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TR-7710
Michael J.Domino,President *rjf SU(/j�o Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O. Box 11 Glenn Goldsmith [ Southold,New York 11971 A. Nicholas Krupski G � O Telephone (631) 765-1892 Greg WilliamsO Fax(631) 765-6641 �yc4UfdT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: r-2, i / Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED BY: �� l/" I Ile C MENTS• �� C",? 5 Qf jP(CIA 5 r CERTIFICATE OF COMPLIANCE: �"� SS✓.� Michael J.Domino, President �QF S (/j Town Hall Annex y� John M.Bredemeyer III,Vice-President 54375 Route 25 ,`O lQ P.O. Box 1179 Glenn Goldsmith [ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 OOUNT`I,N ' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE #.1605C Date: August 7, 2019 THIS CERTIFIES that the as-built 36'x17' swimming pool and 710sq.ft. patio; pool fencing, install a dry well Q01cu.ffl. for pool backwash; connect roof leaders to the da3yell; and install native plantings consisting of 16 sweet pepperbush(Clethra ainfolia)and 6 inkbe!U bushes(Ilex gabra), to be installed 6' o/c at the existing clearing limits; At 4321 Brooks Point Road,Fishers Island Suffolk County Tax Map#1000-4-5-18 Conforms to the application for a Trustees Permit heretofore filed in this office Dated,November 22,2011 pursuant to which Trustees Wetland Permit#7710 Dated January 18, 2012,was issued and Amended on April 17,2019 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the as-built 36'x17' swimming pool and 710sg.ft. patio; pool fencing,install a dry well(301cu.ft). for pool backwash; connect roof leaders to the ddr well; and install native plantings consisting of 16 sweet pepperbush(Clethra ainfolia)and 6 inkberry bushes (Ilex gabra),to be installed 6' o/c at the existing clearing limits. The certificate is issued to David Scott Ketner owner of the aforesaid property. Authorized Signature Cantrell, Elizabeth From: Richard Strouse <rstrouse@cmeengineering.com> Sent: Tuesday, August 6, 2019 11:06 AM To: Cantrell, Elizabeth Subject: FI visit Attachments: 2018811 REC 2019-05-29-2019.pdf Good morning Elizabeth- You may recall the Trustees approved a plan for Scott Ketner a few months ago. I have attached a pdf of the final plan. The Trustees visited the site with me last August. Glenn Just filed an application and attended the Trustee meeting. The only work done since the site visit is the plantings that were required by the NYSDEC and show on the plan. Mike Verity is requesting that the Trustees make a final site visit(maybe on the list for tomorrow already). He realizes it's short notice for tomorrow but the Ketner property is adjacent to the Main Road and they will be going by. Sorry for the short notice. If tomorrow doesn't work please make sure it's on the list for the next trip. Dick Richard H. Strouse, P.E.L.S. CiT19 Email:rstrouse@cmeengineering.com .�: 33 Wilbur Cross Way,Suite 105, PO Box 535 1 Mansfield,CT 06268 T 860.885-1055 ext.2118 1 C 860-377-9340 www.cmeengineering.com ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i • i � I ' r1 J C d TEST HOLE DATA £ \ �e-s rr>< ,�"• d o E c PUC,MAY 19,1994 O"-9"TOPSOIL \ / \ a.: �'"'' W -- -11 SANDY SUBSOIL - SITE '°m W Q m o o E 22"-168"SANDY TILL Vi/BLDRS \ s _ 168"-192" COARSE SAND ROAD '�'� 1176, \ -�^A a o1= 3 VOLS �a-e O N 11448 5 78'33'00•W\ Hpgp \\ fn y E n N/F easel¢ 294' E MERRITT MGDONOU6H FIG1i1T A= A=73 is 1005fi cu S _ --___—^_____t`` FRONT YARD e 13 SEVARIANCE A TBACK— B C TH w i APPROXIMA .'C` I TE LOCATION OF- GRANTED UNDERFROUND URUTES _ -s _�c 2 i NS'e\ \ p .� _ Rg6e� DRWE STONEtj P 00 . DRY DRY WELL-ROOF LEADERS CONNECTED Q \ LOCATION MAP SCALE 1"=400' �`+Y y 20 PIPE TO \ DRY NF3J. SIDE YARD' -------- -- - _---_-- IAWN I FRONT YARD SETBACK \ WALL • ,..,-Y'v�� 'r.��".,:_. POOL \ SETBACK \ �,'iT'Y-•"""- 0 CATS W EOUIP E MENF. \ 3 �$ EXISTING CLOSUR G POOL �'. -+ EXISTING �l 16 r... i eY \ FENCE 0(J •U_•,.,-"""" ® O O 9p LAWN `-• `..:%:H `fad•-• \ N/F �X 50 2 '!^ STEPHEN A GOOK d APPROXIMATE R �- ® SNO r,...`�4C }� 0_ \\ \\ CYNTHIA P GOOK LIMITS OF a 0 0 Sp 3-INKBERRY(Ilex globs)- `� CLEWING r"r� f PLANTED WITHIN FENCED AREA (20 11) 1'rr,m_�Yr+'^"MM `JC J5� `JG \ \ - BATES J-INKBERRY(gex gl bra)- //` YYJJ F e J)F PLANTED WITHIN FENCED AREA CURRENT sl7 v CLEARING -1 �0 .1 ' 1 1)THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED UMITS iSF 17-SWfiEIPEPPFR SUFI- J3F 2018) naF 4 ea I I BEETN£EN THE CLIENT AND THE SURVEYOR OF THE USE YE%CEEDSD THE THEPURSCOPEOF�7HE0 (geNra zdnifdla)5't 0/C f J, PLANTED AT E)QSTING t A/ I I ENGAGEMENT CLEARING UMITS-SLOPE TO / REMAIN UNMAINTAINED I 2)IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR,TO °I SEPTIC LOCATION TIES ALTER AN ITEM IN ANY WAY Ld (n 11/15/99 4 / 3)ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S U p Y Z JOF 1-A= 1450' 2-A=6400' �• SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF Z O O .{ THE LAND SURVEYOR d w } _ 1-C= 15 83' 2-C=54 00' 4)COORDINATE DISTANCES ARE MEASURED FROM U S COAST AND GEODETIC m¢0 1,a0 3 Z LIMBS OF FRESHWATER WETLANDS- a O— DELINEATED BY SP LORENCE 11-27-90 1-D=3425' 2-D=4450 b SURVEY TRIANGULATION STATION'CHOCOMOUNT 2' ZO 1 0 O Z J i SIC 1-E=3300' 2-E=3125' a J VERIFIED BY G JUS(08-24-11 2�. 5)SITE IS IN THE TOWN OF SOUTHOLD.COUNTY OF SUFFOLK TAX MAP 1000, Q W Lr<.I to Ip ssf / SECTION 004,BLOCK 5,LOT 16 00 4 YO �g IRON PIN 6)TOTAL AREA=1 67t ACRES W C)00 In `� / 7)SITE IS LOCATED IN R-120 ZONE. Z D_LLI m mIn FRONT YARD W J Of ,G 2eF SETBACK REAR YARD // LL 0 SETBACK / 1 ZF O // �Ic 22F ti 021 P / S k O. P �D'� / PROPERTY LINE Z ABUTTERS ULEGEND F 15F kg, a / NE -- / O N EDGE OFPAVELIENT _ wo ?� EDGE OF GRAVEL ___________________ tO O STONE WALL _ NyrI � FRESHWATER WETLANDS v ` A > ]L `JG ]C SIL STEPHEN A GOOK d 5 TREE LINE CYNTHIA P GOOK OVERHEAD WIRES ro w P / NOW OR FORMERLY NSF UTILITY POLE BOUNDARY POINT O MERESTONE ■ z - 1 // H / - / DATE 05/23/2019 _ -SCALE 1" = 20' QUALITY CONTROL CERTIFICATION - / / PROJECT #2018811 GROUP REVIEWED DATE SHEET 1 OF 1 1Y, Y i J. M.0. Environmental Consulting Services June 3, 2019 E C E VE Mr. Michael Domino, President Board of Town Trustees JUN , 0 2019 Town of Southold, Town Hall Annex Southo/d Town 54375 Route 25 Boar of Trus P.O. Box 1179 Southold, NY 11971 Re: Wetland Permit No. 7710, David Scott Ketner 4321 Brooks Point Road, Fishers Island S.C.T.M.No. 1000-4-5-18 Dear Mr. Domino: Enclosed please find are the fmal plans for this project which depict the location of the existing swimming pool, patio, recent plantings, the dry well with roof leaders connected, pool equipment and pipe to dry well. We have also enclosed a copy of the statement for the plant material which was purchased to restore the site as well as photographs of the recent plantings. Please feel free to contact me with any questions or comments that you might have. Respectfully, Gle . Just Phone (631) 653-0607 • Email Gjust10215@aol.com 121 Jessup Ave 9 2nd Floor • P.O. Box 447 Quogue, New York 11959-0447 Bill of Lading /'P' acking. Slip i , • i PridesCorner Farms,Inc Page: 1 of 3 122 Waterman Rd Sales Order Number. '500508941 i Lebanon,CT 06249 Shipment Date: 5/10/2019 s (800)437-5168 11 Shipment No.: WS0006217 ! Sell to Ship To: R.G C,EVERGREEN LANDSCAPES INC R.G.C.EVERGREEN LANDSCAPES INC PO BOX 219 PO BOX 219 j FISHERS ISLAND,NY 06390 FISHERS ISLAND,NY 06390 s USA !! USA i; Ph.(631)788-5655 SalesPerson 1002-BT Shipping Agent' )IM GROVER Customer ID C001868 Term's 2%30 NET31 Shp.Agent Service P.O.Number Elig.for . Total Item No. Item Barcode Size Description Shipped Ordered Discount Price Price 1003166! 724529340484 3/3. ACER X FREEMANI'AUTUMN BLAZE' 3 3 Y 430.00 1,290.00 It 5" 1007353!; 724529588114 8" CLEMATIS'HYDE HALL', 3 3 Y 1595 47.85 1001949!', 724529267903 #5 CLETHRA ALNIFOLIA 25 25 Y 29.50 73750 10017571; 724529251926 #3 CLETHRA ALNIFOLIA'RUBY SPICE' 25 25 Y 18.00 450.00 1003862;i 724529399536 25/ CORNUS KOUSA 1 1 Y 275.00 . ? 275.00 ri 1002239 724529285433 #5 CUPRESSOCYPARIS X LEYLANDII 5 5 Y 2783 139.15 ! 1010064 , 724529674688 8" DELPHINIUM NEW MILLENIUM'MINI 12 12 Y 9 00 108.00 STARS' "x 1001888 I 724529263592 . #1 HOSTA'BIG DADDY' 24 24 Y 525 12600 1007513 "' 724529593248 #3 HYDRANGEA M'ENDLESS SUMMER' 12 12 Y 2075 24900 i I 1001516 'i 724529230068 #5 HYDRANGEA M'NIKKO BLUE' 12' 12 Y 27.50 330.00 1009012 724529645886 #3 HYDRANGEA M'ZORRO' 6 6 Y 21.79 130.74 1006673 4; 724529566280 #3- HYDRANGEA QUE.•GATSBY'S STAR 9 9 Y 22105 19845 ` ! 1001866 a1 724529262366 #3 ILEX GLABRA'DENSA 6 6 Y 2153 129.18 1001993 !;724529270569 #3 ILEX VERTICILLATA'SOUTHERN 2 2 Y 22.55 45.10 GENTLEMAN' 1001926 '1,724529265756 #10 ILEX VERTICILLATA'WINTER RED' 18 18 Y ' 65.00 1,170.00 1008928 ;!724529643004 8" LAVANDULA ANGUSTIFOLIA'BIG TIME 12 12 Y 10.25 12300 BLUE' f CSC D ��n JUN 1 0 2019' . . Southold Town I Board of Trustees x • • Bill ®f Lading Packing Slip. Prides Corner Farms,Inc. Page: 2 of 3 122 Waterman Rd Sales Order Number: 500508941 I Lebanon,CT 06249 ,i Shipment Date: 5/10/2019 (800)''437-5168 Shipment No.: WS0006217 i Sell to: Ship To: I R.G.C.EVERGREEN LANDSCAPES INC R.G C EVERGREEN LANDSCAPES INC PO BOX 219 ttPO BOX 219 j FISHERS ISLAND,NY 06390 FISHERS ISLAND,NY 06390 USA li USA Ph (631)788-5655 i Salesperson 1002-BT Shipping Agent JIM GROVER Customer ID C001868 1 Terms 2%30 NET 31 Shp.Agent Service P 0.Number Elig..for Total Item No. Item Barcode Size Description Shipped Ordered Discount Price Price 1000933 724529203215 #1 LAVANDULA ANGUSTIFOLIA'HIDCOTE' 48 48 V 7.00 336.00 � 1s 1001343;� 724529214211 #1 LEUCANTHEMUM X SUPERBUM'BECKY' 12 12 Y 525 63.00 s 1003129 724529334407 #7 LIGUSTRUM OVALIFOLIUM 24 24 Y 43.00 1,03200 101140811 MALUS.DONALD WYMAN 3/3.5 3 3 1004286jj 724529429356 #10 MYRICA PENSYLVANICA 4 4 Y 7613 304.52 i 1001847�j 724529261079 #5 MYRICA PENSYLVANICA 25 25 Y 27.50 j'e"' 687.50 10025321- -17, 724529303168 #1 NEPETA'WALKER'S,LOW' 24 24 Y, 5.25 `S 126.00 ' 10067601 724529569274 #1 NEPETA F.'CAT'S MEOW 12 12 Y 650 '.' 7800 1003961 ;i 724529408849 #3 PAEONIA'SARAH BERNHARDT'-PINK 6 6 `f 1523 9138 1009936 % 724529672011 #3 PAEONIA LACTIFLORA'ALLAN ROGERS' 6 6 Y '15.75 94.50 "F (WHITE) 1002038'1" 724529272273 #3 PRUNUS MARITIMA 20 20 Y 18.00 360.00 1010596 724529686049 #10 RHODODENDRON'GOMER WATERER' 10 10 Y• 99.50` 995.00 1000352 ;= 724529122080 #10 RHODODENDRON'CAT.'ROSEUM 10 10 Y 78.50 785.00 i ELEGANS' 1004474 724529449101 #1 ROSMARINUS'SLUE SPIRE' 6 6 Y 6.83 40.98 1000674 i; 724529135929 #1 SALVIA'MAY,NIGHT' 12 12 N 4.15 49.80 1001991 �'724529270316 #1 SALVIA'SNOWHILL' 12 12 Y 5.25 6300 f 1007092 '724529581047 #5 SYRINGA'MAIDEN'S BLUSH' 6 6 Y 3098 185.88 ; � I ' E i ' JUN 1 0 2019, ', - Scutholci,nw,n Bill of Lading / Packing Slip Pride's Corner Farms,Inc Page: 3 of 3 S 122 Waterman Rd Lebanon,CT 06249 Sales Order Number' 500508941 I Shipment Date. 5/10/2019' (800);437-5168 Shipment No. WS0006217 Sell t6: Ship To: R.G C EVERGREEN LANDSCAPES INC R.G.C.EVERGREEN LANDSCAPES INC PO BOX 219 PO BOX 219 FISHERS ISLAND,NY 06390 FISHERS ISLAND,NY 06390 r USA E; USA Ph (631)788-5655 Sale'sPerson 1002-BT Shipping Agent JIM GROVER- Customer ID C001868 i Terms 2%30 NET 31 -Shp.Agent-Service P.O.Number - Elig.for Total 1 Item No. Item Barcode Size Description Shipped Ordered Discount Price Price 1004176 724529422678 #3 SYRINGA X BLOOMERANG'PURPLE' 6 6 Y 22.84. 13704 1003803 724529393800 8/9' THUJA X'GREEN GIANT' 6 6- Y 29500 1,77000 1000087 724529112814 #3 VACCINIUM CORYMBOSUM'BLUE RAY' 6 6 Y 1995 119.70 i 1000087„ 724529112814 #3 VACCINIUM CORYMBOSUM'BLUE RAY' 6 6 Y 19.95 11970 i 1006459;1 724529558971 #3 VIBURNUM DENTATUM'BLUE MUFFIN' 9 9 Y 18.59 ^. 16731 I NET #+, i FREIGHT 1 1 Y 840.00 ?P, 840.00 I v + iD _ 1D JUN 1 0 2019 , Southold Town ;1 Bad of Tr You may deduct$262 11 if you pay Subtotal: Invoice Discount: Total Sales Tax: Total: with in.'terms. 13,995.28 13,995.28 (NUMBER OF CARTS LEFT W-1-TH/ CUST®MER. If no carts�are'left,�u'a zero on the line. I;STATE OF CONNECTICUT_ I - It is agreed that all items listed above have been received in good condition°Any claims for any Nursery Inspection Cert.No 49112.This is to certify that the discrepencies in quantity or quality must be noted'above with the reason for the discrepancy All nursery stock of PRIDES CORNER FARMS INC.LEBANON,CT claims not noted above must be reported in writing to Prides Corner Farms'office within 5 days has been inspected and found apparently free from :of r,-rpint. I dangerously injunous insects and plant diseases Kirby C Staffofd III-State Entomologist Sighed ;� White-PCF-Accounting Copy Yellow-Driver Copy Pink-Customer Copy s � Ketner - 4321 Brooks Point Road - Fishers Island May 23, 2019 S... ,{���_ - � �•ice - r�. �.! C"i �� •',n,1. mss,,. ♦� - `� , � _ F o ' � r _ S Ketner - 4321 Brooks Point Road - Fishers Island May 23, 2019 r i 11 Jill! IN EC [ V I Jt�N 1 0 2019 southaJ Tcavn Ketner - 4321 Brooks Point Road - Fishers Island May 23, 2019 i y, u;+ 1 s- u 1 2 �>� 3 / JUN 1 0 2019 So",. did Town Boar'of ins es Ketner - 4321 Brooks Point Road - Fishers Island May 23, 2019 t ' _ qf r JUN 1 0 2019 ScOhold Town oar o —ru tees Z to- 13-39 18 j 13-3A 13-2 12-10 V 17-1 to-tA � ^J 12-1tB 1z- 12-9 L.L TEST HOLE DA►TA� \ \ 15-50 13-3C �12-IIAE DUC MAY Ir-1, Igg4 N 16-3 N ° U 16-4 16-2 �� s ° 13-4 =' = SYS LL O a) LOT 1 W Q) N CO Sfi�NDY SUBSOIL GEULA G,9aA (n v c v n°, 22"-I rob" SANDY TILL A/ BLDRS. +�,� SITE SUBDIVISION W Q � o ° 16_1 LOT SUBDIVISION Q) CL 16-s: E 168"-Iq2" COARSE SAND ROAD ��' e/,�j 16-7A > a(J 16-78NO m in n s FISHERS ISLAND LOT a LOT 3 O .� W N S 7833'00* W OWATER WORKS SUBDIVISION SUBDIVISION U) �+ � 0 W N 114.46 ,9a+ ,961 H) ; o r rn N / P E g52.12 2.94' OD POLE 1 - Nl \ ,6-g N E. MERRITT MGDONOUGH �B95 i 16-,0 a L cf)� 00 � MONUMENT A = 73.15' l `� A = 100.56' �� W QL PORTION y !� 16-12 s 14-2,6146-3 =� U 16-11 PORTION a N 1O \\ WU ' ,;! 5-7. 15-12 _ D I \ i `�Q?�\ \ � 16-,3 ORTION 15-6. J FRONT YARD 1 �\ ��� O 15-7. 15-12 SETBACK- Poanow C w 1 i VARIANCE A B TH N i APPROXIMATE LOCATION OFA`- -� r � \ �O \ � a- -6 ------- , // 15-6 15-4 15-1 GRANTED 1 UNDERGROUND UTILITIES 15-3 \ \� -7-3 r1 N �-- 1s-s, S E #L, // SW4 0 � G1 _`�_ PORTION 15-11 PORTIOw 4-7-14 .. M/ r;... —— � STONE >JRN� wE ��• 250*/y ° � as,1. _ —— �qp l 1 .. WF�pl ������ POL\ `� THE NATURE .:::::::::::::::::::....::::::::::::::::::::::::::.:.:: -- \ CONSERVANCY DRY WELL- ROOF X894 \ -� LEADERS CONNECTED � � GLOCATION MAP SCALE 1 =40 : C �� x—�- \020. PIPE TO DRY WELL SIDE YARD ---- LAWN FRONT YARD h� °\ SETBACK ` WALL POOL M SETBACK ....... . GATE W/ EQUIP ENTry _ 0 EXISTING POOL 1v CLOSURE C6°', WLF EXISTING 36' ISA �,► 49 \ \ FENCEPal s 0 �+ h M LAWN ,...,.. _;.:.,...., . , WLF N/I= ® EXISTING}...:.:',' :':::' �X so.7 a"� 4 cp. \ STEPHEN A. GOOK . 5� ..:. .....:'::':':'::: :.::. WL CYNTHIA P. GOOK APPROXIMATE I y ® ` 47 \ LIMITS OF .., Sp 3- F INKBERRY (Ilex glabra)- \ CLEARING �"� �*"' 50F PLANTED WITHIN FENCED AREA 46F 45 \ WLF (201 1) yY� Y 38 3-INKBERRY (Ilex glabra)- r 1+ S' 39 ' LWF PLANTED WITHIN FENCED AREA CURRENT �� 33F o CLEARING WL 41 WLF WLF 40 )�c 1. THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED I ' ^ LIMITS 34 17-SWEETPEPPER BUSH- 32 WL WLF HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSE AGREED TO WLF 2018) 3LF (gethra alnifolia) 5'f 0/C 42 44 I I BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE 36 PLANTED AT EXISTING I ENGAGEMENT. CLEARING LIMITS- SLOPE TO REMAIN UNMAINTAINED 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, 31F ' UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY. SEPTIC LOCATION TIES W (n 11/15/99 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR'S U C) WLF �,�, SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF Q 30 1-A= 14.50' 2-A= 164.00' `�o, THE LAND SURVEYOR. z O O _ 1-B= 14.30' 2-8= 58.59' 0- W m00 t_ 1-C= 15.83' 2-C= 54.00 WLF 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC 0 H z LIMIrS OF FRESHWATER WETLANDS- 1-D= 34.25' 2-D= 44.50' 43 SU2VEY TRIANGULATION STATION "CHOCOMOUNT 2" O —'^ Z W DELINEATED BY S.P. LORENCE 11-27-90 11 1-E= 33.00' 2-E= 31.25' .0 Oz V J O OO Z Q VERIFIED BY G. JUST 08-24-11 �, 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAP 1000, 1- uj —J IRON PIN 4sF / SECTION 004, BLOCK 5, LOT 18. C) Q �/Y z 6.) TOTAL AREA = 1.67f ACRES. LLiN O U (n ct� FRONT YARD 7.) SITE IS LOCATED IN R-120 ZONE. Z a W m 0' WLF SETBACK // 04 m 0 28 REAR YARD SETBACK d- LL- SIG WLF ss / WLF 23 27 SIG 2F SIG F WLF �L 0 Q } 0 26 o j .. `\ • LEGEND cn z a 45 F /'�O� PROPERTY LINE Z (LSIC WLF ulb / ABUTTERS LINE —— 21 / EDGE OF PAVEMENT U) EDGE OF GRAVEL ------------------- TO�+ STONE WALL N/F / FRESHWATER WETLANDS wF# > STEPHEN A. GOOK 4 C-7 / TREE LINE w CYNTHIA P. GOOK A. OVERHEAD WIRES o/w r � W NOW OR FORMERLY N/F o UTILITY POLE -O- 20F / BOUNDARY POINT O / MERESTONE ® o z WLF 3 18F -o W7 / Q F- N Q W Cf 03 00 00 N (f) � � � m L— G✓ I ON ° Z (, w li C) C) t� L� A DATE: 05/23/2019 JUN 1 0 2019 fi SCALE: 1 " = 20' Sxith�M Town QUALITY CONTROL CERTIFICATION ° PROJECT: #2018811 GROUP REVIEWED DATE PROJECT MANAGER SURVEY SHEET ENVIRONMENTAL CIVIL 1 OF 1 STRUCTURAL ARCHITECTURAL Michael J.Domino,President �QF so�Ty Town Hall Annex John M.Bredemeyer III,Vice-President ,`QOl0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 o�ycOUM`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 17, 2019 Glenn E. Just J.M.O. Environmental Consulting Services, P.O. Box 447 Quogue, NY 11959-0447 RE: DAVID SCOTT KETNER 4321 BROOKS POINT ROAD, FISHERS ISLAND SCTM# 1000-4-5-18 Dear Mr. Just: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April 17, 2019: WHEREAS, J.M.O. Environmental Consulting Services on behalf of DAVID SCOTT KETNER applied to the Southold Town Trustees for an Amendment to Wetland Permit #7710 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated February 5, 2019, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management'Practice requirements: the approval of this application, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 17, 2019, at which time all interested persons were given an opportunity to be heard, and, 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, BE IT FURTHER RESOLVED, that the Board of Trustees APPROVE the Amendment to Wetland Permit #7710 for the as-built 36'x17' swimming pool and 710sq.ft. patio in lieu of the originally permitted 30'x12' swimming pool and 550sq.ft. patio; install a dry well (301 cu.ft.) for pool backwash; connect roof leaders to the dry well; and install native plantings consisting of 16 sweet pepperbush (Clethra ainfolia) and 6 inkberry bushes (Ilex gabra), to be installed 6' o/c at the existing clearing limits; and as depicted on the site plan prepared by CME Associates Engineering, Land Surveying &Architecture, PLLC, dated May 22, 2018, and stamped approved on April 17, 2019. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: None Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd Michael J. Domino, President _ O��SVFFQ(�-C Town Hall Annex John M. Bredemeyer III, Vice-President �� GAJ, 54375 Route 25 Glenn Goldsmith o "� P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971- Greg Williams � �apR- Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: J.M.O. Environmental Consulting Services on behalf of DAVID SCOTT KETNER requests an Amendment to Wetland Permit#7710;for the as-built 36'x17' swimming pool and 710sq.ft. patio in lieu of the originally permitted 30'x12',swimming pool and 550sq.ft. patio; install a dry well (301 cu.ft.) for pool backwash; connect roof leaders to the dry well; and install native plantings consisting of 16 sweet pepperbush (Clethra ainfolia) and 6 inkberry bushes (Ilex gabra), to be installed 6' o/c at the existing clearing limits. Located: 4321 Brooks Point Road, Fishers Island. SCTM# 1000-4-5-18 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP 'OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: , I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Michael J.Domino, President OF SUUTy� Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G ' Q Telephone (631) 765-1892 Greg Williams 'O� Y Fax(631) 765-6641 Cou BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: )X411� ter, 10 l j Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: ,e COMMENT: CERTIFICATE OF COMPLIANCE: Z \ 18-18 13-38 13-3A 73-2 12-10 / 1 v 17-1 J 12-116 12-9 ■_ M33D TEST HOLE DATA \ 13-3C 12-11A co E 04 16-3 toU DUC MAY I c�, I c�c�4 18-4 18-2 •� 45 Vii Q" TOPSOIL '�4 = = � — r— 1= q"-22" SANDY SUBSOIL \ LOT 7 W r 22"-168" SANDY TILL W/ BLDRS. SUB 981IGNu /W/� ` 18-1 SITE GEULA SUBDIVISION V/ i CL � > I I68"—I�2" COARSE SAND 16-5 Q 0 ,00 ROAD ���� e/TG 16-7A 0 ' \ 21/ 18-8 U) s i6-7B R to N + f` a'L 18-e. .. o rn LOT 4 LOT 3 O = ` ` w W N O FISHERS ISLAND GEULA GEULA ,^ w` V T w M S 78"3300" W qQ WATER WORKS ,, SUB 98SION SUBDIVISION V+ W 2 0r - N 114.46 rv/'� — N / F E 952.12 2'94 \ POLE I 18-9 ■ �O N E. MERRITT MCDONOUGH - #sss I \ 16-10 Q i Co MONUMENT A - 73.15 \ 9A W (f) co co A = 100.56 PORTION 14-2. 14-3 16-12 \ 16-11 PORTIONcp X 4 �• _-�.-_-----`\ WU E / ,?,� \ —�—� 5-7. 15-12 e� J FRONT YARD D j �� � / 9?, \ .�1 \ ,s-13 115-7, 1TION 5 12 SETBACK- C (A I �� moi' 1%O 4-7-s PORTION 75-4 VARIANCE A B TH N i APPROXIMATE LOCATION OF��--_____- ,r \ �O \\ GRANTED UNDERGROUND UTILITIES N \ �_ 7-3 15-8, ,s-a 75-1 S E i #2 PORTION 15-11 PORTION 4-7-14 ONE pRNE w 2?SO` \ �`F� 45 -14 y —— NOTE AREA TO BE DISTURBED ,; �' // THE NATURE #1 €€i i WE w ��'� 205f SQUARE FEET (INSTALL POL\ 4-7-5 CONSERVANCY i PROVIDE DRY WELL) #894 \ _ DRY WELLLOCATION MAP SCALE 1 », / :; ... ` I :,:: CONNECT ROOF ,' CONNECT FILTER LEADERS R rte' D�NG .,` TO DRY WELL INSTALL SILT FENCE si l 20• ^`< - �\� CTION LAWNIN G h 3 / CONSTRUN 1 t r � SIDE YARD YARD SETBACK WALL .:,:::. :....:... ; ::. :.;:.....:. . / POOL M SETBACK J\ �Ci �� FRONThh GATE W/ EQUIPMENT, 3 +, k EXISTING POOL t, CLOSUREop �o�• \ WLF 36 LAWN F.:. 0 - a 548 -a 0.7 STEPHEN A. GOOK 4 rn EXISTING , 5 *rc`: PATIO WL CYNTHIA P. GOOK APPROXIMATE FENCE ' _ ` J/- � � 47 LIMITS OF �. SQA INSTALL SILT FENCE \ CLEARING -' WLF WLF WLF \ �'°� 50 MAINTAIN DURING 46 45 WLF (2011) '� � T + CONSTRUCTION WLF w7F CURRENT S� 3s \ \ NOTES 'p 37 CLELIMING ITS 2 WLF LANT 16-SWEETPEPPER BUSH- WLF 33F WL 41 I 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE INDICATED 40 (2018) wLF 34 (Clethra alnifolia) 6 0/C AT 32 WL WLF HEREON. ANY EXTENSION OF THE USE BEYOND THE PURPOSE AGREED TO 35 EXISTING CLEARING LIMITS 42 44 I I BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE PLANT 6-INKBERRY (Ilex glabra)- 3LF MINIMUM 3 GALLON STOCK- ENGAGEMENT. 6' 0/C WITHIN FENCED AREA NO CULTIVARS-SLOPE TO REMAIN I I MINIMUM 3 GALLON STOCK- UNMAINTAINED 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY PERSON, NO CULTIVARS �1/_ I UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO 31W�LF SEPTIC LOCATION TIES ALTER AN ITEM IN ANY WAY. w 11/15/99 / 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND SURVEYOR"S U p Y 3LF 1-A= 14.50' 2-A= 64.00' �;,ol� / THE LAND SIGNATURE ANDAN VEYOR. RIGINAL EMBOSSED OR INK SEAL ARE THE PRODUCT OF Z O O 1-B= 14.30' 2-B= 58.59' W Of >- LIMITS OF FRESHWATER WETLANDS- 1-C= 15.83' 2-C= 54.00' 43F 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND GEODETIC rY 0 F- GO 1-D= 34.25 2-D= 44.50 SURVEY TRIANGULATION STATION "CHOCOMOUNT 2" O —//'� Z ~ DELINEATED BY S.P. LORENCE 11-27-90 , Z Li ( J 0 O Z V_RIFIED BY G. JUST 08-24-11 1-E= 33.00 2-E= ;31.25 ,� CL O od.- 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX MAIP 1000, a W Q IRON PIN 0 WLF SECTION 004, BLOCK 5, LOT 18. X � LO Z / Q g 6.) TOTAL AREA = 1.67t ACRES. W p U (n SILT FENCE \� FRONT YARD 7.) SITE IS LOCATED IN R-120 ZONE. W mm Om w mw SETBACK — WOVEN WIRE FENCE (MIN. 14 2LF REAR YARD / Z w N = SPACING)GAUGE W/ MAX. 6" MESH SETBACK / 4- 10' MAX• CENTF 36" MIN. LENGTH FENCE �� Y I R TO CENTER POSTS DRIVEN MIN. 16"I INTO GROUND I WLF `SS• / WLF 23 27 24 F // S 219 /\ I HEIGHT OF FILTER = 16" MIN. Q 1 22 _ P6 D}p = �0 6" MIN. WLF ti� O 0 \ o, PERSPECTIVE VIEW F ,� LEGEND N o /•�° wLF �O PROPERTY LINE Z � WOVEN WIRE FENCE (MIN. 14 �� 25 WLF � // ABUTTERS LINE —— U z 1/2 GAUGE W/ MAX. 6" MESH 21 EDGE OF PAVEMENT _ w SPACING) WITH FILTER CLOTH N o EDGE OF GRAVEL ------------------- E V) 36" MIN. FENCE POST '�o� �, STONE WALL _ O UNDISTURBED a .` / d WF# FLOW— I) GROUND N/F FRESHWATER WETLANDS > STEPHEN A. GOOK C / TREE LINE w COMPACTED SOIL �� \\ Z OVERHEAD WIRES --- o/�^' - o �\ CYNTHIA P. GOOK Q' NOW OR FORMERLY N/F o 0 EMBED FILTER CLOTH �\���\�\\�\\\/ � o DRAdNAGE CALCULATIONS UTILITY POLE �- A MIN. OF 6" IN GROUND 4" 20F / AREA (ROOF- 720 sq. ft.) + (PATIO- 710 sq. ft.) BOUNDARY POINT O SEC110N VIEW / 1,430 SF X 1.0 X 2/12 = 238 CU. FT. REQUIRED MERESTONE ® o PROVIDE 1- 8'0 x 6' DEEP DRYWELL = ±301 CU. FT. Z WOLF CONSTRUCTION SPECIFICATIONS WLF W7 / PROPOSED ROOF LEADER 3 1. WOVEN WIRE FENCE TO BE FASTENED SECURELY TO FENCE POSTS WITH WIRE / RESIDENCE ~ v TIES OR STAPLES, POSTS SHALL BE STEEL EITHER "T" OR "U" TYPE OR 0 HARDWOOD. ¢ m D 2. FILTER CLOTH TO BE FASTENED SECURELY TO WOVEN WIRE FENCE WITH TIES co SPACED EVERY 24" AT TOP AND MID SECTION, FENCE SHALL BE WOVEN WIRE, 4" PVC WYE Go00 6" MAXIMUM MESH OPENING. OVERFLOW /� �l 00 oN to 00 3. WHEN TWO SECTIONS OF FILTER CLOTH ADJOIN EACH OTHER THEY SHALL BE / A PRO /E D BY m � E � � � I o OVER-LAPPED BY SIX INCHES AND FOLDED, FILTER CLOTH SHALL BE EITHER 4" PVC CUT _ FILTER X, MIRAFI 100X, STABILNKA T940N, OR APPROVED EQUIVALENT. TO LENGTH 6" SOIL BOARD OF 'I RUSTEES F- OLd 0 0 4. PREFABRICATED UNITS SHALL BE GEOFAB, ENVIROFENCE, OR APPROVED BLOCKS AND CATCH LLJU Z Z Z Ld Y w EQUIVALENT. BASIN GRATE TO GRADE TOWN OF SOUTHOLD O O 0 Q w 00 w 5. MAINTENANCE SHALL BE PERFORMED AS NEEDED AND MATERIAL REMOVED WHEN / FILTER FABRIC f (NEENAH R-2525-F) OR EQUAL o' O w o' = O w a m o o v v � "BULGES" DEVELOP IN THE SILT FENCE. / ° DATE Afm_ 1171 Zoll DATE: 05/22/2018 90' BEND � @ p 0 O 4" SDR 35 PVC ° ° ° '�-�,` SCALE: 1 " = 20' / SLOPE AS REQUIRED ° O OO OO OO O QUALITY CONTROL CERTIFICATION / __ 0 0 0 0 o PROJECT: #2018811 1" STONE OR p OO 0O 0O 0 , GROUP REVIEWED DATE SCREENED GRAVEL PROJECT MANAGER 1' 8' 1' SURVEY ENVIRONMENTAL STORMWATER DRYL DETAIL 10' WELSHEET CIVIL NOT TO SCALE 1 OF 1 STRUCTURAL ARCHITECTURAL OFFICE LOCATION: ®�xV S® MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) s� Southold, NY 11971 a� Telephone: 631 765-1938 ® Fax: 631 765-3136 c®UNTY,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: April 10, 2019 Re: LWRP Coastal Consistency Review for DAVID SCOTT KETNER SCTM#1000-4-5-18 J.M.O. Environmental Consulting Services on behalf of DAVID SCOTT KETNER requests an Amendment to Wetland Permit#7710 for the as-built 36'x17' swimming pool and 710sq.ft. patio in lieu of the originally permitted 30'x12' swimming pool and 550sq.ft. patio; install a dry well (301cuft) for pool backwash; connect roof leaders to the dry well; and install native plantings consisting of 16 sweet pepperbush (Clethra ainfolia) and 6 inkberry bushes (Ilex gabra), to be installed 6' o/c at the existing clearing limits. Located: 4321 Brooks Point Road, Fishers Island. SCTM# 1000-4-5-18 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, the proposed action is recommended as INCONSISTENT with the LWRP. 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of, Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction. 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The as-built construction does not comply with Wetland Permit 7710. The patio encroaches further into the setback to the freshwater wetland. The setback is not shown on the plans 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: Damon Hagan, Assistant Town Attorney gg+ fFO��-��� Peter Young,Chairman Town Hall,53095 Main Rd. cog Lauren Standish,Secretary d P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Mon., April 15, 2019 the following recommendation was made: D. SCOTT KETNER to Amend Wetland Permit #7710 for the as-built pool, patio and pool fencing, no leaders and drywell installed and no native plants were planted. Proposal to install a drywell and connect the pool filter to the drywell, connect roof leaders to the drywell and install native plantings. Located: 4321 Brooks Point Rd., Fishers Island. SCTM#4-5-18 The CAC did not make an inspection, therefore no recommendation was made. r 1 BOARD MEMBERS, , Southold Town Hall Leslie Kanes Weisman,Chairperson ��®� SO�jy�l 53095 Main Road-P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora y Office Location: Eric Dantes Town Annex/First Floor, Robert Lehnert,Jr. ® a� 54375 Main Road(at Youngs Avenue) Nicholas Planamento ��yCOUhnV Southold,NY 11971 _ http://soutboldtownny.gov fM 'A;-. _€ , RECEIVE® :} ` ! !' ZONING BOARD OF APPEALS TOWN OF SOLTTOI.l) + TmA(� 10'•53 RkXk 2019 Tel.(631)765-1.809-Fax (631)765-9064 NOV 2 0 2018J �I 1 Qje @��J2 �;,,�'{�;^ ,n mIN S,DELIBERATIONS AND DETERMINATION Ut MEETING OF NOVEMBER 15,201s ® 6t®Id Town clerk ZBA FILE: 7211 NAME OF APPLICANT: D. Scott 1Ketner PROPERTY LOCATION: 4321 Brooks Point Road,Fishers Island SCTM No. 1000-4-5-8 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. LWRP DETERMINATION: The relief, permit, or interpretation requested in this application is listed under the Minor Actions exempt list and is not subject to review under Chapter 268. PROPERTY FACTS/DESCRIPTION: The subject property is a 1.67 acre nonconforming parcel located in the R- 120 Zoning District. The property had two front yards, and a large portion of the property contains freshwater wetland areas which may not be disturbed. It is bordered to the south by a paved East End Road, which is a privately-owned extension of the Town Road named Oriental Avenue. The property is bordered on the east by another dirt road. In addition, the subject lot is bordered on the north by a gravel and dirt dead-end right of way which serves as a private driveway for both the immediate northerly neighbor on the developed 2.5-acre parcel (SCTM# 1000-4-5-19.5) and for the adjacent developed 1.7-acre parcel (SCTM # 1000-4-5-10). The property is improved with a single-family dwelling and an in-ground pool to the rear of the house. BASIS OF APPLICATION: Request for a Variance from Article III, Section 280-15 and the Building Inspector's June 15, 2018 Notice of Disapproval based on an application for a building permit to legalize an accessory in- ground swimming pool, at; 1) located in other than the code required rear yard; located at: 4321 Brooks Point Road, Fishers Island,NY.SCTM No. 1000-4-5-18. RELIEF REQUESTED: The applicant requests a variance to legalize an "as-built" accessory in ground swimming pool which is located in a yard other than the required rear yard. ADDITIONAL INFORMATION: As per testimony provided at the hearing by the applicant's attorney, the subject swimming pool was given permits by both the New York State Department of Conservation (NYSDEC) and the Southold Board of Trustees prior to its construction. The applicant's attorney submitted a site plan (unsigned and unstamped) prepared by CME Associates, et al, last revised April 23, 2012, and indicated that the subject site plan showing a 30 feet by 12 feet in-ground swimming pool located in the front yard was approved by the NYSDEC. Also, a copy of a site plan was submitted with a stamped approval by the Board of Trustees on May 8, 2012. The applicant never followed up with the Building Department to obtain the required building permits, and certificates of occupancy for the pool. The applicant is currently amending the pen-nits from both the NYSDEC and the Board of Trustees, as the pool was built to a slightly different size(36 feet by 12 feet)from the approved drawings. Page`2,November 15,2018 97211,Ketner SCTM No. 1000-4-5-18 The applicant's attorney submitted a Memorandum of Law dated November 1, 2018 which outlines the standards for granting area relief to his client, as well as an affidavit describing circumstances surrounding the hiring of professionals to design and construct the swimming pool. The Board received a letter dated October 22,2018 from the neighbors in support of the application. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on November 1,2018 at which time written and oral evidence were presented. Based upon all testimony,documentation, personal inspection of the property and surrounding neighborhood, and other evidence, the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law $267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. This accessory use is a permitted use. The pool has been in place with permits from the NYSDEC & Southold Board of Trustees for more than five years and there is no increase in traffic or noise. The setback of the accessory swimming pool from East End Road is 180 feet, and at least 100 feet from the road to the east and sheltered by the principal dwelling from the road to the north. 2. Town Law §267-b(3)(b)(2). The benefit sought by the applicant cannot if granted as applied be achieved by some method, feasible for the applicant to pursue, other than an area variance. The property has frontage on three streets, so it has three front yards. The topography, and the wetlands on the parcel restrict the applicant's ability to site the pool in a conforming location. Therefore, an area variance is the only option for the subject "as built" swimming pool. 3. Town Law $267-b(3)(b)(3). The variance granted herein is mathematically substantial, representing 100% relief from the code. However, the applicant is burdened with three front yards and substantial wetlands which severely limits a location for a swimming pool; the total lot coverage of the entire lot with the "as built" swimming pool &patio is only 3.5%where 20%is permitted; and there is no visible impact to any neighboring properly 4. Town Law $267-b(3)(b)(4). No evidence has been submitted to suggest that a variance to legalize an"as built swimming pool" in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code and comply with the conditions of the Board listed below. 5. Town Law $267-b(3)(b)(5) The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Lav $267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an accessory swimming pool while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-13, motion was offered by Member Lehnert, seconded by Member Planamento, and duly carried, to GRANT the variance as applied for and shown on the site plan prepared by Richard I-I. Strouse, L.S., of CME Associates Engineering, Land Surveying, and Architecture,PLLC, dated May 22,2018. Page°3,November 15,2018 47211,Ketner SCTM No. 1000-4-5-18 SUBJECT TO THE FOLLOWING CONDITIONS: 1. The applicant must apply to the Building Department for a building permit for the "as built" improvement(s)within 30 days of the date of this decision and submit same to the Office of the Zoning Board of Appeals,or submit a written request for an extension to the Board of Appeals setting forth the reason(s)why the applicant was unable to obtain a building permit in the time allotted. 2. The applicant must obtain a Certificate of Occupancy from the Building Department for the "as built" improvement(s) and submit same to the Office of the Zoning Board of Appeals within 6 months of this decision or submit a written request for an extension to the Board of Appeals setting forth the reason(s) why the applicant was unable to obtain a Certificate of occupancy in the time allotted. 3. The "as built" improvement(s)may not be used until a Certificate of Occupancy has been obtained. 4. At the discretion of the Board of Appeals, failure to comply with the above conditions may render this decision null and void. 5. Swimming pool mechanicals shall be placed in a sound deadening enclosure. 6. Installation of stormwater controls to include a drywell for swimming pool de-watering. 7. Prior to the issuance of a Certificate of Occupancy, the applicant shall submit updated permits to the Zoning Board of Appeals and the Building Department from the New York State Department of Conservation and Southold Board Trustees approving the 36 feet by 12 feet size in-ground swimming pool as depicted in site plan prepared by CME Associates, et al, dated May 22,2018. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variance(s) granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. In the event that this is an approval subject to conditions, the approval shall not be deemed effective until such time that the foregoing conditions are met; and failure to comply therewith will render this approval null and void. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity_ Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3)years from the date such variance was granted. The Board of Appeals may,upon written request prior to the date of expiration, grant an extension not to exceed three (3) consecutive one(1)year terms. Vote of the Board: Ayes: Members Weisman (Chairperson),Dantes, Acampora,Planamento and Lelinert. This Resolution was duly adopted (5-0). c Leslie Kanes Weisman Chairperson Approved for filing /� / �/� /2018 Environmental Consuking Services a P January 31, 2019 E C E V E . D Mr. Michael Domino, President FEB 5 2019 Board of Town Trustees Town of Southold °aid°T'''' '•E es Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Permit No. 7710, D. Scott Ketner 4321 Brooks Point Road, Fishers Island S.C.T.M.No. 1000-004-5-18 Dear Mr. Domino: At the present time we are seeking a modification for the as built pool and patio. On January 18, 2012 the Board issued this permit for the construction of a 12'x30' pool, 550 sq. ft. patio and required that gutters, leaders, a dry well to be installed and areas of disturbance to be planted with native vegetation. The as built conditions are a 36'x17' pool, a 710 sq. ft. patio and pool fencing, no leaders and dry well installed and no native plants were planted. At this time the permittee is seeking approval to install a dry well (301 cu. Ft.), connect the pool filter to the dry well, connect roof leaders to the dry well and install native plantings. The planting shall consist of 16 Sweet Pepperbush (Clethra ainfolia) and 6 Inkberry bushes (Ilex gabra). The plants shall be install 6' o/c at the existing clearing limits. For review we have enclosed 4 copies of the Phone (631) 653-0607 o Fox (631) 653-3348 121 Jessup Ave © 2nd Floor © P.O. Box 447 Quoaue,, New York 11959-0447 �0\ ti l J Applicant proposes to legalize existing pool (36'x17') and patio (7 10 sq. ft.) and fencing, to install a dry well (3 01 cu. ft.) connect pool filter to dry well, connect roof leaders to dry well, plant 16 sweetpepper bush (Clethra Anatolia) 6' o/c at existing clearing limits and plant 6 inkberry bushes (Ilex glabra) 6' o/c at existing clearing limits. project plans prepared by CME Associates last dated November 08, 2018. Upon the review please feel free to contact me at any time should there be any questions or comments. Respec V G enn E. Just Town of Southold L.WRP 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 Lazard 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 pMV2§qA gg ion will be evaluated as to its si ' cant bgnef icial.and adverse effects upon the coastal areawhirl 'includes all of"Southold Town . 1 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 anszve must be ex IaWd in ale€aii listing hoth su oIAn and non- suntDa inn facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertakcta. A copy of the LWRP is available in the following places: Online at the Town of Southold's website(southoldtown.northforkmet),the Board of Trustees Office, the Planning Department, all local libraries.and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION ScTmIZELO PROJECT N 4 The Application has been submitted to(check appropriate response): Town Board F-1 Pianning.Board El Building Dept F] Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital E] 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: At the present time we are seeking a modification for the as built pool and patio. On January 18, 2012 the Board issued Permit No. 7710, for the construction of a 12'x30' pool, 550 sq. ft patio and required that gutters, leaders and a dry well to be installed and areas of disturbance to be planted with native vegetation. The as built conditions are a 36'x17' pool, a 710 sq. ft. patio and pool fencing. No leaders and dry well were installed and no native vegetation was planted., At this time the permittee is seeking approval to install a drywell (301 Cu. Ft.), connect the pool filter to the dry well, connect roof leaders to the dry well and install native plantings. The plantings shall consist of 16 Sweet Pepperbushes (Clethra ainfolia) and 6 Inkberry bushes (Ilex gabra). The plants shall be installed 6' o/c at the existing clearing limits. ' k Location of actionOQ S :rs Site acreage: Present land use: zs - Present zoning classification: 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; c, (b) Mailing address: - Asle (c) Telephone number: Area Code (d) Application number,if any: Will the actionbedirectly undertaken,require funding,or approval by a,state or federal agency'? Yes 9 No O If yes,which state or federal agency"? K[`k f-S j L i= C- 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,. keomplete answers will require that the form be returned for completion. DY VELtPEI .CAST PC3LICY Policy .1. poster a pattern of development in the`Down of Southold that enhances community character, preserves open space, makes efficient use of infrastrueture,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section M—Polities; Wage 2 for evaluation criteria. E]Yes ❑ No Q Not Applicable Attach additional shuts if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Sect�i-on�Ili—Polities Pages 3 through 6 for evaluation criteria !`�-# -~ Yes U No El Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual duality and protect scenic resources throughout the Town of Southold. See LWRP Section Ili—Policies Pages 6 through 7 for evaluation criteria yes No [] Not Applicable � `� .a in ,C < 0 Wcgr< Attach additionai sheets if necessary NATURAL, COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See 1.WRIP Section III—Policies Pages S through 16 for evaluation criteria F] yes n No Not Applicable G ` Ca c� a S 64 Attach additional sheets if necessary Policy S. Protect and-improve water Quality and supply in the Town of Southold. See LWRP Section III --Policies Pages 16 through 21 for evaluation criteria gess 11 No D Not Applicable Wi C ` 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 M—Policies; Pages,22 through 32 for evaluation criteria. El Yes No Not Applicable �S _`S 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 N6 Not Applicable _ C c � 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. 0 Yes Q No t-J Not Applicable J Sc �� as-P nL (a S c 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 LVW Section III—Policies; Pages 38 through 46 for evaluation criteria. El YesO No gj Not applicable 11 'Q P e - �- f Attach additional sheets if necessary WORIaNG COAST POLICIES Policy I.O. 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 [:1 No 9 Not Applicable O (40 Attach additional sheets ifnecessary Policy AI. Promote sustainable use of Diving marine resources in Tong Island Sound, the Peconic Estuary and'Town waters. See LWRP Section III—policies; Pages �7 through 62 for evaluation criteria. 11 Yes 1:1 No Not applicable o ` 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. El Yes 0 No g Not Applicable je-0 4M \� Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LVVRP Section.III M-Policies; Pages 65 through 68 for evaluation criteria. Yes No 91 Not Applicable d o1 oe- a PREPARED BY Cc-L&n..� � TIT LE �. _. DATE4 1 t�' Short Environmental Assessment Form Part 1 -Project Information Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: Proposed pool and decking Project Location(describe,and attach a location map): 4321 Brooks Point Road,Fishers Island,location map enclosed Brief Description of Proposed Action: Applicant proposes to legalize an existing pool(36'x17')and patio(710 sq.ft.)and fencing,to install a dry well(301 cu.ft.),connect pool filter to dry well,connect roof leaders to dry well,plant 16 sweetpepper bush(Clethra alnifolia)6'o/c at existing clearing limits and plant 6 inkberry bushes(Ilex gtabra)6'o/c at existing clearing limits. Name of Applicant or Sponsor: Telephone: 631-788-7563 D.Scott Ketner, E-Mail: Address: 15E 1199 Park Avenue City/PO: State: Zip Code: New York NY 10128 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 0 F 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: ❑ ❑ Southold Town Trustees,Southold Town Building Department and KY S.D.E.C.. 3.a.Total acreage of the site of the proposed action? 1.67 acres b.Total acreage to be physically disturbed? 0.01 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.67 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban m Rural(non-agriculture) [-]Industrial ❑Commercial ❑Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 3 5. 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 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: Z ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? ❑✓ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ ❑ 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: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑✓ ❑ Existing on site sanitary system 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑✓ ❑ 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? Z ❑ 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: m 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 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, � 1:1a.Will storm water discharges flow to adjacent properties? F]NO ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ®YES Leaders and gutters with discharge to dry wells Page 2 of 3 • 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: F-/—] ❑ 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: Z I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE f Applicant/sponsor name: Glenn E u t as a nt Date: Signature: PRINT FORM Page 3 of 3 Board of Trustees Appl•>:i.on AFFIDAVIT D A ✓I D S • fG F. men. BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. &LAIA-Z J latW Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF J&V-V —, 20 JULIE E.MITCHELL Notary Public,Stat®of New York No.0IM16059397 Qualified in New York County _ Commisskm Expires July 2,2019 otar Public Board of Trustees Appta. --jn AUTHORIZATION (Where the applicant is not the owner) I/We, owners of the property identified as SCTM# 1000- 5-- in the town of New York, hereby authorizes W1p E 01 ro►n ev-A Cen 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. 4JA-i S . lee_�Wjyrl - Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS DAY OF JaV-V" , 20_L i___ JULIE S.Mr CHELL Note-ry Public,Stats of Newyork No,01M16059397 Quoldled in New York County _ N tary Publ i commloalon Ares July 2,2019 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Cods,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 infers t and allow it to take whatever action is necessary to avoid sarn YOUR NAME: K `; 'rN f 4 I DAVID So (Last name,first name,giiddle 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 Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (]f"Othef',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 Ni%even a partial ownership of(or employment by)a corporation in which the town off icer 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/agent/represcntative)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 appiicani is not a corporatlon); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th's day of V�►� 20 Signature ,1i .� • lCift4p Print Name Form TS 1 IF W Ole APPLICANUAGENTIREPRESENTATIVE- TRANSACTIONAL DISCLOSURE FORINT The�'rovsm f Sou old's C de of Ethic rohibits eantlic of interest on the art ofiown•ofFee a d,em 1 ee e u se f t is'form iso Ovide-info ma ion which can alert the own'af o ible cb flirts ofintetes-and al ow it to take whatever setion is neeessary to avoid same, YOUR.NAME' (Last time,first name,.gntddie 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 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 xvith'mzy officer or'etitployce of the"t'own of Southold? "Relationship"includes by blood,marriage,or busiaess-interesL"Business intorest"trieans a business, including a partnership,in which the town officer or employee lxas even WNartlal ownership of 6r employment by)a corporation in which the town officer or employee 6vns snorethan 5%of theshares. 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 appliewittagentlrepresentative)and the toren officer or employee.Either check the appropriate line A)through D)andtor 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 ofgrcata than S%of thesbares df the corporate stock of the applicant (when the applicant is a corporation); I3)-the legal or bonefieial ownerofany inti test in a non-corporate entity(when the applicant is not a corporation), C)an officer,director,partnei,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this_�,da n Signature Print Name ✓% Form TS I 1 L PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK oerlwl T-. , residing at being duly sworn, depose d says that on the cU day of (N , 20 e4 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were ma' at the United States Post Office ate �,� "'o , K)j , that said Notices wera�nail t each of said persons by CERTIFIED MAIL/R&UhN RECEIPT. 1' Sworn to before me this Day of k)z1 2-0 Notary Pub 'c ADAM MATRQS Notary Public-State of NOW York No.01MA6354679 Qualified in St",k My Commisslon Exg�'021 ' 02i r''fif John N. Irwin III, Jeanet H. Irwin 58 Cliffdale Road Greenwich, CT 06831 ` Elizabeth Buckner, Leonard Orr 300 West End Avenue New York, NY 10023 John N. Irwin.III, Jeanet H. Irwin 58 Cliffdale Road Greenwich, CT 06831 Merritt E. McDonough 43 Holbrook Road West Hartford, CT 06107 Stephen A. Cook, Cynthia P. Cook 4 East 95th Street New York, NY 10128 William M. Driscoll, Heidi G Driscoll 151 Indian Head Road Riverside, CT 06878 Michael J. Domino, PresidentO�pSUFFO(�-Co Town Hall Annex John M. Bredemeyer 111,Vice-President ��ti� GyJ,q 54375 Route 25 Glenn Goldsmith y z P.O. Box 1179 A.Nicholas Krupski v� "r '� Southold,NY 11971 Greg Williams y ply Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of DAVID SCOTT KETNER COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING THIS FORM IS TO BE COMPLETED A FTER POSTING REMAINS IN PLACE FOR A T LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, 17 OLVU 4 e 67116 eresiding at ldba 11 c! 4 P44- l4l tk VC A-10'r I , 'E New Y4,.,A NY / 0/711 being duly sworn, depose and say: That on the day of A Pff f , 201 Q, I personally posted the property known as Y324 6 ehs P h hx RoadFia 4epd 6n la'i'd A/Y by placing the Board of Trustees official poster Aere it can easily be seen,and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,Anril 17,2019. Dated: (signature) Sworn to b fore me this day of j'(20 �q 1111 IE E.MITCHELL o ry P lic Notary Public Mtate of New York Qualified in New York County Commission Expires July 2,2019 ' • _ MAILP�REEdbPT' e ®a o e. iLn .® only e WE li�TFtR! QCT p61 e �138 y V ; •i; ' R' Certified Mad Fee e t� .tr Ir Certified Mad Fee< •c�1 i Lr) ExtraServlces&Fees(check box,add t y 1 ❑Return Receipt(hardcopy) $ tnfl $ " d \\� 1�J Extra Services&Fees checkbox,add tee a ) C a ❑Return Receipt(electronic) $ �� 'PDStmark ❑Return Receipt(hardcopy) $ •- r \�'>\�'N Qe .amu ❑Certified Mall Restricted Delivery $ _ ^� Yom.. �O Here O ❑Return Receipt(electronic) $ •- \�C n�ytTnark ❑Adult Signature Required $ ❑Certified Mail Restricted Delivery $ (+\�,•} t! Here Adult Signature Restricted Delivery$ 0 F1 Adult Signature Required $ ',\ Postage L GG \ W ❑Adult Signature Restricted Delivery$ �,• 7,,,Q $ 0.`5 p Postage $0.55 ti `� Total Postage and Fees U4�1 � +,x 0 Total Postage and F $. _ ® ,1I, r- Sent To $ y O s__at-d �P ��_ C114� �+ r� L_ r- S To ox No. �9_ c � f (`�' L ---------- --- I Q Street and Apt No., r PO Box No. Crtat ZIW+ ��3 � Q� �- 06 "_j edyra�t1 �� II 1 I r e l e �V P __ 'r e e e e eee•e - _ � - ___— I a 0 ® Ln CE) ru • c °^ NE"ORl ! Y 0128[ '}i I ra • • „ N � O ®t. l Q Certified Mad Fee $3.50Ln • � [air- Certified Mail Fee �.>"y ro Y� ��.�' 0935 I $ Extra Services&Fees(check box,add tee ta) `q Lrl $ ❑Return Receipt(hardcopy) $ Extra Services&Fees(check box,a a�yglplpro le\ O '❑Return Receipt(electronic) $ ,�C�l R�Stmark ❑ Return Receipt(hardcopy) $ - l `{+.`n'.-' Postmark ! 0 ❑Certified Mail Restricted Delivery $ - x�r! C(�� Here C3 .❑Return Receipt(electronic) ,\ Here ❑Adult Signature Required $ \. 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G CertrfledfMad Fee ..� %13,...476 � .� t;+ $2, Er Certified Mad Fee '43.WI Extra Services&Fees(check box,add fee $ ,e) ���b � O ❑Return Receipt(hardcopy) $ q�`1 Extra Services&F885(cheek box,ad$d fee a O ❑Return Receipt(electronic) $ a Postmark � ❑Return Receipt(hardcoPY) s Postmark ('q,, ❑Return Receipt(electronic), $ •�' ,1.hr0 �® E]Certified Mall Restricted Delivery $ ''���(�wyyere 0 ❑Certified Mail Restnoted Delivery $ �[r ') []Adult Signature Required $ �\ (7V` �O1 r $ ' `� '�N ^� ❑Adult Signature Restricted Delivery$' , V ❑Adult Signature Required t • ( CU�� Q� N - O Postage tir Cry ��� �. ' ❑Adult Signature Restricted Delivery$ ta41i1/2019; Er C3-Postage' cc O $ j Q' l�• r.r 1.14/10/2C019��,g" tT1 Total Postage and .'85 4 foil Total Postage and Fees 6.85 O Sent Tp rD Stitt To �� �� -------------- StreetandA t No. or Pd BoxAfo a oh�n 04-- ----- ---1-- � J� fy J� _ 1 .,7 C7 §ireet and Apf. ----- N-T, r PO ox [ ---s� SAV 1 ` Gam+ ---------------- State,Zi , --- ----- O �t :ee e ee eel• e e e o e lee•e• �oo®o Environmental C®nsulUng Services P April 10, 2019 E C D � Q �Y � Mr. Michael Domino, President APR 1 5 2019 Board of Town Trustees Southold Town Town of Southold B artlof rus Town Hall Annex. 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: David Scott Ketner, 4321 Brooks Point Road, Fishers Island S.C.T.M.No, 1QQQ-4-5-18 Dear Mr. Domino: Enclosed please find is the Proof of Mailing of Notice certified ,mail receipts for this project. WSinc r , e E us Phone (631) 653-0607 o Email Gjust10215@aol.com 121 Jessup Ave - 2nd Floor o P.O. Box 447 Quogue, New York 11959-0447 NUTILt: Ulm HLAKING1 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: DAVID SCOTT KETNER SUBJECT OF PUBLIC HEARING : For an Amendment to Wetland Permit ##7710 for the as-built 36'x17' swimming pool and 710sq.ft. patio in lieu of the originally permitted 30'x12', swimming pool and 550sq.ft. patio; install a dry well (301 cu.ft.) for pool backwash; connect roof leaders to the dry well; and install native plantings consisting of 16 sweet pepperbush (Clethra ainfolia) and 6 inkberry bushes (Ilex gabra), to be installed 6' o/c at the existing clearing limits. Located: 4321 Brooks Point Road, Fishers Island. SCTM## 1000-4-5-16 TIME & DATE OF PUBLIC HEARING : Wednesday, April 17, 2019 — 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 for inspection prior 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) 765-1692 James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Ielephone (631 ) 765~ 1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE t_ .11_ I Pre-construction, hay bale line - p ~o.~ro,/o~,.~-- Ist day of construction ~ constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 7710 DATE: JANUARY 18~ 2012 ISSUED TO: DAVID SCOTT KETNER PROPERTY ADDRESS: 4321 BROOKS POINT ROAD~ FISHERS ISLAND SCTM# 4-5-18 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on -January 18, 2012~ and in consideration of application fee in the sum of $250.00 paid by David Scott Kemer and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a pool, pool fencing, patio and landing; with the condition of the installation of gutters to leaders to drywells on the dwelling, and a pool drywell for backwash; and as depicted on the site plan prepared by CME Associates Engineering, Land Surveying and Architecture, PLLC, last dated April 23, 2012, and stamped approved on May 8, 2012. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Pernfittee David Scott Ketner, residing at 4321 Brooks Point Road, Fishers Island, New York as part of the consideration lbr the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Pennittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southotd. That this Permit is valid tbr a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-cotnpliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trnstees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen John Bredemeyer Michael J. Domino Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 January 18,2012 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Glenn E. Ju~ J.M.O. Environmental Consulting P.O. Box 447 Quogue, NY 11959-0447 RE: DAVID SCOTT KETNER 4321 BROOKS POINT ROAD, FISHERS ISLAND SCTM# 4-5-18 Dear Mr. Just: The Board of Town Trustees took the following action dudng its regular meeting held on Wednesday, January 18, 2012 regarding the above matter: WHEREAS, J.M.O. Environmental Consulting on behalf of DAVID SCOTT KETNER applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated November 22, 2011, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on January 18, 2012, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of DAVID SCOTT KETNER to construct a pool, pool fencing, patio and landing; with the condition of the installation of gutters to leaders to dryweils on the dwelling, and a pool drywell for backwash; and as depicted on the site plan prepared by CME Associates Engineering, Land Surveying and Architecture, PLLC, last dated Apd123, 2012, and stamped approved on May 8, 2012. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, James F. King President, Board of Trustees JFK/eac James F. King, President Bob Ghosio, Jr., Vice-President Dave Bergen Jolm Bredemeyer Michael J. Domino Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: DAVID SCOTT KENTER Please be advised that your application dated November 22, 2011 has been reviewed by this Board at the regular meeting of January 18, 2012 and your application has been approved pending the completion of the following items checked off below. XX Revised Plans for proposed project - Separate drywells for roof run-off & pool back-wash XX Pre-Construction Hay Bale Line Inspection - Photographs of installed hay bales with silt fencing in lieu of inspection. __ 1st Day of Construction ($50.00) __ ½ Constructed ($50.00) XX Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: Final Inspection Fee - $50.00 BY: James F. King, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Town Hall, 53095 Main Rd. P.O. Box I 179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 11,2012 the following recommendation was made: DAVID SCOTT KETNER to construct a pool, pool fencing, patio and landing. Located: 4321 Brooks Point Rd., Fishers Island. SCTM#4-5-18 The CAC did not make an inspection, therefore no recommendation was made. Jill M Dohelxy, President Bob Ghosio, Jr., Vice-President James F King Dave Bergen Jotlll Bredemeyer PO. Box 1179 Southold. NY 11971 Telephone (631 765-1892 Fax {6311 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: //~¢]//'~ 2~_ /,/..~0,~/~,~ DAVID SCOTT KETNER requests a Wetland Permit to construct a pool, pool fencing, patio and landing. Located: 4321 Brooks Point Rd., Fishers Island. SCTM#4-5-18 Type of area to be impact~: __Saltwater Wetland ¢' Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland P~cOf Town Code proposed work falls under: hapt.275 Chapt. 111 other Type of Application:__t/Wetland __Coastal Erosion __Administrative__Emergency __ Amendment Pre-Submission Violation Info needed: Modifications: Present Were: J. Doherty B. Ghosio __J. King_ l/' J. Bredemeyer__ D. Dzenkowski __other Form filled out in the field bv Mailed/Faxed to: Date: D. Bergen, J.M.O. Environmental Consulting Services May 2, 2012 Mr.m James F. King, President Board of Town Trustees Town of Southold Town Hall Annex 54375 Main Road, P.O. Box 1179 Southold, N.y. 11971 Re: Application for David Scott Ketner 4321 Brooks Point Road, Fishers Island S.C.T.M.No. 1000-004-5-18 Dear Mr. King I am presently writing as a follow up to the the discussion I had with the Board during the public hearing for this application which was held on 1/18/12. At that time the Board was concerned about dry wells for the proposed pool and roof mn-off. Please be advised that the proposed pool will not have a back wash but we have had the following revisions made to the plan s which have been prepared by CME Associates last dated 4/23/12: 1. The approximate limits of current clearing 2. That a fence shall be installed to establish the new clearing limit line 3. That a dry well shall be installed and connected to the existing roof leaders 4. That after the construction of the pool, patio and landing and the removal of the hay bales and silt fencing all the disturbed areas beyond the clearing limit line will be planted with native Phone (631) 653-0607 ,, Fax (631 ) 653-3348 121 Jessup Ave · 2nd Floor · P.O Box 447 Quogue, New York 1 ~1959-0447 wetland shrubs and seeded with a native perennial seed mix and that area will be allowed to revert to it's natural state. Upon your review of this material please feel free to contact me at anytime should you have any comments or questions. OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cot. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM JAN ! 7 2012 mo~ Jim King, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: January 17, 2012 Re: Proposed Wetland Permit for DAVID SCOTT KETNER SCTM#1000-4-5-18 J.M.O. Permit Island. Environmental Consulting Services on behalf of DAVID SCOTT KETNER requests a Wetland to construct a pool, pool fencing, patio and landing. Located: 4321 Brooks Point Rd., Fishers SCTM#-4-5-18 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 proposed action is CONSISTENT with the denoted following Policy Standards and therefore is CONSISTENT with the LWRP provided the following: 1. Require the installation of pool dewatering well. 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: Lori Hulse, Assistant Town Attorney Office Use Only Coastal Erosion Permit Application ~rWetland Permit Application Administrative Permit ~ __Amendment/Transfer/Extension Received Application: I I ] ~l,,gJ II t/Received Fee:$ _~,~X~~ %~mnpleted Application~J_/~]j! Incomplete SEQRA Classification: Type I Type II__Unlisted Coordination:(date sent) 2,~"LccWRP Consistency Assessment Form J 2]~l~Jll AC Referral Sent: ? ~.~ *] I I1 ' ~Date of Inspection: I '1 ! ] ] I ~' Receipt of CAC Report." ' Lead Agency Determination:__ Technical Review: .-'Pfi'~licHearingHeld: t 11 ~ [I ~ Resolution:/ · ' - NameofApplic~t David Scott Ketner Address P.O. Box 208~ Fishers Island. N.Y. 063q0-0208 Phone Number:( ) 631-788-7563 Suffolk County Tax Map Number: 1000 - 004 - 5 - 18 PropellyLocation: 4321 Brooks Point Road, Fishers Island (provide LILCO Pole #, distance to cross streets, and location) AGENT: Glenn ~., Just/JMO Environmental Consulting (If applicable) Address: ?. 0. Phone: 653-0607 of Trustees Application Land Area (in square feet): Area Zoning:~ R- 1 2 0 GENERAL DATA 1.67 acres Previous use ofproperty: Single family dwelling Intended use of property: same Covenants and Restrictions: Yes x No If"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals __ If "Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Date Southold Town Trustees N.Y.S.D.E.C. 12/9~ 12/90 Yes No __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? x No__ Yes If yes, provide explanation: Project Description (use attachments if necessary):_ Applicant proposes to construct a pool, pool fencing, patio and l~ndln9 as p~£ ~nclu~ud pl~na p£ep~ied by CME Associates last dated 8/4/11. of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: swimming pool Area of wetlands on lot:~l, 000 square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 53 feet Closest distance between nearest proposed structure and upland edge of wetlands: 34 feet Does the project involve excavation or filling? No x Yes If yes, how much material will be excavated? ~-~120 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 10 Proposed slope throughout the area of operations: 1: 1 Manner in which material will be removed or deposited: ~ackhoe feet 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 attaclmaents if appropriate): Utilizing hay bal~g and milt f~ncing ~horo sho,,ld be no negative impacts on the wetlands of Trustees Application COASTAL EROSION APPLICATION DATA Purposes of proposed activity: swimming pool Are wetlands present within 100 feet of the proposed activity? No x Yes Does the project involve excavation or filling? No × Yes If Yes, how much material will be excavated?~ 2 O (cubic yards) How much material will be filled'? 0 (cubic yards) Manner in which material will be removed or deposited: nackhoe Describe the nature and extent of the environmental impacts to the subject property or neighboring properties reasonably anticipated resulting from implementation of the project as proposed, including erosion increase or adverse effects on natural protective features. (Use attachments if necessary) The project as proposed should have no negative impacts (erosion) and should not impact any natural protective features Tc~/n H~ll, S~)~$ Main Rd, P.O 8ox 1179 Soulhold, NY 11971 T~honc (631) 765-1892 Fax (631) 765-~1 BOARD OF TOWN TRUSTEES TOWN OF SOUTUOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Mat~er of the Application of DAVID S COTTJi[ET~NER COUNTY OF SUFFOLK) STATE OF NEW YORK) being duly sworn, depose and say: That on theO~.lday of t O'~ ~a ,201 , l personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure tile post~ has re~ained in place for eight days prior to the date of~he public hearing, Date of hearing noted thereon to beheld Wed. Jam Dat~l: N~ Sworn to bO'om me this rvAfL 2012 on or s~J~out 6:00 PM. KARLA S. HEAIH NOTARY PUBLIC, STATE OF NEW YORK NO. 01HE6222563 QUAUFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 05/24/2014 dAILING OF NOTICE ~IFIED MAlL RECEIPTS Address: Rd West ~artford,CT 06107 ..1 Indian Read Rd Riverside, CT 06~ I PO Rox 1000 Millbrook NY 12545-1000 lan A & Cynthia P Cook 4 E 95th St, New York, NY 10128 Elizabeth ~ruckner $ Orr Leonard 300 West End Ave,New York,NY 100~ John N Irwin III & Jeanet H Irwin 58 Cliffdale Rd Greenwich CT 06~{ George C& Stalet C Sednaoui PO Rox 213 Princeton NJ 08542-0213 STATE OFNEW YORK COUNTY OFSUFFOLK Glenn F,. Just ,residingat 121 Jessup Avenue, Ouoque, NY , being duly swum, deposes and says that on the ~ day of~, 200~, deponent mailed a true copy of the Notice set forth in the Board of TrusteiJs Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were ~iled at the United States Post Office at f-~..tC~ 1' ~;, /Id~f~- , that said Notices werofra~leql to each of said persons by Swum t~ore me this /_7 Day O~ (/z~.. ~20.~_~.,~ ~ ~/ Notmy Public JANET M. TOOKER Notary Public.State of New York No 01T05051905 Qualified n Suffolk County Comm ssion Expires November 13, 20.~J 617.20 Appendix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only 'ART I - PROJECT INFORMATION (To be completed by A~plicant or Project Sponsor) 1, APPLICANT/SPONSOR ]2. PROJECT NAME David Scott Ketner [ Proposed pool, patio, etc 3. PROJECT LOCATION: Suffolk Municipality Fishers Island County PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) 4321 Brooks Point Road Location map and survey enclosed 5. PROPOSED ACTION IS: 6. DESCRIBE PROJECT BRIEFLY: Applicant proposes to construct a pool,pool fencing, patio and landing as per enclosed plans prepared by CME Associates Engineering, Land Surveying & Architecture, PLLC last dated 8/4/11 7. AMOUNT OF LAND AFFECTED: Initially 0.10 acres Ultimately 0. i0 acres 8. WILL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? [] Yes [] No .No, descdbe briefly 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? [] Residential [] Industrial [] Commercial Describe: Single family dwellings [] Agriculture [] Park/Forest/Open Space [] Other 10. DOES ACTION INVOLVE A PERMIT APPROVAL. OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FEDERAL, STATE OR LOCAL)? [] Yes L] No if Yes, list agency(s) name and permit/approvals: Southold Town Trustees- Wetlands 11. DOES ANY ASPECT OF THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? [] Yes [] No if Yes. list agency(s) name and permit/approvals: 12. AS A RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? E]N° If the action is in the Coss~'l~rea, and you are a state a~l.ency, complete the Coastal Assessment Form before proceeding with th,s assessment I OVER Reset PART II - IMPACT ASSESSMENT (To be completed by Lead A~lency) A_ DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR. PART 617.47 If ~s. ce~dinate the re'~=w process and use the FULL EAF. r--] Yes [~No B. ~ ACTION ~VE COOR[~NATED REVIEWAS PROVIDED FOR UNUSTED ACTIONS IN 6 NYCRI~ PART 617.6? If No. a negative dedarabe~ may be s~peraeded by another Involved agency. C. COULO ACTION RESULT IN ANY AOVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be hamiwdifefl, if legil~e) C1. EMs~g ah' quality, sudace or groundwater quality or quantity, noise levels, efts(lng traffic pa(tern, solid waste pmduc~o~ of disposal, potential for emsk~, drainage or fleeing problems? Explain txiefly: C2. A=~;,~.~,. agricultural, arch~, historic, or other natural er cultural resources; or ~ommunity er ne~ghberlmod characted/F~In I~elly: C6. Long erin. sho~t tenn. cumulative, or other effec~';'~;t ide~fll'~d in C1-C57 Explain t~eff~i ~ PART III - ~: ~ t:~il~k11ON OF 81~(IFIOANCE (To be mmpteled by ,~) . #~TRUOTIO~$: Fa¢ea~hadver~ee~fe~identi~edab~ve~de~erm~newhe~her#issubstantia~'~arge~imper~ant~r~en'Ase~gn~canL Each effe~ should be ~ In connection with its (a) seltJng (i.e. urban or rural); (b) ~ of oocun'ing; (o) dumlion; (d) In'evem~l'e/; (e) ~ eoape; and (0 mag~xle. If necessa~/, add attachments ar referenee euplx~lng matedal~ Emum that mq~na~m mnle~n .u~ resurc m any S~lfllflcant aclvefse en~l Impacts ,AND prov(de ~ attachm~flt~ ~ ~,~..~.~, ~ .:=~,,~.T~ ~ ~ deten~nat!on. - ................... · ......... SUpbeethlg .,~ Board of Trustees ~,/,~,~'/ / Name of Lead Agency Date j ,~,/,~ ~ ,~' /c. /~ President ~ ~ T~ Name ~ Re~s~ ~r in Lead Agency T~e of Res~n~e S~a~e'of R~ble offi~r ~ Le~ ~en~ S~na~ ~ Preparer (If d~( ~om ms~n~ble of Trustees Application County of Suffolk State of New York DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. 1N COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS /'~ DAY OF ~(~'.,t ,20// KARLA S. HEATH NOTARY PUBLIC, STATE OF NEW YORK NO. 01 HE6222563 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES 05/24/2014 of Trustees Application (print owner of property) AUTHORIZATION (where the applicant is not the owner) (mailing address) do hereby authorize (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) J.M.O. Environmant l Consultin S rvic s To whom it may concern: Please be advised that we have authorized the firm of J.M.O. Environmental Consulting Services to act as our agent on our behalf in applying for certain approvals through your agency and others involved with this project. $.M.O. Consulting Services has been retained to coordinate all approvals necessary through your and other involved agencies, as well as our architect, engineer and contractors. We request that all communications, correspondences, notices, approvals and calls be addressed directly to the offices of J.M.O. Environmental Consulting Services. Phone (63]) 653-0607 · Fax (63 ]) 121 JessuF~ Ave · 2nd Floor · P.O. Box 447 Quogue, New York ] ~o~o APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics orohibits conflicts of interest on the oart of town officers and emolovces. The vuroose of this form is W omvide information which can alert the town of oossiblc conflicts of interest and allow it to take wh~evcr action is necessary to avoid same. (Last name, fi~st name, middle initial, u~less you arc 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 Change of Zone Coastal Erosion Approval of plat Mooring Exemption fi'om 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 parmership, 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 ~ I you answered YES , complete the balance of th s form and date and s~gn where indicated. Name of porson employed by the Town of Southold Title or position of that person Describe the relationship between you~elf (the applicant/agcot/represantative) 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 coq~ration); B) the legal or beneficial owner of aay interest in a non-corporate entity (when the applicant is not a corporation); __C) an officer, director, pmemer, or employee of the applicant; or __D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS 1 Submitted this Signature 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 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. 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). o If any question in Section C on this form is answered "yes", then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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 AUI'ION SCTM# 1000 - 004 - 5 18 The Application has been submitted to (check appropriate response): TownBoard [] Planning Dept. ~-~ Building Dept. [] BoardofTrustecs [] 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: fencing, patio and landing as per plans prepared by CME Associates last dated 8/4/11 Location &action: 4 3 21 1.67 acres Site acreage:. nrooks Point Road, ~ishers Island l~e~ntlandu~: single family dwelling P~sent zoning classification: R - 120 If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Nameofapplicant: David Scott Ketner C0) Ma~lingeda%ess: P.O. gox 208, Fishers Island, N.Y. 06390-0208 (c) Telephone number: Area Code ( ) 7 8 (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [~ No[~ Ifyes, which state or fedemlagency?_ 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 IH - Policies; Page 2 for evaluation criteria. r~Yes [] No ~ Not Applicable negatively impact the character cf thc ccmmunity an~ will not dov~]~po ~p~n ~p~o~_ It is felt that this project is consistant with this policy 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 [] Not Applicable archaeological resouces of the Town. It is felt that this proiec?-- is consistant with this policy Attach additional sheets ifnecessa~ Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. Sec LWRP Section HI - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No [-~ Not Applicable should have no impact upon the vis,ia] quality or any scenic resources, It is felt that this Drogect is consistent with this policy 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 HI - Policies Pages 8 through 16 for evaluation criteria [-~ Yes [-~ No [] Not Applicable The proposed structures should have no impact upon erosion or flooding. It is felt that this project is consistent with this policy Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section HI - Policies Pages 16 through 21 for evaluation criteria [] Yes [] No ~ Not Applicable fhi~ proi~cf i~q con~i~f~n~ with thi~ policy Attach additional sheets if neeessa~ 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. [] Yes [] No [] Not Applicable The proposed project should not result in the degradation or physical loss of any ecological components nor shall it result in any fragmentation of anyecological communities. The project should also have no impacts on any Significant Coastal Fish and WllOllIe ~aD1EaEs. ±E 1S ~e±E EnaE ~nls pro3ec~ is conslsEen~ with this policy Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section m - Policies Pages 32 through 34 for evaluation criteria. [] Yes ~-~ No [~ Not Applicable The proposed project shall have no impact upon the quality of the air. It is felt that this project is consistent with this policy Attach additional sheets ifnecessavj Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section HI - Policies; Pages 34 through 38 for evaluation criteria. [] Yes [] No ~ Not Applicable The proposed project does not involve the~eneration of any hazardous substances or wastes. It is felt that this project is consistent with this policy 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 HI - Policies; Pages 38 through 46 for evaluation criteria. ~ Yes~ No [] Not Applicable The project site is an inland site and is not located adjacent to coastal waters, public landsor public resources. It is felt that this policy is not aappllcab£e to this pro3ect Attach additional sheets ifnecessa~ 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 HI - 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 [] Not Applicable The project site is inland and not located adSacent to the Long Island Sound, the Peconic estuary or Town waters. It is felt that this policy is not applicable to this project 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 The project does not involve agricultural land.~_ T~ i.q f~l~ that this policy is not applicable to this project Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section HI - Policies; Pages 65 through 68 for evaluation criteria. [] Yes [-~ No [] Not Applicable The DroDosed Droject does not involve the appropriate use of or the development of energy or mineral resource. It is felt that this policy is not applicable to this project Created on 5/25/05 11:20 AM ~ ...~ ./'C-' / ~ /'~E,~-= ~o. ~ ',/,, ~x .... .... ~ ~% LOCATION MAP SCALE 1"=400' ~ ~ ~ BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF ~HE 5) ONLY COPIES OF THIS SURVEY MARKED WITH 7HE ~ND SURVEYOR'S / SIGNATURE AND AN ORIGINAL EMBOSSED OR INK S~L ARE THE PRODUCT OF Z ~ ~ 0 ~ ~ ~ ~~ ~ ' ~' '~ ~, 4) COORDINATE DISTANCES ARE MEASURED FROM gS COAST AND GEODETIC ' / SECTION 004, BLOCK 5, LOT 18 ~' ~ / ' .... ",, APPROVED BY - ~ ~ ~ ~ + ~ ~ / ~ARD OF TRUSTEES / ~ / ~) ,~. L "~J. - ~ J , T~~ ~ ~~" ..... ~¢ ..... %. ~ ~ ~ ~/ ~ ~~~.,.~.~~ ~ w~ ~ ~.;~ DATE: 06/30/201 / ' ~ ~ ~, SCALE: 1" = 20' / ~' ~ 1 OF 1 QVlL . ~ ~[ff~ll~ G~PHIC SC~E IN FE~ FILE ] I