HomeMy WebLinkAboutTR-8239A
QF SOpr~,o Town Hall Annex
John Bredemeyer, President 54375 Main Road
Michael J. Domino, Vice President P.O.Box1179
James F. King T Southold, New York 11971-0959
Charles J. Sanders -
• ~O~ Telephone (631) 765-1892
291'A. Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0947C Date: January 14, 2014
THIS CERTIFIES that the construction of a +/-3' high concrete retaining wall around
existing patio, • addition of approximately 30 cv of fill around patio wall; addition of
gpproximate1y 170 cv of fill for proposed new driveway with a new dgwell for runoff-, roof
runoff directed into drywell
At 504 Conklin Road, Mattituck, New York
Suffolk County Tax Map # 139-4-5
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated June 20, 2013 pursuant to which Trustees Administrative Permit #8239A Dated
July 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 construction of a +/-3' high concrete retaining wall around existing patio; addition of
approximately 30 cv. of fill around patio wall; addition of approximately 170 cv. of fill for
proposed new driveway with a new drywell for runoff; roof runoff directed into dry.
The certificate is issued to KEN & WENDY KMETZ owners of the
aforesaid property.
Q,oe
thorWSignature
0
James F. King, President o~OgpFFO(,~co Town Hall, 53095 Main Rd.
Bob Ghosio, Jr., Vice-President !(y P.O. Box 1179
Dave Bergen s Southold NY 11971
John Bredemeyer O~ Telephone(631)765-1892
Michael J. Domino y4j ! Fax (631) 765 I
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: %p~
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1 at day of construction
%a constructed
Project complete, compliance inspection.
INSPECTED BY. /z~ / A)
COMMENTS:
fC - Co,t--Fr1> S 7-0 09,e4to T 7,//7/)3
CERTIFICATE OF COMPLIANCE: 1
•
James F. King, President g~FFO( Town Hall, 53095 Main Rd.
~ K
Bob Ghosio, Jr., Vice-President ti~~ ~O~ry P.O. Box 1179
Dave Bergen ~ ~ Southold, NY 11971
w
John Bredemeyer ~~F.. Telephone (631) 765-1892
Michael J. Domino 1 f Fax (63l) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINI`MENT FOR APRE-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 oonstnaction
_ %z constnacted
Project complete, compliance inspection
•
James F. King, President ~OF SQU~y Town Hall Annex
Bob Ghosio, Jr., Vice-President 54375 Main Road
P.O. Box 1179
Dave Bergen ~ # Southold, New York 11971-0959
John Bredemeyer y ~
Michael J. Domino • ~O Telephone (631) 765-1892
~~~ou~,~ Fax (631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 8239A
Date of Receipt of Application: June 20, 2013
Applicant: Ken 8~ Wendy Kmetz
SCTM#: 139-4-5
Project Location: 504 Conklin Road, Mattituck
Date of Resolution/Issuance: July 17, 2013
Date of Expiration: July 17, 2015
Reviewed by: James F. King, President
Project Description: To construct a t3' high concrete retaining wall around
existing patio; add approximately 30 cubic yards of fill around patio wall; and add
approximately 170 cubic yards of fill for proposed new driveway with a new
drywell for runoff; with the condition that roof runoff be directed into drywell.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Michael Macrina, Architect, last dated on June 17, 2013,
and stamped approved on July 17, 2013.
Special Conditions: Roof runoff be directed into dnnnrell.
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
James F. King, President
Board of Trustees
to .i h
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Ib3lITOTIOn9'OX 8U88EOVENT OWNERl.
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gpFFa(,~
James F. King. President C~, P.O. Box 1179
Bob Ghosio, Jr., Vice-President ~ '1 Southold, NY 11971
Dave Bergen ~ ? Telephone (631 765-1892
John Bredemeyer ~ a Fax (631)765-6641
Michael .I. Uomino 'F
sy~f ~ ~aor
Southold Town Board of Trustees
Field Inspection/Work Session Report
DatelTime: ~I u C. l.~ 3~ ~ r ~
Michael Macrina, Architect on behalf of KEN 8 WENDY KMETZ requests an
Administrative Permit to construct a t3' high concrete retaining wall around
existing patio; add approximately 30 cubic yards of fill around patio wall; and add
approximately 170 cubic yards of fill for proposed new driveway with a new
drywell for runoff. Located: 504 Conklin Road, Mattituck. SCTM# 139-4-5
Type of area to be impacted:
-Saltwater Wetland f~Freshwater Wetland -Sound -Bay
Distance of proposed work to edge of wetland
Parj of Town Code proposed work falls under:
_Chapt.275 Chapt. 111 -other
Type of Application: _ Wetland -Coastal Erosion -Amendment
r%Administrative_Emergency -Pre-Submission Violation
Info needed:
Modifications: ~~k~~oF i~.IN_. a F>~ s~sd~~ D ,~"k' nlz~E'c~T~~D
i N%"D U a~./la C C f
Conditions: - ~C-cor /t~rv.oJJ ~t>frs~.,T (y ~it<<7.Q.~
iN7D a.~/~ 7 2-r'a~ ;j
Present Were: J. King _B. Ghosio D. Bergen,
J. Bredemeyer Michael Domino D. Dzenkowski other
Form filled out in the field by ,
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Mailed/Faxed to:
Date:
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Kmetz Residence, 504 Conklin Road, Mattituck, NY
photos taken on 5!8106 at 3:00 pm
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suFFOC.r
James F. King, President Cq- P.O. Box 1179
Bob Ghosio, Jr., Vice-President ~ Southold, NY 11971
Dave Bergen ~ ? Telephone (631 765-1892
John Bredemeyer ~ Fax (631)761-6641
Michael J. Domino ~ 't`
y~ol ~ ~ao~
Southold Town Board of Trustees
Field InspectionNVork Session Report
DatelTime: ~FI~ /a ~ a(3 i 7: a o
KENNETH P. KMETZ requests aPre-Submission Inspection to discuss adding
fill to an area in rear yard and all of driveway to prevent future flooding; and
installing a retaining wall around back patio to prevent further flooding into
dwelling. Located: 540 Conklin Road, Mattituck. SCTM# 139-4-5
Type of area to be impacted:
-Saltwater Wetland -Freshwater Wetland -Sound -Bay
r~-~ i
Distance of proposed work to edge of wetland ] 7 8~
Part of Town Code proposed work falls under:
~I'apt.275 _Chapt. 111 -other
Type of Application:Wetland -Coastal Erosion -Amendment
_Administrative_Emergency -Pre-Submission Violation
Info needed:
/1/~~t ~3 ~'avn, I~`
Modifications:
Conditions:
Present Were: ~J. King '~B. Ghosio ~D. Bergen,
_~J. Bredemeyer 4-'Michael Domino D. Dzenkowski other
Form filled out in the field by J ~1,
Mailed/Faxed to:
Date:
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MONUMENT
SUBD/V/S/O' MAP F/LED /N TNf OFF/CE
fesf /jc% ~ DF THE CLE~K OF SUFFOLK COUNTY ON
fAE LOCAT70N OF 1PELL3 AND CESSPOOLS 11J/NE 24P /9LR9 AS MAP All. 677
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OFFICE LOCATION: O~~OF SOUryOI MAIL[NG ADDRESS:
Town Hall Annex 't O P.O. Box 1179
54375 State Route 25 1~[ # Southold, NY 11971
(cor. Main Rd. & Youngs Ave.) y ~
Southold, NY 11971 ~ ~ ~p~ Telephone: 631 765-1938
p~yCOU~'~A~ Fax: 631 765-3136
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM p E C~ I V~ D
D
JUL 1 1 2013
To: Jim King, President `01'~~'~~~~°~n
Town of Southold Board of Trustees ar . ii ; e
From: Mark Terry, Principal Planner
LWRP Coordinator
Date: July 10, 2013
Re: LWRP Coastal Consistency Review for KEN &WENDY KMETZ
SCTM# 1000-139-4-5
Michael Macrina, Architect on behalf of KEN &WENDY KMETZ requests an Administrative Permit to
construct a t3' high concrete retaining wall around existing patio; add approximately 30 cubic yards of
fill around patio wall; and add approximately 170 cubic yards of fill for proposed new driveway with a
new drywell for runoff. Located: 504 Conklin Road, Mattituck. SCTM# 139-4-5
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.
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
I
• ~
James F. King, President ~QF SO(/j Town Hall Annex
Bob Ghosio, Jr., Vice-President ~~p 5 P O 1~
Dave Bergen ~ ~ Southold, New York 11971-0959
John Bredemeyer ~
Michael J. Domino ~ Telephone (631) 765-1892
~rM Fax (831? 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only '
Coastal Erosion Petmit Appticatioy
Wetland Petmit Application V Administrative Pettnit -
_AmendmenVTtans /Extynsion
t~eceived Application: 7"Af11~3
? eceived Fce:$ p E C E I V E
Completed Application ,
lncomplete~ _ ~
- '
_sEQRA Classification: JUN 2 0 2013 '
Type IType II_Unlisted___
~oordination:(date sent) _ r ` _ ^ I • „ '
,7LWRP Consistency Assessment Fotm `P lI %~'('Tf`''~
f;P.C Referral Sene _ d awn
y~~ate of Inspection: _'7 ~ e
Receipt of CAC Report:
Lead Agency Determination:
~e~hnical Review:_
? Yublic Hearing Held i
Resolution: i
- _ _
Name of Applicant / ~ I Gt
Mailing Address ~ W 1~4~C I~I~ ~ ~ I ~ 7i
Phone Ntunber:
_ ( ) ~a~_J_I-L~
Suffolk Cotmty Tax Map Ntunber: 1000 - ~ -
Pro y Location: ~O I~
I K-t~ ~T N~ ~ ~ 7i
L(Jh~l~Ll ~ o~P~
(provide LI O PolIle distance to cross streets, and location)
AGENT: ~I~?i~~n~2 r~~~+QL
(If applica~bjle) I II ~ ~ ~ ~ v~ d
Address:_"// I AkI1J. 1 ~''lot.~
~ Imo. I la
- - - - Phone: (y ~'7 ~ ~p 7ri7 S
~rd of Trustto>r Applicatio,
~l GENERAL DATA
Land Area (in square feet): ?'j'°f~ _
-T
Area Zoning: ~ - ~ (7
Previous useofproperty: ~I~GFI-~ -~IL~ ~ ~~1_~~~_
T
Intended use of property: ~ ~ ~u~ ~rJ
Covenants and Restrictions on property? Yes t~No
If "Yes", please provide acopy. /
Will this project require a Building Permit as per Town Code? Yes ? No
If "Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review
and Elevation Plans will be required. ,
Dces this project require a variance from the Zoning Board of Appeals? Yes No
If "Yes", please provide copy of decision.
Will this project require y demolition as per Town Code or as determined by the Building Dept.?
Yes ~No
Does the structure (s} on property have a valid Certificate of Occupancy/! ? Yes No
Prior permits/approvalsfnr site improvements:
Agency Date
i
No prior permits/approvals for site improvements. . /
Has any permiUapproval ever been revoked or suspended by a governmental agency? r' No Yes
If yes, provide explanation:
ascription (use atta~~chnnments if neLLCessary): ~ /
~ LL ?~ti-~o ~LJO fCk I ~~G+ ~IYI
pp ~
~I VL ~-(~o~lnlo `/~o WAw
i
Nunemaker, Amanda
From: Michael Macrina <mmacrina@optonline.net>
Sent: Wednesday, June 26, 2013 1:24 PM
To: Nunemaker, Amanda
Subject: Kmetz Application
Hi Amanda,
Please see below the following as per your request for the Kmetz application:
Written descriotion of orogosed work:
- Proposed aft. tall patio wall around existing patio to be constructed of reinforced poured concrete for the
purpose of preventing flood waters from entering the home.
- Add approx. 20 - 30 cubic yards of fill around proposed patio wall to create positive drainage away from the wall
and house.
- Add approx 170 cubic yards of fill for proposed driveway, which is to be sloped toward the property to a new
drywell.
Proposed fill required for the new drivewav:
- Approx. 170 cubic yards of fill
Sincerely,
Mike
Michael Macrina Architect, pc AIA
Address:
21 Main Street
Stony Brook, NY 11790
Phone (631) 686-6585
Fax (631)686-6786
Email mmacrina@ootonline.net
Web www.mmarchitectoc.com
t
S~d of Trustees Applicatioa
i
WETLANDtTRUST~EE LANDS APPLICATIO~N,,D~ATA
Purpose of the propolse/d operations: i 1 O J ~~K
~ ire
J i! r ~ ~ I~Vf ~ -I H ~ rl (7M ~ k L~- ~K ,4.n1
f~ 1. ~
Area of wetlands on lot: square feet
Percent coverage of lot:__,~_%
Closest distance between nearest existing structure and upland ~
edge of wetlands: 't'1 O feet
Closest distance between nearest Qroposed structure and upland
edge of wetlands: ^'!O feet
i
Does the project involve excavation or filling?
i
No Yes
If yes, how much material will be excavated? 2 ~ cubic yards
How much material will be filled? ~ ~ ~ cubic yards ~I
i
Depth of which material will be removed or deposited: ~ feet
Proposed slope throughout the area of operations: I ~
I
Manner innnw~~hich material will be removed or dlelrosited: I .
~Zl.~`~~ i /~rtn t~li~/ ~I~-~i.~a~
~r7 ,~~I,J.ra a-l
~ ~ l~o.u,
Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by
real son of such proposed operations (use attachments if appropriate):
l~l~.l~Y'L~y~ ~ A-I.~t~'r Nr /Ir~~ ~ l L ~n._
~ Di2r~f~~r (~y~a~•(n -T~~ pr~y°s~~
G~l~ ~ ~t1 ~ ~o~ o~~p~
ANA Ir~~~f i~ ~~-~c-~ ~ v- ~w ~~INv Pao W[~w
• snso • SEUR '
PROJECT ID NUMBER - APPENDIX C
STATE ENVIRONMENTAL OUALfiY REVIEW
SHORT ENVIRONMENTAL ASSESSMENT FORM
for UNLISTED ACTIONS Ony
PART 1 -PROJECT INFORMATION (To be completed by Applicant w Project SpofLSOr)
1. UCA /SPONSOR 2. PROJECT NAME
L
3.PROJECT LO ION:
i
Municipality p 90 D County O
4. PREGI E LOCAITION: Street Addes and Road Intersections. Prominent marks etc -or provide man
~->'o~ l~N.{~I.Ir~ Rr7, ~Ar(-~?~~.I.c Cop-~Jr~a- of~ Cor.lKl-1,~ per.
v ~ ,,P
5. IS PROPOSED ACTION : ~ New ~ Expansion odiftcatbn / aaeratton
6. DESCpRIBE PROJECT BRIEFLY:
• f ~ P~S~o ~ ~ ~ ~It~~ ICx i s~(~lcr ~~(,b
fiw ~~I~~.~~
~ ~w Ai+-o~1rL~ ~jy~p ~Aw I~
i
7, AMOUNT OF LAND AFFECTED: j
Initially ?O'1 acres Uttimalety acres
8.I~~~W~IL(((L PROPOSED AC710N COMPLY WITH F~LISTING ZONING OR OTHER RESTRICTIONS?
Yes ? Nn If no, describe briefly:
9. WHAT IS PRESENT LAND USE IN VICINITY OF PROJECT? (CAoose as many as appry_)
I/ycX~'Jf Residential ~Industdal ~Commemial ~Agrfwl[ure Park/Forest/Open Space ~OU~er (de5caibe)
10.' DOES ACTION INVOLVE A PERMIT APPROVAL, OR FUNDING, NOW OR ULTIMATELY FROM ANV OTHER GOVERNMENTAL
AGENCY (Federal, State or Loral)
Yes No tt yes, Iis[ agency name and permit !approval:
%~d I
---~1"~6E5--AT7Y-ASPECT OF THE AC110N"F
V~VE-A-CORRERTLV VALl6 APR VAL2 J
?Yes ~No If yas, fist agency name and permit /approval:
72 AS A RE LT OF PROPOSED ACTION WILL EXISTING PERMITI APPROVAL REQUIRE MODIFICATION?
es Pb
i
I CERTIFY THAT THF+ INFORMATI PROVIDED ABOVE IS TRUE TO THE BEST OF MV KNOWI.E GE j
Applicant ! Sponsor N ~~r~ ~1~~~~(7L Date: f ~I I
1..~.~ I 1 I
Signature
If the action is a Costal Area, and you are a state agency,
complete the Coastal Assessment Form before proceeding wRh this assessment
PART 11-IMPACT ASSESSMENT o be corn feted b lead A en
0. GOES ACYION IXCEED ANY TYPE tTHRESFiOLD iN 6 NYCRR, PART fi1T.47 fl yes, coordinate fire review -
process and-use flte FULL FJ1F.
Yes Q No
8. WILL /1C710N RECEIVE C0l7ROINAT~ REVIEW AS PRlrilOED FOR UNLISTED ACTIONS IN6 NYCRfi, PART 617.6? tt No, a negative
declaration mar be superseded by anoNler invdved agency. -
Yes Q No
C. OOl1L0 ACTION RESULT IN ANY ADVERSE EFFECTS ASSOClATEO WIfH TtiE FOLLOWING: (Arawors mar be haMmfltea, U legible)
C1. Elds6ng ak quafi4y. slaface «prourWweter quafity a qualdily, wise levels. existtrg traffic pattern: sofid waste production «diaposal,
eMial eloslon, dratrlage or goodklg problems? Explain briefly:
C2 Aeslhetlo. agrlaAltxal, alclleleelogksd, lt)s6ork, «otller tlatraat ur arftrrat lasblMCea; a « Etlaladeft Egllala btlafly:
C3. Vegetation a fauna, Gsh, steep "or ~apedes, signiflcanl habitats. or tlxeatened or endangered spedesT ExpWn bddefly:
C4. A community's ezislkg plans or goals as offidaay adopted, or a~change M use or inlensay of use of land or other natural resoutce57 Explain lxiesy.
C5. Growth, gubsequent devebPmen( or related adivAies likely to be induced by (he proposed action? Fxptain briefly:
C6. Long lertn, sfwn-term, emulative, or other effects not idenliaed in C 7 C5? Ezplaln briefly:
C7: Other impacts ndud cha sin use of either uanta or t of ene ? Ez alit briefl. ; - ~ - - -
O. HALL THE PROJECT HAVE AN IMPACT pN THE ENVIRONMENTAL CHARACTERISTICS THAT CAUSED TFIE ESTA6WSHMENT OF A CRITICAL
ENVIRONMENTAL AREA CFA7 s. bfie ~
Q Yes Q No _
E 18 THERE. OR IS THBtE UI~lY TO REIJITED TO P07FNilAI. BiVIRONMENi'AL IMP If .
Yes Q No
PART NI - OETI~MMIATIOPt OF SfOfNFtCgNCE (To be oanpleted by ABenq)
INSTRUCTIONS: Fbreachadverse~eotidabove.dotemlinewheUlerRlsslA>Ietastlal,lel9e,imparfaRt«otflelwlsea~nifa~nt Eadf
eRsa sholAa be aaeoeaed in co1Mle~on MALI, Il5 (a>u setglty a8. Iabarl «IUfBQ; ro) lam' et dCNIRM1f?: (eJ rl«atlotC IReM811': le)
~ aaM fQ ff Ileol>a:selty. torrid aHadMtlBnfa «Aeferenoe stglpolWtg nlaledella. Fyrelae tlret elgllsate0otls ooatain _ .
WRolakdetaNtodlowtllet>~IekvalgadrefaekapealshavebeenWetlUfiadandadat~klyaAdnageed.lf~tlaaaofpeatiwasdlgdaed
yes,lbadelaminaBoNOfsignKioenoemueteMdlm6elhePoteRtlet knaozdoftheplepr>&edaolial antlle~Id~ofC(et~A.
ClledctHsbaiclfYdubtlyeWalltifbdgp«maepotel~apyWlga«aigNfir~nLadMNaehpaciswfidlMAYOOGa'. ThenpmceeddileWytotlte
EAF arWfor Pr'eP~ a P~'R dedarstiaL
Clrodc tlAs bwc Hyoufiave deHlmkled, based an the trdormatian atM analysis aboMe arM any slrppolting dccumeMaNon, that the proposed
WILL NOT result M arty sigh adverse ~1 kneads ANO provide, on' aaectarlort4s as necessary, the reasons supporting till
detertninadon.
Board of Trustees
Name of Lead Agency - ll U L /a L o / 3 ,
II ' / Date
~V/'~'GL/~f ~ ~~//v ~ President ~
Prml or Type erne of Responsible Officer m L ad Agenq Ltle of Responsible ORcer
Rn uro of Roennn iNa llfFm.l.. 1 n _
i
~~'t Town of Southold
Erosion, Sedimentation 8 Storm-Water Run-off ASSESSMENT FORM
$ PROPERLY tOCATgIt ry. a: TIE FOLLONNiG AC170N5 NAY R~tNg6 TIE Sel~lION OF A
~ ~
~ ~A~ IROFESS IN TIIE ATE OF ellKn~ ,
SCOPE OF WORg -PROPOSED CONSTRUCTION 1TEM # / WORN ASSE4SMENT Yes No
a. What h the Tdai Area d ttm Project Paroek? / ~t ~ ywn ryRs project Retain NI StortrrWaler RurfOn
(erdMe 7oml Area d eY Parcels Iomtea wi1Nn GenemiM by a Two (2'1 loch Rairtfee on SIOa?
the Scapa d Wok far Proposed Oorrstrtrction) ram) (This Warr wi Include aR runoR heated by site ? .
b. What is the Tafal Area d IoM Clesrng dearlrtg andlor construction activtYies as wen as an
andla GrauM Deeabance for Ute Ixolx>sed ~ Site Improvements eM the permartem vealfon d
censeueeon arrive)/! impervious mrdaces.)
PROVIDE BR~F PAOIF,CI' DE4Qt~TtON iP,wa.ams~r PidaNr/ral Z Does eta Stia Plan andlar Survey Show Ae Ptaposetl ii
Draewpe StrtrrLaes Indreatetg Sine 6 Loeation? This f/
Item shen indMe an PropoeM Grade t>wtges ant
• . sbpas Conbaning surface water Fbw.
~ / ~.1 3 !)acts the site plat, arrdlor survey aeson,e ere arosioa
ant sedknerrt control practices ttmt wiN be,rreea to
coned one erosion ant storm water dischangea. Ties j
v Item mud be maWained eaoaglwd ore Ereke
Constructlon Period. _ I:
4 W7 this Project Regrtm any Land Fr~rg, Gradnp or
Fxravation where tltem is a change to the Naeaal
Existing Grade Involving mare elan 20n CWxe Yards D _
d tAetwid within arty Parcel?
Wel this R
5 encomp>~shan Ar~~F
was dThau~ar ~ ;
{5,000 S.F.) Square Feel d Grouts Surface? ~ -
s Is them a Naetrd Water Cause RuatYtg tluagh ate ~
Site? is e~ Pmject witiiln the Tnaees jutrdctlort ?
OerwnY DEC SWPPP Imauirameda: u wihin One HruMred (100') feet d a Wetland or
Sudrmtsion da SY/PPP ie requaad for d Cgnatlrraon acMdYBS hvaN'uq ad Beall?
ersaaaharrms done (1)a more saes: 6resenme d Len mar om acre tlta 7 Wtll these tre Site pmpamtlon On Fxlstirg Grade Slopes ~
are Dart d a lagarmaagn pen Ma we ulenahy desab one ormom aaasd lens: Wtdldl Exceed Fineen (151 feel of Vertical Rise b
hrludeg OOnseutlion eatrwes sa'aeiN SCl dimahaiusdless than nu(1)eae Mae tkm Hundred (100')dhlattmntal Distance?
the nEC hm dehrrrtud out a SPOES Poma § regaree for txarrrt Yallardaftlalgaa.
(swwvte st.m madtta Neimurt tOgreraemw dme swoea ituraral Parma j3 WHI OrNeways, parkktg Areas a abler lml>Piviou5
tar ammr w.ta awahaass tram r:ametrdmn aea.rtq. Pwrrlf tto. 6podaadt.) surfaces be Sloped to Direr Starm•Water Runl)It a
1. The SYVPPP atoll to pwrared 0rgrb Me auwNW of er NOI. The tpt alto r" info ardor in tlta dkecnort de Tawn right-d-wB~7
suhrtikd b tlu napaNrwd piano tlr axrrrwnmrrma dmnNUghn agiNry.
2 RU SYVPPPSMdeaaiethe ermhn end se6mrt mn6d paWmsand w4ere 9 Win this Project Require the PlacantedoftAeeaiN,
requved, POdcoruhadim abmrabrrnmagarwntpaAOas Metwi ee used endkr Renrovaid Vegetadion andbr ere Caohuryan dray
caieeuaedb rectum tla POruleriahsmrmmYerAadirgas erd baaaum Item WNtin Um Town Rightof-WayaRoad 9ltodder
mnW~oe eAer tfbterrrn and amdeaadeas Pamq.haaatwn, Me stePPP anar -
~NP~~dPaa~n'M~^mYrweoneDymarperMtl BO aeec[Me Ar88?now xswxmraura,.wrr.. ~nmwayeywsa) i
gtWly datomtYrBlBrltlaltaryea. Ilar6: RMy Menarb OuwiwwOrwtleaagh Nlrr NAmmatlvMal7aar Wek
~.NSwPPPa Mtrqute the 0?at<oneeuabn atmmwderawugenmd paahe ins aatarWtlwmaawuoem a7adma6rwaabdra'e 4am5P.i7eewmW i
mrpomM~hat be praPaed MapaNae Deagn Prefamcnd LioanzedhtYwVmk aswmiYm..rrary,or.r.aeabaron OOnaet PlmaRapirM grow tared
Mnahraatadg.eerhMaphrfpwaandprammadstamvyatarwarapenrmt. EaMaldaweMatbasraaaardtrW.RewPdvMlwramdM7'9MArB?Mmi
ppTE: Aohr#IaR(~) rkb Amrreemd amrmwtbpuireryaOaaaae Aapbam)
STATE OF NEW YORX . SS I
lIN'1'Y OFD.... .
1'haz t, i~huiiuuerLr~::l ) 1[.1duly sworn. deposes artd sags th
h'~e he is the applicant fax Permit,
And th~she is the ........+.....amw.......~~~ .
(owwr. Cwihsaor, Agent. Corpora Olraa, ere.) .
Owner and/or representative of dx Owner ar Owners, and is duly audtoriaed m perform or have performed the said work and m
make and fde Ifris application; that all statements contained in Htis.applitation are tore In the has wledge and 6elieE and
drat the work will be performed in the manner set truth in the application filed herewith
Sworn to before me this; I
1~~M -''N?~Cc Za 13 !
day of '
,f11Mr$'LOUf3 L USSO
Notary Public:.. .,,,_._NotuX PuWiq.: Sate of New Y _
Nb. b1tA8273952 ~sgvmeaagplwm)
FORM - 061 cnntnw.ean Eegntt 2 ~
i
B~d of Trustees Applicatioa•
County of Suffolk
State of New York
BEING DULY SWORN
OSE AND AF IItMS 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 REV TH1tS APPLICATION.
Signature of Prop ty Owner
SWORN TO BEFORE ME THIS ~ D DAY OF Yl--e 20L3
No Public
MICHELLE DISTASIO
ary Public, State of New York
No. 4994753 '
Qualified in Suffolk County I
Commission Expires May 22, 20
B~ of Trust®®e Applioatioa•
AUTHORIZATION
(where the applicant is not the owns'}
I, , ~ry~rt~ residing at `S~n ~D~I ~Gn
(print owner of property (mailing,~a/ddress)
MRTT I T1lCk-~IJ l~ (l R S~- do hereby authorize ,_II~ C~ ~'"1(1C11I1G~
(Agent)
~ p , C, to apply for permit(s) from the
Southold Board o T Trustees on my behalf.
(~g~
i
APPLICANT/AGENT/RF.PRESEN'I'ATIVE
TRANSACTIONAL DISCLOSURE, FORM
TFre Town of SoutMld's Code of Ethics omh't>;rc eanflids of interest on the Dart of town o(fiotts and emnlovem. The ouroose of
vi i i staff wn of ibk f' alb - w
rkoasserv m avoid same. ~ I - .
YOUR NAME: c.NA,~ t~ ' I ~ Pc~ .
(Last name, first namq rpiddk ipihel, uNCSS you aro app ytttg rn ille Dame of
someone else or other entity, such as a company. If so, iadiote the other
parson's or mmpmy's nanteJ ~ '
i
NAME OF APPLICATION: (Check all that apply.) -
I
Tax grievance _ Building
Variance Ttusaee ~ ~r
Change of Zone _ Coastal Erosion
Approval of p!az , Mooring
Exemption from plat or official map Planning ~
Other
(]f"Other', name the activity.)T- _
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, rttarriege, or business interest `Business inleresC' means a business,
including a partnership, in which the town officer or amployce Iles even a partial ownership of (orempbyment by) a corporazan I -
in which the town officer or employee owns more than 5% of the shares.
YES NO
If you anstKred "YES", complete the balance of this form and date and sign where indicated. ~I
Name of person empbyed by the Town of Southold _ _ _ ~
Tide or position of that person -
Describe the relazionsltip betwcen yourself (the applicandagenUreptesentative) and the mwn officer or employee. Either click
the appropriate line A) Mrough D) and/or describe in the space provided.
The town ollicer or amployce or his or htt spouse, sibling, parent, or child is (check all thffi apply):
_A) the owner of greater than 5%of tlx shares of the corporate shock of the a(~licanl
(when the applicant is a corporation);
B) the legal or beneficial owntt of any inkresl in anon-corporate entity (when dre
applicant is not a wrporatan); - ~ I
an officer, director, partner, or amployce of the applan~ or
D) tlx actual applicant, I
- - - - 1
DESCRIPTION OF RELATIONSHTP -
I
Submitted this of 201yJ
Signtttttre
Print Name
Forth TS 1
Town of Soathold i
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
i
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 Lora!
Waterfront Revitalization Program. A proposed action will be evaluated as to its simg
fist !
beneficial and adverse effects upon the coastal area (which includes all of Southold TownZ '
3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will ~
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each answer most be e~htined in detai4 lirtine both soonortina and non- i
suooortina facts. If an action cannot be certified as consistent with the LWRP policy standards and ~ j
conditions, it shall not be undertaken.
i
A copy of the LWRP is available in the following places: a ~tl t'oi~o o
website (southoldtown.northfork.net), the Board of Tnrste t, all
local libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION JUN 2 0 2013
S(,~.~ 2j9' uthold own
I
i
PROJECT NAME 2 I u ~
The Application has been submitted to (check appropriate response):
Town Board ? Plaonhrg Board ? Baildmg Dept ? Board of Trustees
l . Category of Town of Southold agency action (check appropriate response):
`r
(a) Action undertaken directly by Town agency (e.g. capital ?
constratction, planning activity, agency regulation, land transaction) ?
(b) Financial assistance (e.g. grant, loan, subsidy)
(c) Pemvt, approval, license, certification:
Nature and a nt of action: I ~
'~P-~(~Qs~o WAw ~12.~;ll~lo Xis-~~~,c, ~o
P I ~w~gl"'~ arf I s WAL'li
Nunemaker, Amanda
Prom: Michael Macrina <mmacrina@optonline.net>
Sent: Wednesday, June 26, 2013 1:24 PM
To: Nunemaker, Amanda
Subject: Kmetz Application
Hi Amanda,
Please see below the following as per your request for the Kmetz application:
Written descriution of proposed work:
- Proposed aft. tall patio wall around existing patio to be constructed of reinforced poured concrete for the
purpose of preventing flood waters from entering the home.
- Add approx. 20 - 30 cubic yards of fill around proposed patio wall to create positive drainage away from the wall
and house.
- Add approx 170 cubic yards of fill for proposed driveway, which is to be sloped toward the property to a new
drywell.
Proposed fill required for the new driveway:
- Approx. 170 cubic yards of fill
Sincerely,
Mike
Michael Macrina Architect, pc AIA
Address:
21 Main Street
Stony Brook, NY 11790
Phone (631)686-6585
Fax (631)686-6786
Email mmacrina Caoptonline.net
Web www.mmarchitectoc.com
1
Location of action: ~o,~,.ln ~~IS~~~~ .~itYli~ f~-I~,f] A~;liarkrk'1 " In 5~~~
Site acreage: s ~ /~~.K,y~ '
Present Land use: ~ Ill C.il.r. G/I ~I i
Present caning classification: ~ t~
2. If an application for the proposed action has been filed with the Town of Southold agency, the following i
information shall be provided:
(a) Name of applicant ~2
(b) Mailing address: O V 'i
tk'Gf-r,~~c tiN`-~ ~ ~ ~ ~2 'J
(c) Telephone number: Area Code ( ) lr ~ I ~ ~ Q~ ~ ~ ~ " I ~
I
(d) Application number, if any:
Will the action be directly undertaken, require funding, or approval by a state or federal agency?
I
Yes ? No L~ If yes, which state or federal age~y?
/ I
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 Maaagement Practices that will further each policy, j
Inrnmplete answers will require that the form be returned for completion.
DEVELOPED COAST POLICY
Policy I. Foster a patteru of development in the Town of Southold that eahances community character,
preserves open space, makes efficient use of infrastructure, makes 6ene8cia! use of a coastal location, and
minim¢es adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation ~
criteria.
i
Yes ~ No Not Applicable
i
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~NotApplicable
' ~ ~ I
4~1-S ~ P~ ~rr~l ~ ~ Y Uc(
,~~P~x{
r~ir2-rf~+.~r~/ ran
Attach additional sheets if cecessary
Policy 3. Enhance visual quality and protect scenic resources througbout the Town of Sontho(d. See
LWRP Section III -Policies Pages 6 through 7 for evaluation criteria
Yes ? No ? Not Applicable
i
i-
I
i
Attach additional sheets if necessary
G
NATURAL COAST POLICIES
Policy 4. Minimize loss of life, structures, aed natural resources from flooding and erosion. Sce LWRP
Section III -Policies Pages 8 throug616 for evaluation criteria
Yes ? No~Not Applicable
llll I
I
__Jnl ~ Iy~d`T~~PA.~C~ ~
~
O~ ~(Lt~K
i
Attach additional sheets if necessary !
Policy 5. Protect and improve water quality and sapply in the Town of Southold. See LWRP Section III
-Policies Pages 16 through 21 for evaluation criteria i'
Yes ~ No Not Applicable ~
Attach additional sheets ifnecessary .
i
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal ash and Wildlife Habitats and wetlands. See LWRP Section III -Policies; Pages 22
through 32 for evaluation criteria. ~
? ?
I
Yea No Not Applicable •
~i APP~Irot~ i oe, YiC~I ~ ~~U
hl~ r. ~4Yr~Jt,~~
a~ ~L~
i
Attach additional sheets if necessary
Policy 7. Protect and improve sir quality in the Town of Southold. See LWRP Section III -Policies
Pages 32 through 34 for evaluation criteria.
? Yes ? No~Not Applicable 'i
i
I
i
I
Attach additional sheets if necessary
t
Policy 8. Minimize environmental degradation in Town of Southold from solid waste aad hazardous
substances and wastes. See LWRP Section III -Policies; Pages 34 through 38 for evaluation criteria.
i
? Yes ? No ~ot Applicable
i
s S
al" IL~(2 `
C.
PUBLIC COAST POLICIES
I
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. I
? Ye~ No~Not Applicable
i
I
~ b r~h iu ~ ~e ~~1 i
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 evaMation criteria.
? Yes ? No~Not Applicable
Attach additional sheets if necessary
Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic
Estuary and Town waters. See LWRP Section III -Policies; Pages 57 through 62 for evaluation criteria.
i
i
Yes ? No Not Applicable
i
i
Attach additional sheets if necessary
Policy 12. Protect agricultural lands m the Town of Sonthold. See LWRP Section III -Policies; Pages ~
62 through 65 for evaluation criteria. i
? Yes ? No~Not Applicable
111111 ~
~ U
I
Attach additional shcets 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 ~
1.S- CAP ~ ~L~ ~ R~ a!!` m~ol~~ I o -f
1---- I
I
PREPARED BY I TITLE_1
~GI ~il~I DATE
# ~
IV~ic~la~.~ IV~acwNA ARC~hT~.cT, P.c.
21 Main Street, Stony brook, N. Y. 11790
(631) 686-6585, Fax:(631) 686-6786
Mmacrinaldoptonline.net
-
p ECEIVE
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MAR 1 42013
Southold Town
and f T
~4Yl~vY1~~'Z~ ~(Q~oO <CGY~II_
ii
3'-6" Architect
1 2, 10" 6" Michael Macrina Architect
Install Haybales&Silt Fence Pin New Wall to exist'g set wall tight to existing 1�_____ - --- 21 Main Street
(see details) (see detail 2, same shl.) fireplace foundation Stony Brook, N.Y. 11790
S14Oo2 'S0 "E 140.4 '
— — phone (631) 686-6585
I m fax (631)686-6786
- _-- email MMacrina@optonline.net
proposed FII = _ Align i web MMArchitectpacom
se v 3 _ j Theme piece ere en Imtrument of service and
\ OW o I O I ere the exclmtve propertyme the architect
frl
Ivvgemavfe of the e pb end deet,. id...
rommodtad ..preelected to hm
e themefuad enlevt of tithe tan.
I� I
Copyright ht coed, no .t 6la.1 then Ar.hTerm o, All
YI 1Q I repro reed wit, ut part x the Alam may be
N 11 `�exisling existing 1 p c reproduced without the axpreeeed written
to of wall to be ant ae he Bran¢eat.
P I _ i� post Post i 34"above patio
(level with house foundation) Dates
384 ___ W E
plop, Ir ,i1 Existing I so i1 ii 1 m i j 5/10/13 Issued for Construction
Retme Second Floor ( V 1' � rn
Existing Wood I 5/23/13 Miscellaneous Revisions
Wood Deck ro 1p` existing Deck Above exlsling 1
o II post \ post 1 6/17/13 Add Haybales & Silt Fence
\ txg a- a II \
existing house (� N I -
4D 3' Y. vim+ proposed 34"t4ll
0
g0.
olHep°%o.\tsd W 4°\h\ouse
-
I �Oe =vm
P.C. retaining w
II II lI
1I
II
a 3
Existing new 8'x4' g I Existing t o
N (a
One Story tall drywell 0-
with
with open e 1A 1AFrame Patio
ttde Dwelling grae
1existing
4C3 5 .0' post
exstnghouseii ___________45 4-0exlsLng- _____ �Q'
8.. 3.�4, , I Post 16._6., I
O\ H I Q i--- - ---., No. Date Description
N " s FIII and RCA base to
�N n o,
be added for driveway --TR - axis Ing
xisg
i1
Project
provide floor cram
over
U Pro
posed
new 24'x24' 2'didee per\
asphalt driveway
8 y drwallstairs
io ---_____ ___________ Patio ci
toward
J
N14c) ja,1 - new ` 1 Pro m For The
106.04' concrete steps ¢II p
______(8-1/4" max. riser)------------------- eta, 34"tall
- (12"treads) -------------- - P.C. retaining wall
-I— -- 20'-6"
- -
Drop top of wall 8' 20'-fi" e' Metz
Corilcliri Road dPcstepsr
21'
(Patio Wall) Residence
�= Plot Plan Patio Wall Floor Plan CQ E V -
04 Conklin Road
� V
plan north 1i4" = 1 '-0..
attituck, NY 11952
FINISHED GRADE
Southold Town
D
'-"0 e own of Southold
" Suffolk County
X X 12
aD d° PROP 1 2 MAX I
P
No. 4 REBAR io io No. 4 REBAR Sf0 F/N/g
rDrawn By2' O.C. ® 2' C.C. HED GA.P.No. 4 REBARn ° Checked ByEXISTING PATIO EXISTING PATIO d �_EXISTING_GRADE
APPROVED BY ory
BOARD OF TRUSTEES a s4i :' oalzeb o��
TOWN OF SOUTHOLD o. 4 REBAR Sheet Title :
DATE 1 3 b a 2' O.C. i
° D Z
Misc. Drawings
- Details
D °
PLAN °
No. 3 REBAR O 12" ° No. 3 REBAR ® 12"
The Connection Instructions of the O.C, D c O.c.
[_ --_ __ New Foundation wall to the Existing °
Foundation Wall are os Follows : TT ° T Project: Job No
Exist' --New 1) Clean the Exist'g Foundation of = 2�� D D m Z" 2" 4 d 4 2' 1m 1325
any Sall adjacent to the new °
--7 Foundation Wall. o e a Scala: File Name
2) Drill a Hole 0 12" o.c. Vertically, ° °
I Large enough for a N5 Rebar. ° ° d As Noted 1325-Constm.A
-_ -- 3) Install (1) ,y5 Rebar In each Hole D a a
& Set w/ Epoxy Mortar.
- -- 4) Extend each Rebar 12" min Into No. 3 REBAR ® 18" O.C. No. 3 REBAR ® 18" O.C. Drawing No.
ELEVATION the New Poured Concrete Foundation
wall. 3,_O,. 3._0..
- --__J A- 1
2 Connection Dtl . Retaining Wall Detail � � Retaining Wall Detail
Not To Scale I ill = 1 '-O" 1 " = 1 '-O"