The URL can be used to link to this page

Home My WebLink About1000-107.-7-6PLANNING BOARD MEMBERS JERILYN B. WOODHOUSE Chair KENNETH L. EDWARDS MARTIN H. SIDOR GEORGE D. SOLOMON JOSEPH L. TOWNSEND PLANNING BOARD OFFICE TOWN OF SOUTHOLD MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY Telephone: 631 765-1938 Fax: 631 765-3136 To: Ruth D. Olivia, Chair Town of Southold Zoning Board of Appeals From: Mark Terry, Senior Environmental Planner LWRP Coordinator Date: October 20, 2006 ZBA File #5969 (Isabella) SCTM#1000-107-7-6 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 proposed action is INCONSISTENT with the denoted following Policy Standards and therefore is INCONSISTENT with the LWRP. Flood zone information was not provided in the submission to the Board. Policy Standards I Policy 5 Protect and improve water quality and supply in the Town of Southold. Note, that dry wells are not shown on the survey. To further Policy 5, it is recommended that gutter~ downspouts and drywells be installed to minimize surface runoff entering Mattituck Creek. Policy 6 Protect and restore the quality and function of the Town of Southold ecosystem. 6.3 Protect and restore tidal and freshwater wetlands. ,4. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all ,4ndros Patent and other lands under their jurisdiction. 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The proposed setback from the deck structure to the bulkhead is 71.6 feet and from the proposed stair to the bulkhead is 61 feet; a minimum setback of 100 feet is required pursuant to Chapter 275 and a minimum setback of 75 feet is required by Article XXIII Section 100-239B of the Town of Sonthold Town Code. Please require that the applicant amend the application to meet the above policy to the greatest extent possible. APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 · Fax (631) 765-9064 Mailing Address: Southold Town Hall 53095 Main Road · P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex/First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 Mark Terry, Senior Environmental Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold, NY 11971 Re: ZBA File Ref. No. 5969 (Isabella) Dear Mark: We have received an application for additions and alterations to premises on Mattituck Creek, and shown on the enclosed map. A copy of the area map is also attached for your use and reference. May we ask for your assistance in an evaluation and recommendations for this proposal. Thank you for your assistance. Very truly yours, RUTH D. OL1VA ~RBARA~ISABELLA !8$5~.STVIEW DRIVE MATTITUC LooMng east at existing dwelling/dec~' and at location of proposed dec~ and upgraded sanitary ~l,stem. Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 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 infomaation 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. 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). 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 Supportina and non- suooorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 107 7 6 PROJECT NAME ISABELLA The Application has been submitted to (check appropriate response): Town Board [--] Planning Board[--] Building Dept. [~ Board of Trustees [--] 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) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: CONSTRUCT A SECOND STORY ADDITION OVER AN EXISTING ONE-STORY DWELLIlqG; REMOVE EXISTING DECK AND CONCRETE WALK; AND CONSTRUCT A 10' X 38' DECK AND (2) SETS OF STAIRS. CONSTRUCTION OF NEW PORCH AND DRAINAGE SYSTEM ARE SITUATED MORE THAN 100 FEET LANDWARD OF WETLANDS AND TI-IEREFORE BEYOND THE TRUSTEES JURISDICTION PURSUANT TO SECTION 97-12(C) OF THE TOWN CODE, ALL AS DEPICTED ON THE SITE PLAN PREPARED BY JOSEPH A. INGEGNO, LAST DATED JULY 7, 2005 Location of action: 11155 WEST'v-mW DRIVE, MA YIIIIJCK Site acreage: 0.311 ACRES Present land use: DEVELOPED-RESIDENTIAL Present zoning classification: R-40 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: BARBARA & JOSFJ'H ISABELLA (b) Mailing address: 49 DARTMOUTH STREET ROCKVILLE CElqTRE, NY 11570 (c) Telephone number: Area Code516-764-I054 (d) Application number, if any:. 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 Ill - Policies; Page 2 for evaluation criteria. [-']Yes [-'-] No [~ Not Applicable Atlach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section IH - Policies Pages 3 through 6 for evaluation criteria ~'~ Yes ~-~ No ~ Not Applicable At/ach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section Ill - 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 ~-~ Yes ~ No ~ 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 ~'] Not Applicable ALTHOUGH ONLY MINOR EXPANSION AND RENOVATION OF AN EXISTING STRUCTURE ALONG A DEVELOPED SHORELINE IS PROPOSED, THE PROJECT WILL BE CONSISTENT WITH POLICY 5 IN THAT IT WILL MAINTAIN A NON-TURF BUI~'I-'I~R ADJACENT TO TIDAL WATERS (PREVIOUSLY IMPOSED BY TOWN WETLANDS PERMIT 5626) AND ESTABLISH A DRAINAGE SYSTEM OF DRYWELLS TO CAPTURE AND RECHARGE ROOF RUNOFF. 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 llabitats and wetlands. See LWRP Section Ill - Policies; Pages 22 through 32 for evaluation criteria. [] Yes ~ No [~ Not Applicable THE PROJECT WILL BE CONSISTENT WITH POLICY 61N THAT IT WILL MAINTAIN THE EXISTING NON-TURF BUF~'gR AS NOTED ABOVE; INSTALL A DRAINAGE SYSTEM OF DRYWELLS TO CAPTURE AND RECHARGE ROOF RUNOFF; AND USE A PROJECT-LIMITING FENCE AND STAKED HAYBALES TO CONTAIN SITE DISTURBANCE DURING CONSTRUCTION. FURTHER, THE PROJECT WILL HAVE NO IMPACT ON THE ADJACENT TIDAL WATERS AND WETLANDS AND WILL COMPLY WITH ANY AND ALL REQUIREMENTS OF THE TOWN OF SOUTHOLD TRUSTEES AND NYS DEC. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Sonthold. See LWRP Section III - Policies Pages 32 through 34 for evaluation erlteriz. ~-~ Yes ~-~ No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~-~ Yes ~ No ~ Not Applieable 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. ~-~ Yes ~ NoN 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 Pohcnes, Pages 47 through 56 for evaluation crstena. [---] Yes [--] No ~ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peeonic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ['--] Yes ~-] No ~ Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III - Policies; Pages 62 through 65 for evaluation criteria. [~ Yes ~ No [~ Not Applicable Attach additional sh~ts 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 E~ Not Applicable PREPARED BY -4q~.. ROBE TITLECoASTAL MalVlTSPECIALIST DATE v2s/o6 Amended on 8/1/05 Office Notes:, - Filed By: Date Assigned/Assignment No. ! APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS Parcel Location: House N0.1855 StreetWESTVIEW DRIVE HamletMA vrrrtJCK SCTM 1000 Seetionl07 Block7 Lot(s)6 Lot Size10,890 sY Zone DistfictR40 1 (WE) APPE~HE WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED: JULY{I_~2006 i'll Owner as Applicant: BARBARA & JOSEPH ISABELLA Mailing Address:49 DARTMOUTH STREET, ROCKVILLE CENTRE, NY 11570 Telephone: 516-764-1054 Fax: NOTE: If applicant is not the ownor, state if applicant is owner's attom~'y, agent, architect, builder, contract vendee, etc. Authorized Representative: EN-CONSULTANTS, II,lC Address: 1319 NORTH SEA ROAD SOUTHAMPTON, NY 11968 Telephone:631-283-6360 Fax: 631-283-6136 Please specify who you wish correspondence to be mailed to, from the above listed names: [] Applicant/Owner(s) [] Authorized Representative [] Other: WHEREBY THE BUILDING INSPECTOR DENIED AN APPLICATION DATED 7/t2/06 FOR: [] Building Permit [] Certificate of Occupancy [] Pre-Certificate of Occupancy [] Change of Use [] Permit for As-Built Construction Other: Provision of the Zoning Ordinance Appealed. Indicate Article, Section, Subsection and paragraph of Zoning Ordinance by numbers. Do not quote the code. Article III Section 100- 244 Subsection Type of Appeal. An Appeal is made for: [] A Variance to the Zoning Code or Zoning Map. [] A Variance due to lack of access required by New York Town Law-Section 280-A. [] Interpretation of the Town Code, Article Section [] Reversal or Other A prior appeal [] has [] has not been made with respect to this property UNDER Appeal No. Year Page 2 Owner: BARBARA & JOSEPH ISABELLA REASONS FOR APPEAL (additional sheets may be used with annlicant's signature): .4RE~d VARIANCE RE.ISONS. (1) An undesirable change will not be produced in the CHARACTER of the neighborhood or a detriment to nearby properties if granted, because: SECOND STORIES AND ATTACHED DECKS ARE TYPICAL FEATURES OF THE NEIGHBORHOOD, AND THE FACT THAT EACH WILL BE LOCATED APPROXIMATELY 5 INCHES AND 9 INCHES, RESPECTIVELY, CLOSER TO THE PROPERTY LINE THAN WHAT THE CODE ALLOWS IS INSIGNIFICANT. (2) The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue, other than an area variance, because: THE EXISTING DWELLING IS SITUATED ON A SLIGHT ANGLE SUCH THAT THE EASTERLY PORTION OF THE HOUSE MEETS THE REQUIRED SETBACK BUT THE WESTERLY PORTION OF THE HOUSE DOES NOT BY A MARGIN OF APPROXIMATELY 5 INCHES. THEREFORE, CONSTRUCTION OF A SECOND STORY OVER THIS EXISTING FOOTPRINT INVARIABLY REQUIRES APPROXIMATELY 5 INCHES OF RELIEF FROM ARTICLE HI, SECTION 244, ACCORDING TO THE BUILDING INSPECTOR'S INTERPRETATION OF ARTICLE XXIV, SECTION 242A. (3) The amount of relief requested is not substantial because: THE AMOUNT OF RELIEF REQUESTED IS LESS THAN 12 INCHES, WHICH IS NOT SUBSTANTIAL BY ANY MEASURE. (4) The variance will NOT have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district because: THE VARIANCE WILL HAVE NO ADVERSE EFFECT OR IMPACT ON THE ENVIRONMENTAL CONDITIONS OF THE SITE OR NEIGHBORHOOD WHATSOEVER. TO ENSURE THIS, AN UPGRADED SANITARY SYSTEM AND DRAINAGE SYSTEM WILL BE INSTALLED, AND A PROJECT LIMITING FENCE AND STAKED HAYBALES WILL BE SET IN PLACE TO CONTAIN SITE DISTURBANCE DURING CONSTRUCTION. A 10-FOOT NON-TURF BUFFER ADJACENT TO THE BULKHEAD WILL ALSO BE MAINTAINED PURSUANT TO TOWN WETLANDS PERMIT NO. 6222. (5) Has the alleged difficulty been self-created? ( )Yes, or This is the MINIMUM that is necessary and adequate, and at the same time preserve and protect the character of the neighborhood and the health, safety, and welfare of the community. Check this box ( ) IF A USE VAPdANCE IS BEING REQUESTED, AN~ PLEASE COMPLETE THE ATTACHED USE VARIANCE SHEET: (Pie, me be sun: to consult your attorney.) ~ Signafil~'~of Appellant or Authorized Agent (Agent must submit wri~n Authorization from Owner) Sworn to before me this2gTH ROBERT E. HERRMANN day of/~UGUST ~2006 ~ EN-CONSULTANTS, INC. 1319 North Sea Road Southampton, New York 11968 631-283-6360 Fax: 631-283-6136 www.enconsultants.com ENVIRONMENTAL CONSULTANTs TO WHOM 1T MAY CONCERN: This letter will authorize En-Consultants, Inc. to represent mc and act on my behalf with regard to environmental matters and/or permits. Print QUESTIONNAIRE FOR FILING WITH YOUR Z.B.A. APPLICATION Is the subject premises listed on the real estate market for sale? [] Yes [] No Are there any proposals to change or alter land contours? DYes IlNo 1) Are there any areas that contain wetland grasses? NO 2) Are the wetland areas shown on the map submitted with this application?lq/A 3) Is the property bulkheaded between thc wetlands area and the upland building area? YES 4) If your property contains wetlands or pond areas, have you contacted the office of the Town Trustees for its determination of jurisdiction?yEs Please confirm status of your inquiry or application with the Trustees: WETLAND PERMIT g6222 ISSUED 10-19-05 AND AMENDED 4--19-05 (COPIES ATTACHED) IS there a depression or sloping elevation near the area of pruposed construction at or below five feet above mean sea level? NO Are there any patios, concrete barriers, bulkheads or fences that exist and are not shown on the survey map that you are submitting?NO (Please show area of these structures on a diagram if any exist. Or state "none" on the above line, if applicable.) F. Do you have any construction takingplace at this time concerning yourpremises? NO If yes, please submit a copy of yourbuilding permit and map as approvedby the Building Department and describe: G. Do you or any co-owner also own other land close to this parcel?NO the proximity of your lands on your map with this application. If yes, please label H. Please list present use or operations conducted at this parcel RESIDENTIAL, ONE-STORY, $INOI~MILY DWELLING- and proposed use SAME WITH SECOND STORY (exam~siugle-fnmUy;~proposed: same m~ Authorized S~"g'fi"ature and Date ROBERT E. HERRMANN COASTAL MANAGEMENT SPECIALIST APPLICANT'S PROJECT DESCRIPTION (For ZBA Reference) Applicant: BARBARA & JOSEPH ISABELLA Date Prepared: AUGUST 28, 2006 1. For Demolition of Existing Building Areas Please describe areas being removed: EX~STING DECK, SLATE & CONCRETE WALK. I 1. New Construction Areas (New Dwelling or New Additions/Extensions): Dimensions of first floor extension: +/-5.5' (FRONT PORCH) Dimensions of new second floor: +/- 26.3' x +/40.1' Dimensions of floor above second level: N/A Height (from finished ground to top of ridge): +/-30' Is basement or lowest floor area being constructed? If yes, please provide height (above ground) measured from natural existing grade to first floor: NO 111. Proposed Alterations or Interior Structural Changes without enlargement/extension (anaeh extra sheet if necessary) - Please describe building areas: Number of Floors and General Characteristics BEFORE Alterations: ONE-STORY Number of Floors and Changes WITH Alterations: TWO STORIES IV. Calculations of building areas and lot coverage (from surveyor): Existing square footage of buildings on your property: +/- 1,222 S.F. Proposed increase of building coverage: +/-380 S.F. Square footage of your lot: 13,559 S.F. Percentage of coverage of your lot by building area: +/-11.8% V. Purpose of New Construction Requested: SECOND STORY ADDITION & PORCH. VI. Please describe the land contours (flat, slope '/o, etc.) as exist and how it relates to the difficulty in meeting the code requirement(s): N/A Please submit seven (7) photos, labeled to show all yard areas of proposed construction after staking corners for new construction), or photos of existing building area to be altered (area of requested changes). (PHOTOS OF EXISTING DWELLING ATTACHED - BECAUSE VARIANCE REQUESTED DUE TO PROPOSED CONSTRUCTION OF 2ND STORY 7/2002; 2/2005; 1/2006 ADDITION OVER EXISTING, NON-CONFORMING, ONE-STORY DWELLING, STAKING IS NOT APPLICABLE.) ? / TRANSACTIONAL DISCLOSURE FORIVl The Town of $outhgld's Code of Ethics prohibits conflicts of interest on the Bart of Town offioers and em~lovecs. The pumese 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. (Last name, first name, middle initial, unless you arc applying in thc name of someone else or other entity, such as a company. If so, indicate the other person or company name.) NATURE OF APPLICATION: (Check all that apply.) Tax Grievance Variance Change of Zone Approval of Plat Ex~nption fi.om Plat or Official Map Other If "Other", name the aetivfl/y: Do you personally, (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of $outhold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which thc 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 / If you answered "YES", complete the balance of this form and date and sign where indicated. Name of person employed by the Town of S outhold: Title or position of that person: Describe that relationship between yourself (the applicant) and thc Town officer or employee. Either check the appropriate line A through D (below) and/or describe the relationship in the space pro,Aded. 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 PROJECT I.D. NUMBER 817.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I -- PROJECT INFORMATION (To be completed by Applicant or Project sponsor) I APPLICANT/SPONSOR: I 2. PROJECT NAME I BARBAKA & JOSEPH ISABELLA BY EH-CONSULTANTS, INC. 3 PROJECT LOCATION: Municipality MATTITUCK County SUFFOLK 4 PRECISE LOCATION (Street address and mad intemections, prominent landmarks, etc, or provide map) SEQR 1855 WESTVIEW DRIVE, MA I'J'J'H3CK, TOWN OF SOUTHOLD; SCTM #1000-107-7-6 ISPROPOSED ACT, J~ New L~ Expansion [] ModlflcaflonlaReraflon DESCRIBE PROJECT BRIEFLY: CONSTRUCT A SECOND-STORY ADDITION OVER AN EXISTING ONE-STORY DWELLING; REMOVE EXISTING DECK AND CONCRETE WALK AND CONSTRUCT A 10' X 38' DECK AND (2) SETS OF STAIRS; REMOVE EXISTING STOOP AND ?.ONSTRUCT NEW PORCH AND STEPS; AND INSTALL A DRAINAGE SYSTEM OF DRYWELLS, ALL AS DEPICTED ON rile SITE PLAN PREPARED BY JOSEPH A. INGEGNO, LAST DATED JANUARY 12, 2006. 7. AMOUNT OF [AND AFFECTED Initially 0.311 acme Ultimately 0.311 .acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [~Ye$ [] NO If NO, describe briefly PROPOSAL CLOSER TO THE PROPERTY LINE THAN WHAT CODE ALLOWS. 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial [] Agriculture [] Park Forest/Open space [] Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yea [] NO If yes, list agmlcy(s) and permit/approvals DEC, SOUTHOLD TRUSTEES, SUFFOLK COUNTY DEPARTMENT OF HEALTH 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? []Yea [] No If yes, list agency name and pemMt/approval DEC TW #1--4738-03077/00007; SOUTHOLD TRUSTEES #6222, AND SUFFOLK COUNTY DEPT. OF HEALTH - RESIDENITAL. 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? []Yes []No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE ApplicantJaponaor name ROBER~HERRMANN, COASTAL MANAGEMENT SPECIALIST DATE AUGUST 28, 2006 Signature: .-4~ ~ If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment OVER PART II- ENVIRONMENTAL ASSESSMENT (To be completed by Agency) DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes. coordinate the review process and use the FULL lEAF DYes DNo WILL ACTION RECEIVE COORDINATED REVIEWAS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR. PART 617.6? If no, e negative declaration may br~ supersededr.b..~ another involved agency, I lYes L.JNo C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING, (Answers may be handwritten, If legible) C1. Existing air quality. Surface or groundwater quality or quantity, noise levels, existing traffic patteme, solid waste production or dlepceal potential for erosion, drainage or flooding probtamel Explain bdafiy: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources: or community or neighborhood character? Explain briefly: C3. Vegetation of fauna, fish, shal]flsh or wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain bdefiy, C5. Growth, subeeguent development, or related activities likely to be induced by the proposed action? Explain bdefly. C6. Long term. snort term, cumulative, or other effects not identified in Cl-C57 Explain briefly. C7 Other Impects (including Changes in use of either quantity or type of energy)? Exptain bdefly. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CEA? IS THERE, OR IS THERE LIKELY TO SE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL iMPACTS? r-lNo If Yes, explain briefly PART III- DETERMINATION OF SIGNIFICANCE (To be Completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial, large, important or otherwise significant. Each effect should be assessed in connection with Its (a) setting (i.e. urban or rural), (b) probability of occurring; (c) duration; (d) irreversibility; (c) geographic scope; and (f) magnitude, if necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have boon identified and adequately addressed. If- question D of Part 11 was checked yes, the determination and signiticance must evaluate the potential impact of the proposed action on the environmental characteristics of the CEA. [] Check this box if you have identified one or more potentially large or significant adverse impa, cts which MAY occur. Then Proceed directly to the FULL EAF and/or prepare a positive declaration. ' [] Check this box it 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 AND provide on attachments as necessary, the reasons support ng th s determination: Tax ~ice &~v PROPOSED SEPTIC SYSTEM DETAIL (NOT TO SCALE) \ % SURVEY OF PROPERTY ~ SITUA TED A T \ %% MATTITUCK % OF ~ ~ SUFFOLKCOUNTY, NEW YORK ~ ~ % ~ / S.C. TAX No. 1000-107-07-06 ~2/~o~,s ~ ~ ~1, % · .. ~ SCALE 1":20' cABOLz~' 0NIS ~SAg" ~ . ~ ~ ~ JUNE 17, 2002 ~'- O~ZUU~G~ ~ / ~ ~ ~] ~ AUGUST 18, 2005 UPDATE SURVEY FOR DOCK ,us~S ,~.uc ~ ~ ,~ Tn ~ JULY 7, 2005 ADDED PROPOSED ADDITIONS ~ ' ~ - ~ ~i ~ t ~ ~ ~ ~ ~ JANUARY 12, 2006 ADDED TEST HOLE, SPOT EL~ATIONS ~.% ~,~o~ / ~, ~ ~ ~ ~, ~ ~ ~ '~ & PROP, SEPTIC SYSTEM )~ ~/ ~ ~ ~ t, ~._~z ~ ' ~ ~ g ~ ~ ~ CERTIFIED TO: ~ ) ' ~ ~ ~, . ~ ~ JOSEPH ISABEL~ 1 TANK; 8' LONG, 4'-5" WIDE, 6'-T' DEEP ~..O.OS~9 DESCRIPTION AREA x LOT COVERAGE HOUSE 1,055 sq. fi. 7.78~ DESCRIPTION AREA X LOT COVERAGE HOUSE 1,055 sq. fl, 7.78~ FRONT STOOP W/STEPS 100 sq. fl, O./A~ DECK SSO sq. ff. 2.80% STEPS 67 sq. ft. 0.49% EXIST. DRIVEWAY 715 sq. ft. 5,27% TOTAL PROPOSED 2,317 sq. fl, 17.08% PROPOSED LEACHING POOl ~ PROPOSED SEPTIC TANK 5. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. 6. THE EXISTING SEPTIC SYSTEM SHALL BE PUMPED CLEAN AND EITHER REMOVED OR FILLED WITH CLEAN SAND AS PER S.C,D.H.S, SPECIFICATIONS. SEPTIC TANK (1) MiN 4" dfc. TOP EL APPROVED PIPE LEACHING POOLS (2') TEST HOLE DATA THE EXISTENCE Of RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, If No, 49658 Joseph A. Ingegno Land Surveyor PHONE (651)727-2090 Fax (631)727 1727 22-222]}