The URL can be used to link to this page

Home My WebLink AboutTR-7467 NEW DEC PERMIT NUMBER 1-4738-03533/00001 FACILITY/PROGRAM NUMBER(S) YORK~TE DEPARTMENT OF ENVIRONMENTAL CON~VATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE June 15, 2006 EXPIRATION DATE(S) June 14. 2011 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15. Title 5: Protection of Waters [] Article 15. Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [3 6NYCRR 608: Water Quality Certifica- tion PERMIT ISSUED TO David Shamoon [3 Article 17, Titles 7, 8 SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control TELEPHONE NUMBER (631) 537-2177 ADDRESS OF PERMITTEE P.O. BOX 446, Brid~lehampton, NY 11932 CONTACT PERSON FOR PERM['FI-ED WORK Bruce A. Anderson, Suffolk Environmental Consulting, P.O Box 2003, Brid~lehampton, NY NAME AND ADDRESS OF PROJECT/FACILITY Shamoon property, Kreh Road, Mattituck COUNTY TOWN Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: SCTM # 1000-122-9-7.2 TELEPHONE NUMBER (631) 537-5160 WATERCOURSEjones Creek J NYTMCOORDINATES Construct a single family dwelling, garage, pool, decking, sanitary system, dr/wells and pervious driveway. Place 400 cubic yards of fill and grade. All work must be done in accordance with the attached plans stamped NYSDEC approved on 6/15/06. By acceptance of this permit, the penmittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: I ADDRESS Geor~le,W. Hammarth {DMG) I Re~]ion 1 Headquarters, BId~], ~40~ SUNY, Stony Brook, NY 11790-2356 AUTHORIZED S,GNATURE~.... ~..~../~~ LDATEjune 15, 2006 I Page 1 of 4 SPECIAL CONDITIONS 1 During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, m~xers, or other devices enter tidal wetlands and/or protected buffer areas 2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands or protected buffer areas 3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities 4. All areas of soil disturbance resulting from the approved project shall be stabilized with appropriate vegetation (grasses, etc.) immediately following project completion or prior to permit expiration, whichever comes first, If the project site remains inactive for more than 48 hours or planting is impractical due to the season, then the area shall be stabilized with straw or hay mulch or jute matting until weather conditions favor germination. 5, The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 75 linear feet from the tidal wetland boundary. 6. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales / silt curtains (or other NYSDEC approved devices) placed on the seaward side between the fill and the wetland or protected buffer area. Tarps are authorized to supplement these approved methods 7. All fill shall consist of "clean" sand, gravel or soil (not asphalt, slag, flyash, broken concrete or demolition debris) 8. To protect the values of the tidal wetlands, a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 50 linear feet landward of the tidal wetland boundary. 9. A row of staked haybales or other approved erosion control devices shall be placed at the tandward edge of the buffer area or 50 linear feet from the tidal wetland boundary, or as per the NYSDEC approved plan, prior to commencement of any regulated activities and remain in place and in good, functional condition until the project is completed and ali disturbed areas are stabilized with vegetation 10. Necessary erosion control measures e.g., staked haybales, silt fencing, etc are to be placed on the downslope edge of any disturbed areas This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good and functional condition until thick vegetative cover is established. 11 Roof runoff shall be directed into dry wells a minimum of 75 linear feet landward of the tidal wetland boundary for immediate on-site recharge. 12 Dry wells for pool filter backwash shall be located a minimum of 100 linear feet landward of the tidal wetland boundan/. 13. There shall be no draining of swimming pool water directly or indirectly in tidal wetlands or protected buffer areas. 14. Driveway must be 100% pervious (no asphalt or oil and stone surface.) 15 Driveways and parking areas shaft be constructed of NYSDEC approved pervious materials. 16 Roads, driveways and parking areas shall be graded to direct runoff away from tidal wetlands and protected buffer areas. 17. Sanitary systems (bottom of the tank and teaching pools) shall be located a minimum of 2' above seasonal high groundwater. I I DEC PERMIT NUMBER / J PAGE 2 of 4 I 1-4738-03533/00001 4 If future 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. 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. 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. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. There shall be no unreasonable interference with navigation by the work herein authorized. 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 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 If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 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 futly 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 and, if required, a survey. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved survey was prepared by Joseph A. Ingegno on 7/24/04 and hast revised on 4/10/06. DEC PERMIT NUMBER PAGE 3 of 4 1-4738-03533/00001 ' ' NE STATE DEPARTMENT OF ENVIRONMENTAL CONSE N 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 compliance 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 nor does it authorize the impairment of any dghts, title, or interest in real or personal property held or vested in a person not a party to the permit GENERAL CONDITIONS Genera( Condition '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 ail referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the proiect site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit, General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Uniess 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, General Condition 3: Applications for Per'mit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must inctude any forms or supplemental information the Department requires Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control iAPC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook NY 11790-2355 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the fight to modify, suspend or revoke this permit in accordance with 6 NYCRR Part 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; 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 matedal information or a matedal 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 regu)ations of the Department related to the permitted activity. OEC PERMIT NUMBER I PAGE 4 OF4 1-4738-03533/00001 SURVEY OF PROPERTY APPROVED BY ~,T[ '.~/.~- ~,/o ? .~. Nathan Taft Corwin III Land Surveyor SOU NO,,, TR.US' Address~ SOUTHOLD, N.Y. 11971 TEL..: 7G§-lSg2 2 WHEREAS, the proposed construction of a detached garage complies with the standards set forth in Chapter 275 of the Southold Town Code, and, 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, and, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees has found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees APPROVES the application of PAUL PAWLOWSKI to construct a detached garage with the condition gutters, leaders and dryweils are installed in accordance with Chapter 236 - Stormwater Management of the Town Code, the 30' buffer and 50' buffer are non-disturbance buffers with no further clearing, and as depicted on the revised survey prepared by , and, BE IT FURTHER RESOLVED, that there will be no further development of the property. 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, Jill M. Doherty', Presider Board of Trustees JMD/Ims Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 January 19,2011 BOARD OFTOWNTRUSTEES TOWN OFSOUTHOLD Mr. Paul Pawlowski P.O. Box 783 Mattituck, NY 11952 RE: 2404 CAMP MINEOLA RD., MATTITUCK SCTM#122-9-7.20 Dear Mr. Pawlowski: The Board of Town Trustees took the following action dudng its regular meeting held on Wed., January 19, 2011 regarding the above matter: WHEREAS, PAUL PAWLOWSKI applied to the Southold Town Trustees for a permit to install a 16'X 32' in-ground swimming pool under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated November 29, 2010, 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, a Public Hearing was held by the Town Trustees with respect to said application on January 19, 2011, 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 location of the proposed in-ground swimming pool does not comply with the setback requirements set forth in Chapter 275-3, specifically with Chapter 275-3D. Setbacks. The fo/lowing minimum setbacks apply to any and all operations proposed on residential property within the jurisdiction of the Board of Trustees: (1)(a)(5) swimming pools and related structures: 50', and, WHEREAS, the structure is proposed in an environmentally sensitive area, and, WHEREAS, the Board has determined that the proposed in-ground swimming pool will have a detrimental effect upon the health, safety and general welfare of the people of the town, and, NOW THEREFORE BE IT, RESOLVED, for the foregoing reasons, and based upon the application's failure to meet the setback requirements contained in Chapter 275 of the Town Code, and the location of the proposed swimming pool in an environmentally sensitive area, that the Board of Trustees deems the proposed project to be Inconsistent with the Local Waterfront Revitalization Program pursuant to Chapter 268 of the Southold Town Code, and, RESOLVED, there will be no further activity within the 30' and 50' non-disturbance buffers, and, BE IT FURTHER RESOLVED, that the Board of Trustees DENIES WITH PREJUDICE the application of PAUL PAWLOWSKI to install a 16'X 32' in-ground swimming pool, as applied for. This is not a determination from any other agency. Very truly yours, resident, Board of Trustees JMD/Ims Board of Trustees 17 January 19, 2011 WETLAND PERMITS: TRUSTEE DOHERTY: Wetland permits, number one, PAUL PAWLOWSKI requests a Wetland Permit to construct a detached garage and a 16x32' inground swimming pool. Located: 2404 Camp Mineola Road, Mattituck Camp Mineola Road, Mattituck. The CAC suppods the application with the condition the drainage for the garage and swimming pool complies with drainage code. Conservation Advisory Council requires more information regarding elevations. This is an application that was under a previous name that the Board had spent a lot of time on, and they made the house in such an area where there was minimal clearing of the property, and we put buffers on the area. It's basically a filled area, and we checked the previous permit and there was no conditions of a non-disturbance area. We did talk about in the Minutes how we didn't want any further expansion of the dwelling, but we didn't make any mention there is no condition of no clearing, for further clearing of the area. We all went out and inspected it. I don't know if, how we -- I don't think that the area for the pool is the best area, so I don't know if that, I'm not really inclined to approve that. Is there anyone here who would like to speak for or against this project? (No response). The other condition I would like to put on this, whatever approval we do, is that the existing 30 foot buffer and the existing 50 foot buffer, that we make it a non-disturbance area so there is no further clearing in those buffer areas. Is there any comment from the Board? (No response). It's found consistent with the LWRP. TRUSTEE GHOSIO: I think in lieu of the things we discussed when we did the original permit on this and knowing, you know, where the pool is going to be, I think encroaches on an area that we didn't want to see this, I would recommend that we don't allow the pool. As far as the detached garage, that's up in the front over by the road, and in a different spot. I didn't have a problem with that. TRUSTEE DOHERTY: I agree with that. Any other comments? TRUSTEE KING: Jill, we tried to keep the house at a minimum size because it's a pretty sensitive area there. I agree with Bob, I don't have a problem with the garage. It's up in the front between the house and the road. I think it's an inappropriate place for a pool. TRUSTEE GHOSIO: We should probably make a note on the file when we do the consistency compliance, certificate of compliance, that we just check the clearing to see what is going on in the back there. Because based on this picture you can see they have done some clearing, we were not really sure where they were doing it. So. Board of Trustees 18 January 19, 2011 TRUSTEE DOHERTY: Yes, and we surmised, basically, that was just a lot of it was broken and not sawed off. So just clearing up. All right, hearing no further comment, I'll make a motion to close the hearing TRUSTEE GHOSIO: Second. TRUSTEE DOHERTY: All in favor? (ALL AYES). TRUSTEE DOHERTY: I'll make a motion to approve the detached garage with gutters, leaders and drywells, and deny -- let me interrupt myself here. Lori, should we do two separate resolutions? I mean it's all applied for one. Can I do one resolution? MS. HULSE: Sure. TRUSTEE DOHERTY: So to approve the garage with the proper drainage, and deny the swimming pool. And with the conditions set on the property that the 30-foot buffer area and the 50-foot buffer area are non-disturbance buffer areas, so they can't be cleared at all. And I also want to put on, if it's okay with the rest of the Board, no further structures to be placed on this property after the garage. TRUSTEE KING: No further development of the lot. TRUSTEE DOHERTY: No further development. And we resolve to find it consistent with LWRP. TRUSTEE GHOSIO: Second. TRUSTEE DOHERTY: Any further discussion? TRUSTEE BERGEN: Question. On the original permit for the house, the buffers, were they designated at the time non-turf buffers or -- TRUSTEE DOHERTY: No, just says 50-foot buffer. TRUSTEE BERGEN: So, Lori, do we have to amend that original permit to change those from buffers to non-disturbance buffers or can we just go with this resolution where we are designating them as non-disturbance buffers? MS. HULSE: They are the same areas? TRUSTEE BERGEN: Yes. MS. HULSE: And on the old permit they are designated as -- TRUSTEE BERGEN: Just buffers. MS. HULSE: It's like putting an added condition. That's fine. You can do that now and it will basically trump the old permit. TRUSTEE BERGEN: Thank you. TRUSTEE DOHERTY: All in favor? (ALL AYES). TRUSTEE BREDEMEYER: Madam Chairwoman, as we discussed, I have to take leave of the meeting at this point. The storm last week rescheduled some mandatory fire department training that I really can't miss. If I could take leave and have the record reflect I had to leave. (The time noted is 6:53 PM). TRUSTEE KING: Number two, ERIC KOENIG requests a Wetland Permit to construct a two-story, single-family residence with 1,890 Board of Trustees 19 January 19, 2011 square foot first floor and 1,605 square foot second floor, 406 square foot two-car garage, 1,755 square foot cellar, 233 square foot front porch, 198 square foot second floor roof deck and 295 square foot rear decks. Located: 610 Jackson Landing, Mattituck. This was found consistent with the LWRP. The Conservation Advisory Council resolved to support the application with the condition trees over six inches in caliper are depicted on the survey. The area seaward of the house up to the six foot contour should be non-turf and non-disturbance seaward of six foot contour. No filling seaward of the house. I believe we went out here on a pre-submission last year and they have now come in for an application. The house is approximately 98 feet from the wetland line, so it's just jurisdictional, and we talked in the field about it. We are just looking at the Conservation Advisory Council recommendation. They wanted non-disturbance and six foot contour seaward. TRUSTEE GHOSlO: So more than the 50 feet we are talking about? TRUSTEE KING: That's more than what we inspected. MR. BOSSEN: Jim, I was the one that made the recommendation. The recommendation that the Conservation Advisory Council made was that there is the six foot contour, they were going to do the limit of the ground disturbance, so anything seaward of that would be non-disturbance, non-turf, and then there is the other dashed line, the limit of, I guess, I assumes is the 50-foot Trustee buffer, pretty much no fill in from here back. TRUSTEE KING: What we talked about in the field was possibly from the wetland line landward a non-disturbance buffer, to 25, and then from landward, another 25 feet non-turf. Just to kind of, because the next door at that neighbor has turf right down almost to the end. MR. BOSSEN: I just saw it as a really Iow spot. TRUSTEE KING: It's a good idea, really. MR. BOSSEN: They are saying no ground disturbance. I mean, it's a well-treed site, so turf will not grow anyway without removal of the trees. And the main thing is the Conservation Advisory Council saw was the removal of the large trees would exacerbate erosion on the site. TRUSTEE KING: If we did 25 and 25, it gets you almost ten feet landward of the six foot contour. MR. BOSSEN: Fine by me. TRUSTEE KING: This was flagged by Eh-Consultants in 2001. MR. HERMAN: It's actually a pretty old line. The DEC won't accept that line. It looks right, based on the topography. TRUSTEE KING: Any Board comments? Any comment from the audience? MR. KOENIG: Eric Koenig, I'm the owner of the property, and we are asking to build a house. It's the last vacant lot in that area and we thought we could build on there. I have a rendering here of the proposed house. TRUSTEE KING: We have it, yes. TRUSTEE GHOSlO: That one is prettier. It has more color. Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (631) 765-6641 BOARD OF TOWel TRUSTEES TOWN OF SOUTHOLD TO: PAUL PAWLOWSKI Please be advised that your application dated November 29, 2010 has been reviewed by this Board at the regular meeting of January 19, 2011 and your application to construct a detached garage has been approved pending the completion of the following items checked off below. XX Revised survey for proposed detached garage to include gutters, leaders, and drywells, notation of a 30' non-disturbance buffer and 50' non-disturbance buffer and the deletion of proposed in-ground swimming pool. __ Pre-Construction Hay Bale Line Inspection Fee ($50.00) __ 1st Day of Construction ($50.00) __ % Constructed ($50.00) XX Final Inspection Fee ($50.00) __ Dock Fees ($3.00 per sq. ft.) Mooring/Duck Blind Permit Fee ($25.00) 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, TOTAL FEES DUE: $ 50.00 BY: JiIIM. Doherty, 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 Tues., January 11,2011, the following recommendation was made: Moved by Derek Bossen, seconded by Audrey Horton, it was RESOLVED to SUPPORT the Wetland Permit application of PAUL PAWLOWSKI to construct a detached garage and a 16'X 32' inground swimming pool. Located: 2404 Camp Mineola Rd., Mattituck. SCTM#122-9-7.20 Inspected by: Audrey Horton, Derek Bossen The CAC Supports the application with the Condition the drainage for the garage and swimming pool complies with the drainage code. The CAC recommends more information regarding the elevations. Vote of Council: Ayes: All Motion Carried Jill M Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer PO Box 1179 Southold, NY 11971 Telephone (631 ) 76% 1892 Fax (631 ) 765-6641 Southold Town Board of Trustees Field Inspection/Worksession Report Date/Time: PAUL PAWLOWSKI requests a Wetland Permit to construct a detached garage and a 16'X 32' inground swimming pool. Located: 2404 Camp Mineola Rd., Mattituck. SCTM#122-9-7.20 t,~ of area to be impacted: __Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Pao~.h~ Town Code proposed work fails under: __Chapt.275 Chapt. 111 other Type of Application: C'~Wetland __Coastal Erosion __Amendment __Administrative__Emergency Pre-Submission __Violation Info needed: Modifications: Conditions: Present Were.'~J.King ~0herty/~J. Bredemeyer B.Ghosio, __ D. Dzenkowski other Form filled out in the field by D. Bergen? Mailed/Faxed to: Date: BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6620 DATE: MAY 16. 2007 ISSUED TO: DAVID SHAMOON PROPERTY ADDRESS: 2404 CAMP MINEOLA ROAD EXT. MATTITUCK SCTM~ 122-9-7.20 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 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 ~ and in consideration of application fee in the sum of $250,00 paid by Da~_.~_..c~_hamoon and subject to file Texw~ and Conditions as s~ated in the Resolution, thc Southold Town Board of Trnstees authorizes and perm/ts the following: Wetland Permit to construct a single-family dwelling, deck, driveway, and sanitary system with the condition that the dwelling and deck be on pilings, installation of gutters and dryweHs to contain roof runoff, no fill except for the sanitary system, no additional and/or nor further expansion to dwelling will be permitted, a pervious driveway, and a line of staked hay bales to be installed prior to construction, and as depicted on the survey prepared by Nathan Taft Corwin IH, last revised July 12, 2007, and received on August 20, 2007. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majorily of thc said Board as of this dale. ~kers6n - Absent DEC PERMIT NUMBER 1-4738-03533/00001 FACILITY/PROGRAM NUMBER(S) ~TATE DEPARTMENT OF ENVIRONMENTAL'~ONSERVATION I EFFECIIVE DATE June 15, 2006 P E RM IT ~xP,RAT,ON DATE(S) Under the Environmental June 14, 2011 Conservation Law TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to'Construct [] Permit to Operate [] Article 15, Title 5: Protection of Waters [3 Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15:.Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certifica- tion [] Article 17, Titles 7, 8; SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [3 Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37;6NYCRR 380: Radiation Control PERMIT ISSUED TO David Shamoon ITELEPHONE NUMBER (631) 537-2177 ADDRESS OF PERMITTEE P.O. Box 446, Bridgehampton, NY 11932 CONTACT PERSON FOR PERMI'I-I'ED WORK Bruce A. Anderson, Suffolk Environmental Consulting, P.O. Box 2003, Bddgehampton, NY NAME AND ADDRESS OF PROJECT/FACILITY ITELEPHONE NUMBER (631)537-5160 Shamoon property, Kreh Road, Mattituck COUNTY I TOWN Suffolk Southold SCTM # 1000-122-9-7.2 WATERCOURSE Jones Creek NYTM COORDINATES DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a single family dwelling(.garage, ~ool,~ecking, sanitary system, drywells and pervious driveway. Place 400 cubic yards of fill and grade. All work must be done in accordance with the attached plans stamped NYSDEC approved on 6/15/06. r~/~~ /,..) ~.~ By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ] ADDRESS George W. Hammarth (DMG) I Region 1 Headquarters, Bldg. #40, SUNY, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE~~.~.~~ IDATEjune 15, 2006 ] Page 1 of 4 OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. 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 To: Jill Doherty, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: January 18, 2011 Re: Proposed Wetland Permit for PAUL PAWLOWSKI SCTM#1000-122-9-7.20 PAUL PAWLOWSKI requests a Wetland Permit to construct a detached garage and a 16'X 32' inground swimming pool. Located: 2404 Camp Mineola Rd., Mattituck. SCTM#122-9-7.20 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 LWRP policy standards to the greatest extent practicable and therefore is CONSISTENT with the LWRP, Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (63 I) 765-1892 Fax (631 ) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only __Coastal Erosion Permit Application ZWetland Permit Application Amendment/Transfer/Extension ~Rece~vved Application:~ .~Received Fee:$ r.~.~'a"~ --.~ompleted Appli-c'ation ! ! ~ 0-C~ i L~ __Incomplete __SEQRA Classification: Type I Type II Unlisted __Coordination:(date sent). ' ~[~WRP Consistency Assessment Form }&lOq ~_CAC Referral Sent:D ~o~%,\~3 ~,~'Date of Inspection:_ I~ 10-1 IO- ~ __Receipt of CAC Repod: __Lead Agency Determination: Technical Review: ~ublic Hearing Held: I !] c~ ! ~ I Resolution: Administrative Permit Name of Applicant Address Phone Number:( Suffolk County Tax Map Number: 1000- ~ Property Location: -c)"/o~ ('..qr~/~ ~/'A~'~'o'~'~ (provide LILCO Pole #, distance to cross~ AGENT: (If applicable) Address: Phone: of T~us2ees ~ppl~c~ Land Area (in square feet): Area Zoning: GENERAL DATA Previous use of property: Intended use of property: ~; ~ (,~.~ Covenants and Restrictions: Yes If "Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals~ Yes If "Yes", please provide copy of decision. Prior permits/approvals for site improvements: Agency Date __ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? If yes, provide explanation: No__ Yes No Project Description (use attachments if necessary): / of Trustees Applic~ WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose ofthe proposed operations: ~g.~ ~.xm~m_ Area of wetlands on lot: Percent coverage of lot: .square feet % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? No ~ Yes If yes, how much material will be excavated? ~ ',~ cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: ~/" feet Proposed slope throughout the area of operations: /q~ ~>/,9t(~ ~ Manner in which material will be removed or deposited: .5~t,~t/ ~ ! 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): PROJECT ID NUMBER PART 1 - PROJECT INFORMATION 617.20 APPENDIX C STATE ENVIRONMENTAL QUALITY REVIEW SHORT ENVIRONMENTAL ASSESSMENT FORM for UNLISTED ACTIONS Only ( To be completed by Applicant or Project Sponsor) SEQR 1. APPLICANT / SPONSOR3.PROJECT~..~.~.3~LOCATiON: ~ ~'~'~7'~/~*~f 2. PROJECT NAME 4. PRECISE LOCATION: Street Addess ~m~Road Inters~c~oons, Prominent land~arks etc -or provide maa 5.1S PROPOSED ACTION: [] New [-'-]Expansion []Modification/alteration 6. DESCRIBE PROJECT BRIEFLY: 7~ AMOUNT OF LAND AFFECTED: Initially acres Ultimately acres 8. V~LL PROPOSED ACTION COMPLY WITH EXISTING ZONING OR OTHER RESTRICTIONS? L~es [] No If no, describe briefly: 9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (Choose as many as apply.) ~esidential [--'~lndustria, []Commercial r-]Agriculture [~ Park / Forest / Open Space [~Other (doscdbe) 10. DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANY OTHER GOVERNMENTAL .~NyCY (Federal, State or Local) es F-"] No If yes, list agency name and permit / approval: 11. DOES ANY ASPECT OF THE A'CTION HA~E A CURRE~--TLY 'VALID PERMIT O'~ APPROVAL? ]Yes [~No If yes, list agency name and permit / approval: 12. AS ARRSULT OF PROPOSED ACTION WILL EXISTING PERMIT/ APPROVAL REQUIRE MODIFICATION? [~YesI~'No I ~ERTIFY THAT THE INFORMATION PROVIDED ABOVE IS TRUE TO THE BEST OF MY KNOWLEDGE Si~n~t~m If the action Is a Costal Area, and you are a state agency, complete the Coastal Assessment Form before proceeding with this assessment PART II. IMPACT ASSESSMENT ~To be completed b~/Lead AgenCy)- A. DOES A~ EXCEED ANY TYPE I 'II'~RESHOLD IN 6 NYCRR, PART 617.47 ff ye~, ooeea'inate the ~ prc~e~s a~d use Ihe FULL EAF. B. W~U-ACTIONRECEIVECOOR~NATEDREV1EWA~PROVIDEOFORUNMSl~DACT~ONSIN6NYCRR, PART617.67 IfNo, anngaOve C. COULD ACTION RESULT IN ANY ADVERSE EFFECTS ASSOCIATED WITH THE FOU.OWING: (Answem may be headwdtle~, If leglfl~e) No C6. Long tern% shqrt lemt, c~mulaflve, or other effects not Henfllled In Cl-C57 Explain Ixletly: O. ~ THE PROJECT HAVE AN IMPACT ON THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED ~ ESTABLISHMENT OF A CRITICAL lc IS THERE, O~ IS ~ UKELY TO BEI CoN'rR~)VI~ REt. ATED TO'POI'EJ~FIAL ADVERSE F-~IVIRO,~;M~C,%'TAL IMPACTS? If PART III- De I ~I~A'IION OF $1GNFICANCE (TO be (x)mpleted by Agency) IN~'IRU~I'ION8: F~eachadver~e~ectide~t~ed~b~ve~determk~e~etheri~i~ub~tan~ia~`~ar~e~imp~rtan~m~n~ Each ~ ~sou~f be aa~a~l in ~om~lon wi~ ira (m) ~etti~ (Lo. urba~ o~ mraO; (b) prol~ll~ of m~u~O; (~ d~a~on: (d) geographic ac(~e; and (f) magnitude, ff necesaaW, add att~ or re~,auf:k~:~lno mat~ Eneum that explmlalloos EAF ar, d/er prepare a posfOvedecim,a~. WILL NOT result In any ~g~flcant adverse envh'onmenlel ~ AND la'o~de, on aifadxnm~ as nec~y, the reasorls SUpporting Beard of Trustees Name of Lead Jill M. Doherb/ Date President Ti'de of Responsible Officer 8~lti~iU~u of Preparer (If dilfemnt from i~spo~ble offleer) Town of S - uthold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER~ GRADING~ DRAINAGE AND EROSION CONTROL PLAN District Section BLocK Lot CERTIFIED BY A DESIGN PROFESSIONAl. IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM # / WORK ASSESSMENT ] Yes No a. What is the Total Ama of the Project Parcels? 1 Will this Project Retain All Storm-Watar Run-Off (include Total Area of all Parcels located within Generated by a Two (2#) Inch Rainfall on Site? the Scope of Work for Proposed Construction) (This item will include all run-off created by site b. What is the Total Area of Land Cleating (s J=' i Acme) cleadng and/or construction activities as well as ail , and/or Ground Disto~bance for the proposed Site Improvements and the permanent creation of construction activity? impervious surfacas.) (s.F.,,=.) 2 Does the Site Plan andlor Survey Show AIl Prop<:~ed PROVIDE BRIEF PROJECT DF~ON IPro~ ~ r~e,. N.~) Drainage Structures Indicating Size & Location? This item shall include all Proposed Grade Changes and -- 3 Does the Site Plan and/or Survey descdbe the erosion and sediment control practices that will be used to ~, - control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Pedod. 4 Will this Project Require any Land Filling. Grading or Excavation where there is a change to the Natural i i Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface?~ -- 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustaes jurisdiction 3eneral DEC SWPPP Requirements: or within One Hundred (100') feet of a Wetland or -- Submission of a SWPPP is required tix all Construction activities inv~ving soil Beach? disturbances of one (1) or mom acres; including disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that wil ultimately dlsr~ rb one or more acres of land; which Exceed Fifteen (15) feet of Vertical Rise to including Construction activities involving soil disturbances of lass than one (1) acre where One Hundred (100') of Horizontal Distance?~ -- the DEC has determined that a SPDES permit is required for stem1 water discharges. SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways. Parking Areas or other Impervious f~' Ston~ Water Discharges from Construction activity. Permit No. GP-0-t0-00~.) Surfaces be Sloped to Direct Storm-Water Run-Off ~" 1. The SWPPP shall ha prepared prior to the subrniaal of the NOI. The NOI shall ha into and/or in the direction of a Town right-of-way?~ -- STATE OF NEW YORK, .~ . / / - ~, courrrY or..W..~...~ .............. ss And that he/she is the ................................... [E,:%.~.:9.~.......:. ........................................................................................... Owner and/or representative of the Ovmer 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 ~u~d belief; and that the work will be performed in the mmmer set forth in the application Fried herewith. Sworn to be£ore me this; ~ ~ ~'r '~ es Jan 30 2011 Jill M. Dohcrty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredcmcyer Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631 ) 765-1892 Fax (63 I) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of PAUL PAWLOWSKI COUNTY OF SUFFOLK) STATE OF NEW YORK) ,i! ' dA[! - 3 2011 AFFIDAVIT OF POSTING I, /~/~{/y//~,//~Z,-residingat/~ C-~O being duly sworn, depose and say: That on the day of ~ $~,) ,201~, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that 1 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 Wed., January 19~ 2011 on or about 6:00 PM. Dated: ..la ~a~x~ '5, ZO t ~ Sworn to before me this day of Jo vx 20 I I PENNY BEDELL Notary Public, Stero of New York PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS ma~le; Address: STATE OF NEW YORK COUNTY OF SUFFOLK , being duly sworn, deposes and says that on the day of ~/~_ ,20 { I , deponent mailed a tree 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 mailed at the United States Post Office at /'91,oa-F~ ~ aa.-. ,,,t ~ , that said Notices were mailed to each of said persons by (certified) '(registered) mail. - Sworn to before me this Day of 20 Notary Public of Trustees County o f A~'d/b?2~ State of New York ~pd.~ ~.o~e,-~z~r.~ [ 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 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 /~ DAYOF /~/~ ,20 ROBERT MARTOCCI Notary Public - State of New York No. 01MA6081936 Qualified in New Yerk County M:t Comm ~E~)r~_/~.~ _3~,_ 2011 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics urohibits conflicts of interest on the hart of town officers and emnloveez. The ouroose of ~i~ form is to nmvide info~natior~ which can alert the town of oossible conflicts of intem~t and allow it to rake whatever action is ne t ids e' ~/~,~ f~Kl,~ (Last name, fuat name,~alddle initial, unlesz you are applying in ~he name of someone else or other entity, such as a company. If so, indica~ thc other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance _,~ Building Variance ~ Trustee Change of Zooe Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If "Other", name the activity.) Do you personally (or through your company, spouse, sibling, parent, or child) have a relationship with any officer or employee of the Town of Soathold? "Relationship" includes by blood, marriage, or business interest. "Business interest'? means a business, including a partnership, in which the town officer or employee has even a partial ownership of (or employment by} a corporation in which the town officer or employee owns more than 5% of~ares. YES NO V~ ~ 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(thc applieanl/agentffrepresc nt ative) and the town officer or employee. Either check the appropria~ 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 applic~ant (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 Form TS 1 Submi~edthis dayof i(' ~0 200 Signature ~.~-~--~ Print Name ~'~'14,~ 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). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus~ each answer must be explained in detaiL listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# /,; ~ - . ,/, ~ / The Application has been submitted to (check appropriate response): Town Board ~- Planning Board ~-~ Building Dept. '~ Board of Trustees~ Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Site acreage: / flll~ Present land use: ~ Present zoning classification: 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: /~/Cl~t (b) Mailing address: QD ~ (c) Telephone number: Area Code ( )_ (d) Application number, if any:. Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes [] No [~' If yes, which state or federal agency?. C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III - Policies; Page 2 for evaluation criteria. [~Yes ~-] No ~] Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria --t~L Yes ~ No F'~ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria [] Yes [] No ~r~Not Applicable Atlach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ~[-~ Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria [~Yes No Not Applicable 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. ~ No Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III - Policies Pages 32 through 34 for evaluation criteria. ~-] Yes [] No ~ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southoid from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ~Yes ~-~ No ~Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. [] Ves~ No ~] Not Applicable Attach additional sheets if necessary WORKING COASTPOLI~E$'~ 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. Applicable Attach additional sheets ifnacessary 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 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 ~k~Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. Y P~PA~DBY KRAUS ROAD SURVEY OF PROPERTY SITUA TN MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-122-09-7.20 SCALE 1"=50' JULY 24, 2004 dUNE 3, 2005 ADDED TOPOGRAPHICAL SURVEY SEPTEMBER 21, 2005 AODED SITE pLAN NOVEMBER 29, 2805 REVISED AS PER N.Y D E C, NOTICE OF INCOMPLETION CANUARY 13, 2006 ADDED PROPOSED WATER LINE MARCH 21 2006 SET LATH FOR SITE INSPECTION MARCH 50, 2008 ~EMOVED RET. WALL ALONG DRIVEWAY · GARAGE APRil 1o. 2006 REVISED PROPOSED DECK ~ POOL JUNE 7, 2006 R~SED DRYWELLS PER flYSDEC NOTICE DATED 5X25/'06 OCTOBER 26, 2006 LOCATE WE~ND FLAGS 1A-~'A JANUARY 15, 2007 SET LATH FOR SITE INSPECTION MARCH 5, 2007 REVISED PROPOSED HOUSE · SET LATH FOR SITE INSPECTION JULY 12, 2007 REVISED A~ PER SUPFOLK ENVIRONMENTAL CONSULTING, INC LETTER 06/1'*/07 OCTOBER 20, 2007 REVISED PROPOSED DRYWELL LOCATIONS APRIL 15, 2008 REVISE PROPOSED SEPTIC SYSTEM MAY 17 2010 STAKE HOUSE ,JULY 19, 2010 UNDER CONSTRUCTION SURVEY AUGUST 26. 2010 FINAL SURVEY NOVEMBER 15 2010 ADDED PROPOSED ADDITIONS JANUARY 5, 20 STAKE PROP, POOL & GARAGE FOR SITE ~NSPECTION AREA = 40,817 sq. ft. 0.957 NOTES: 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM MAR - 7 2011 LOT COVERAGE DATA (OVER UPLAND ADJACENT AREA 40,045 s, ft.) DESCRIPTION AREA % LOT COVERAGE EXISTING HOUSE 1,258 scI. fl. 3.1% EXISTING DECK 581 sq. ff. 1,4% TOTAL EXISTING 1,799 sq. ff. 4.5% PROPOSED GARAGE 560 sq. ft. 0.9% PROPOSED POOl 512 sc~. ff. 1.3% TOTAL EXIST. & PROPO. 2,671 scI. ff. 6.7% NOTE: AREA OF WETLANDS = 762 sq. ft. UPLAND ADJACENT AREA,= 40.055 sq. ft. SEPTIC SYSTEM TIE MEASUREMENTS ~ HOUSE HOUSE CORNER [] CORNER[] SEPTIC TANK COVER 1 70' 37' LEACHING POOL COVER 2 83' 48' LEACHING POOL COVER 5 79' 42' LEACHING POOL COVER 4 77' 58' LEACHING POOL COVER 5 85' 46' LEACHING POOL COVER 6 92' 56' LEACHING POOL COVER 7 85' 50' BOUNDARY AS SOUTHOLD TOWN TRUSTEES S 84°50'5°'' W 130.00' TEST HOLE DATA UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD. I¢ ANY, NOT SHOWN ARE NOT GUARANTEED, Nathan Taft Corwin III Land Surveyor Successor To: Stanley d Isaksen, Jr ES Joseph A Ingegno L S, PHONE (651)727-2090 F~x (651)727-1727 30-126E