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HomeMy WebLinkAboutTR-10790A Town Hall Annex Glenn Goldsmith, President Z� S® 54375 Route 25 ® P.O. Box 1179 A. Nicholas i, Vice President Southold, New York 11971 Eric c Sep Sepenoski Liz Gillooly �' Telephone (631) 765-1892 a® pax (631) 765-6641 Elizabeth Peeples � �CUUNTi,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OFT H T ES CHEOF TRUSTEES OFF VCK72 HOURS PRIOR TO COMMENCEMENT OF THE AC BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 15t day of construction '/2 constructed When project complete, call for compliance inspection; I -1 Glenn Goldsmith,President `*®f S®�/f� Town Hall Annex A. Nicholas Krupski,Vice President �O� ®�® 54375 Route 6 P.O. Box 1179 Eric Sepenoski l Southold, New York 11971 Liz Gillooly Telephone(631) 765' 1892 Elizabeth Peeples � �� Fax(631) 765-6641 C®unrr°�,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10790A Date of Receipt of Application: May 20, 2025 Applicant: Pete& Maureen May SCTM#: 1000-70-4-18 Project Location: 2505 Wells Avenue, Southold Date of Resolution/Issuance: June 11, 2025 Date of Expiration: June 11, 2028 Reviewed by: Board of Trustees Project Description: Extend existing deck 22'-9" along south elevation of dwelling; with the condition of a 1-to-1 tree replacement for any removed using native hardwoods with a minimum 3" caliper. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance'of an Administrative Permit allows for the operations as indicated on the site plan prepared by Formworks, received on May 20, 2025, and stamped approved on June 11, 2025. Special Conditions: a 1-to-1 tree replacement for any removed using native hardwoods with a minimum 3" caliper. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees PROJECT FRAMING NOTES MAY RESIDENCE ADDRESS Based upon Table R507.5 - Based upon Table R507.6- SOU SELLS AVENUE SOU WELLS NY DECK BEAM SPAN LENGTHS DECK JOIST SPANS for Common Wood Species Live Load: 40 psf Live Load: 40 psf Dead Load: 10 psf Dead Load: 10 psf Species&Grade: Southern Pine ACID Joist Spacing: 16"o.c. Beam Size: (2)2"X 8"Wood Beam Species&Grade: Southern Pine ACQ Deck Joins Span <_ 8' Joist Size: 2"X 8" ARCHITECT Maximum Permitted Beam Span = 7'-7" Maximum Permitted Joist Span = 11'-10" Actual Maximum Beam Span = 6'-9",therefore,o.k. Actual Maximum Joist Span = 9'-6",therefore,o.k. Note:Contractor to provide solid wood blocking at mid span and over beam at any cantilever F@Mwoft Amhng(DRUM p00o 1 82 John Mr992 Brno Dyn, NY 11261 PAVER PATIO CONC. �nb@ rmworks-arc° .com for 1PT11V�Mi orks—arch.c® lmi � I m•PT FLI­ �EW DECK ..WWII.. rr%cT.imcen (EEEOET �,� IT nusxarx I- I oR ' J%r P.i ftUSHffI1I 1; ' rMr PT IEDOEA f t. /� �EEo uLu n.coPae axaemea,.aax m,Ay 2 0 2025 PC6T BASE,pB tr PoLPEULOaLRETE 13000 PSFlSOtUNBE iC ONPIat OH7% ' NEW DECK FRAMING °ob.` vnmwEwurromu�mEn ew*rw,austia%mm+ i — — — — — — — RI ' EXISTING DECK FRAMING >r 64 H yH, QQH Sla'PL PL�OdiJd5i3 7b'E%ISIivG%b,3 E Hausa AB'Sar4w Howse E*WW A`77 (C5 VVo H."sift i �- mertawov,rB¢ Lap Ak Swilteavet •, �6'-D' 25'-5' q ` w0w*y­�4—P4--d T; NEW FRAMING EXISTING FRAMING SSNA"tom611"010 ji kledo w Z end kwir atp `,1' Norma 1 v a 12'aa d*O" 7 y PROPOSED FRAMING PLAN Dw*ft to be Fw"O.W K&OW 3 O N 11Y'tRa X d•Esg S&t,,"at 16'm ,.1## b be tt�dipPsd ga+. o A � at sa[fi Qsok prcd nW Fimlwe Treated -�-•-� _ -.'• - O 0 0 O O C) 0 O «{�a�i _ KITCHEN 9 -•''�„ "`v.,,,,w4., PAVER PATIO CONIC. _D '�-F' tea" +�..4$ ISSUE DATE "mot — — } t ..,. 'S,mPso,P OTTfC(8'14 k}d,t1t tanaNrt — — O*ot PTeswe beaked Pyaaod FNEW DECK — . ..- to fedtl dowrtQavka wKh a men.75A s,B i t x+waN N0. DATE DESCRIPTION L .... ,.. bsr+pet s>tson9 Hs"00"it"epwavtaBs it2'Q.ax�ae masarryE 96ews al ; .. SOW,"WW%wa"(8)101n1-1Z aaas. I; w was b v of oti,o,8l secure 8e b / I; ........_ to on Ftift wn ffi8"so"W rhea HOG wriew es Pa,'k m*W a , ---- I o 0 N LEDGER DETAL N.T.S. - ---- ---- • I NEW DECK NEW 514 DECKING ON " EXISTING FRAMING REVISION HISTORY: aaaB rBu N0. DATE DESCRIPTION 8,-0. 25.-5. NEW DECK EXISTING DECK 2 N PROPOSED DECK PLAN O 1/8„=1°-O„ EMBEDDED SIMPSON POST EAST ELEVATION BASEPB44 '! DRAWING STATUS 0 0 PAVER PATIO CONIC. EX.KITCHEN ®® DOB ID NUMBER: Q NEW DECK • • Q 18"ROUND CONCRETE PIER WITH(3)#4 REBAR UJI EX LIVING /'• EX BEDROOM I!n 0 it -- �1iI o- --- o a I lII w m TITLE a EXISTING DECK FIRST FLOOR PLAN "i a P'X Z X 8'FOOTING ON Q UNDISTURBED SOIL smTaonoLeTxEE • • • I 25-5 SEAL & SIGNATURE DATE: o PROJECT NO.: DRAWING BY: .4 A� ;w� CHK B EAST ELEVATION DECK FOUNDATION (TYP) N(:� EXISTING DECK PLAN R ` ` t,, `P \ A-10 t: ` �� CAD FILE NO. ' I - S.C.T.M. NO. DISTRICT 1000 SECTION: 70 BLOCK: 4 LOT(S): 18 IV E AUG - 5 2022 TIDAL WETLAND BOUNDARY AS . i� � � SautlloldTown DELINEATED BY EN-CONSULTANTS BowdofTtusiees NOV. 1. 2022 1 _ Nbyp1929 F1b� is LAND N/F OF AWSON NATHEL two V1 17A '! 12 10 710AL WEIiAND BOUNDARY DEUNEATED. BY t.os ti ivtz -g EN-CONSULTANTS NOV. 01, 2021 o:. Q00, —� �20` ,i:,•r- �GRAVLl'OANEWAY ` SIK \ 14 2�1 Ark,\ 3p004 l LAND N/F OF lL 0 RALPH VMNETTO - 1)} 20 •4l' ,5��0� / REVISED .07-29-22 f��r fps 5� THE WA7ER SUPPLY. WELLS DRywaLS AND CESSPOOL Op, LOCARONS SHOW ARE:PROM PIELD.OBSOMAAONS FEMA MAP#36103CO166M AND OR DATA OBTAINED FROM 07HOM es. AREA:27,787 S.F. or 0.64 ACRES Ef"AAW DATUM NAVD88 UNAUNORI2 D ALURANON-OR AMMON I0 VHS SURWY 6 A WOLAROM OF SEC801V 7209 OF RIE NEW MW STATE mucaROM LAW COPIES of W S SURVEY mp NOT BEARING WE.LAND SURVEYOR°9 M?OSSED:SEAL SHALL NOT BE CO1VSfDERm 7D BE A VALID 7RUECOPY. GUARANEEi 1JV01CA7m HEREON MALL.REIN � - ol�r�r�'Prn�v�TFw?'mr"ri�"iRc`Svmc?fg Pam A�Fa7Hu 6"rrGArr P"v'�R'i�E i;'GP3`��"ific R�aar2'iAY.r�Lao;.. lr�°�`Si. US7ED HOM M, AND 70 THE A8Sf&9ES OF'R/E LENDING INSWURON, GUARANIM ARE NOT TRANSFERABLE THE OFFSEIS OR DIMMMONS SHOW MEW FROM RE PROPERTY LINES M THE SRNICIURES ARE FOR A SPWRC PURPOSE AND USE R#BEFORE THEY ARE NOT INE7VDED TO M40NUMENT THE PROPERTY UNES OR 70 GUIDE WE ERECTION OF FENCE$ ADVnIONAL SIRUCIUMS OR,AND ORIER INPRON3 M8 EA56MENIS OAKLAWN AVENUE ANDIOR SUBSURFACE SIRUMWES Mom m OR UNRECORDED ARE NOT GUARANup UNLESS PHY mum ENDENT ON WE PREil/SES AT WE RNE Gr SURVEY SURVEY of DESCRIBED PROPERTY , MAP OF. CERTIFIED TO: EVEN NATIONAL TITLE INKS RANCE COMPANY: FILM BNY MELLON; SMAIM AT: SOUTHOLD TOWN OF SOUTHOLD EMUMH M WOYCEM LAND SURVIKIM. PLLC SUFFOLK COUNTY. NEW YORK Profeaatonal Lead Surveying and Deolga P.O. Box 153 Aquehogue. New York 11891 FRE/221-63 SCALE:1=30' DATE:APRIL 28, 2021 I+go N.Y.S USG Na 05OB82 M(631)Ee8-INS VAX(ON)08-IM ES SOUTHOL' D TR,USTE. No. Ohio A n Pe c� � 1Jlaureen M4 Date.�o- H- Ig . Issued To _ _ Addres s asO5 wells Aveoi&eik--, soup ova THIS. NOTICE M-l7ST BE DISPLAYED DURING CONSTRUCTION .TOWN TRUSTEES OFFICE,TOWN OF SOUTMOLD SOUTHOLD, N.Y. 11971 TEL.: 765.1892 Glenn Goldsmith,Pi stuunt ��OvOGy Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski ' ,? P.O.Box 1179 Liz Gill ooly y • 0� Southold,NY 11971 Elizabeth Peeples Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Completed in field by: L ^ it lo<f)L Formworks Architecture on behalf of PETE & MAUREEN MAY requests an Administrative Permit to extend existing deck 22'-9" along south elevation of dwelling. Located: 2505 Wells Avenue, Southold. SCTM# 1000-70-4-18 Type area to be impacted: / Saltwater Wetland Freshwater Wetland Sound ✓ Bay Part of Town Code proposed work falls under: ✓Chapt. 275 Chapt. 111 other Typ of Application: ✓ Wetland Coastal Erosion Amendment ✓ Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: I -krM repl r ce Mch +- Q eS o r G . I t� o tc ►a 3`' 1 a►�t.�.+e�arc. a✓1 � yd1GtC�i Present Were: G. Ggkfsmith N. Krupski E. Sepenoski ,/L. Gillooly E. Peeples 2505 WELLS AVE,SOUTHOLD DECK EXTENSION-SE CORNER OF EXISTING DECK (Proposed) a,T �+M,ys it fed" i y # t _ ,014, {. ...:. - View from South East 04/15/25 2505 WELLS AVENUE, SOUTHOLD PHOTOS OF VIEW oe. .. ■.ems-� M •7!- i� FROM THE EAST 04/15/25 1 VIEW L ))� ♦2 Y.N � 4 FROM THE SOUTH 04/15/25 \ 6UTg1 L+`^• ,f w -, _."'� ..iw, r <� _v _ _. ♦ A t`mV e - �� ar p s _ 'a r- .. ,sumo : 4 a��l<, �' �.:p. \ q. �'bqy �;c>`. - �� � w aT�"°:-�--lax--,J�a .�. � » e 4�.•r u, �0.. � '� ran awF - _ off' a•w � � ) , ro a o ea w q�' �� " f a33 �✓ - " M �.,.� GL4ka NEC M„ 1NR1 xAU i«�� �rv'e ee� efe� s�� � � :; 90.'1NfMD S.1t001D»1RICT NDA ��`•:t•'f' ,au 3' Pr�� 2F 3'�79`+ $ 6 `� o paaa -E a -wy« ... �_.'°.:-.1°9 _. � .+ tx: � i- y .e. n �4 - ,r.. _�'i w� .. iw .,.X-'`-•n i .�• .x fit "...9' , , L 6.. e• Ai' ,'p' V. .ugyM,. a � 'sue •` .. 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"•• q ., et� Ip 3 e je N 4 r� + N b,`7.19'm �t <or+�\ k''r�\ fr..0 ram., ,.-7., :AJ�.. ,.,wk$ - 1 ' M '^ x. - n�a - a yr /� �„ .e_Y a_-".* a _ -a s.•f J'' E .Nn s „ of Fa "•^ 4jfyya m gi 9x mA w k 9 aea p D r �• 9.o,os m, i° • snwpom pl�.��, a ;f a `�s's p s { rarm fps ,. e --�—l— COUNTY OF SUFFOLK raT CF '_�rL foa sic Jicww ne _ .,. __ _ r„� ,�„� enyl Menace�Re Y E — _ Ik'rp O u a N r_�_ — — — ,. —_— .« •. yr nr.. .R�mut 11 s» W e:ip>BIED IM wrr w' 070 A, a• p e[v. +c.o» — — ru. --- r.9., ufl rre..� "� / wrtwur MtelJFN 1t11r.WH a'fra a —-- —— --••—— ...� .___.____�yi aw ntvvnrr rwA eecvice roeCr � 4�u1 O�MvUI -•_ OFFICE LOCATION: ` �,� MAILING ADDRESS: Town Hall Annex _ ; P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) yxy ae i Southold, NY 11971 i �' ': 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: June 3, 2025 Re: LWRP Coastal Consistency Review for PETE & MAUREEN MAY SCTM# 1000-70-4-18 Formworks Architecture on behalf of PETE & MAUREEN MAY requests an Administrative Permit to extend existing deck 22'-9" along south elevation of dwelling. Located: 2505 Wells Avenue, Southold. SCTM# 1000-70-4-18 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 � Glenn Goldsmith,PresidentQT Sa(/J Town Hall Annex A.Nicholas Krupski,Vice President � �� 54375 Route 25 P.O.Box 1179 Eric S'epenoski ti Southold,New York 11971 Liz Gillooly G � Telephone(631) 765-1892 Elizabeth Peeples �► �'4 r Fax(631) 765-6641 coU(dT�l,<� .OP BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application D 1', ECEIVE Wetland Permit Application Administrative Permit Amendment/Transfer/Extension kA 4Y 2 0 2 225 Received Application: Received Fee: $ — L ComCompleted Application: Southold Town P PP — Board of Trustees Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: __Technical Review: Public Hearing Held: Resolution: Owner(s)Legal Name of Property (as shown on Deed): Pete and Maureen May Mailing Address: 2505 Wells Avenue, Southold, NY 11971 Phone Number: 516-330-6526 Suffolk County Tax Map Number: 1000- 70 -4 - 18 Property Location: 2505 Wells Avenue, waterside, between Hill Rd W and Oaklawn Avenue (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable):Jonathan Baker, Formworks Architecture Mailing Address:402 First Street, Greenport NY 11944 _ Phone Number: 646-245-3603 Email:jon@formworks-arch.com Board of .Trustees Applicat' GENERAL DATA Land Area(in square feet):.27,787 SF Area Zoning: R-40 Previous use of property:Single Family Residential Intended use of property:.Single Family Residential Covenants and Restrictions on property? Yes _E_No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? _aYes _nNo 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. his project reqpirq any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure(s) on property have a valid Certificate of Occupancy? Yes=No Prior permits/approvals for site improvements: Agency Date Trustees Permit#10233 09/14/,2022. Dept of Buildings, .01/13/1918 ❑ No prior permits/approvals for site,improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? [71 No .❑ Yes If yes,provide explanation: Project Description(use attachments if necessary): Extend.existing deck 22'-9"along South elevation of house (see site plan G-001.00) _ oard of Trustees Applicat' WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Enlarge the existing deck to grade along South elevation of house Area of wetlands on.lot: 2,664 square feet { Percent coverage.of lot:,9.6 Closest distance between nearest existing structure and upland edge of wetlands: 37 feet Closest distance between nearest proposed structure and upland edge of wetlands: 60 feet Does the project involve excavation or filling? ❑ No ✓ _Yes If yes,how much material will be excavated? +/' 7 cubic yards How much material will be filled?,. 0 cubic.yards Depth of which material will be removed or deposited. 3 feet Proposed slope throughout the area of operations: Existing grade Manner in which.material will be removed or deposited: N/A a 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): To mitigate temporary project impacts, the minimal area of soil-removal will be planted wA vegetation, and the project as designed will maintain the stable, vegetated slope without significant impact on the adjacent tidal wetlands or waters of Jockey Creek. 617.20 Appendix B Short Environmental Assessment Form Instructions for;Completing Part I -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 l 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 Projecfand sponsor Information Name of Action or Project: .May Deck Addition ' ..Project Location(describe,and attach a location map): 2505 Wells Ave, Town of Southold, east side of Wells Ave, +/- 675' S of Jernick Lane Brief Description of Proposed Action: Construct 8'x 22'-9" deck addition to existing deck, along South side of house, deck to ' have 6 new posts with 2'x2' footings at 3' depth. Name of Applicant or Sponsor: Telephone:646-245-3603 Jonathan Baker E-Mail:jon@formworks-arch.com _.Address:., 402 First Street ChylP6: State: Zip Code; q Greenport NY 11944, l: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. Z ❑ 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? '-'.NO 'YES . 1f Yes, list agency(s)name and permit.or approval: ;Southold Dept of Buildings 3.a.Total acreage of the site of the proposed action? 27,787 SF acres b.Total acreage to be physically.disturbed? _SF 'acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 27,787 SF acres 4. Che I land us at occuron,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial ©Residential(suburban) Forest [:]Agriculture Aquatic —]Other(specify);, Parkland Page 1 of 4 x5. Is the proposed action,-. NO YES 'N/A a.A permitted use under the zoning regulations? ✓ b.Consistent with the adopted comprehensive plan? ✓ 6. Is the proposed action consistent with 11 the predominant character of the existing built or natural NO YES' landscape? i/ 7. Ts the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO, ;.;YES, If Yes,identify: .Peco is Bair and Environs - Protect Dublic health, water, vegit%ion, & scenic b��ut�,�gencSuffolk Count , Date.'7-12-88 - Q; '0✓ 8. a.Will'the proposed action result in a substantial increase in traffic above present levels? NO, V 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? 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: e 10. Will the proposed action connect to an existing public/privatewater supply? NO .YES A Z If No,describe method for providing potable water: i 11'.Will'the proposed action connect to existing wastewater utilities? N0 . 'YES If No,describe method for providing wastewater treatment: 1.2. 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 'NQ, YES } wetlands or other waterbodies regulated by a federal,state or local agency? ✓ b.Would the proposed action physically alter,or encroach into, any existing wetland or waterbody? If Yes;identify the wetland or waterbody and extent of alterations in square feet or acres: 14.-Identify the typic bitat types that oc n,.or are likely to be found on the yroject 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? ✓ 16.1s 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.Will storm water discharges flow to adjacent properties? ❑NO ,DES '210 b.Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes,briefly describe: (7NO �'ES 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, damp 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- z completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE % Applicant/spons aanBaker 05/20/2025 Signature:. _....' Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all ofthe;following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsoror 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 regulations? EJj, EJ 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? a' Y ra 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? a 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? ❑ a• 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? a, 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,airquality,flora and fauna)? ❑k, ' a• Page 3 of 4 1 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 problems? ----------------- _.-._..----- I]. Will the proposed action create a hazard to environmental resources or human health? # Part 3-'Determination ofsignificance. 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. 5 t Check_this box ifyou have determined',,based.odt'he information and analysisabove,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 i Name of Lead Agency bate President Print or Type Name of Respomible:Officer in Lead.Agency Title of Responsible Officer Signature of Responsible Officer in'Lead Agency Signature of Prepares(if different from Responsible Officer) PRINT Page 4 of 4 yard of Trustees Applicat.,' AUTHORIZATION (Where the applicant is not the owner) I/We, �� A-A./4�S �L/2aiti I'l k Y owners of the property identified as 8CTM#.1000-. in the town of U ,New York,hereby authorizes to act as myagent 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 Prop rty Owe Signatur V----,,- SWORN TO BEFORE ME THIS._ DAY OF �! �i•4 l 20.o2S Gf NOtOypublic ,!ard of Trustees Appl cat' i� a :AFFIDAVIT -A4 . VAAVCL f_". ` _,.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 HISIHER KNOWLEDGE.AND BELIEF;AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH:IN THIS APPLICATION AND AS MAYBE 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 AL.Ll DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF;SAID PERMiT(S),IF GRANTED.: IN COMPLETING THIS APPLICATION,IHEREBY AUTHORIZE THE TRUSTEE.S,T)MR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,.TO ENTERONTO 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. 1 l hit Al-m. Signature o Praparty Owner Signa ure of pro rty Owner SWORN TO BEFORE ME THIS 6 H DAY OF_�ga rp_ ,:20 e Neff*Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town-ofSouthold's Code.of Ethics arohibits conflicts df interest on.the hart'oftown.officers�and,emolovees.The nwvose_of, .this form is°toa5rovide inforrrrationwhich ean'alert'the-,town ofpossible conflicts of innteresZ and allow.it to-take..whatever action is; hecessarV to avoi&sain., YOURNAME: Jonathan Baker (Last name,-first name,rriiddle initial,unless you are applying'inthe name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building ' Variance Trustee Change of Zone Coastal Erosion Approval of pint Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you-personal ly'(or'through,youreompany,spousei sibling,parent,or child)have a relationshipi ith any officer or'employee: •N of the Town of Southold? "Relationship"includes^by blood marriage,or'businesfinterest:"Business interese..'means,a.,busirress, including,a,partnersh in.which the.town officer,or employee hawevematpartial ownership of(or employment by).a corporation in which the-town of.cer or employee owns more than.5%of,`theshares. YES F NO n . j r 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/agent1representative)and the townotficer 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): E_A)the owner of greater than 5%of the shares of the cotpofate stock of the.ap11, plicturt = (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when,the -FIapplicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted tW day of May 20 25 Signature Print Name J a an,Baker Forin TS 1 11 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...prouosed action. will .be evaluated,.a§: to__ 6 .sii=i i&int 'beneficial•and-adverse.effects.uoon'the coasta 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:answe"r,.niust'be exnlamed' in detail;..listide both supporting_and non- ' su^ppurting facts. If an action cannot be certified as consistent with the LWRP policy standards and condifions,it§hall.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 E SCTM# 1000 ,.70 -4 - 18 f PROJECT NAME 2505 Wells Avenue Deck Addition i - `Ct The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑✓ Board of Trustees ,❑✓ 1. Category of Town of Southold agency action(check appropriate`response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: ❑ Nature and extent of action: Wood..deck addition.to existing wood deck. .._ . . _ . .,.. �l Location of action: 2505 Wells Avenue, Southold Site acreage: 27,787 sf Present land use: Residential, single family dwelling 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: Jonathan Baker (b) Mailing address: 402 FirstStreet, Greenport, NY 11944 (c) Telephone number: 646-245-3603 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes '❑ No❑✓ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. ` Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes No Not Applicable 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 0 Not Applicable Attach additional sheets if necess anr 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 ❑✓ 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 21 Yes ❑ No DNot Applicable The slope between the existing dwelling and deck and the adjacent Jockey Creek tidal wetlands is currently Stabilized and protected from erosion. Consistent with P011cy"4;the deck addition prOJect N. i" seeks to combine new footings for deck posts with vegetative restoration to maintain the stabilized s„ope an protect the existing dwelling, deck addition,,and slope from potential erosion dqRage. r. __. .. . , if __..., Attach additional sheets 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 ONO Applicable Attach ad itiona 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. 0I Yes ❑No ❑ Not Applicable The slope between the existing dwelling and deck and the adjacent Jockey Creek tidal wetlands is currently stabilized and protected from erosion. The proposed.deck addition project seeks to extend the deck per plans.,subm,itted: -To mitigate potential rpjppt.impacts, the,portions of the slope disturbed ,by removal of soil for post footings will be planted with native vegetation. Thus, consistent with Policy 6, the project will'protect the quality and function of the surrounding tidal wetland ecosystem. while avoiding causing any si nificant adverse iiri acts thereto. 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 0 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. ❑ Ye❑ No Not Applicable Attach additional sheets if necessary r n WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III--Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No ❑✓ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑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❑✓ Not Applicable PREPARED B Jonathan Baker TITLE Architect DATE 05/20/25