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HomeMy WebLinkAboutTR-8144John M. Bredemeyer III, President®��lo SOF so Michael J. Domino, Vice -President James F. King, Trustee Dave Bergen, Trustee Charles J_ Sanders, Trustee ®l�G'01 JN� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 CERTIFICATE OF COMPLIANCE # 1109C Telephone (631) 765-1892 Fax (631) 765-6641 Date: May 11, 2015 THIS CERTIFIES that the demolition of existing residence and construction of new two-story frame residence with new sanitary system and detached garage At 8860 Great Peconic Bay Blvd., Laurel, New York Suffolk County Tax Map # 126-5-4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated February 28, 2013 pursuant to which Trustees Wetland Permit #8144 Dated April 17, 2013, was issued 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 demolition of existing residence and construction of new two-story frame residence with new sanitary system and detached garage. The certificate is issued to JAMES & JANET D'ADDARIO owners of the aforesaid property. Authorized Signature t- t ,_f John M. Bredemeyer Ill, President OG Michael J. -Domino, Vice -President James F. King C* am Dave Bergen • O Charles J. Sanders - BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE F INSPECTION: IMt9)1 �a I,"., 9' a Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre -construction, silt fence 1St day of construction % constructed _-Z Project complete, compliance inspection. INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 James F. King, President Bob Ghosio,' Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 0 Town Hall, 53095 Main Rd- P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 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 Pre -construction, hay bale line 1" day of construction % constructed Project complete, compliance inspection BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8144 DATE: APRIL 17, 2013 ISSUED TO: JAMES & JANET D'ADDARIO PROPERTY ADDRESS: 8860 GREAT PECONIC BAY BLVD., LAUREL SCTM# 126-5-4 G11tW1MyAF4:1W1M 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 April 17, 2013, and in consideration of application fee in the sum of $250.00 paid by Samuels & Steelman Architects 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 demolish existing residence and construct new two-story frame residence with new sanitary system and detached garage; and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated February 28, 2013, and stamped approved on April 17, 2013. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to he affixed, and these presents to be subscribed by a majority of the said Board as of this date. 0 0 TERMS AND CONDITIONS The Permittee , James & Janet D'Addario, residing at 8860 Great Peconic Bay Blvd., Laurel, New York as part of the consideration for 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 Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for 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. 3. 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. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. 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. 7. 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 Trustees, 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. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. 0 James F. King, President Bob Ghosio, Jr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 17, 2013 Mr. Thomas C. Samuels Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: JAMES & JANET D'ADDARIO 8860 GREAT PECONIC BAY BLVD., LAUREL SCTM# 126-5-4 Dear Mr. Samuels: 0 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, April 17, 2013 regarding the above matter: WHEREAS, Samuels & Steelman Architects on behalf of JAMES & JANET D'ADDARIO 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 February 28, 2013, 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 found that the proposed application be Consistent with the standards of the LWRP, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on April 17, 2013, 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, 0 0 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 JAMES & JANET D'ADDARIO to demolish existing residence and construct new two-story frame residence with new sanitary system and detached garage; and as depicted on the site plan prepared by Samuels & Steelman Architects, last dated February 28, 2013, and stamped approved on April 17, 2013. 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: $ 100.00 Ve truly yours, 0.'t5r James F. King President, Board of Trustees JFK/amn E James F. King, President Bob Ghosio, Jr., Vioe-President Dave Bergen John Bredemeyer Michael J. Domino BOARD OF TOWN TRUSTEES TOWN OFSOUTHOLD TO: 0 Town Hall Annex 54375 Route 25, P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 t Talne+ EMgdar b Please be advised that your application dated ZB 3 has been reviewed by this Board at the regular meeting of 3 and your application has been approved pending the completion th following items checked off below. Revised Plans for proposed project Pre -Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) '/z Constructed ($50.00) 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: TOTAL FEES DUE: $ (D D • Lb BY: James F. King, President Board of Trustees Peter Young, Chairman Lauren Standish, Secretary Conservation Advisory Council Town of Southold 0 Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 At the meeting of the Southold Town Conservation Advisory Council held Wed., April 10, 2013 the following recommendation was made: Moved by William McDermott, seconded by Audrey Horton, it was RESOLVED to SUPPORT the application of JAMES & JANET D'ADDARIO to demolish existing dwelling and construct new two-story dwelling with new sanitary system and detached garage. Located: 8860 Peconic Bay Blvd., Laurel. SCTM#126-5-4 Inspected by: Peter Young, Audrey Horton, William McDermott The CAC Supports the application with the Condition of a 15' non -turf vegetated buffer. Vote of Council: Ayes: All Motion Carried �(� W �e. K _ D'A d&ri 2b-5-4 0 .lames F_ King- President Bob Ghosio,.lr., Vice -President Dave Bergen John Bredemeyer Michael J. Domino Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: IWO? /O .2613 P.O. Box 1179 Southold, NY 11971 Telephone (631 765-1892 Fax (631)765-6641 Samuels & Steelman Architects on behalf of JAMES & JANET UADDARIO request a Wetland Permit to demolish existing residence and construct new two- story frame residence with new sanitary system and detached garage. Located: 8860 Great Peconic Bay Boulevard, Laurel. SCTM# 126-5-4 Type of area to be impacted: _Saltwater Wetland _Freshwater Wetland _Sound ✓Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: _Chapt.275 _Chapt. 111 _other Type of Application: _✓Wetland _Coastal Erosion _Amendment —Administrative—Emergency _Pre -Submission Violation Info needed: F Modifications: Conditions: Present Were: L J. King_✓B. Ghosio / D. Bergen, Bredemeyer y Michael Domino D. Dzenkowski Form filled out in the field by Mailed/Faxed to: Date: other New York State Department of Environmental Conservation Am of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631) 444-0362 _ Fax: (631) 444-0360 Website: www.dec.nv.aov Joe Martens Commissioner March 7, 2013 Mr. James D'Addario 45 Clock Tower Lane Old Westbury, NY 11568 Re: Permit No.: 1-4738-00668/00005 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, MarA. . MacKinnon Agency Program Aide MAM/Is NEW YORK STATE DEPARTMOOF ENVIRONMENTAL CONSERVATS low Facility DEC ID 1-4738-00668 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: JAMES D'ADDARIO 45 CLOCK TOWER LN OLD WESTBURY, NY 11568 (516)455-2786 Facility Application Contact: SAMUELS & STEELMAN ARCHITECTS 25235 MAIN RD CUTCHOGUE, NY 11935 (631)734-6405 Facility: D'ADDARIO PROPERTY 8860 PECONIC BAY BLVDISCTM 1000-126-5- 4 LAUREL, NY 11948 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Laurel Facility Principal Reference Point: NYTM-E: 707.223 NYTM-N: 4538.723 Latitude: 40°58'24.2" Longitude: 72°32'13.7" Project Location: 8860 Peconic Bay Blvd - Watercourse - Great Peconic Bay Authorized Activity: Reconstruct existing stairway from retaining wall to beach. All authorized activities must be in strict conformance with the attached plans stamped "NYSDEC Approved" on 3/6/13. Please note, the property landward of the 15' contour, as shown on the survey prepared by John C. Ehlers last revised 1/13/2013 is beyond Tidal Wetlands Act (Article 25) jurisdiction. (MAM) SAP # 1-09-001 Tidal Wetlands - Under Article 25 Permit ID 1-4738-00668/00005 New Permit Permit Authorizations Effective Date: 3/6/2013 Expiration Date: 3/5/2018 Page 1 of 5 NEW YORK STATE DEPARTMR OF ENVIRONMENTAL CONSERVATS Facility DEC ID 1-4738-00668 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: SUSAN ACKERMAN, Deputy Regional Permit Administrator Address: NYSDEC REGION 1 HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: Distribution List SAMUELS & STEELMAN ARCHITECTS Habitat - TW MARY A MACKINNON Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Date AZ NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS 1. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by John C. Ehlers last revised 1/13/2013 and stamped NYSDEC approved 3/6/13. 2. Regulated Activities Authorized By This Permit This permit ONLY authorizes those regulated activities / structures identified under the section titled "SAP Authorized Activity". The Department does not issue after -the -fact or as -built permits. This permit does not authorize activities, or legitimize the existence of structures, which would have required a permit but for which no permit or other authorization has been granted by the Department. Page 2 of 5 da NEW YORK STATE DEPARTMO OF ENVIRONMENTAL CONSERVATi NEW Facility DEC ID 14738-00668 3. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 4. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 5. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 6. No Dredging or Excavation No dredging, excavating or alteration to underwater areas is authorized by this permit. 7. Vegetate All Disturbed Areas The permittee shall revegetate all exposed faces and disturbed areas to prevent soil erosion prior to the project completion or expiration date of this permit, whichever comes first. 8. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 9. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. 10. State May Order Removal or Alteration of Work If fixture operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 11. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. Page 3 of 5 ew NEW YORK STATE DEPARTMEOOF ENVIRONMENTAL CONSERVATS NEW Facility DEC ID 1-4738-00668 12. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal, modifidation or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK, NY 11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands. 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; Page 4 of 5 da NEW YORK STATE DEPARTMOOF ENVIRONMENTAL CONSERVATIO Now Facility DEC ID 1-4738-00668 b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work not does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Page 5 of 5 '• t 14, f ♦ c + . 1, c 10 � cILc J r I �`. t • • p' 1 r,OWNair ,h�,�7,1 tin . tal r .�� �� , �•A` Ij a :,-;a \�ir� � ,. � ,ji � � s, r s \ ' A4I 73 r T, qk I Z6 rEII p� .... ni ■1 iii I Few p'Ly i 9 5 �aaeme pO � 1L s i O nn wrt s p� fe s ♦ 4 0 d Onr rs lanes cnx 4 R / NMICE O O SEE SEC uo I.w 0 ,ilo 0 0 IL- S A M U E L S& S T E E L M A N April 17, 2013 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 RE: RECONSTRUCTION OF THE D'ADDARIO RESIDENCE 8860 Peconic Bay Boulevard, Laurel, NY 11948 SCTM# 1000-126-5-4 Total size of property 25,160 sf The coverage of structures in the above referenced project total the following: Residence 1,920 sf Porches, areaway 1,105 sf Garage 660 sf TOTAL 3,685 sf = 14.6% coverage -R, Wutb Thomas C. Samuels, Architect nRCIIn[( I5 i', MAIN R)AI) (HI(u)(MCNEWMRF 1195 FAX ILSI,- SI ('10 Cantrell, Elizabeth From: Randolph, Linda Sent: Friday, April 12, 2013 10:26 AM To: Cantrell, Elizabeth Subject: LWRP's Hi I just spoke with Mark. He said to tell you all the LWRP's this month can be marked "inconsistent." Linda i Office Use Only 96astal Erosion Permit Application Wetland Permit Application Administrative Permit _Amendment/Transf /Ex nsron ✓Received Application:_ t C2eceived Fee:$b D �, ompleted Applicifio '? _SEQRA Classification: Type I_Type II_Unlisted_ Coordinafion:(date sent) —'LWRP Consistency Asse sm t Form ,'3 ✓°' DAC Referral Sent r Date of Inspection: }}��''ff__�_QQ'�'�''jj�_ _Receipt of CAC Repo _Lead Agency Determination: _PTechnical Review: ublic Hearing Held-. Name of Applicant— m P.re A � rr(,wul A-r01,Np'.�'f Address I ( ` 6- Upok Tms. t' I, _Dt ILy 1 • . 6CA w� �"M � IV • 7• hone Number:( ) Suffolk County Tax Map Number: 1000 - a r� 9— + Property Location: O v v — 1 91con Q (c i-� W Ia, , / • 1 ' av-3 I (provide LILCO Pole #, distance to cross streets, and location) AGENT: �IYI Salti1UG� Od1+tc�el�d ��VNGfM tEficiufZC�d (If applicable) Address: _Jd35 ma(h �, Gxc,�, (�1t, .5 Phone: Boagof Trustees Application • GENERAL DATA Land Area (in square feet): 25-1(00 C F Area Zoning: Previous use of property:St h AAIB ippAfM ((hi rXii ��.C�o ce, Intended use of property: $ fY1G(t10 rpV11 t��t 1(Q&1wcY1P.Pi Covenants and Restrictions: Yes ✓ No If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept. ✓ Yes No Prior permits/approvals for site improvements: Agency Date VNo prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ,/ No Yes If yes, provide explanation: Project Description (use attachments if necessary): lfmgl iA Q K lSl f F1 A kr6i , Ka and C019{vJ MAJ tu)0_ C+orrw 6-&W I& Boat of Trustees Application • WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:_ m iu nW M;Az" Ct Area of wetlands on lot: Q square feet Percent coverage of lot: ZL_% Closest distance between nearest existing structure and upland edge of wetlands: 8 ( feet Closest distance between nearest proposed structure and upland edge of wetlands: 9 1 feet Does the project involve excavation or filling? NYes If yes, how much material will be excavated? 560 cubic yards �(�a How much material will be filled? %0 cubic yards Depth of which material will be removed or deposited:_ feet ;M&t 6H Proposed slope throughout the area of operations: O YQ Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): T tM wi(I bt no of fect oh uxi-I.utd>a and f-;W y ers , &E a(( -effects will 6e cbn R'n to " Ild CvYIS'iVtt ct r DV l � Lh^r`e r c1,nG( S i lf- f-L�-IGPi e • Appendsndix C State Environmental Quality Review SHORT ENVIRONMENTAL ASSESSMENT FORM For UNLISTED ACTIONS Only PART I - PROJECT INFORMATION (To be completed by Annlicant nr Pminrt_ Annnsnrl 1. APPLICANT/SPONSOR2. $aYlbwe(S Sf 2e1 nut H t I Leets PROJECT NAME VM 4ArL o {acs is ,vl rti 3. PROJECT LOCATION: MID 6 ID peeon i v a l u -.' L.v*/ k., Municipality County 4. PRECISE LOCATION (Street address and road intersections, prominent landmarks, etc., or provide map) '-K460 Recmic (v A. SouN side o f NosA, en G -veal' Pemn is 5. PROPO ED ACTION IS: yj New [:] Expansion Modification/afteration 6. DESCRIBE PROJECT BRIEFLY: bDCI%0(15h tV IS+iPtq r,SikeW4 4*4 0.64brj FdWl fwk y 6yskfti - Cv�[sif uct vew r ►'de►tce , �aVage at A sawIinPy syst�w� 7. AMOUNT OF IJ�jJD AFFECTED: (— Initially �- CS acres Ultimately 0 •ZJ acres 8. WILL P POSED ACTION COMPLY WITH EXISTING ZONING OR OTHER EXISTING LAND USE RESTRICTIONS? Lfjas n No If No, describe briefly 9. WHAI IS RESENT LAND USE IN VICINITY OF PROJECT? I YJ Residential ❑ Industrial Commercial Agncuiture [-] Park/Forest/Open Space [3 Other Describe: 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL AGENCY (FERAL, STATE OR LOCAL)? Lvj Yes [] No If Yes, list agency(s) name and permittapprovals: NKS DEC, Sautltold Tvustces, Scb&,S 11. DOES ANY ASPECT THE ACTION HAVE A CURRENTLY VALID PERMIT OR APPROVAL? ❑ Yes [No If Yes, list agency(s) name and permitiapprovals: 12. ASA RESULT OF PROPOSED ACTION WILL EXISTING PERMIT/APPROVAL REQUIRE MODIFICATION? Yes No I CERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE �'' Applicant/sponsor name: :f hot C 54 (.S gcs , nt kp. Date: , g Signature: miwizkA If the action is in the Coastal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with is assessment OVER 1 DART 11 _ IMPACT ASSFSSMF*n he romninleted by Lead ADencv) 0 A. DOES ACTION EXCEED ANY TYPE I THRESHOLD IN 6 NYCRR, PART 617.4? If yes, coordinate the review process and use the FULL EAE. Yes [] No B. WILL ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.6? If No, a negative declaration may be superseded by another involved agency. E] Yes [:] No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOLLOWING: (Answers may be handwritten, if legible) C1. Existing air quality, surface or groundwater quality or quantity, noise levels, existing traffic pattern, solid waste production or disposal, potential for erosion, drainage or flooding problems? Explain briefly: C2. Aesthetic, agricultural, archaeological, historic, or other natural or cultural resources; or community or neighborhood character? Explain briefly: C3. Vegetation or fauna, fish, shellfish or wildlife species; significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as officially adopted, or a change in use or intensity of use of land or other natural resources? Explain briefly: C5. Growth, subsequent development, or related activities likely to be induced by the proposed action? Explain briefly: C6. Longterm, short term, cumulative, or other effects not identified in C1-05? Explain briefly: C7. Other impacts (including changes in use of either quantity or type of energy? Explain briefly: D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL AREA (CEA)? Yes n No If Yes, explain briefly: E. IS THERE, OR IS THERE LIKELY TO BE, CONTROVERSY RELATED TO POTENTIAL ADVERSE ENVIRONMENTAL IMPACTS? ❑ Yes No If Yes, explain briefly: PART III - DETERMINATION OF SIGNIFICANCE (To be completed by Agency) INSTRUCTIONS: For each adverse effect identified above, determine whether it is substantial,large, important or otherwise significant Each effect should be assessed in connection with its (a) setting (i.e. urban or rural); (b) probability of occurring; (c) duration; (d) irreversibility; (e) geographic scope; and (f) magnitude. If necessary, add attachments or reference supporting materials. Ensure that explanations contain sufficient detail to show that all relevant adverse impacts have been identified and adequately addressed. If question d of part ii was checked yes, the determination otsigmncance must eva nate me powmen impar[ui um pi upuxu aw" r vi 1 u le m m v..... Check this box ifyou have identified one or more potentially large or significant adverse impacts which MAY occur. Then proceed directly to the FULI EAF and/or prepare a positive declaration. Check this box if you have determined, based on the information and analysis above and any supporting documentation, that the proposed actio WILL NOT result in any significant adverse environmental impacts AND provide, on attachments as necessary, the reasons supporting thi determination. Name of I e Agency Print or Type Name of Responsible Offloar in Lead envy Signature of Responsible Officer in Lead Agency Date Title orf Responsible Officer Signature o reparer (if different from responsible officer) 11 PART 11- IMPACT ASSESSMENT (To be cornnfeted by Lead Anpnrvl. 0 A. DOES ACTION EXCEED ANY TYPE f THRESHOLD IN 6 NYCRR PART 617.4? - If yes, coordinate the review process and use Me FULL EAF. ❑Yes ONO S. VW.L ACTION RECEIVE COORDINATED REVIEW AS PROVIDED FOR UNLISTED ACTIONS IN 6 NYCRR, PART 617.67 If No, a negative declaration may be superseded by another involved agency. Yes Q No C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED Vv1TH THE FOLLOWING: (Answers may be handwritten, N legible) C1. Existing air quality, surface or groundwater quality or quantity, raise levels,existing traffic pattern, solid waste production or disposal, . potential for erosion. drainage or flooding problems? Explain briefly: C2. Aesthetic, agduAlurai. archaeological, historic, or otlar natural or cultural resboces; or comm or neighbodlood ctarardet? Explain briefly: C3. Vegetation or fauna, fish, shelifshor wildlife species, significant habitats, or threatened or endangered species? Explain briefly: C4. A community's existing plans or goals as offxi2tly adopted, or a change in use or intensityof use of land or other natural resources? Explain briefly: .. .. .__ "._ ". .. ". "_._ .... ... _. C5. Growthh, subsequent development or related activities likely to be induced by the proposed action? Explain bdeFly: C6. Long term, short term, cumulative, or other effects not identified in Cl -057 Explain briefly -- C7: Other impacts indudin9 changes in use of either uantit o typeof D. WILL THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED THE ESTABLISHMENT OF A CRITICAL ENVIRONMENTAL ARFJ1 CEA 7 K s, Iain briefl Yes ❑✓ No EOR IS THERE LIKELY To M , CO RELATED TO POTENTIAL E ENVIRONMENTAL IMPAyesIf Q NO - rwry I m - ue I alwtrlvw I am vm slcWFICANCE (To be completed by Agency) . INSTRUCTIONS:. For each adveweeffedidendWabove. de(erminewhetherMlssubstaotiatl irge,MWIantaotherwisesigalikant Each aged should be assessed M connection with its (a) setting (Le. urban or ruraQ; (b) probability of occur ing; (c) durapM (t) Irever>db�Ay; (e) geographic 8000 and (1) magnitude. N neoessary, add attachments or reference supporting materials. Ensure Unit explamatbrts contain su111cierddetall to show Olaf cit relevant adverse Impacts have been Mentme i and adequately adds HquesMort d of part 6 was ctadked we rhndrtrwmxinnrinn rrfelwnsLw...,s.,.,...r_..-r.._.-.u_---`--., . ... ChookOft box IfYou haileIdentified one ormorepotentiality law orsigNficennadverseln EpadswMdtMAYooxvr. Then proceed ditectlylolheF AF atWor prepare a positive dedarstion. Checkft box ff you -have determined. based on Ante Information and analysis above and any suppaMng documentation, that me proposed ao WILL NOT result in any sigrdGcant adverse environmental impacts AND provide, On attachments as necessary, the reasons supporting determination. Board of Trustees O Name of lead Agency .� Date J19 i 1 • President D Print or Type Name of Responsible Officer in Lead Agency Ti le of Responsible Officer 6C 1 apmature 01 Respomslble (Nficer in Lead ency --malum of Preparer (if different from responsible officer) Name: ?&F�Q,i v�6� qQl f 01&41" S� . I R 3-4(17 -jom,R3 � M(ofl Any-, A�ba L4, LJ PROOF OF.MAILING OF NOTICE ATTACH CERTIFIm MAIL RECEIPTS Address: ,-J��>_ M � W� )26&A>t LAO' 1� STATE OF NEW YORK COUNTY OF SUFFOLK Yam w D.3-s� �),RoK Pe C , residing at ( 047E �qh-C d �No u1 k04-eX being duly sworn, deposes and says that on the day of 20�, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite 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 jhc Town of Southold; that said Notices were mailed at the United States Post Office at (Gt that said Notices were mailed to each of said persons by CERTIFIED MAIL ETURN RECEIPT. Sworn to � fore e this Day of 201[J7 Notary Public ll CONETANCE LIRiWnt NOTARY MDLIC•ETATE OF NEW YORK No. OFL16110900 OIIpIRNd In Suffolk County My Commlpl0n balm JMM 01, 2610 lames F. King. President Bob Ghosio. Jr. _ Vice -President Dave Bergen John Bredemeyer Michael J. Domino • ~�o�OgUf F0( y�19 N Z BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of JAMES & JANET D'ADDARIO COUNTY OF SUFFOLK) STATE OF NEW YORK) Town Hall_ 53095 Main U. P.O. Bos 1179 Southold. NY 11971 "telephone (631) 765-1892 Fax(631)765-6641 AFFIDAVIT OF POSTING TO RE COJIPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS 11MA-S C. '�LW1.tiL Q , residing at /dba { O t 2- 1 V EW �0/ &k VJ- being duly sworn, depose and say: That on the 01 day of A-j3/L(J 20IJ I personal]}]f� posted the property known as `� -V A-0AA' T v e .Y SOA A 0 by placing the Board of Trustees official poster where 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, April 17, 2013. Dated:(-PA,Q 17r46J3 (sig ature) Sworn to before me this I-) day of+i 20/3 P, v PA J�LNotary Public :..�w Notary Public, State of Now Yoth No. Ot RISO42467 Gualiffed in Suffolk County Commission Expires May 3o,4meg- 7x)Ic NOTICE OF HEARING NOTICE IS HEREBY GIVEN that a public hearing will be held by the SOUTHOLD BOARD OF TRUSTEES at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: Z.me-s Ee�`ar�o SUBJECT OF PUBLIC HEARING: To demolish existing residence and construct new two-story frame residence with new sanitary system and detached garage. TIME & DATE OF PUBLIC HEARING: If you have an interest in this project, you are Invited to view the Town file(s) which are available for inspection rior to the day of the hearing during normal business days between the hours ofp8 a.m and,4 a.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Boafof Trustees Application • County of Suffolk State of New York I ILI AW -4 S �- • '�l 04, it e, l S BEING DULY SWORN DEPOSES AND AFFIRMS TnAT 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. IN 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. SWORN TO BEFORE ME THIS a p DAY OF ,20a r/v_ 1�QL� NdM Public, State of New Yor No. 01 RI6042467 Qualified In Suffolk County Commission Expires May 30,4892-- )� Feb 27 2013 5:40PM D'Rdda� and Company 6314393 page 2 Board of Trusts** AwliCA'A'O► AUMORIZATION (wheee tbo nppiieant im toot the owrAr) L (print owner of p opem) (nlaitmg- rte) �V 1(Q N do hereby authmIM Q M up- ` S (lteaet) apply for pu7nit(i) a mm the 0 0 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM YOUR NAME: I. M AbL QS a (Last name, fust name, middle 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 Variance Change of Zone Approval of plat Exemption from plat or official map Other (If"Other", time the activity.) Building Trustee Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Southold? "Relationship" includes by blood, marriage, or business interest. "Business interest" means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by) a corporation in which the town officer or employee owns more than 5%o 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/representative) and the town officer or employee. Either check the appropriate line A) through D) and/or describe in the space provided. The town officer or employee or his or her spouse, sibling, parent, or child is (check all that apply): _A) the owner of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a corporation); _B) the legal or beneficial owner of any interest in a non -corporate entity (when the applicant is not a corporation); _C) an officer, director, partner, or employee of the applicant; or _D) the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this i 0 day of at 4A9 —zO ( 3 Signature Tido wty( d Print Name p jea#kA S. 0—. Vdj,kn Form TS 1 0 o� > ® Town of Southold Erosion, Sedimentation & Storm -Water Run-off ASSESSMENT FORM PROPERTY LOCATION: B.C.T.tl.k THE FOLLOWINO ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM—WATER,STORM-WATER, GRADING, DRAINAGE AND EROSION CONTROLP e an C 1 BYA SIGNP F S A O i1N YORK SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT Yes No a. What Is the Total Area of the Plo)ecl Parcels? a ij (60 S F Will this Project Retain All Storm -Water Rung (IncWde Total Area of all Parcels located within O �. QaVGenerated by a Two (2') Inch Rainfall on Sae? the Scope of Work for Proposed Construction)NF /lose) (This gem will Include all run-off created by site (� ❑ b. What k the Total Area of Land Clearing I.� $ f clearing and/or construction activities as well as all — and/or Ground Disturbance for the proposed Q�.� Site Improvements and the permanent creation of n construction activiryR IMF./Anal impervious surfaces.) 2 Dcas the Site Plan and/or Survey Show Proposed PROVIDE BRIEF PROJECT DESCRIPTION )PmdeeAdftlmW PeareeNMntd) tion? This Drainagelnape Structures Indicating Size 8 Location? Item shall Include all Proposed Grade Changes and Dejymld twq Slopes Controlling Surface Water Flax. L $ Does the Site Plan and/or Survey describe the erosion '(AICs {Y11AA 154.tU and sediment conted practices that will be used to ❑ f control site erosion and storm water discharges. This TYdAMLf. r� S 11A Gs 1 CA 1111 1'rt JIM item must be maintained throughout the Entre Construction Period. JJ , a Y to <M F.l.CQ Ca AMAA T— 4 Will this Project Require any Land Filling, Grading or Excavation where there Is a. change to the Natural ✓ Q a.1/d IIA. Existing Grade Involving more than 2Do Cubic Yards ❑ of Material within any Parcel? 5 Will this Application Require Lend Disturbing AcMes . Encompassing an Area in Excess of Five Thousand a (5,000 S.F.) Square Fest of Ground Surface? 6 Is there a Natural Water Course Running through tie Sita? Is"Project within the Trusteejurisdiction ❑ or within One Hundred (101r) feetof a Wetlanda Ge l DEC SWPPP Rwulnmms: Subnasion of a SWPPP N Required for Y CauWdbn adMties Involving all Beach? disturbances of om (1) or mora scan; including disturbances of Ms than we acre that 7 Wil there be Site preparation on Existing Grade Slopes are part of a larger common pan that see WtnaWy disturb one or mon sora of land; which Exceed Fifteen (15) feet of Vertical Rim to ✓ Including Construction aetivides lnvWhg son dsbubences or lose than one (1)aem where One Hundred (11 OU) of Horizontal Distance? the DOC DEC has determined that a IMPOSE remit Is required for atarm water dlstl4pese. ( SINPPP's Shall name On Nlnbnwn Requirements of the SPDP.S rremnl Permit 8 Will Driveways, Parking Aron or other Impervious for Sean Waler DMhareee from Ce4Nuefim activity -Parma Nw oP.040-001.) Surfaces be Sloped to Direct Slo rn-Water Run -Off ❑ V/- 1. The SWPPP shall be prepnd prior a the subrdea of to Not. The NO] shag be 1. brut and/or In the direction of a Town fight-~ slAnAad to 04 Department prior lo Use tamwncemmofcombud on 69041". 2. The SWPPP"describe thsaroelon and sediment control produces end where 9 Will We Project Require the Placement of Material, requbed, pntaomhuctlon storm water mnmpement interim Mel wet be used ardor Removal of Vegetation and/or the Construction of any V,constructedtoreduce ere polaams instexm uses,risoMrgat and 4 seam tem Within the Town bight- &Way or Road Shoulder cernpemce with the names and coralBm ofthle pamA In addition, the 8wPPP shat Idenay pose" sources of poahtlon vasch my maeomby be ameaed Ic efaol M Area?1nh4 awewa xoT4wusm.arrwarheadwayApnhrl quslly disarm vMedacaepes. a. M SWPPPo enl nquee gw pmtaonamtioo a4rnh w mma9amm pnotice NOTE: It Any Amwarto Questions One Enough Mm In Answered with a Chack Nark In a Bet and the CmM4Uaeea W disturbance Is babes 6.0011 S.F. a 1 Asn In aa, corupor4m shall be prepared by a quaffed Design Professorial Lbere a l In Now York that Is Moudedirs" In use, principles and practices of Slam water Management a Smmiya4r, Grading, Drelmge, a Erosion commit Penn In Rpuhd by Me Town a Southard and Must be assembled for Renew Prior to Mena of AM aWIdInB Permit paTre: Atawtltlba N) arWe AmwrbreaM Ourbnh ReWlredMeOanpene Applke4n) ST ArlE OF NEW YORK, c �� OF ...vf7. S(^.'.>1 ........................ SS `jCOOUNTY ac.1�..... being duly That I, ..........4..:7m. Y.:...Al�.�{ir.�t.�(.�1�. sworn, deposes and says that he/she is the applicant for Penni[, (Nem d br@+IdrN slpxrg Ooerrmat). Andthat he/she is the s 1 rV................................._........._..................................... .................................................... . (Oenuy ,AganL Capae4 p09sr. ea) ••...••... Owner and/or representative of the Owner or Owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed herewidt. Sworn to before me this; oL:C...f!(rTr!I:IC...............................r� Notary PubG .........a................................. r.... _ _ (Sipnanv6clAppgaM) FORM - 06/10 Notary Public, state of New Yoe.. No. Ot R16042467 Qualified In Suffolk County Commission Expires May 30, L1694't T(( -L 0 0 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes", 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 Truste r tqg, local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION U ll FEB 2 8 2013 SCTM# 126 _ 05 4 Sauthcld Town The Application has been submitted to (check appropriate response): e ar o Tr s; Town Board E Planning Dept. 0 Building Dept. 0 Board of Trustees I . Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital 0 construction, planning activity, agency regulation, land transaction) FE (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Demolition of existing residence and abandonment of existing sanit residence with new sanit , construction of new two story all 0 Location of action: 8860 Peconic Bay Blvd. Laurel, NY Site acreage: 0.578 Acres Present land use: Single Family Residence Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address:. James and Janet D'Addario 45 Clock Tower Lane Old Westbury, NY (c) Telephone number: Area Code( ) 631-439-3256 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑X No ❑ If yes, which state or federal agency? DEVELOPED COAST POLICY NYS DEC Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III — Policies; Page 2 for evaluation criteria. 0 Yes ❑ No ❑ Not Applicable Demolishing an existing structure and replacing it with a new structure, and sanitary system will improve the environmental situation on this beach and site. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III — Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable There are no historic or archeological structures on property. C� Attach additional sheets if necessary • Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III — Policies Pages 6 through 7 for evaluation criteria R Yes [f] No E Not Applicable The new structure is in keeping with the style of all neighboring structures. Attach additional sheets if necessary - NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III — Policies Pages 8 through 16 for evaluation criteria ® Yes 2 No 2 Not Applicable All rainwater runoff is and will be retained on site with the use of underground drywells. During construction hay bales will be placed between the construction and the shore, to keep runoff spoils on the site. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria ® Yes E No E Not Applicable All rainwater runoff is and will be retained within the upland, by use of underground drywells. The sanitary system for the residence meets current SCHD standards for sanitary waste water. Thp i rn prty i G spryted by pulnl i c water a)scYPmC Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III — Policies; Pages 22 through 32 for evaluation criteria. P Yes E] No © Not Applicable No development will take place in the "protected" or "natural indiginous Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. © Yes ❑ No ❑ Not Applicable The development will not add pollutants into the air. All construction vehicles meet the Federal standards for air pollution discharge. The mechanical systems of the residence meet the federal standards for air pollution discharge. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III — Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable The construction and use of the residence will make use of the town's disposal and recycling center. All waste water "sanitary" will be discharged into an approved SCDHS sanitary system. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III — Policies; Pages 38 through 46 for evaluation criteria. © Ye Eln No ❑ Not Applicable No public land involved. Littoral access unimpeded. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See LWRP Section III — Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No © Not Applicable There are no public or commercial activities or uses on site. Historically this property and neighboring properties are residential in use and will Attach additional sheets if necessary Policy It. 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 This project will protect and preserve the living marine resources by maintaining all rainwater discharge and sanitary flow from the residence on site by approved SCDHS sanitary system and drywells for rainwater runoff. 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 D Not Applicable There are no agricultural lands on site. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III — Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ❑ Not Applicable The construction will be using equipment approved by the Federal government for energy usage. The residence will meet Federal standards for conserving energy "energy Star Program" and will use "NY State Energy Conservation and rnngfrurtion (Inde" for rnngtrurfinn of the regidenre PREPARED BY I�tiu�ct,� TITLE L' • Pef DATE ZJ Created on 5125105 11:20 AM S A M U E L S& S T E E L M A N February 28, 2013 Southold Town Board of Trustees Town Hall Annex Main Road Southold, NY 11971 RE: RECONSTRUCTION OF THE D'ADDARIO RESIDENCE 8860 Peconic Bay Boulevard, Laurel, NY 11948 SCTM# 1000-126-5-4 Dear Sir/Madam- We are requesting a WETLANDS PERMIT for the above reference project, for the reconstruction of an existing residence, and associated improvements. All drainagewill be directed to subsurface systems. For your review we are submitting the following documents: 1. Application 2. Short Environmental Assessment Form 3. Application Affidavit 4. LWRP Consistency Assessment Form 5. (3) SITE PLAN, FLOOR PLANS and ELEVATIONS 6. Stamped current Survey 7. Letter of authorization from Owner 8. Check for $250.00 9. Six (6) photographs of existing site conditions 10. Transactional Disclosure Form 11. Storm water run-off assessment form Please call us with any questions or concerns. Sincerely, SAMUELS & STEELMAN ARCHITECTS Thomas C. Samuels, Architect enc. a1AIN IZO,AI) ( LIT(. IIOG(JI:, N46CYORK 11')11 163 I 1733-6-101 ICU 16311'14 6407 SURVEY OF LOT #4 "MAP OF PROPERTY OF A. L. DO"45" FILED AUG. 14, Ig2q AS FILE # 21 SITUATE: LAUREL TOM OF SOUTHOLD SUFFOLK COUNTY, NY 5URVEYED 03-08-2012 UPDATED 0I-13-2013 SUFFOLK GOUNTY TAX # 1000-126-5-4 CERTHgM TO: JAMD'ADDARJO / JANET D'ADDARIO NATIONAL LAND IMURE COMPANY, LLC w CMCA00 TfrLE WSURANCE COMPANY MPN FF9 2 8 2013 NOTE5. n' 5 1 m =,28 E�'�BSS h. 0 MONUMENT FOUND O PIPE FOUND Area = 25,180 5q. Ft. Or 0S-781 Acres AREA TO TOP OF BLUFF = 21,28-7 5c1. Ft. FLOOD ZONE LINE A5 5HOM ON FEMA FIRM NUMBER 36103GO481H LAST UPDATED q/25/200q ELEVATIONS REF. NAVD '88 DATUM GRAPHIC, SCALE I"= 40' -30'1 �` s ,4A A J J Q` 1w to d 0dK S54 056 p�.4�°�cBay i' �� O� j �����AN�\) '�JOHN C. EHLERD SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.–C:\Users\Iohn\Dropbox\12\12-115 for HD.pro 0�0 </\ O Jae / / \ pp NEW UNDERGROUND WATER LINE FROM PUBLIC ` MATER MAIN AT ROAD TO RE5IDENGENEA \ o, _ LL / \ A \� METAL INLET 6(RATEE ( R RAI INK4TER FF \ Iq FROM DRIVEWAY \ G /a°� \ / \ NETRUGTURE \ /� �GO / 5���. / q \ NEW RYWELL (DW (3'x8' DIA) FOR \ \ Qy I TER SA 4 D FRENCE OM 6UTfER5 AT `/ / // �\ �\ NEIGHBORING /' \ STRUCTURE \ NEW UNDERGROUND WA LINE FROM LIG \ /- $ \ 1 WATER MAIN AT ROAD RESIDENCE `\ / EXISTING DRIVEWAY \ \ 1 \ / TO BE REMOVED \\ 1 X15TIN6 DRIVEWAY BE MOVED `\ GAGE, \ - MA 614 16HT "(� NEW DRYWELL (DW 8'-A) (4'xDIA) W/ OPEN \ \ . \ FT METAL INLET � / FROM DRIVEWARA� OR RAINWATER RUNOFF \ \` NEIGHBORING STRUCTURE \ '� DW NEW DRYWELL (121-13) (3'x8' DIA) FOR \' la 1� RRAINA TGE TR RUNOFF FROM &UTTERS AT \ x \ \ \ 1 NEW ¢R'''te- \ NEW BASEMENT ENTRY \ 1 €xP PARKI1�16 AREA � ` \ IB � NSTRUGTURE \ \ \ PROPOSED W SEPTIC SYSTEM \ FOR A 4 BEDROOM RESIDENCE 1000 GAL SEPTIC TANK (5T) / / \ - (2) 8' DIA x 6' HIGH LEAGHIN6 POOL (_P) \P Sr EXISTING HOUSE DEMOL15HED \ - FUTURE LOCATION FOR (1) 1 DIA x HIGH LEAGHIN6 POOL NEIGHBORING LP �/ . PROPOSED SCREENED PORCH \ 5TRUGTURE - ' .\ ST HOLE EL +19 \ EXISTING HOUSE K DEMOLISHED \`\ LOCATION OF EXI5TIN6 5ANITARY'- 5Y5TEM TO BE REMOVED - BUILDING WALL FF EL 19.0 GRADE LINE ELEVATION I"1.3 FT. 61RZADE LINE ELEVATION 19.5 FT. I' MIN. 2' MAX. I' MIN. 2' MAX. 107FT. TOP OF POOL 14.09 FT. SEPTIC LEACHING TANK IE +13.84' POOL BOT OF POOL B.Oq FT. ;.+16.2 IE. +13.96' GROUND WATER ELEV 3.4 FT _ I I' -n" — — S -O 3' MIN SEPTIC PROFILE (N.T.S.) \NP, E51DENGE \ \ 'FF ELEV \ \\ A + Iq.O '\ �. zx EX15TINO HOUSE DEMOLISHED— NEIGHBORING 5TRUGTURE / EXI5TING BEACH STAIRS IG■I■■G� off / ..■E■.■■G% aa■CA M III p ■G■■� 1 •i9�G NNEN MEMO \■■■■ENE i' . r1 PROP05M HAY BALES 4 SILT FENCE DURING GONSTRIIGTION NOWTURF EXISTING I SHOWN HA SURFACE TO X°e," `EXISTING BULKHEAD FLOOD ZONE LINE BEACH STAIRS TO BE REPLACED .00 ALINE OF HIGH WATER OBSERVED Great Pecon is Bay 9� SITE PLAN SCALE: V'= 20'-0" SITE DATA SCTM # 1000.126-5-4 PROPERTY: 8860 Peconic Bay Blvd. ADDRESS Laurel, NY OWNER: James and Janet D'Addario DRY WELL AREA x RAINFALL x 45 Clock Tower Lane (121-A) 5254 SF x (2/12 FT) x Old Westbury, NY SITE: 25,160 sf = 0.578 ACRES ZONING: Residential 40 (R-40) SURVEYOR: John C. Ehlers 360 GU. FT. 4 East Main St. Riverhead, NY 11901 RUNOFF FACTOR LICENSE # 50202 1.0 = 466 GU. FT. DATED March 8, 2012 LOCATION MAP TEST HOLE BROWN SILTY SAND SM WATER IN PALE 17 FT, BROWN FINE SAND SP 14.1 FT BELOW SURFACE - WATER p ENCOUNTERED, ELEV+3.4' DRAINAGE CALCULATION AREA OF NEW DRIVEWAY 06 DRY WELL AREA x RAINFALL x RUNOFF FACTOR (121-A) 5254 SF x (2/12 FT) x 0.9 • 560 CU. FT USE: (5) 8' DIAMETER x 4' HIGH POOL (5) VX *STORM DRAIN RING - 506.61 GU. FT. PROVIDED REQUIRED 506.41 Cu. FT. > 360 GU. FT. AREA OF NEW RESIDENCE DRY WELL AREA x RAINFALL x RUNOFF FACTOR (DW -B) 26126 SF x (2/12 FT) x 1.0 = 466 GU. FT. USE: (4) 8' DIAMETER x B' HIGH POOL (4) VX V STORM DRAIN RING - 506.6 GU. FT. PROVIDED REQUIRED 506.8 GU. FT. > 486 GU. FT. AREA OF NEW GARAGE DRY WELL AREA x RAINFALL x RUNOFF FACTOR 07104-C) 660 5F x (2/12 FT) x 1.0 - 110 GU. FT. USE. (1) V DIAMETER x 4' HIGH POOL (1) 8' X B' STORM DRAIN RING - 126.1 W. FT. PROVIDED REQUIRED 126.9 GU. FT. > 110 CU. FT. APPROVED BY BOARD OF TRUSTEES TOWN OF SOUTHOLD DATE(71- 13 FED 2 8 2013 TOWN APPROVALS I Z .I W Q� J 0 W J m Q V W (L W CD W 00 DD UI c PROJECT NO: 1206 DRAWN BY: TS DATE: 2/28113 SHEET TITLE: SITE PLAN 1 06 Z UIQ• �� o $ W J•�,i�� LL 7 W•�N�+� a W• u u� Q F-• UI c PROJECT NO: 1206 DRAWN BY: TS DATE: 2/28113 SHEET TITLE: SITE PLAN 1 t I� Zonlhq setback Ilna ------------------ ------ I I I ; ; ENTRY IPORGH I I . 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Acussoll Ings danot ba Isgall d a� 'habltaalp apace". I � LOFT PLAN SCALE: 114" =1• -0'• eo• FIRST FLOOR PLAN L0" REGULATORY APPROVALS } Z J W C W J m a m z 0 w a W c� O t0 co O Go z Jam• 5�.. p� W J• z z 7 W • rc � Q 2 W• QF• Sg W N• PROJECT NO: 1208 BY: TCS 2/28/13 1/4" = 1' - 0" SHEET TITLE: GARAGE SHEET NO: 5