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TR-8601
II,��� • John M.Bredemeyer III, President •�� *QF SOu45, Town Hall Annex �� O Ol0 54375 Main Road Michael J.Domino,Vice-President �� IiigAlig , P.O.Box 1179 James F.King,Trustee ; � , ? ; Southold,New York 11971-0959 cn Dave Bergen,Trustee � Telephone(631) 765-1892 Charles J.Sanders,Trustee lif�,oU� 1/, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1175C Date: October 6, 2015 THIS CERTIFIES that the construction of a one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry deck and 6'x'12' rear deck; existing 8.3'x11.4' shed; and existing 9.8'x10.5' shed; with the condition the sheds are to go through complete permitting processes when replaced in the future to comply with standards for flood zones; At 235 Carole Road, Southold Suffolk County Tax Map#52-2-7.4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated March 12, 2015 pursuant to which Trustees Wetland Permit#8601 Dated May 20, 2015,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 one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry deck and 6'x'12' rear deck; existing 8.3'x11.4' shed; and existing 9.8'x10.5' shed; with the condition the sheds are to go through complete permitting processes when replaced in the future to comply with standards for flood zones The certificate is issued to TOM BRENNAN owner of the 691.4foraid,, op. rty. Authorized Signature rrr'11FFU(--- - lohn M. Bredemeyer I[[,President Town Hall,53095 Main Rd. it ps xe ff' �G . P.O. Box 1179 Michael J.Domino,Vice-President �'�� y James F.King o Southold,NY 11971 Dave Bergen 4$ Telephone(631)765-1892 yl �a��1 Fax(631)765-6641 Charles.T. Sanders r,r' BOARD OF TOWN TRUSTEES TOWN OF SOUTH[OLD DATE OF INSPECTION: `•� Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, silt fence 1st day of construction 1/2 constructed Project complete, compliance inspection. INSPECTED BY: - COMMENTS: rea44-1- 0--ed sod 1, 2-6! CERTIFICATE OF COMPLIANCE: „,,,,, John M. Bredemeyer 111, President �,,�''' Town Hall,53095 Main Rd. /0 4:9;` Michael J. Domino, Vice-President '`o`��� �Gy� P.O. Box 1179 James F. King _ ” x Southold,NY 11971 hT 1 Charles J. Sanders :y%it ����\ Telephone(631)765-1892 Dave Bergen l ao`�, Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, silt fence 1st day of construction % constructed Project complete, compliance inspection /Y '; f.+li 1i r' 1 ...... .-.• Orf §� f°a +a 4-'.'," •',..",,,,-;.-v",„ ,i,‘ } yai �e i„!,, , ;p w � P� 7d'- �P r e ;,,,�� 'I- --4,0,...,4",,,-;,R' ` l�- ,» ft: '$16'1:::::‘,14* �y t1 #i b �PP ` fir^15,5$LL ` �r i.tat '� jy ti --.1 .1 i r, :.. ! ' 4 4!".14°-..c.,---4.%\t/V4 ' r/ ",` :,..,.. .,�� tw. '"5i:,a'�m3,,.�...n,3sa4°i_.'a 'Ts.�_`�Xa. ?"�`�'..:-"' k...2?IS�vn_v.� �..^3,3'Sza'`Y 4."�*2�a*�w2S?'�•.k. .a3.FS 'T`' rr. :4`-�'�"':Ysm?_w4."' T'._.,..s..g mow.'. .Y'tP�E1+ • BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK s:1‘ ' 7y PERMIT NO 8601 DATE: MAY 20,2015' VI.•�,I ISSUED,TO: TOM BRENNAN . i..7::::1_,e; 7, ,#, OM ..` PROPERTY ADDRESS: 235 CAROLE ROAD, SOUTHOLD \� q ....,...f.- ( SCTM#52-2-7.4l'OP,, .. . ;� 1:" ' `. B¢ if AUTHORIZATION 13. : it V. , P6 ursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in t; accordance with the Resolution of the Board of Trustees adopted at the meeting held on May 20,2015,and in consideration of application fee in the sum of$250.00 paid by Thomas Brennan and subject to the Terms and A Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the < bwgk �� ,,,,/,`,"1-- � . following: +. 7 Wetland Permit to construct a one-story 13'x14' addition onto the seaward side •': x` ..'---i•° of existing two-story 593.5sq.ft:dwelling with an existing 5.2'x16.2' front entry deck � ti and 6'x12' rear deck; existing 8.3'x11.4' shed, and existing 9.8'x10.5' shed; with thepe` '"t°. condition the sheds are to go through complete permitting processes when replaced in { .4( t the future to comply with standards for flood zones; and as depicted on the site plan7. ' : submitted by Eileen Santora, received on March 12,2015 and stamped approved ona. a � ` -;'�. _, \ May 20,2015. y M�Y x' IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed and these presents to be subscribed by a majority of the said Boar_as of this date. t. ! g I tg At:, . ,,,,,, fri.,..- ..z(..,Jr on . ,.., , ,,,. - v�' • !,,,,q-5,7-4\-:::: ' ae , 0, , ,..p,,e. I , l ``maI. y 1 +'� �T •c . ' = 'fled illig �•a4�,,� o�sI,, I le 4 i�i5 � t�i)¢°aqr a,€.4-1i' 3t" ,{:;Ciu.'u":eVWae's., tr,C:nu.*.."g4S'u`EG,' %:1'ukk*aaM;t C;J 'a i'"a.�Si' a u�Ttr S7M.— la W"* site .t+ir.'S5'^+$'''',k'? u' F.' . n.swi+r?. 'i-7 e' :-'"* a "+.7 .13:4:' 1 ,J( 5 i t : --';- $0,,„...;-,. k: 9t °). - {Pd "J' 4-., t ` 1 ,- i •..§,R - (, 4i TERMS AND CONDITIONS The Permittee,Tom Brennan,residing at 235 Carole Road, Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense,defend any and all such suits initiated by third parties,and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town Of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an_extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely,or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. .That there will beano unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. 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 rights,title,or interest in real or personal property held or vested in a person not a party to the permit. ,,�__'a,`A V SO(/r�,- John M. Bredemeyer III, President ���"® 54375 Main Road * `' of Town Hall Annex �� Michael J. Domino,Vice-President . ' ' , �[ o• e �E1 P.O. Box 1179 James F. King, Trustee c, •'• - . Southold, New York 11971-0959 41, Dave Bergen, Trustee ge Telephone (631) 765-1892 Charles J.Sanders, Trustee = �'QU ��`;°i� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 20, 2015 Ms. Eileen Santora 650 Vanston Road Cutchogue, NY 11935 RE: TOM BRENNAN 235 CAROLE ROAD, SOUTHOLD SCTM# 52-2-7.4 Dear Ms. Santora: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 20, 2015 regarding the above matter: WHEREAS, Eileen Santora on behalf TOM BRENNAN of applied to the Southold Town Trustees for a permit under the provisions,of Chapter 275-of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 12, 2015, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinatorrecommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the sheds are to go through complete permitting processes when replaced in the future to comply with standards for flood zones; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 20, 2015, at which time all interested persons were given an opportunity to be heard, and, 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of TOM BRENNAN to construct a one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry deck and 6'x12' rear deck; existing 8.3'x11.4' shed; and existing 9.8'x10.5' shed; with the condition the sheds are to go through complete permitting processes when replaced in the future to comply with standards for flood zones; and as depicted on the site plan submitted by Eileen Santora, received on March 12, 2015 and stamped approved on May 20, 2015. 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, John M. Bredemeyer III President, Board of Trustees JMB/amn .„,,,, Town Hall Annex John M. Bredemeyer III, President r,� stfFQLA.- = Michael J. Domino,Vice-President �`'�Z4�0 C�Gy 54375 Route 25;P.O.Box 1179 Southold,NY 11971 James F. King j H ” � Telephone(631)765-1892 Charles J. Sanders y _.. �,. , P Dave Bergen ` �Ol.*, aO`'� Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD .[- � San--b-a. 47- I LSM e_n n a Please be advised that your application dated 511211-s has been reviewed by this Board at the regular meeting of o �Zb 1.5 and your application has been approved pending the completion o thefollowing items checked off below. Revised Plans for proposed project Pre-Construction Silt Fence Inspection Fee ($50.00) 1st Day of Construction ($50.00) 1/2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. . COMPUTATION OF PERMIT FEES: o, 6/11//3 TOTAL FEES DUE: $ 5D/C) I 66 BY: John M. Bredemeyer III, President Board of Trustees 11110".. P ,..„,............,,,, , • ' qt - •-;' . 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'..-, .:.. ,..1' :„.-4., ',;‘• .1.:...-k'' - '.'-.!:,,--•,,-S. - ., , - . ' '14.'''r'''''''S ..'.,. ••• . , ,..4''' -.44.. -'-c,,.e, !' . ,-.',4-,,„.-,M,'„-',_.4,:i .1.1eV' • -.':7,,-,i: ;--•-•,- .- -.-.\, '....!'- r ....--.'''•: • ' ..- '.. __ Olt 11611,:: ‘-',.•'r..-.7k.::‘,Awi,-- ' --.1".' ....-rror. ..---., ',.'- '_.4.jr-.',- '-,, .-.....:A::' '.,..-- - ': . .-„:.,' :...,- ..":',`"--"41i,.- •*'- . - " , -.1011 ,gi..„"4:4. "---- .' •,- ,..-4. ''-',;j' ••-''''z'?'1"--. '.''• ' ' ' .. „ ., : ,'. -' -r.t.te-*•,•-i- . ''''• ',., . , ,• -., ..• .... ' •:. . - . • . , • . • . , . . "., . • , . • , . ,. . , . ,. . • • , .. . - , om Brennan .,'-'-. . ' '''' • r. .'l ''' ... '. '...'''''':'.... ''' ' ' ' 1 . ' ,-..''' . • '' ; ..,:!.'..r, ;''',..' '',",r(..‘ - " ' ' ; ...,.. , . . , , . •:-• . 35 Carole Road,Southold CTMit 52-2-7.4 . ••'-=_• , ,..' , ...-• • ,„,„,... 7„ • ,-'-.,. ..i•- -,;. • ,- , • • -• ', , • , . .. ,...., ,. 5/13/15 , .. ., . ., 9 : 23 .. ,....„ , , • . , ,,, , , . •„ • [ 1 5/ 13/2015. , . . . . . •• = . . . . ,. . 1 • , 1 ',..7 2.. '1 2i/ '..,1''-..ii. :. , .-%"•'. ''' ', ' ' . !'. i' ' . .:' .. .' ' . . .' r President FFo Town Hall • Annex John Bredemeyer, u c - Michael J. Domino, Vice-President ,,off° S K��y;, 54375 Route 25 James F. King ,y P.O. Box 1179 41 Charles J. Sanders ? ,+� Southold, NY 11971 Dave Bergen 'yOl * �a°��' Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: C Eileen Santora on behalf of TOM BRENNAN requests a Wetland Permit to construct a one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry deck and 6'x12' rear deck; existing 8.3'x11.4' shed; and existing 9.8'x10.5' shed. Located: 235 Carole Road, Southold. SCTM# 52-2-7.4 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound eBay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ✓Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: /Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: / Present Were: (`-'J/. Bredemeyer M. Domino/J. Kin�4C. Sanders /D. Bergen Bay Constable Other Form filled out in the field by `11/ as • Mailed/Faxed to: Date: loii .i',iR� ��,,,,,,,, s f ' •'„,..4b r-iimoms... ;4111.;04 4„,........_,.., .., - +• I APPLIC�. ?" TQMi �Z... Soo-{-Dui ii it" A ' '' '-"---r - ' . -, ,,- ,,, . I jilt I, - r `ter ---- - w. \ ' >�r (+r s • 11; . = j ' ' A 1 OfIr.t-r- Tp 11,4 1.)1\1 AN. a35 aAebu ez ilk i otlT _1 � ...., ,.. ... .... � www ..,.;.... ... 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COUNTY OF SUFFOLK © E .. mUTNOL° SECTIO0 NO iO..._-,. oaArReal Tax Service Agency r W - ce ` I .Rak County R-....Nr„w 52 N w.. ., —__— ___ LACONNM N ' - a INK .T,.R «NT rte,- P 333 - / .NNo ,om PROPERTY MRP 'opf S004 OFFICE LOCATION: r� Q� �'0l MAILING ADDRESS: • Town Hall Annex ��� P.O.Box 1179 54375 State Route 25 * * Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 p � Telephone: 631 765-1938 iii lyOOUNTVpia ... .iii LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD • MEMORANDUMra 0, � �1....Y,, MAY 1 9 2015 To: John Bredemeyer, President I Town of Southold Board of Trustees I c; f:Avri From: Mark Terry, Principal Planner h�. ; of�r„�t LWRP Coordinator . Date: May 19, 2015 Re: Local Waterfront Coastal Consistency Review for TOM BRENNAN SCTM#52-2-7.4 Eileen Santora on behalf of TOM BRENNAN requests a Wetland Permit to construct a one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry • deck and 6'x12' rear deck; existing 8.3'x11.4' shed; and existing 9.8'x10.5' shed. Located: 235 Carole Road, Southold. SCTM#52-2-7.4 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 actions is INCONSISTENT with LWRP Policy 6, specifically 6.3 (below) and therefore, INCONSISTENT with the LWRP. . Policy 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The structures were not constructed with the benefit of a Board of Trustees review or regulatory permits. Policy 4. Minimize loss of life,structures, and natural resources from flooding and erosion Both shed locations are located in FEMA flood zone VE (velocity hazard). It is recommended that the Board require the structures to be removed from this hazard area to further Policy 4. The proposed addition is located within the FEMA flood zone AO 2'. These areas are subject to inundation by 1-percent-annual-chance shallow flooding (usually sheet flow on sloping terrain)where average depths are between one and three feet. This area is mapped as 2 average flood depths (FEMA). It is recommended that the Board verify that construction will comply with standards set for this flood zone. 1:://7/// / ,,,,;' 7/1" ,/J , , -y7779:////:///1/1://////9 - '« ';,:p.:-:- &ap hTe s Ql y r'r " ! y,,,,,,..,,`,/,/ :>///7 1// // o `',a LayerWitr181q ,, ,� ?�", � # „,,, ...00; ,,/,',/07:07/7////4, ti ','+q:;,<S'-• 'l// / /-/ / A A-4? ,/,/ / ,/,' //,/ , // n r Fw srnucru� -,,t,-.'x''',7,-1,,,4, ' . sw ., r /,�.? s s t,, �91.,/,..-'7, i r, i� EdJV1RbNtRENTRL. € y r s ,r; ^"'<� L $le1Tt{SYatef C6tlaIIS g {fes tv �.: y :"/?;("tet 'ICl/ / ,/,/;(4/C,:///// A ReSr�ar9e SasiAe «,`,�”Vs,itatft4, �y xa 23�O': rtn 1'y' j43• ��f f� �r !t � 7 f ����„„„„zxxz������ ��A yF� , r� FresRwa[erV.'ellanAst ,,-,.;1,,,:e;14,1710'47; M"y � �'13, �f " t 1J0 QROIE FD s�F�, I� ry F .a4F« �' Pin9 B2geQ5 CCce g .f 1 ayy6 .'" VE 4'., 39 s � a * 9 90 CFROLF RD A Mae BaIteRSJ:Gh r N try t 73.*V• + ,# a" :'r !fh int y . .t,,,:ibl , . f� _ .1.�� �' r r'� � ? �urutur ren �.� /.. _ ,,,.„ ,9,,,„.,..z ,...,,,,,,,,,AET , ^ �u a 3 ,,+fir#.1. 2:::,' "�',. ,3 . "" :'1;...itgty,:-'''''',/.//' / ,A4 wsmnmwxr 44:4%.4,` n '° ..::a.=w,/,.///'',/' .,0„/! i ' E Nebo hazard flood zone. Fi .",%, re 1. Sub'ect arcel showin areas in the V t 9 1 P 9 Y ) 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 '' sOFFO1+ 11 Peter Young,Chairmani Town Hall,53095 Main Rd. Lauren Standish, Secretary c.. P.O.Box 1179 Southold,NY 11971 • `-, c3ta� Telephone(631)765-1889 „SOa' Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of.the Southold Town Conservation Advisory Council held Wed., May 13, 2015 the following recommendation was made: Moved by Doug Hardy, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of TOM BRENNAN to add a one-story addition to the existing two-story dwelling on the southeast side; for the existing 11'4"X 8'3" shed, 9'8"X 10'5" shed; front entry deck 16'2"X 5'2", deck and rear deck 12'X 6'. Located: 235 Carole Road, Southold. SCTM#52-2-7.4 Inspected by: Doug Hardy, Keith McCamy Vote of Council: Ayes: All Motion Carried F: Cia; Y a `V l!. MAY 1 5 2015 • Eileen Santora 650 Vanston Road Cutchogue,NY 11935 PHONE: 631-734-2794 Email: eileendrawblu@optonline.net Board of Town Trustees Southold Town Hall Annex 54375 Main Road Southold, NY 11971-0959 April 22, 2015 I would like to add the following Existing Structures to the application of Mr.Tom Brennan Suffolk County Tax Map Number 1000-52-02-7.4, Property location 235 Carole Rd Southold, NY. 11971; Shed 11'-4"x 8'-3",Shed 9'-8"x 10'-5",Front entry Deck 16'-2"x 5' - 2", Deck and Rear Deck 12'-0"x 6'-0". This is an addendum to the Existing application submitted to the Trustees prier. Thank you, gdz 9/. Eileen Santora Eileen Santora 650 Vanston Road Cutchogue,NY 11935 PHONE: 631-734-2794 Email: eileendrawblu@optonline.net ( L' 11;1J 1 APR 16 2015 April 15, 2015 : ^` This certifies that the northeast side entrance deck and the proposed northeast rear addition meets the average setbacks of the street. Location of property: 235 Carole Rd Southold Tax Map No.473889 Section 52 Block 2 Lot 7.4 Eileen Santora S4Pt P'1' '`:� 4,,x ,re QQ 2%�e_ CJ�\SSW 331 G 111.1r 11111114 4 \',:.,PRQFESSt( ' z.h r-- ,,ill Or FOL Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish, Secretary ,�. P.O.Box 1179 �/� Southold,NY 11971 ��� ri Telephone(631)765-1889 `f00 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 15, 2015 the following recommendation was made: Moved by Keith McCamy, seconded by Peter Young,it was RESOLVED to SUPPORT the application of TOM BRENNAN to add a one-story 13'X 14' addition to existing two-story house on the southeast side. Located: 235 Carole Rd., Southold. SCTM#52-2-7.4 Inspected by: Peter Young, Keith McCamy Vote of Council: Ayes: All Motion Carried f! f;! APR 1 7 2015 Lam... . .'.:01)rt!!.`1-?1`ari J .- • James F.Kin President 011OF SO(/T Town Hall Annex King, �•10110 � � yQ ' 54375 Main Road Bob Ghosio,Jr.,Vice-President ,�O l0 P.O.Box 1179 Dave Bergen 41% Southold,New York 11971-0959 John Bredemeyer o y;e G • ��,0 Telephone(631)765-1892 Michael J.Domino -b Fax(631) 765-6641 BOARD OF TOWN TRUSTEES iE ( U ll 5 TOWN OF SOUTHOLD To: Southold Town Building Department _ 11 MAR 2 5 2015 2) Re: Verification of Building Department Permit Requirements BLDG.DEPT. TOWN OF SOUTHOLD SCTM#: 5 — 4:›7— Li Property Owner Name: J Or- .c (\O C Date Sent to Bldg. Dept.: 3P54.3 The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: • YES NO Will the proposed project require a Building Permit? -----1 . Will the proposed project require a variance determination from. t Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: . 0„3/2-.0-X5 74€‘1-e' Signature of eviewer Date 04'.• 7 ,e,i ,. John M.Bredemeyer III,President /of �a®� S00Town Town Hall Annex Michael J.Domino Vice-President 1�, � a �t l® 54375 Main Road ' � P.O.Box 1179 James F.King, Trustee ` ��& w � ° Southold,New York 11971-0959 e % Dave Bergen, Trustee G a mac` qma" °' , �® �� Telephone(631) 765-1892 Charles J.Sanders,Trustee O •' Fax(631) 765-6641 =-"c®UNTY,V• i11° BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application. x Wetland Permit Application Administrative Permit Amen dment/Transfer/Extension -X)( Received Application: !d I-- Y. Received Fee:$ 1 0' )G Completed Application 3 `/ / fr;) � ' ;;% y.Incomplete `: — —–= --` -- SEQRA Classification: Type I Type II Unlisted MAR 1 2 2015 Coordination:(date sent) )( LWRP Consistency As essment Form yl3l/j ± t Y. CAC Referral Sent: H 3 11" {t. Date of Inspection: 13J _Receipt of CAC Report: _Lead Agency Determination: Technical Review: V Public Hearing Held: qp"a--1-4-- ,441130)6 Resolution: Name of Applicant 1 0 IL1 KJ A I Mailing Address �' (�. �O X ( � p1 CSL 17 C7LJ i N"( 1 (991 Phone Number:( G(Prtj ` ZS! Suffolk County Tax Map Number: 1000 - FJ 2 OfE 4 Property Location: F--S CARO.IE R,D ,1001-4-67)L IJ 1 Ca ,2 Pr '500TH DR M7RrH ED(6-R,40) W 61,1E7 sir. Op (provide LILCO Pole #, distance to cross streets, and location) AGENT: . EiLLESI S/VvTO1A (If applicable) D Address: 6,s- 1/44/57-61 fe TG/1106(( AIK Phone: % 234 P7q4 -2(15 -22500 0 t-- - rd of Trustees Applicatic GENERAL DATA Land Area(in square feet): 117 '74O 5F Area Zoning: Previous use of property: /De Al T?q t Intended use of property: RE-f.)/ DENT/A L Covenants and Restrictions on property? Yes / No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? vi 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. Does this project require a variance from the Zoning Board of Appeals? Yes 1/ No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? ;/ Yes No Prior permits/approvals for site improvements: Agency Date NYS E /M/15 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? I/No Yes If yes,provide explanation: Project Description (use attachments if necessary): to ADD aN e, .,6-1-707Q.---r .- 1 ��"X 1�{i ' 0 l� 7 O TI-1E Sour ErAor (i47Tz) Bo I. of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: LiS V R 114 Area of wetlands on lot: 30,3 q square feet CP Percent coverage of lot: 21 , Closest distance between nearest existing structure and upland edge of wetlands: 17 I feet Closest distance between nearest proposed structure and upland edge of wetlands: 4 feet Does theproject involve excavation or filling? No l( Yes If yes,how much material will be excavated? 3 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 3 feet Proposed slope throughout the area of operations: " 26 Manner in which material will be removed or deposited: 5 MAL-L- f5013 c-r 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): %fitkr L ' Ze k.1O. DiSTO1 bi NZ" £ LNig7 LA/Jb iB ' Ms C 1il0i,l 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part ]. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: ?Th 11/41 AN LJtaiW/-4 lttiH A� '>-iT701 Project7JLocation(describe,and attach a location map): ���� t1/b 2U F'r C)F :. 'l 44E 3nL-,rF � l ca Jtf�' t. NOM C, �r42/ ct,tna- e• Brief Description of Proposed Action: �; J- i 9_. , ( i Tb ice)E 't-0/( 1.B1-0 1')<- /4o (1€2 ) /WT I a IQ i? 'e) ( -1-1 fJ (h TWO .,)1-012;s114+0O� —W1 X ,261 ..11it (VI 8 d 6F') 5Po /te 34/V0214 � `7 54 2.93q/ Name of Applicant or Sponsor: Telephone: ( r t d TO H f i` Kt k1 E-Mail: i-by-en n G 2.0oproki u Y�?, ri Address. a-� 5 Cara f ' D City/PO: PO, 150K 12 State: Zip Code: h�`� �0 1-4-f-0t-b NV( I N l l qq I-0(1- 5 I.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that p may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 17e. f —4710434 3??`.UVB r/ u1s' N Ys c t AR,RG/3D i l'd 3.a.Total acreage of the site of the proposed action? /rA 74-0`_SF .>res b.Total acreage to be physically disturbed? / ' j l 6'racres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? `.l 91061= acres 4. Check all land uses that occur on,adjoining and near the proposed action. �� ❑Urban ❑Rural(non-agriculture) ❑industrial ❑Commercial Residential (suburban) EForest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES if Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? " ❑ IT ' c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? P 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ��/ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: n 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ t/ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? I `I ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban uburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? [ ❑ 16.1s the project site located in the 100 year flood plain? NO YES ]7.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? [NO []YES Er b.Will storm water discharges be directed to established conveyance systems(runoff and story drains)? If Yes,briefly describe: []NO I ES ;RAJ N RUNOFF /40 TTERf E L/ a/LL OViViV l) 7 A et)Ai77)16 / PA 'Der Gfi Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: f 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? �r If Yes,describe: q`/,I� ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ^ - - n_ _,_E/LEG/ ej vror Applican ;.ponsor an_. _ > Date: .L.." Signature: (S , ' A Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? VIV 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or Er affect existing infrastructure for mass transit,biking or walkway? 6._ Will the proposed action cause an increase in the use of energy and it fails to incorporate Fr reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. ' Will the proposed action impair the character or quality of important historic,archaeological, Imo° architectural or aesthetic resources? V J 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, . rt waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? ✓ 1 Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and cumulative impacts. nCheck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an ixenvironmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees //—�//J N me of L genccyyDate 145r -ge.Olgti President Print or Type Name of Respon,;,ible ffic r in Lead Agency Title of Responsible Officer SignatReRespons.•Anf icer to Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 ,„e 4.,.. = Town of Southold • 0 )= Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM 115 4. PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A %-iff„Ol 4"/ /OM ,5 / 6e, /).,f. STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN iEFIFct Sect o� Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT YesNo a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within /� '� Will this Project Retain All Storm-Water Run-Off the Scope of Work for Proposed Construction) f a�/4 © 6p Generated by a Two(2")Inch Rainfall on Site? / (S.F./Acres) (This item will include all run-off created by site ✓- 11 b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed /0 2 g Site Improvements and the permanent creation of construction activity? impervious surfaces.) (S.F./Acres) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages asNeeded) Drainage Structures Indicating Size&Location?This Item shall include all Proposed Grade Changes and — Ei 1 ✓ eA) 'I o A CA/ ji n A pm Slopes Controlling Surface Water Flow. /, f 1103 _ �/ _ ( 3 Does the Site Plan and/or Survey describe the erosion 1' ,( /4 –Q Zi / O E$ �c`5.f/�Lf and sediment control practices that will be used to y� / " P. f y control site erosion and storm water discharges. This /i '70 // q5 � r.IC"', -j/ item must be maintained throughout the Entire _ Construction Period. Q,,.�_q /` 0 4 Will this Project Require any Land Filling,Grading or < Excavation where there is a change to the Natural IN / Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities a I/ 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 Trustees jurisdictionGeneral DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or lErn---,-- • Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to Ell including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0.10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 111 17 1.The SWPPP shall be prepared prior to the submittal of the NOI.The,NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. ' 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item will NOT Include the Installation of Driveway Aprons.) identity potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000:S.F.8,1 Acre in area, I component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. (NOTE: A Check Mark(4)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, COUNTY OF SS 'That I, '"`". /LE EN -94 At f Oi74 being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) And that lig/she is the A b Ev / (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this; (1 5 ay of N/ . / ��rr nn , Notary Public: ... .tom' - / .. .1 %` -\CONSTrAN€E,UMWV (Signature of Applicant) . FORM - 06/10 NOTARY PU,B.LIC-STATE OF`•-NON YORK i;;: ''' No. D11.10110100 ,Qualified In 101(,olk.cou , Qtitli MY.Cornu ssion.Expires John 01. 20-1'6 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: To H 1,1 ,k..)A W Address: CA(2-0 Com!✓ (® • • STATE OF NEW YORK COUNTY OF SUFFOLK • 51 L C 1N1 `�R v-11 Dr2A i 1AY residing at C) V A 1,1 ST)kI 2D C:1)TC-F-J-0(,e 11 Yl 1835 , being duly sworn, deposes and says that on the 4 day of /`'4 A , 201 b , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at G LC*DCA u C ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. C.41(40 4toitt, ' Sworn to before me this / Y Day of I// , 20 4 / Ovaid.groW ./ Notary Public LINDA S. CARLSON Notary Public, State of New York No. 01CA6137178 Qualified in Suffolk County ,�q Commission Expires Nov. 14,20 L-/ U.S. Postal ServiceTM U.S. Postal ServicelM CERTIFIED MAILTM RECEIPT CERTIFIED MAILTM RECEIPT IT- ru (Domestic Mail Only;No Insurance Coverage Provided) MI (Domestic Mall Only;No Insurance Coverage Provided) rg For delivery information visit our website at www.usps.coma -° For delivery information visit our website at www.usps.come n R r-9 Ln SOgIllitli ir 1u 1973., A L U S L-- G _CIT 14)1ri. m0' Ff.. .' L US Lg ARDEN . _ L--0AS N. 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City,State,ZIP+4 t.....{,f1u A - .c.zi nCity,State,ZIP+4 il iti9r2/ / ,4i,// • -/ PS Form 3800,August 2006 gee Reverse for Instructions PS Form 3800,August 2006 See Reverse for Instructions John Bredemeyer, President --''suFFo� Town Hall Annex Michael J. Domino, Vice-President ;'11 �cOos;` 54375 Route 25 James F. King CAz ; P.O. Box 1179 Dave Bergen . g/ Southold, NY 11971 Charles J. Sanders �r , �°.� Telephone:(631) 765-1892 -••' Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of TOM BRENNAN COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR EIGHT DAYS I, EJLEN '3,41 Tol~A r sid gat/dba LP O vA OST01,I IZD CO-r—G4064UE' 1 n1gj85 being duly sworn, depose and say: That on the j' day of M A\( , 2015, I personally posted the property known as a 3 5 C,A ease f7 S o OT14t 1 D N.Y by placing the Board of Trustees official poster where it an easily be seen, and that I have checked to be sure theposter has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,May 20, 2015. Dated: C /.5 (signature) Sworn to before me tilts - - j q day of fda.(f 20/ ,Tota y Public LINDA S. CARLSON • Notary Public, State of New York No. 01CA6137178 Qualified in Suffolk County Commission Expires Nov. 14, 20,L NUTILL UF HEARING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: TOM BRENNAN SUBJECT OF PUBLIC HEARING : To construct a one-story 13'x14' addition onto the seaward side of existing two-story 593.5sq.ft. dwelling with an existing 5.2'x16.2' front entry deck and 6'x12' rear deck; existing 8.3'x11 .4' shed; and existing 9.8'x10.5' shed. TIME & DATE OF PUBLIC HEARING : Wednesday, May 20, 2015 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Bc I of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, TOM biz& N aiJ residing at 255* CA1DLE L (print owner of property) (mailing address) Sort f x-LOLO N Y do hereby authorize CI LEEN 'Aura' (Agent) to apply for permit(s) from the Southold Board of Town Trustees on my behalf. (Owner's signature) Bo of Trustees Application: County of Suffolk State of New York 77101-16 &tv Al di 1J 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. Signature of Property Owner SWORN TO BEFORE ME THIS 5#y DAY OF t`3A��- ,20eteee4V te& I Notary Public Eileen Haynie Notary Public,State of New York No.01HA4916018 Commission Expires 41Vii/2o le APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of • this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is • necessary to avoid same. _/ L - I . YOUR NAME: 3 A 6q TO®/2.1 J L-i it— N i (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate.the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) • - - • . Tax grievance Building - Variance Trustee • c% Change of Zone Coastal Erosion • Approval of plat Mooring Exemption from plat or official map Planning Other • (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation • in which the town officer or employee owns more than 5%of the shares. YES NO A/ , If,you answered"YES",complete the balance of this form and date and sign where indicated. . Name of person employed by the Town of Southold Title or position of that person • Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. - The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant • (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the • applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or . D)the actual applicant. DESCRIPTION OF RELATIONSHIP 4 l Submitted this5M day of, 116 C-4 200 i J , 4tki.ALS ' Signature �,z /Xi�%��/ G?GL (�,�/ toPrint Name Ell EA( cV%4/R-2RA Form CON1STANCE LISOWY / E-PJvcfafe 2&'' -//-- / WARY PUBLIC-STATE OF':NEW YORK NO. 01L16110900 ®tltilliltn1 in Suffolk County MY/Q®f BITS ion Expires June 01, 2016 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this formshould 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 evaluatedas to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3: If any question in Section C on this form is answered "yes" 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# 5 - D 2 - ni• 4 PROJECT NAME T 75iJ 1V A Ai j' Li V DD}T1D►� The Application has been submitted to (check appropriate response): Town Board Planning Board Building Dept. gi Board of Trustees D 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity,agency regulation, land transaction) (b). Financial assistance(e.g. grant, loan,subsidy) (c) Permit, approval, license,certification: Nature and extent of action: are 61-0/?—Y „ (lege-5-) TD )LifT V:›7- ,- ADD/T/ DIV /3-O. x 14-U TO ex .5;Iii 1 TWQ3TC 05c.(2)6- 6"K 00-1/"(5q6 ) • Location of action: .Z) (Robe .c9i) )4y Site acreage: /'�� �-O 64 /1 Present land use: /?E /1)Sn! Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: /O COPNA/A Al Z55 /2nI?L7 K ies-59 (b) Mailing address: a)tirti401_1D 4/ g).V-1-4676t i4r (c) Telephone number: Area Code("1 /6)5 26/3 • - _ _ _ _ - • (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes No 1� 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. n Yes No i/ 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 Yes No 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 n No rqr.Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes No Not Applicable • • Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes No IN 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. d ' • Yes No Not Applicable • • 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 n No 'jNot Applicable • Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. ee LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. fl Yes No . Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, andP ublic resources of the.Town of Southold. See LWRP Section III-Policies; Pages 38 through 46 for evaluation criteria. WI I No Kj Not Applicable • Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. n Yes No I of Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria. " Yes No Not Applicable • • Attach additional sheets if necessary • Policy 12. Protect agriculturallands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 forevaluation criteria. Yes No u 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. Yes n No le Not Applicable PREPARED6,11,(Av.Avivov) �L 'i/Z L0-lir 1-✓ 5 - _/J BYTITLE DATE • • • • r ' • YANH X F T F TAI "" ••• ► c0 N ^y fa. 02•01.... ..Oe FLOW_T 'w - .r:.nt ar .......40. tr �y O pra ��\� I.f} AOn N b AAA.•I.. a® Ii �••_ GRI • .acco" ....,_._e SLOPE) I �'VERTICAL v V r i✓ . rt'"5- �+.-?_ E- Y wroNe eat g f r a m11..R 'M•e •;fp •: I FACE p'� .: ... :•:_,+i�'"v y.•-`x...,,417. �1 C� ▪ C�, • 0 , BEDDING DETAIL PERSPECTIVE VIEW - ys,iY ;q-�3.''i4=�ti°-,'-,`;. F3 z U „z„ W :< .._ O E4. p. Ttz --~ r wsmFRENCH DRAW DETAIL -`." -��-rte' /_+ _'�_� S _ •"c�' ES.-----r. ••• .. .. ANGLE FIRST STAKE TOWARD 11 ..,5S4-.4.',......., _ -v..�... 4"'.� z y W • PREVIOUSLY LAID BALE .tiac-MINIUM 2 c2 ¢. ly HA N I FT MTA! "="=. .-'V FENCE POST �y W O E. lm.N WF.at 6w KR cwE -...• AAA. FLOW L • ,. r..-.-7-..;--.'^ '• a. beeR.wtuomu •.• eM<.R�•t. 1_I."•I=m' ,7yc�: - ,,<:42-'s r- Y.oVEK MIRE FENCE Yt 0 ▪ 0 1,e4 D4 • (<nc.1of10 WM'FI Mgr IIr.oct nmearaio ...AC° nuc CAST min �G.:.. - '',...‘r-.C...... .. r ..---.--= 11 - FUER CLOTH II .. q AN�1%W f"'( z(�W dj- ufa.�.. �� ....ac vn..m.. ink-' U . Itlinntr ......rn.aa =1 ¢mmoon• _ aL ✓ rn W IMAM ff a a 0 _ •itga s--. .-.---- I �J � �E I gyp] c7(+1 • r;,..0.1.1 >o�-` 1➢I �M—_. '' :4-..,.5.1-..:4.0..!7-----___-,-.1------ BOUND HAY BALES EMDEO FILTER CLOOI • II .. I ^ (7�Q .. —► t�L... _ PLACED ON CONTOUR MN,c'INTO GROUND �I K D A D Q O TAIL «no.c�0'^ =' ': 2 REbAILS:STEEL PICKETS OR �_ € �.....-. �.•..ap.._ W ti to . • s AR 1111 ..e..-..--,,,-..,---" 2'A2-STAKES IX W Y IN GROUND- NOTE; I"" • _ MIll�ILII ^ • • DRIVE STAKES FLUSH WITH TOP OF MA)UMUM DRAINAGE AREA :=.1-....-=:..-----,.....z.,.—:--- O w ZQ W z w w HAY BALgS. 12 ACRE/ISO MEM FEET �� �� �. C• [J] �`'� • ...,�.~~ ANCHORING DETAIL L z �-I Miffs r.� <u MA. SECTION DETAIL • �..-..r �� STRAW BALE DIKE DETAILS TEMPORARY CONSTRUCTION ENTRANCE z~� F-�r Typical S.c.L.•k1 Lcdr"c P.a. SILT FENCE DETAILS . cR.ass ATOLL DETAIL ,�. _-..._. --_.. __-.8STANDARD PRECAST CONCRETE CITCIf BASIN - • 114'X1"- T)plyd) (5 RET TO 20 RET H DePMt). , • • i • • • • • STORMW,4TER MANAGEMENT CONTROL PLAN N ��: FOR PROPERTY • • 111 — � AT SOUTHOLD N Y I • la y N .Y . -1Itl 1000 2 02 7. 4 • • �I - �1 Aug. 5,. 2 01 4 H • t - / Q U F wQ Typical Section @ Leaching Pool W vi • a o •. U SITE PLAN DATA: (To'Include)• U r-I NAME OF PROPERTY OWNER a E— co r , PROPERTY ADDRESS o U L SUFFOLK• COUNTY TAX MAP NUMBER • E TOTAL SITE AREA/ACREAGE • 0 .}�-• TOTAL AREA WITHIN CLEARING LIMITS • _t f: NI r- � * •4. LOCATION OF ALL PRIVATE WELLS WITHIN HIN 100' 4 TEST HOLE LOCATION 1j �a `'i-i IL:a Il 1 t i`-a t i-N, /. G'.? 1.e•fF` 3 N •.--i • • STORMWATER DRA• INAGE ,.r L;,,YII.>• w g RAINAGE J CALCULATIONS: (To Include) .- ._; I,„t:J � �r , •;•• -i ` ` ' �MAR 1 2 2015k;r li;:f4•,:••••;ti-,9 s " ! p- TOTALAREA OF ALL IMPERVIOUS SURFACES: NI p?;• -a.tt jj E --' U ROOF AREA ��s�_.;,_ •-.� DRIVEWAY AREA i-_._..�._-_,..—_.._ _ PATIO AREA • 40t1'il::i iD;I,r. ��-, t,44,..„..:,..01'71................,_,H7-7•1:0,99--46. t f / ................................... • �. .e i---- 1 .• vKt� F ALL OTHER IMPERVIOUS AREAS = L 1 �,�s�`a ;�O �� SI.ORMWATER CALCULATIONS FOR A 2"RAINFALL • °t-.. W 4 J DESIGN ELEMENTS TO INCLUDE:SIZE&DEPTH OF SHEET N F LEACHING POOLS,DRAINAGE PIPE SIZING&TOTAL • •n J• �.p)O �0,? '� CAPACITY. 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STUDS CONTINUOUS TO SOLE PLATE CEILING &LOCKING a PANEL DIAPNRAGH EDGES IF REQUIRED WALL SHEATHING NAILED PER CODE 11 I BIDING ; • A HIGH WIND RAKE GALLOON FRAME II I : 1 , i [ • ?' L __ L .-i ! 1 '1 i 2 :„: I . I I I f ( V • P;JIVIK Ir/1I _ -- 1 �. I ,. et-izirrN/r4-tr2, 5-V146121, -1-/ .\ . i r : • ii 1 . 1 . ....._ MAR 1 2 2015' - - — — — — — !! — _ __ _ . ____ _. t,r �—T I 1'V-tti `1tt? f . I —II l.- �%�� � �jC..�-1-- 'a SID `I _ .. ... 1.10-1-1 . N Y" 5, 6IJ IzGI Y CJDDIvtt2 ro t-r, 131?- NKL.60-4 F=02 47-DD1T1 Dk L 114 41~1 5W S- ' . I CD U Di rl O 1.1>✓D pLOO fX35 CA S- RD OU rF}DLA NY Pf SCg►rfi v e skiveLG PE u l ) ! ti&TE h 14. 14 1 .11.4E AbD sriQki Mme. NYS. ( MI NI i -f'UM cote 12'ec)t.f gats—tE 4 ) •. , . . . . . . .. t I5To Liv g 'ADDIj'1O4 4 4 i 2. I 2 DF2 1 ____ _.._______.-. ... __._____w__ ..__ _ _ _ T N Lo O\ •-4 ti z 1 Y !r +al _- ,O co 4- ch •* s I � �. rnrn 1 t c d 1 .- U o ,.�4 ,_ 0,I I ' I I i " N i; in in • 2)x61,t. 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Coolet - i ,, (o-s � ey\ u 1.414_4_, 16, 47- 1:11, 40*: _..."_.. s ,\ } 84 • / . k - • I1E. re2e1 >,g1I LIZ N1 235 Erol- R 19 i-4-k.L.,13 Nr fr l'ui [4- r-rooT tK- .rVz1.7"gectf7'` , ..:iL_ 1512171ICrI —___._. ._._.W. _________.._ ___._-__-...-_-____._._____._____.. ----- • FLOOD ZONE AO (DEPTH 2' SURVEY OF PROPERTY FIRM MAP NUMBER 36103C0158H IN SOUTHOLD N TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000-52-02-7.4 \ = SCALE: 1'=30' r JULY 1, 2014 NOV., 17, 2014 (REVISIONS) 1 , ; ' 1 i MAR 1 2 2015 ! Ain SI t1/4G . \ ES840 ,00 STORMWATER MANAGEMENT CONTROL PLAN k. �P \ \ PG���k AUG. 5, 2014 g 10 1416 IA \ 0 1 V3 \ \ O. \141 \'' \ \ 0 IV OAS �c� o� G /0 if 5 $r� unuir 30 14 IA 1 9 rE 0 a o6 °' d pN �101F r L \ •E 5 9• \ o O. GE • t kel -ANNP s \ RAIN RUNOFF CONTAINMENT 6N ao N� \.� � c � k$ 1.1).k ••° o .�, 1% SRP PROP. ADDITION - 182 sq.ft. �. . — ' ♦ (t 182 x I x 0.17 = 31 cu.ft. \ off" c°��R '��`' �. Z�J`�` `^�'�,,; 'S 31/22.3 = 1.4 VF. xco-- 2�+�,o oEc4 \ \ O�N`E �. PROVIDE I DW 6'0 2' DP. rili Connected with Gutters & Leaders ? 1 ,p. , 01 8 / 1�� �, O F S ��' a LT, PAGES 5 v'N -,-/ ts,p-lzy ' `4‘ \ t4 �- .; \ 30 G x �s -'Jr. -ecl` NI ' /0I \ ti / ski S 2' ifs Jim OltP 0_, e \ . os 4, it.= - 0 . et.' -A,- �\` ` SSP e._, o\ai`. , 0 \ 01 5 . ��R"6R 0. 4,:..., %a\Q^ `d NSP Ox\ )\\ V / e OL R LSI • ti \ \ of / testi \ GO, off, \ `�O. G AREA OF UPLAND = 13,901 sq.(' F`s,, \ K��14 13901/17740 = 78.4 '. \ 6 AREA OF WETLANDS = 3839 sq.ft. 6 3839/17740 = 21.6% 44 . \ \ OP' \\ . m \ 11 \ \ %., \ \ \-, \ 4'AI** \Zi ^ 5k'19\ �Q .1' ) S 1 1 tp o4 NYSDEC APPROVED AS PER TERMS e AND CONDITIONS OF PERMIT NO./- , -i 33 i DATE 3 I o = MONUMENT _ `� / f C. t\ i .. = WETLAND FLAGS — AS DETERMINED BY SUFFOLK ENVIRONMENTAL c"\;...-- --,-;---,91, \�5, CONSULTING, INC. ON JUNE 12, 2014 (' c ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION r�`'"�• " y" ' "f /.�i��• C. Na 49618 OF SECT)ON 72090F THE NEW YORK STATE EDUCATION LAW. PECONIC:SUR-VEYOR , P.C. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS AREA - 17 740 SQ. FT. (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER SIREET I S1GNA LURE APPEARS HEREON. SHEET I of 2 11-14 4 SOUTHOLD, N. Y. 11971