ 8th DAY OF May ___�;,20 25 Notary Public BARBARA QIACRUN Notary Public,State of New York No 01014635190-Suffolk County Commission Expires Oct.31,20a 40U Town:Halt l�xnaez • . Glenn Goldsmith,President , +,r;.. i� �� y� 54376 Route 25' A.:�.chalr.s carps ,Vice President Pm:33;6ic,1179 Eric$epeaoski Soul hold,:14 York 11971 'Liz Gillooly. H` Telephone C63 )765�1892 Elizabeth Peeples ' lax(631)7.65-66411 BOARD 1F TOWN.-TRUSTEES ' TOWN QQF SOUTI30LD., This Section For Office Use 0n13 E GE Coastal..Emsion Permit Application : Wedand.Pennit Application Administrative Permit MAR. 2:4 2025 AmendmenV Transfer/Extension Received:Application:. a< . •'Southold To.". Received l+ee:.S c�SZkJ �f Board of Trustees Completed Application: �'• - - incomplete: SEQRA Classification Type I : 'Type 11 Unlisted.' Negative Dec. Positive Dec. Lesd'Agency Deteiminatii�n Date:. 'Coordination:(date sent):. �-LW".Consistency Assessment Form.Sent: . 0 CAC.Referral Sent Date of Inspection: Receipt bf CAC Report I� Technical Review _Public Hearing Held: 1It Resolution: Owner{s}.Legal Name of Properly(as shown on Deed}: Kevin :Cierach Mailing Address' 1280 Jockey 'Greek Drive, 'S'outholdi, NY" 11971 Phone Number: (631.) 377-9097 Suffolk County Tax Map Number: 1000 115-17-3 Property Location:' 450.0 Deep Hole Drive, Mattituck, Nev. York (If necessary,provide ZILCO Pole#,distance to cross streets,and-location) AGENT(If applicable): Beverly Cierach Mailing Address: 1280 Jockey Creek Drive, Southold, -NY 11971 Phone Number: (631) 3774097 Email: pecliq@yahoo..com pocf ` 5 PROJECT PLAN The project plan is to legalize the 2 story stucco house with cellar to comply with the New York State Building Code. The grade plane surrounding the existing house has to be raised with fill so that the first finished floor surface will be more than 6 feet above the grade plane to comply with the New York State Building Code. The proposed grade plane calculations and the location of the proposed fill to be placed around the foundation are shown on the survey of the property prepared by Nathan Taft Corwin III, Land Surveyor, last revised February 20, 2025 . pOC # 8 n^,!ird of Trustees Application GENERAL DATA Land Area(in square feet): 56,419 sq. ft Area Zoning: R-40 Previous use of property: 'Single-family dwelling and two accessory A artma,nfia Intended use of property: Single-family dwelling and two storage buildings Covenants and Restrictions on property? x Yes No If"Yes",please provide a copy. (see attached Exhibit 1) Will this project require a Building.Permit as per Town Code? x 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? x Yes 'No If"Yes",please provide.copy of decision. Application to the Southold Town Zoning Board. of Appeals, Area Variance, dated 2/17/25 and filed 2/20/25. Will this project require any demolition as per Town Code or as determined by the Building Dept.?, Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? Yes x No Prior permits/approvals for-site improvements: Agency Date Suffolk County Department of 5/17/23 (see attached Exhibit 2) Health Services Approval of a Single Family Residence No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No x Yes If yes, provide explanation: Southold Town Building Department Notice of Disapproval dated March 27, 2024, last amended December 23; 2024 (see attached)(Exhibit 3) Project Description(use:attachments if necessary): Raise the grade plane of -the existing 2 story 'stucc.o house .with cellar to conform with the New York State Building Code .definition for a 2 story building. . Doi �� • ard of Trustees Applicati WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Raise the grade plane of the existing 2 story stucco house with cellar to conform with the New York State Building Code definition for a 2 story building. Area of wetlands on lot: 0 square feet Percent coverage of lot: 6.6 % Closest distance between nearest existing structure and upland edge of wetlands: 44 feet Closest distance between nearest proposed structure and upland edge of wetlands: 39 feet Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? 234 cubic yards Depth of which material will be tx xwxdeposited: t east foundation wall 3' to 61 ; west foundation wall 6"; north foundation wall 0' to 10' ; and south foundation wall 0' to 10' Proposed slope throughout the area of operations: 0° to 40' Manner in which material will be removed or deposited: manually Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): None � 0C3 61 Z20 Appendix B SlzorfEnvironmentalAssessment Form Instructions for Coinpleting \ 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 l. 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 I —Project and Sponsor Information Name of Action or Project: Trustees application of Kevin Cierach Project Location(describe,and attach a location map): 4500 Deep Hole Drive', Mattituck, -New York (SCTM #1000-115-17-3) Brief Description of Proposed Action: Raise the grade plane of the existing 2 story stucco House with cellar to conform with the New York State Building Code definition for a 2 story building. : Name of Applicant or Sponsor: Telephone: (631) 377-9097 Kevin Cierach l E-Mail: pecliq@yahoo.com Address: 1280 Jockey Creek Drive City/PO: State: Zip Code: Southold NY 11971 1.Does the proposed action only involve the legislative adoption of a plan,18cal 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: ❑ ❑ Zoning 'Board of Appeals, Town of Southold — area variances 3.a.Total acreage of the site of the proposed action? ` 1.295 acres b.Total acreage-to-.be physically disturbed? 0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.295 acres 4. Check all land uses that occur on,adjoining and near the proposed action. . ❑Urban ❑Rural (non-agriculture) ❑Industrial ❑Commercial ®-Residential.(suburban) ElForest ❑Agriculture ' El Aquatic El Other(specify)- ❑Parkland Page I of 4 DoC 4q 5. Is the proposed action, NO' YES N/A a.A permitted use under.the zoning regulations? ❑ 10 ❑ 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: ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES l ❑ b.Are public transportation service(s)available at or riear the site of the proposed action? El ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ® ❑ 9.Does the proposed action meet or exceed the state energy code requirements? _ 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: 1 I.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: septic tank; two ❑ leaching pools 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?. ❑ r b.Would the proposed action physically alter;or encroach into,any existing wetland or waterbody? - ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely•to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ®Suburban 15.Does the site of the proposed action contain any species of 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 X 17.Will the proposed action create,storm water discharge,either from point or non-point sources? NO YES If Yes, � ❑ ' a.Will storm water discharges flow to adjacent properties? ❑NO XQYES b.Will storm water discharges be.directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Drainage ditch along easterly boundary of property that drains excess surface.water from nei hborin ro erties and New Avenue. 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 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: X❑ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons n e: Kev'n Cierach Date: 3/7/25 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 1. 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 ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 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 El ❑ 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. EICheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 ` `►ard of Trustees Applicat., AUTHORIZATION. (Where the applicant is not the owner) I/We; Kevin Cierach owners of the property identified as SCTM# 1000- 115-17-1 in.the town of Mattituck New York;hereby authorizes Beverly Cierach . 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 Signature Kevin Cierach SWORN TO BEFORE ME THIS 7th DAY OF March 320 25 Notary Public BARBARA DIACHU14 Notary Public, State of New York No 01 D14635190-Suffolk County Commission Expires Oct.31,20 a.G .,o 6 C � APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold s Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide mforinalion which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOURNAME: Cierach, Kevin (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 V Trustee 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 personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest'means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO 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 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP 25 Submitted t 's 7th d�f May h 204 Signature ,o Print Name Kevin fteraCLL Form TS 1 DOC �* 7 APPLICANUAGENUREPRESENTATI VE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics urohibits conflicts of interest on the part of town officers and emalovees The purpose of this form is to provide information which can alert the town of possible conflicts of mterest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Cierach, Beverly (Lastname,first name,.ipiddle initial,unless you are applying in the name of . someone else or other entity,such as a company.If so,indicate,the.other person'.s or company's name.) NAME OF APPLICATION: (Check all that apply Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption froth plat or official map Planning Other , (If"Other";name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest_"Business interest"means a business, . including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO 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 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal,or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation);. C)an officer,director,partner,or employee of the applicant;or D)the actual,applicant. DESCRIPTION OF.RELATIONSHIP Submitted this 7th day of M c 20 25 Signature Print Name Beverly 'erach Form TS 1 06 ( 7la-) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM . The Town of Southold's Code of Ethics tirohibits conflicts of interest on the Dart of town officers and emalovees The auroose of this form Is to provide mforivatioh which can alert the town ofaossible conflicts of interest and allow it to take whatever actio.Ws necessary to avoid same. YOUR NAME: Lark, .Richard F. (Last name,first name,rx►iddle 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:;nanie the activity) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, or employee.has.even a partial ownership of(or Employment by)a corporation including a partnership,in which the town officer in,which the town•officer or employee owns more.than 5%of the shares. YES NO % If you answered"YES?,-complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold- Title or position of that person ' Describe the relationship between yourself(the applicant/agont/representative)and the town officer or employee.Either cheek the.appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his of her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant`is not a corporation); C)an officer,director;partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION'OF RELATIONSHIP Submitted this 3rd day of March 20?S S ignattue Print Name Richard F. Lark Form TS 1 .. poc7�b> APPLICANT/AGENT/REPRESENTATIVE. TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this 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. YOURNAME: Folts, Mary Lou­ (Last (Last name,first name,Middle initial;unless you are applying in the name of someone else or other entity,such as a company.If so,indicate.the.oiher 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)-hive a relationship with any officer or employee of the,Town of Southold?."Relationsfiip"includes by blood,marriage,or.business interest."Business interest"means a business, including a partnership,in which the town.officer or employee has even a partial ownership of(or"employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES . N0. 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 of or,employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any.interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant.. DESCRIPTION OF RELATIONSHIP Submitted this 3rd day of March 20 25 Signature�'�l? Print Name Mar Lou Folts Form'TS.1 } Do � � (C) LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele. No. (631)734-6807 RICHARD F. LARK Fax No. (631)734-5651 MARY LOU FOLTS E-mail: Attys@larkandfolts.com June 30, 2025 Elizabeth Cantrell, Sr. Clerk Typist 1 s Board of Trustees Town of Southold Jut 54375 Main Road - P. O. Box 1179 9 Southold NY 11971 (--- - �0<f RE: Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) Dear Ms . Cantrell : In connection with the above-captioned application, I am enclosing the green signature cards (PS Form 3811) from the certified mailings . Also enclosed is the Authorization of Kevin Cierach for W. ' Jonathan Fabb to act as his agent . If you need anything else, do not hesitate to contact me . Very truly yours, ffichard F. Lark RFL/pl Enclosures Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) 1000-115 . 00-17 . 00-004 . 000 SEWERyCOMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. nat ■ Print your name and address on the reverse ©Agent so that we can return the card to you. ❑Addressee IN Attach this card to the back of the mailpiece, ec ived r Name) C. Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is delivery address,diftergnt from iteml? ❑Yes If YES;enter delivery address below: ❑No Peter Treiber 310 Oyster Ponds Lane Orient.NY 11957 3. Service Type ❑Priority Mail Express® p Adult Signature El Registered MailTM 0 Adult Signature Restricted Delivery M Registered Mail Restricted ®Certified Mail® Delivery 9590 9402 9393 5002 9785 39 ElCertified Mail Restricted Delivery 0 signature ConfirmationTM ❑Collect on Delivery O Signature Confirmation 2. Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery 7022 1670 0002 8342 2811 ricted Delivery PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt 1000-115 . 00-17 . 00-017 . 005 ( IUO-[ �elurrj ect m r 3 JU 9 �0/11 Nye Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) 1000-115 . 00-16 . 00-022 . 000 , • COMPLETE THIS SECTION COMPLETE ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. CI Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery i or on the front if space permits. 1. Article Addressed to; D.is delivery address different from item 1? ©Yes r t f If YES,enter delivery address below: (p No f Vlahos Thomas Irry Trust e i ,y e Vlahos Mary Irry Trust # 114 Country Club Road E �Port Washington, NY 11050 I 3. Service Type CI Priority Mail Expresso "1 III IIII IIII 1111111111111111 Jill I111111111111 ❑Adult Signature ❑Registered Ma1lTM I ii ❑Adult Signature Restricted Delivery f]Registered Mail Restricted Certified Mail(D Delivery 9590 9402 9393 5002 9785 77 Certified Malt Restricted Delivery ❑Signature ConfirmationTM ❑Collect on Delivery ❑Signature Confirmation 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery ?018 3090 0000 4?04 ?961 very PS Form 38't , UTy ZD2(fPSN 7530-02-000-9053 Domestic Return Receipt 1 1000-115 . 00-16 . 00-023 . 000 i , SENDER: ■ Complete items 1,2,and 3. A. Signat re ■ Print your name and address on the reverse X4kw�� Cl Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Npme)_ C. Date of Delivery or on the front if space permits. -ar-je Z J—" r 1. Article Addressed to: �d D. Is delivery address different from item 1? O Yes Peter J. Doherty If YES,enter delivery address below: M No PO Box 644 New Suffolk NY 11956 II I IIII I IIII IIIIII! II II III I IIII I IIIIII II III 3. service Type ❑Priority Mail Express ❑Adult Signature ❑Registered MaIITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted C9 Certified Ma!10 Delivery 9590 9402 9393 5002 9785 60 ❑Certified Mail Restricted Delivery Cl Signature ConfirmationTM ❑Collect on Delivery 13 Signature Confirmation 2. Article Number(Transfer from service label) ❑Correct on Delivery Restricted Delivery Restricted Delivery ❑Insured Mail 7018 3090 0000 4704 7978 otedDelivery PS Form 3B'1 l -Ju(y 't20—PSN 7530.02-000-9053 Domestic Return Receipt 0'� )9e Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) 1000-115 . 00-16 . 00-024 . 000 SENDER: • SECTIONCOMPLETE • • DELIVERY ■ Complete items 1,2,and 3. A, Sign ure ■ Print your name and address on the reverse X 13 Agent so that we can return the card to you. ❑Addr see ■ Attach this card to the back of the ,mail iece B. eived by Printed Na ) 0.�Dat pf live or on the front if space permits. p (� 1. Article Addressed to: s delivery address different from item 1? Cl es If YES,enter delivery address below: ❑No Felix W Bialeski Anne Bialeski PO Box 678 Mattituck NY 11952 3. Service Type ❑Priority Mail Expresso ❑Adult Signature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ;1 Certified Mail® Delivery 9590 9402 9393 5002 9785 91 ❑Certified Mail Restricted Delivery ❑Signature ConfirmationTM ❑Collect on Delivery [3 Signature Confirmation 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery 7018 3090 0000 4704 7947 (Delivery PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt 1000-115 . 00-16 . 00-025 . 000 G pz i6 t'i JUL ��clutho;t� q � 1 Kevin Cierach 4500 Deep Hole Drive, Mattituck, New York (SCTM #1000-115-17-3) 1000-115 . 00-17 . 00-002 . 002 N t 1000-115 . 00-17 . 00-017 . 004 SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ® Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse X C!Agent so that we can return the card to you. i ❑Addressee ■ Attach this card to the back of the mailpiece, B• Received by(Printed Name) ff? O of Deliveryor on the front if space permits. (I5(1A A R1. Article Addressed to: D. ISdel' ery address different from item 1 Yes If YES,enter delivery address below: [] No Michael, '3r'-b,t1C' Mattituck, NY 11952 p8t P iI I 3. Service Type ❑Priority Mail Express® ❑Adult Signature ❑Registered Mail ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted W Certified Mail® Delivery 9590 9402 9393 5002 9785 22 ❑Certified Mail Restricted Delivery ❑Signature Confirmation7m ❑Collect on Delivery ❑Signature Confirmation 2. Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery ❑Insured Mail 7022 1670 0002 8342 2828 Id Delivery PS For ,July 2p20 PSN 7530 02-000-9053 Domestic Return Reoeipt <pt�y y �) Glenn Goldsmith,President o��S�FFOL,I'�oG Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski ti a P.O.Box 1179 Liz Gillooly 0 Southold,NY 11971 Elizabeth Peeples Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NOTICING ADJACENT PROPERTY OWNERS ll� ;k Its-- /& - gam W) /6 Above are property tax map numbers (SCTM#'s) listed that you need to notice for the properties that are located on either side of you, across the street from you and fall within your property lines, and possibly other properties that require noticing per Chapter 55 of the Southold Town Code. In order to find the legal mailing addresses to the SCTM#'s please visit the Southold Town'website at https:Hsoutholdtownny..qov and go to the Assessors page. Under the Assessor's page click on "Forms and Links." Under that page, click on the "2024 Assessment Roll." This will take time to download as it is a large pdf. Once downloaded when you go into it you will see that the list goes numerically by property tax map numbers (SCTM#'s). Scroll down to find the SCTM#'s listed above. The legal mailing address to each of the neighboring properties can be found directly under the property tax map number on the far-left side of the lists. Please mail each property listed above a completed copy of the Notice to Adjacent Property Owners form and a photocopy of the proposed plan/site plan (construction pages do not need to be mailed). Each neighbor's noticing packet must be mailed by certified return receipt mail through the USPS no less than seven days prior to the Public Hearing date. After all mailings have been submitted to the postmaster, all, receipts from the mailings and the completed Proof of Mailing form must be submitted to this office prior to the Public Hearing date. The bright green Notice of Hearing card needs to be posted in front of your property close enough to the street that public can read it. This sign must be posted and stay posted for no less than seven consecutive days prior to the Public Hearing. After the seven days you can complete the Proof of Posting form which needs to be submitted to this office prior to your hearing. If you put the sign up where there is more than seven days before the hearing, just leave it up through the day of the hearing. You can take it down the next day. LM - H 't:NOTIL ! OF l " ING 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: KEVIN CIERACH SUBJECT OF PUBLIC HEARING: For a Wetland Permit for the as-built 59.6'x37' three-story dwelling with garage under and attached wrap-around raised decking consisting of a 10.2'x33.8' raised deck with ±3.6'x18' steps and landing to ground, and ±7'x8' raised deck with steps down to on-grade brick landing; modify the height of the as-built three-story dwelling to become a two-story dwelling by adding fill and retaining walls around existing foundation consisting of: along east foundation wall place 23 cubic yards of fill in a 34' long area to raise the elevation to 3' above current grade, and add 28 cubic yards of fill in a 21' long area to raise the elevation to 6' above current grade; along west foundation wall place 1 cubic yard of fill in a 59' long area to raise the elevation to 6 inches above current grade; along north foundation wall construct a 10' high by 20' long retaining wall and add 78 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade; along south foundation wall construct a 10' high by 34' long retaining wall and add 104 cubic yards of fill to raise the grade within the retaining wall area to 10' above current grade. Located: 4500 Deep Hole Drive, Mattituck. SCTM# 1000-115-17-3 TIME & DATE OF PUBLIC HEARING: Wednesday, June 11, 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 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- sup porting_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 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# 115 _ 17 3 PROJECT NAME Wetland Permit Application of Kevin Cierach The Application has been submitted to(check appropriate response): . Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate'response): (a) Action undertaken directly by Town agency(e.g.capital El construction,planning activity,agency regulation,land transaction) (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,.approval,license,certification: x❑ Nature and extent of action: .Raise the grade plane of the existing 2 story- stucco house with. cellar to conform with the New York State Building Code definition for a 2 story building. 1 I Location of action: 4500 Deep Hole Drive, Mattituck, New York Site acreage: 1.295 acres Present land use: residential Present zoning classification: x-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: Kevin Cierach by Beverly Cierach, Agent (b) Mailing address: 1280 Jockey Oreek Drive,' Southold, NY 11971 631 377-9097 (c) Telephone number: Area Code( ) (d) Application number,if any: Nl Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 0 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. Q Yes No ❑ Not Applicable Obtaining a wetland permit will allow Kevin Cierach to legalize the single-family dwelling to a 2'st.6ry=dwe1ling, which is in keeping with the residentiaj character of the community. 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 ❑ Yes ❑ No x❑ 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 0 Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No 0 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 ❑ Yes ❑ No 0 Not 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 HI—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ 0 i t j Yes No Not Appucable 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 0 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. ❑ YeZ1 No❑x 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 1 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. ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ 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 ❑x Not Applicable Kevin Cierach by PREPARED By Beverly Cierach TITLE Agent DATE 3/7/25 LARK& FOLTS Attorneys at Law 28785 MAIN ROAD PO BOX 973 CUTCHOGUE,NEW YORK 11935 Tele.No.(631)734-6807 RICHARD F.LARK Fax No. (631)734-5651 MARY LOUTOLTS E-mail: Attys@larkandfolts.com March 21, - -� Glenn Goldsmith, President D ECEIVE Board of Trustees Town of Southold EMAR2 4 2025 54375 Main Road - P.O. Box 1179 Southold, NY 11971 hold Town of Trustees RE: Kevin Cierach 4500 Deep Hole 'Drive, Mattituck, New York (SCTM #1000-115-17-3) Dear Mr. Goldsmith: On behalf of Kevin Cierach, I am enclosing an original and three copies of the following: DOC #1 - Wetland Permit Application, Board of Town Trustees, Town of Southold DOC #2 - General Data DOC #3 - Wetland/Trustee Lands Application Data DOC #4 - Short Environmental Assessment Form DOC #5 - LWRP Consistency Assessment Form DOC #6 - Authorization of Kevin Cierach DOC #7 - Applicant/Agent/Representative Transactional Disclosure, Forms of Kevin Cierach, Beverly Cierach, Richard F. Lark and Mary Lou Folts DOC #8 - Project Plan DOC #9 - Survey of property prepared by Nathan Taft Corwin, III, Land Surveyor last revised February 20, 2025 Glenn Goldsmith, President -2- March 21, 2025 Board of Trustees DOC #10 - Current photos of subject area DOC #11 - Check payable to Town of Southold in the amount of $2, 500 . 00 for the application fee If there is anything else you need, do not hesitate to contact me. Very truly yours, Richard F. Lark RFL/pl Enclosures