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TR-8685
Michael J.Domino,President ®f S0!/T�o Town Hall Annex John M.Bredemeyer III,Vice-President h0 l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Telephone (631) 765-1892 Greg WilliamsO Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 17, 2018 Walter & Barbara Fitzgerald .9 Smith Street Glen Head, NY 11545 RE: 8915 SOUNDVIEW AVENUE, SOUTHOLD SCTM#: 1000-59-6-27.3 Dear Mr. and Mrs. Fitzgerald: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, January 17, 2018: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8685 for a proposed irregularly shaped patio around the pool consisting of side 1 to be 107' wide, side 2 to be 4' wide, side 3 to be 6' wide, side 4 to be 6' wide, and a diagonal 25' wide by 15' deep pool patio area; and as depicted on the survey prepared by John C. Ehlers Land Surveyor, last dated November 12, 2017, and stamped approved on January 17, 2018. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, ifa' � Michael J. Domino President, Board of Trustees MJD/dd 5URVEY OF PROPERTY APPROVED PAY N 51TUATE: 5OUTHOLD BOARD O� i �USTEES TOWN: 5OUTHOLD ; TOWN OF S�` W 5UEEOLK COUNTY, NY UTHOLD _ v SURVEYED 03-22-2012 f-DATE A'!f �' �7� ��g S PROP. POOL 06-15-2015 WETLAND DESIGNATION Oa-15-2015 UPDATE 11-05-201-7, 11-12-201-7 SUFFOLK GOUNTY TAX # -- - 1000 - 5Q - 6 - 2-7.3 — _--- Land Now or Formerly of: George L. Penny iv ' _S 86026-428M, 253.10' V l N a� --.--- ------ — 0 f j 606 lit Ell y aP� o pay � 0 ej � m metal fence x� N s� , � q 9 P°,°,trp• 1 � 1 i / \ - \ 1 o to Nov 1 7 2077 inV►N P�Pe CERT=TO: Walter 1['ll .gG1l�JWlt � 11 mbara Fitzgerald) w h• Olaf Republic National Title Insurance Company o� For\ areat �- - 600 ,1�-------- 4 '. s NOTES: O e PIPE FOUND �'Q^neW of 3 "IFmlhor'I d olleralion or addlllon to a survey trap tM@M f I-t1o.1 0q SUNeyar)o Seal IS a Nalatlo d>ec'k oro 1.1.E->bn l of 1hB • Nen York 51010 E6rcallon Lan" ' ly.1th Io,1 Ik ap Lwl or lhiS a,rvey Proposed Patio to beTavertine Stone on Grade ped.°"" °r1g1 al al fhe lad>.r�yar'6 >I d>eal>hgll by coreldered to M valid trua copbs" 'C rlirlcalloro li of t.d herrson 519 lfy that this THE NYS FRESHWATER WETLAND BOUNDARY 15 EQUAL TO R. FOX'S LINE AS SHOWNVeyHmpeporednacordaxniththea"- nting endo or rraou�e for Laed survey adopted ON THE SURVEY PREPARED BY JOHN EHLERS LAST REVISED 3/14/05 AS DETERMINED BY �Lt-d 5'— S`a��9nitlelt���"nI to the per>on For rhi the wrvey L•p-ped R. MARSH 4/6/05 •ab-hl>b&.1F to the tltle ca / til agency and 1e 1,19 Institvtlon II>[ed herea �tl to the a»Ignee>°F lh." 1�M[I[ulbn Cerlltl-- [lons are rot lran'o'.lo to addlU-1 In tbtr— Area = Ibcl .8G FT JOHN C. Ei SURVEYOR Area = I.bQ ACRESES , 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHI G SCALE I"= 40' I RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 i REF.C:\UserAh,'� ropbox\03\03\03-249-LM-27 3FINAL REDO 11-03-2017.pro 11A]/Y111 1Ir09ia1N.1 G.VNo-AJdnYiadu.MlOTds a 3LTe11 �° L'a November 16, 2017 t Town of Southold Trustees PO Box 1179 Southold, NY 11971 RE: Amend to Permit #8685 We are requesting to amend permit #8685 for an on grade patio to surround the pool. The patio will be travertine stone, dimensions are depicted on the enclosed updated survey. Thank you for your time and courtesy. Mrs Barbara Fitzgerald 516-587® 019,'cell . , dog E NOV 1 7 1017 � -�- to 2, )C w, Michael J.Domino,Preside' StfFU( cOG 1` Town Hall Annex John M.Bredemeyer III,Vice-President �� yam, 54375 Route 25 Charles J. Sanders y - P.O.Box 1179 Glenn Goldsmith 0 ® 3 Southold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD Date/Time: Y Completed infield by: L25— WALTER 5 - WALTER & BARBARA FITZGERALD request an Administrative Amendment to Wetland Permit #8685 fora proposed irregularly shaped patio around the pool consisting of side 1 to be 107' wide, side 2 to be 4' wide, side 3 to be 6' wide, side 4 to be 6' wide, and a diagonal 25' wide by 15' deep pool patio area. Located: 8915 Soundview Avenue, Southold. SCTM# 1000-59-6-27.3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: V//j.Bredemeyer 4. Domino -G Goldsmith VIN. Krupski :; zc�jlrs Other Page 1 of 2 Michael J.Domino,PresidtgVFFO(� f, 1 �N0 CdG Town Hall Annex John M.Bredemeyer III,Vice-President y� 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith 0 1 Southold,NY 11971 A.Nicholas Krupski ���?, per Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: WALTER & BARBARA FITZGERALD request an Administrative Amendment to Wetland Permit #8685 for a proposed irregularly shaped patio around the pool consisting of side 1 to be 107' wide, side 2 to be 4' wide, side 3 to be 6' wide, side 4 to be 6' wide, and a diagonal 25' wide by 15' deep pool patio area. Located: 8915 Soundview Avenue, Southold. SCTM# 1000-59-6-27.3 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, .or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other \ Page 2 of 2 � �'� � ter,,�,a , •Ap .,, � ����9 � j �,. �� t t_ � f �- 8915 Soundview Avenue,Southold 1000-59-6-27.3 119/18 V 74 1 9 9 32 alter&Barbara Fitzgerald 915 �„ x r" 201 . 1 . 9 9 : 32 SOF !/jy Michael J.Domino,President SO � ®. Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders CA 4= Southold,New York 11971 Glenn Goldsmith ® �@ Telephone (631) 765-1892 A. Nicholas Krupski I�COUN�,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: t�( ® G1- Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed VProject complete, compliance inspection. INSPECTED BY: n\n <-Ii - c d✓���.I COMMENTS: 44 0 VVIC.- '13 Yl;5- V"tp_O S e3LC' cv�f CERTIFICATE OF COMPLIANCE: Michael J.Domino,President *oE SOujyOlO Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 Vs ANC A. Nicholas Krupski Yp� Telephone(631) 765-1892 Greg WilliamsFax(631) 765-6641 �y�OUNTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1499C Date:August 15, 2018 THIS CERTIFIES that the installation of a 16'x30' gunite swimming pool with cartridge filter system,• and install pool enclosure fencing and an irregularly shaped patio around the pool consisting of side 1 to be 107'wide side 2 to be 4' wide side 3 to be 6' wide side 4 to be 6' wide and a diagonal 25' wide by 15' deep pool patio area, At 8915 Soundview Avenue, Southold Suffolk County Tax Map#1000-59-6-27.3 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 24, 2015, pursuant to which Trustees Wetland Permit#8685 Dated October 21,2015,was issued and Amended on January 17, 2018 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 installation of a 16'x30' gunite swimming pool with cartridge filter system; and install pool enclosure fencing and an irregularly shaped patio around the pool consisting of side 1 to be 10'7"wide, side 2 to-be 4' wide side 3 to be 6' wide side 4 to be 6' wide and a diagonal 25' wide by 15' deep pool patio area. The certificate is issued to Walter&Barbara Fitzgerald owners of the aforesaid property. Authorized Signature r' Michael J.Domino, President OF SOUTyO Town Hall Annex John M. Bredemeyer III,Vice-President '`� l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G Telephone (631) 765-1892 Greg Williams Ol Fax(631) 765-6641 �COUNIy,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: l� V Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed V/ Project complete, compliance inspection. INSPECTED BY: COMME T CERTIFICATE OF COMPLIANCE: John M. Bredemeyer ill, President o�OguFFD(,t-c Town Hall,53095 Main Rd. Michael J. Domino, Vice-Presidents OGy� P.O. Box 1179 James F. King C Southold,NY 11971 (hone Tele ,631)765-1892 Charles J.Sanders P Dave Bergen 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 NN 'v k-1 :its i NU., BOARD OF SOUTHOLD TOWN TRUSTEES :w ti;;l =< SOUTHOLD, NEW YORK PERMIT NO. 8685 DATE: OCTOBER 21, 2015 ISSUED TO: WALTER & BARBARA FITZGERALD PROPERTY ADDRESS: 8915 SOUNDVIEW AVENUE, SOUTHOLD SCTM# 1000-59-6-27.3 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in 15 accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 21,20L,and in consideration of application fee in the sum of$250.00 paid by Walter&Barbara Fitzgerald and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to install a 16100' gunite swimming pool with cartridge filter system; and install pool enclosure fencing; and as depicted on the survey prepared by John C. 4 Ehlers Land Surveyor, last dated on June 15,2015, and stamped approved on October 21, 2015. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. M T John M. Bredemeyer, III Abseni F g 0 5 V TERMS AND CONDITI®NS The Permittee Walter&Barbara Fitzgerald residing at 8915 Soundview Avenue, 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 be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if,in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. John M.Bredemeyer III, President *Of S® yOIO Town Hall Annex Michael J.Domino,Vice-President 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Telephone(631) 765-1892 Charles J.Sanders,Trustee ® �O O�ffcouff 1,�c� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 21, 2015 David Cichanowicz Creative Environmental Design P.O. Box 160 Peconic, NY 11958 RE: WALTER & BARBARA FITZGERALD 8915 SOUNDVIEW AVENUE, SOUTHOLD SCTM# 1000-59-6-27.3 Dear Mr. Cichanowicz: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 21, 2015 regarding the above matter: WHEREAS, Creative Environmental Design on behalf of WALTER & BARBARA FITZGERALD 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 August 24, 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 Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 21, 2015, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, i 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure'complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of WALTER & BARBARA FITZGERALD to install a 16'x30' gunite swimming pool with cartridge filter system; and install pool enclosure fencing; and as depicted on the survey prepared by John C. Ehlers Land Surveyor, last dated on June 15, 2015, and stamped approved on October 21, 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, Michael J. Domino, Vice-President, Board of Trustees MJD/dd SUR\/EY OF PROPERTY N 51TUATE: 5OUTHOLD TOWN: 5OUTHOLD W E SUFFOLK COUNTY, NY SURVEYED 03-22-2012 PROP. POOL 06-15-2015 S SUFFOLK GOUNTY TAX # 1000 - 5a - 6 - 27.3 Land Now or Formerly of: George L. Penny IV 86 253.10' � 16 t N ------------- � O t v1(206 d ~ (� yk'°reWay e d<<v moo `Lrb o�c y\cp-"oS. p< ., a�° _ Qv 5\'ory (I d 02�� x eyeP��g \ •� 9- C: 2 eo " ` `}t a \ �� �ojs'oqft O cs. dryW° to 9� 0 1 ,, ,•^ oyed � - �.2spr0\ — rn9 t t\1�ndj 0) \00 Vp ao '00 at°�na a� gr APPROVED BY 9ag t G et y r006d t � � g rodana oodeBOARDQtSEES ` a o TOWN o+�9 `jam t° rem � area t\ DATEA dcro � 2X; 10(:5 . �, - , + `` a i - La t -.K- m 24 ' O 01%A PSP --� w V AUG 242015 ►` .14 t s- Snuthrld Town � � M � �� 00 %Nov or Walter IFitzgeraIld m�"t 14 Barbara Fitzgenvid Old Republic National TKe lasurance Company %F Ihori a onarono or oaanbn to a ewvey map bear 0 Ilcen52tl IaM eNtsn 9MNOOi W 6Yrvea5rb'S 52301 15 al Yak St.te Eott—Lo ' C.Ey n y copes Iran the a gha of lms Bey ® a 1 11 or'—f of Ibe IoM-lid V- O 5201 Snan b2 con5laeren to r»�aib true � � ceple5" N 'eerli/koltac lMkwea tzrcon Slgruiy iLh.Ih�s NOTES: ,� G s'rv2y was prepares In accoruaea nnn the I yOTEJ: ' burg code of R oclke For Loro 5u'X o�11p by tln Nen Yak Stole A»xbtton of Aor...brnl LOM Su'v2yOrs :Ala c2Hipcalbre stall tun only PIPE FOUND / to the pe Son For Man l2 the wrvay is p'pa ed to Lhe kn O and an Ms bena6 compay garerronen- t01 ogawy-d' &6t abn 11 tea h.—.and / Q+ to the ossgtnes a lM Iercrrg retnvtm eertilica- V� O tlOr9 aro noL lroreiorObl9 to a�tlOMl WtnNiors Area = FT � pArea = 1.6LI ACRES tANJOHN C. EHLERS LAND SURVEYOR GRAPHIC SCALE I = 40' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.0-.\UsersVohn\Dropbox\03\03\03-249-.OT-27 3FINAL REDO 03-119-12.pm Ogll4a] 4• - -ti ' J John M. Bred'emeyer 111, President guFFO(,�-C Town Hall Annex Michael J. Domino,Vice-President ,`�4 �Gy 54375 Route 25,'P.0 Box 1179 James F. King Southold,NY 11971 Charles J. Sanders �y r► �� Telephone(631)765-1892 Dave Bergen Fax(63 l) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 1/1oa 23•L� TOVV Pran-se f7ft-W-14 RTMW�r? V0 aemlvc E'VVIP'O�M67ML_ : has been Please be advised that your application dated- ��� 24 24t.a�� 2-4, 2-01-5- and reviewed by this Board at the regular meeting of your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Silt Fence Inspection Fee ($50.00) 1St Day of Construction -($50..00) Y2 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: F/A,A'L 1A1546�,rl0Al - 450,0 lot TOTAL FEES DUE: $ BY: John M. Bredemeyer III, President Board of Trustees - r S l John Bredemeyer, President �ogUFFOLre Town Hall Annex Michael J'. Domino, Vice-President 54375 Route 25 James F. King ti ; P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen y�O1 ,� �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: ® 7 JLl Creative Environmental Design on behalf of WALTER & BARBARA FITZGERALD request a Wetland Permit to install a 16'x30' gunite swimming pool with cartridge filter system; and install pool enclosure fencing. Located: 8915 Soundview Avenue, Southold. SCTM# 1000-59-6-27.3 Type of area to be impacted: ` Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: ✓Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre ubmission 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: V . Bredeme er M. Domino �✓J. King ✓D. Bergen . Sanders Bay Constable , Other Form filled out in the field by_ Mailed/Faxed to: Date: ,� .-r. ,1 ,}ham•< s•` l- YY f sy � Aft IA a Walter&Barbara Fitzgerald . Southold y 1000-59-6-27.3r 1 10/14/15 jo 1 :0/.1.4/2015 16 , 57 t M� AIS. �� •...'�� 1i � t A � - " .'1 �r �. f � ,- w:,w u4 t r 1, ,r. Ar i. - •� :. - r k � a y a�• Y d ' Bard Of Southold Town Trustees SOUTHOLD, NEW YORK _ PERMIT NO. ... .... DATE: Dec,20, ..290A { ISSUEDTO .ANTHONY All).tILCOf,r�...: C11�{4!t.0 .1. ..._........................... ... . e Pursuant to the provisions of Chapter 615 of the Laws of the State of New York, 11393; and Chapter 404 of the Laws of the Y State of New York 1952; and the Southold Tovim Ordinance en- titled--"'REGULATING-AND-THE PLACING-OF OBSTRUC1I014S. IN AND ON TOWN WATERS IC LANDS and the MA'i�R SOLS �F.OM I . REMOVAL OF SAND, GRAVEL-OR OTHER LANDS .UNDER TOWN-WATERS:!'.' and in accordance with the Resolution of The Board adopted at a meeting held on _.D S:4— t 2004 and in consideration of the sure of V50,.0-0..... . . paid by ' Anthony. and..I3ico�,�..S..R�.X.�dr�kis...................._................................. ' of ...Southold....... .......... ... N. Y. and. subject to the Terms and Conditions listed on the reverse side hereof, of �o thold Town Trustees authorises and permits the following: Wetian ermit to construct a single-family dwelling with a I garage, sanitary system and pool with the conditions' of gutters and drywells to contain all roof runoff, a 501non-disturbance buffer and a dry well for the pool, and all as depicted on the y planal` in accordance Vdh the detailed specifications as presented in -the originating a liication. ` 9 9 pp surveyed by Sohn Ehlers last dated ' s 2/14/05 IN WITNESS WHEREOF. The said Board of Trustees We- by causes Its Corporate Seal to be affixed, and these pments to be subscribed by a majorrty of the said Board as of this date. Artie Foster a � j � '� . !fit.w. - .if"'tf:?,!'`• w���^^± ,_ OWN OF 'SOUTHOLD PROPERTf R .. ORD CARD •� �`� C '�Jl•ICJ' l �'��� ""�'� �.•+W OWNER STREET VILLAGE DIST. SUB. LOT i i1 V� ` �� ✓•'(�9 ��• ��� 1 'lJ(l/J d•'tr � Y C '� lfit I ! {r'4• �'f'-6�rr.t�i. ��n f rC (( �, - . .. FORMER OV1( ER Nr (� R'l� !'�YL.L'.'6r4•il �F r.,�.'�?..�f n 4r c;n,� J� �f, ACR, �•_�,., 1 �7 !.�'1'P.(�}r'1.l?_ !��- ' j �'� 1���''�::�,�I��' -C:v'•ro�-����de.;,.<<,s}I �I��, ' YPE , T OF BUILDIN 6 RES. SEAS. VL. FARM COMM. CB. `MICS. 4u Mkt. Value � ( 01 LAND IMP. TOTAL DATE REMARKS /rl G..1 el�,x "J ��` p�'•,'� / r f `v�•-� �r ,+4'/" �N 4-0 Clem m U• 1. +�{ 1� i/r.7 .•:.YyAY � 4$ .� «lr( {:r�s 3 l'L �/ C+-_. ¢ �m "., d0 x ��^-1• /ZS /"Ir1lY9��ifr. r1G�C��6G'O F..,.[ pp e� '' 4d4. s r�' f9iyr r� o' 1 A ilei 3 0 6 f Il/�ma-yy," [1/ �I�ll /��J ft 4 r_ +...myc� �4•�` ✓ _f -----L'�[/ 0 boo r bIi•l 1) �JN *gf�J '' dryt`�'.{�9fI ,YI' H/ •.t1/�'/(I' C7`ti, P:if eYlf'��( r� , U r'' �L�, l/.Cw'f i�.f.�✓�/ �'� / i"/ „lS� /�(�•dfL LS• /'�P:1;��,� �'1.�•'', nes ca wc� I I i r i 91 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD' Meadowland DEPTH _ House Plot BULKHEAD 200 "�© t" -70 Total du 1004' C�'irr. � t E 3 ,a,s„ , i` 1i,r t , xy.,n /'�,JJW) � _ ^ter/'— /pJ � ■ �®'r'�"'���•C!'a 4_^�iP+:•aa'e'Jr�:+;WY:'»” I} - r�tii���>s €•n L'Y+'..v�" °f,i•YJy�, `"1 f {o c { aw cnrs- r•c n- ,vva �. ,u.« ',. h,�.a;,x{ilci� L. a.'F„"3t 4{ s .( 3 .au,r.,r�a;. .;.w;ur.�.x:.xn,��.±; � �• .,, •� E"�s*�iY=�a�P��ai'��a OWNER _Rr,�,:�>t�z�:e�=��w•�;•h��• ,... rt ,I. r ,r"{r;E�k,.�:,, ., t..,,� .. +".n`:'4.a�;,�.x�eruxx �:. pr�,^•"3t5.- ni I}"'p11t�y4''I Fe^r. w.w.•.J s.le ,�+... �r.<. "°..•rx7e_=wN�-%'s; y•ar.4,•..-' s-�a�o ,ii,';y!:�:7�-,3'i�';;rT4..: i�'Y'� &JREET � e �4y' uhVILLAGE TRICT SUB. LOlDIS �, �.I a�t. �� �. J..' f ,+� ,yam.�I 6� '+w/" '� y.�� ,'rI�` ' '��{•1 r .,.,, a+' ,.1; n�1!,'J .M^":'°54°,•,�,dt�..r^»,A� '�nd`� .P` E r ���t�i Nam 4"',.r,�r '.. �a}�.r i� i., �°`"( "Y RM ER OWNERr N / � " EP, AC/RE�AGE �; d F__,n�»���`��� �y dd'$4�"ZF•r4��,• -� ✓�''iT�+"i�yrtr /r.+J.,'�D .,,",.,,•,w,..,_., .' _ _.._.._. ., S /p� � t r� V/ !1 �� TYPE OF BUILDING ' ,+•^"✓'/ 4+ f•'A,PdtrY'f ,.rt,.�f x'A'C,,.t• v F�6`�`4+.�a+a� �W i`+''7 1 , _RES. SEAS. VL• FARM COMM. ' I IND. I CB. I MISC. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS � ,� ,� „�.. �..-��.�..•1�. pp a'.rJ..xir•>'�"^ .,,r * 7`�� '�/ �L��}'C 11r.7 �•�•,�h((r'��L7 • AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per,Acre Value FRONTAGE ON ROAD r c�% � �•� �•I Aiµ Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot Total ®r' ". CIE,-�"'-�,4GV' .- i,�' �r �1y9�I��'F..M1r�m'Zr�," 3 54-4 ' YkiL4'C1Cr •'+Wu'uYiF.vlu i ri ,� dCA• t " , f ,r c .. r 7=f.� C(Ctpl y,!„' c.+_'.4 I T.j i ' •a, 59.-6-27.3 3/06 — A M. Bldg, I Foundation Bath I �,• —7— Basement .c., Exte°sion . .� y l x 1\ 7f Floors ✓ EExtension �D ?� .`a' t� - kr t,l-,;.� -E-5"t. Wallst' ; Interior Finish - 914:, =xtensionQ — e-.� 2 2 Z Fire Place Heat - z�v `o0 23 Porch Roof _ Type rte {X t 5G - Porch Rooms 1st Floor � 3reez@wayrC Patio Rooms 2nd Floor �ri iarage L q°ce p t��l;?G• �' `� -- - � �' . 9 _ �, =� � 2 _ Driveway Dormer - —r— B. -4ko �f, l ( FORM NO. 4 j TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31484 Date: 03 16 06 THIS ,CERTIFIBS that the building NEW DWELLING Location of Property; 8915 SOUNDVIEW AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 59 Block 6 Lot 27.3 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 30, 2005 pursuant to which Building Permit No. 31288-Z dated JULY 18 2005 was issued, and conforms to all of the requirements of the applicable Provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH COVERED PORCH SCREENED PORCH AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to ANTHONY & NICOLE SPIRIDAKIS of the aforesaid building. (OWNER) , -UPPOLK COUN'rr DBPAR7Mffi0T OF HEALTH APPROVAL R10-04-0188 03/13/06 ELECTRICAL C33RTIFICAT33 NO. 2077040 02/28/06 PLUMERS CERTIFICATION DATED 02/10109 JASON Sonnzo Au hori ed Signature Rev. 1/81 i y�KO(,f Town of Southold Annex 1/13/2014 P.O.Box 1179 54375 Main Road Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36710 Date: 1/13/2014 THIS CERTIFIES that the building ALTERATION Location of Property: 8915 Soundview Ave,Southold, SCTM#: 473889 Sec/Block/Lot: 59.-6-27.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 12/6/2013 pursuant to which Building permit No. 38602 dated 12/31/2013 was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "AS BUILT"WINDOWS IN AN EXISTING PORCH OFA ONE FAMIL DWELLING AS APPLIED FOR The certificate is issued to Fitzgerald,Walter&Fitzgerald,Barbara (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED hori ed Signature , )2 OSOx 2O / !�/° J a y ,b ny]�'+• 3� 3h �'pF��v�+ Od � ° ! "n�YJ )�! 1 m y0J F m ,�,yr rr „ '�xprvF A\ ^�s'rj}^°8• ° A 9 F "� � 5 a rulq 6x a o] v2U ,' � ^. O� r� F F B <h q N�M°+' ° ° ° '� •^+ i f , � s ]!° a OP M a ,J hr ° � r 4 °a ^ry F �.,p`�F s a• z81 abs 9 t\ { ]M Ot ai 0 � rF a Q Y Nay. ..• 1 OB 26t] v J PF ,p Yk4§ O a1 r ^'t^OBx�^ry S 81� roR ,cnrs)Ex � , 25 ° FOR ROL NO WN TOOF souTHoID Qsm'N'^' ° d 63q�` h E� maSEE E 05 ao1 50 GREATPOND i ,°rJ 4T•F CT B^ ry�EEmvs uxu '':T a ';q� � � 'a � �° � dry, 21 M1 O� � h x°F^ ^Nm F e ^o°F? R� �� o rvv^ �aav 5x°• � `~ � ° tie° ' 8 ^ry•Y o ` ryr zjJ o I w t°gym °j„ "° ear e y ,y s Nr e ',�' ,x ; °''•. 5 111All ' n ° NI COUNrvoF w � soacFwLes�,q � •°'� M k ]� Nr h d ea +° TM1 gM1 ° 4 2e 3A 9 A •c d° Pi mi a y�a°;`o \< 5 JOE ,1e,^ O 31e 2,N ^° h 4 OEv wacuEx Rpu 30a $ y P1 Ulm b 4 M19 y5 \ 35A 9 SNP` 27 `, d ]BA19 305 TBAIcI :7 � � yq,ms's 19A m IOAIc� O�BVEM ovq ExlgMO)n A C i Mrs) rp 20 2 9 6 d to sA(q .ry xseRwroxEAssuEMn °d° J o�svE�xErrtRaH s) 2 r s � xs ° \\ b 281 5AIc1 121IA uiti x FDR PCLNO EEE SEC No w 0091 '< a• _ z? sit siL xa .e 6 un x n9 x s>a ee x --------- ---------- ---�� LINE MATCH LINE tae oamsl MATCH SEE EEC NO 009 EEE EEC NO 069 - wx or W 7— ' NOTICE �,?' u COUNTY OF SUFFOLK _ —__ _ 1_ q Real Property Tex Sernce Agency vK SOUTHOLD SECTION NO�n uae°n 559 -- y f - <'a \,\®f So OFFICE LOCATION: ®�4 5--, �® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 :, Southold, NY 11971 7t, (cor.Main Rd. &Youngs Ave.) _ Southold, NY 11971 -s` ` �� Telephone: 631 765-1938 On LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM ,w; jT If OCT 162015 To: John Bredemeyer, President , Town of Southold Board of Trustees Sa,,ihold'ia�rn From: Mark Terry, Principal Planner Board,of Trusteea LWRP Coordinator Date: October 16, 2015 Re: LWRP Coastal Consistency Review for WALTER & BARBARA FITZGERALD SCTM# 1000-59-6-27.3 Creative Environmental Design on behalf of WALTER & BARBARA FITZGERALD request a Wetland Permit to install a 16'x30' gunite swimming pool with cartridge filter system; and install pool enclosure fencing. Located: 8915 Soundview Avenue, Southold. SCTM# 1000-59-6-27.3 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 are CONSISTENT with the Policy Standards and therefore are CONSISTENT with the LWRP. The following in recommended to further Policy 5 and 6. 1. Establish a minimum 50'wide natural vegetated buffer incorporating existing vegetation. A recommended definition for the natural vegetated buffer is as follows: A land area of a certain length and width where existing vegetation occurs prior to the commencement of any grading or clearing activity....Maintenance activities within the buffer are limited to removing vegetation which is hazardous to life and property, trimming tree limbs up to a height of 15 feet to maintain viewsheds, replanting of vegetation and establishing,a four- foot-wide access path constructed of pervious material for access to the water-body. The buffer will contribute to improving water quality of Great fond. 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 Peter Young,Chairman Town Hall,53095 Main Rd. cog Lauren Standish,Secretary d P.O.Box 1179 i Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., October 14, 2015 the following recommendation was made: Moved by Doug Hardy, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of WALTER & BARBARA FITZGERALD to install a 16'X 30' gunite swimming pool with cartridge filter system and associated fence. Located: 8915 Soundview Ave., Southold SCTM#59-6-27.3 Inspected by: Doug Hardy, Peter Meeker Vote of Council: Ayes: All Motion Carried BOARD MEMBERS ®F S0 Southold Town Hall Leslie Kanes Weisman,Chairperson ®�� y®l 53095 Main Road• P.O.Box 1179 Southold,NY 11971-0959, Eric Dantes Office Location: Gerard P.Goehringer G Q Town Annex/First Floor,Capital One Bank George Horning p ® YO 54375 Main Road(at Youngs Avenue) Kenneth Schneider COU N(Y,� Southold,,NY 11971 http://southoldtown.northfork.net ZONING BOARD OF APPEALS RECEIVED TOWN OF SOUTHOLD D -AM - Tel.(631)765-1809•Fax (631) 765-9064 SEP 2 3 2015 ek. FINDINGS,DELIBERATIONS AND DETERMINATIO y MEETING OF SEPTEMBER 17,2015 SEP 2 .5 2015 ZBA FILE# 6878 NAME OF APPLICANT: Walter and Barbara Fitzgerald outhold Tarin PROPERTY LOCATION:,8915 Soundview Avenue(adj. to Great Pond) Southold,NY S - - SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category_ of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated July 31, 2015 stating that this application is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued a recommendation dated August 20, 2015 Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to us, it is our recommendation-that the proposed action is CONSISTENT with LWRP policy standards and therefore is CONSISTENT with the LWRP. It is recommended to preserve existing vegetation on site that a 50' wide NATURAL VEGETATED BUFFER be installed landward from the wetland line. The purpose of the buffer is to lessen water quality impacts from residential development on Great Pond. PROPERTY FACTS/DESCRIPTION: -The parcel is a code conforming 1.69 acre water front parcel located in an R-40 district. The property has 448.18 feet of frontage on Great Pond. The property runs 770.52 feet along Sound View Avenue. The property runs 253.10 feet on the North Side and 100.96 feet on the South side. The parcel is improved with a 2 story frame house with attached Garage. All is shown on a survey by John C. Ehlers L.L.S. dated March 22, 2012 and revised June 15,2015. BASIS OF APPLICATION: Request for Variance from Article III`Code Section 280-15F and the Building Inspector's October 27, 20,14, renewed June 16, 2015 Notice of Disapproval based on an application for building permit for an accessory in-ground swimming pool, at: proposed accessory in-ground swimming'pool located in other than the code required rear yard or front yard for waterfront property. RELIEF REQUESTED: The applicant requests a variance to construct a swimming pool which is partially located in a side yard where code requires a swimming pool to be located in the front yard or rear yard of water front properties. Page 2 of 3—September 17,2015 ZBA96878—Fitzgerald SCTM#1000-59-6-27.3 FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on September 3, 2015 at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property and surrounding neighborhood, and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law &267-b(3)(b)(1). Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The neighborhood is a wooded neighborhood which consists of park land and single family homes. The pool in the side yard will not be visible from the street or from any neighboring property. 2. Town Law &267-b(30)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The applicant has a water front property. There is not enough space for the applicant to put the pool in the front yard or the rear yard while maintaining code conforming setbacks from the front property line or from Great Pond. Anywhere the applicant places the pool will require the benefit of an area variance. 3. Town Law 4267-b(3)(b)(3). The variance granted herein is mathematically substantial, representing 100% relief from the code. However, the proposed location of the pool is the closest location the applicant has to a code conforming location on the property. 4. Town Law §267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code. 5. Town Law $267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law §267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of a swimming pool while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Dantes, seconded by Member Weisman (Chairperson), and duly carried,to GRANT the variance as applied for, and shown on the survey by John C. Ehlers L.L.S. dated 3-22-2012 last revised June 15, 2014 and the site plan by creative environmental design dated June 13, 2014. Subject to the following conditions; Conditions: 1. Pool mechanicals shall be placed iAa sound deadening enclosure. 2. Drywell for pool de-watering shall be installed. 3. To preserve existing vegetation on site, a 50' wide NATURAL VEGETATED BUFFER be installed landward from the wetland line That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Page 3 of 3—September 17,2015 ZBA#6878—Fitzgerald SCTM#1000-59-6-27.3 Any deviation from the variance(s) granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations,, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the right to substitute a similar des:gn,that is de minimis in nature for an alteration that does not increase the degree of nonconformity.- Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three(3)years from the date such variance was granted. The Board of Appeals may,upon written request prior to the date of expiration, grant an extension not to exceed three(3) consecutive one(1)year terms. Vote of the Board.-.Ayes: Members Weisman (Chairperson), Horning, Dantes, Goehringer. (Absent was: Member Schneider) This Resolutio as duly adopted(4-0). Leslie Kanes Weisman, Chairperson Approved for filing `� /.�/ /201-5 5URVEY OF PROPERTY 51TUATE: 5OUTHOLD 'ElIAD TOWN. 5OUTHOLD 5WFOLK COUNTY, NY � �,J; ,2ot� w E SURVEYED 03-22-20121 S PROP.POOL 06-15-2015 eQ1 SUFFOLK GOUNTY TAX# 1000-54-6-2"1.3 Land NON or FOrmc of. George L Penny IV VA 'yS860262XB. 253.10, v � I N - ---- 0 O+ k IJP b` a tpj 1Fy ° r exol 6A(A9 yye p 1 A 2 J o ��A 9 \ --` •�a °��� t Qfo4pO1 / Pm° L *✓ a�mtt.\ dyad f k %�tm9 cue ° to9`Pe yyt°iMd d19, e to t �}mttr9 f 0d pfo)eLtcle0f�r9 d w0dtyt � 44c'Phqp4 00 ond'` T.p cestn nP o�/9 rrr LTOO to ® i n sb 71 6' x " FIMAL MAP '.�Vtt=_tiaL- SEE DECISION# DATED� 00 100 WdtaHtzg=W Ell— eeaIla 0 R��Netion®1'Il"nBeIlwa—Company �e�of �N NOTES. 0 PIPE FOUND Area = i5q A 4 So FT �Fti &U Arcot °�� JOHN C. EHLERS LAND SURVEYOR Are = I 64 GRES SF�LAND JP 6RAPHI G 567ALE 1"= 40' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 RIVERIHAD,N.Y.11901 369-8288 Fax 369-8287 REF.C:\Us—\JohnM)-pbox\03\03\03-249 LOT 27 3FINAL REDO 03-119-12.pro 1 John M.Bredemeyer III,President \rjf SU!/l�® Town Hall Annex Michael J.Domino,Vice-President '`� 0. 0 54375 Main Road P.O.Box 1179 James F.King,Trustee ! Southold,New York 11971-0959 Dave Bergen,Trustee G Q Charles J.Sanders,Trustee 'O ® Telephone(631) 765-1892 Char l�'COU�'.�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only 0 AUG 2 4 ZQiS _Coastal Erosion Permit Application ; g Wetland Permit Application Administrative Permit �u.'-th Cj fif9�l E I/ —Amendment/Transfer/Extension Received Application: $t 2 •15_ Received Fee:$7-,S0400 Completed Application t MI5 _Incomplete _SEQRA Classification: Type I Type 11 Unlisted Coord i nation:(date sent) q,/,,5r ZLWRP Consistency Assessment Form I/ CAC Referral Sent: q-Sat Ia Date of Inspection: /0•/ .1,5' _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: /6-21-/5— Resolution: Ot2(t%jResolution: Name of Applicant ,). Mailing Address( Phone Number:(5{b)' ,97_�3o)j Suffolk County Tax Map Number: 1000 - Property 000 -Property Location: &I 1 S ©uu� `,Q�� AyeL. (provide LILCO Pole #, distance to cross streets, and location) AGENT: j)&_V%c�- (^ It CACA 01).(49 bd (If applicable) Creative Environmental Design PO Box 160 Address: P-acn a ire NY 11958 Phone: 01-D M-7`15-2 E,- -,-,,d of Trustees Applicatior- GENERAL DATA Land Area(in square feet): 141 4c�&5 �7�)q 11 •-6q 5G.�p , Area Zoning: �_X40 Previous use of property: &S;) "k,a-I Intended use of property: �e Agw, `,a_ Covenants and Restrictions on property? Yes �No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? V 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 No If"Yes",please provide copy of decision. _-Lo 0_ �i [C� ( g"i v, j S g 13//3- Will /SWill this project requirepy demolition as per Town Code or as determined by the Building Dept.? Yes V No Does the structure(s) on property have a valid Certificate of Occupancy? L_ Yes No Prior permits/approvals for site improvements: Agency Date �-LX_6,._e5 fa-- ao 2c� No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency? V No Yes If yes, provide explanation: Project Description (use attachments if necessary): Creative Environmental 6317347924 p.1 0910312815 08:52 6317651 SOUTHOLD TRUSTEE:- - PAGE 02103 Board of Trusteds Agpl,idat iOn WF-TLANDITRUSTEE L,tSXVDS APPLICATION DATA purpose of tlIe proposed operaiions: 1 0 Area of wetlands on lot: ^ square feet Percent*overage of lot: 3 _% Closest distance between nearest existing structure Ond upland edge of wetlands: / ; _fcot Closest distance between nearest proposed straet M and upland odge of wetlands: i' feet Does the project involve excavation or filling? Nom Yes m If yes,how much material will be excavated? e;L0 cubic yards How much;material will be filled? 1\10 cubic y x& Depth ofwhich material will be rewoved or depositcd: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect,if any,on the wetlands and tidal water's of the town that may result by reason of such proposed gpemtjons(use attachments if appropriate): i& f? --k a.. bD 1 i S ig� YJ?— C( y1 617.20 Appendix B Short Environmental Assessment Form Instructions-f—Or—C-0 m p 1etin 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 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project. Project Location(describe,and attach a location map): " Brief Description of Proposed Action:_ Per- � �ul i Name o Applicant or Sponsor: Telephone:�3(�—�3 Address Creative EnvirOnmental Design PO BOX 16® City/P0: Peeallic9NY 11958 t State: Zip Code: 1.Does t e proposed action only involve the legislative adoption of aplan,local law,ordinance, admin strative rule,or regulation? NO YES If Yes,a ach a narrative description of the intent of the proposed acti In and the environmental resources that may be a Wed in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does he proposed action require a permit approval or funding fro any other goVernmentai Agency? NO YES If Yes,li t agency(s)name and permit or approval: . 3.a.Total acreage of the site of the proposed action? b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned acres or cc trolled by the applicant or project sponsor? __acres 4. Check all land uses that occur on,adjoining and near the proposed&tction. Urban ❑Rural(non-agriculture) D Industrial ❑Commercial -Z Residential(suburban) Forest D Agricultureeci❑Aquatic ❑Other(specify): Parkland ( fy): Page ] of 4 5. Is the proposed action, a.A permitted use under the zoning regulations? NO YES N/A b.Consistent with the adopted comprehensive plan? t/ 6. is the proposed action consistent with the predominant character of the existing bilt or natural NO YES landscape? u I e the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO S 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? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements,describe design features and technologies: NO YES 10. Will the proposed action connect to an existing public/private water supply? If No,describe method for providing potable water: NO YES 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 12. a.Does the site contain a structure that is listed on either the State or V Places? National Register of Historic NO YES b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ✓ If Yes,identify the wetland or waterbody and extent of alterations,in square feet or acres: V/ 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that E3 Shoreline p"Forest apply: E Wetland El Agricultural/grasslands 17 Early mid-successional O Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed by the State or Federal government as threatened or endangered? NO YES 16.Is the project site located in the 100 year flood plain? NO YES Will the proposed If Yes, action create storm water discharge,either from point or non-point sources? NO YES a.Will storm water discharges flow to adjacent properties? —1// 1,7'NO 0 YES b.Will storm water discharges be directed to established conveyance systems(rano and storm drains)? If Yes,briefly describe: O0YES Page 2 of 4 I the proposed action include construction or other activities that result in the impoundment of NO YES r or other liquids(e.g.retention pond,waste lagoon,dam)? xplain purpose and size: / 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED KNOWLEDGE ABOVE IS TRITE AND ACCURATE TO THE BEST OF MY Applicant/sponsor Signature: - Date: Part 2-Impact Assessment. The Lend Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I 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 In ay may I. Will the proposed action create a material conflict with an adopted land use plan or zoning occur occur regulations? 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 charac / establishment of a Critical Environmental Area(CEA)? teristics that caused the / 5. Will the proposed action result in an adverse change in the existing level of traffic or 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 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, architectural or aesthetic resources? / 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? J 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 EIproblems? 11. Will the proposed action create a hazard to environmental resources or human health? 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. Check 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 environmental impact statement is required. Q/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 ®✓ ,3 - / Name of Le gency66 / Date 1,e YPresident Print or TAZIOZ nsible Officer in Lead Agency Title of Responsible Officer n ure of Res s le Officer in Lea Agency Signature of Preparer(if different from Responsible Officer) g ) PRINT Page 4 of 4 a6��SuIFQ/ Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM o PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A OlyD STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN Distractecction —90, — Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a• What is the Total Area of the Project Parcels? Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within 3c� Generated by a Two(2")Inch Rainfall on Site? / the Scope of Work for Proposed Construction) s t— (S F./Acres) (This item will include all run-off created by site / b. What is the Total Area of Land Clearing ,1,(etf No' clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 11��,�,,feY� l o Site Improvements and the permanent creation of construction activity? "'> (S.F./Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed — PROVEDE BRIEF PROJECT DESCRIP'T'ION (PmvideAdddwnalPages asNeeded) Drainage Structures Indicating Size&Location?This Item shall include all Proposed Grade Changes and r r Slopes Controlling Surface Water Flow. ��.. Grr7 e,r 1 k rho CKAP A_( 3 Does the Site Plan and/or Survey describe the erosion and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? rj Will this Application Require Land Disturbing Activities F]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 jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or 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 larger common plan that well ultimately disturb one more acres land; which Exceed Fifteen(15)feet of Vertical Rise to El including Coo nstruction activities involving soil disturbances of lesss a 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-040-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the Not.The NO[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) identify 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.&1 Acre in area, 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(.J)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, �V FFO CK COUNTY OF.................. .................SS t t T7tat I. �1f:..`�..r..�,.1�-... V7�+?.l.�Z ............being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) Andthat he%she is the ..................Al �+f�.: '.............................................................................................................................. VV (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; dy o Z " AV T o.�� P*7 � DIANE DISALVO WfNotary Public: . .. ..... ...NOTARY-PUStIC-STATt-OF--NIW VOtaK........ ............. .............. ........................... plican FORM - 06170 Qualified In Suffolk COUnIV My Commission Expl�fCAptll 101 1019 r PROOF OF MAILING OF NOTICE ATTACK CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK Creative Environmental Design COUNTY OF SUFFOLK PO Box 160 residing at Peconic,NY 11955 being duly sworn, deposes and says that on the day of 00obg- , 20 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at �LA!�M Lc— , that said Notices were mailed to each of said persons by CERTIFIED MAIU/RETURN RECEIPT. Sworn to before me this 761 Day of f�TOr' � , 2015- Notary 0f5- Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. O1 D1475593 Qualified In Suffolk County My Commission Expires April 30, 2019 Post [ServiceTM RECEIPT RECEIPT CERTIFIED MAIL,. MAIL. e. • e • �I Ln t ,�• £ >in 50UTHl1L1LU P�Y1I971 i >, rn m Postage $ 3.45' '--m Postage $ f3.45 �- "` Certified Fee Q �Yfl!C 7T Certified Fee p0�RO Nt c� • s Postmark 9 '-q Postmark C3 Return Receipt Fee SGOO Here � , M Return Receipt Fee . Here C3 (Endorsement Required) C3 (Endorsement Required) Ln C3 �, CO Restricted Delivery Fee ! 915 Restricted Delivery Fee / C3 (Endorsement Required) /07!2015 ! O (Endorsement Required) 7/201 .n • M l Total Postage&Fees $ M- Total Postage&Fees $ 16.74 ru Sent To "�=•--"" y ----------- Sent To '� ----------------- '�L��.��`ick t�---------------- a �i��� C�rt�'�------------------------------------------ p Street,A t No; ------------------ ----- _ P c\,,,, � � O Street Apt No.; �� or PO Box No. /jl U� r- or PO Box No. 1 `J- T L-•L-Y�—J , ----B- -- --- - -- -------------------- Crty,State,ZIP+4 � City State,ZIP+4 - hr�c��� �►R 17;x2— 3t��,c.-4lr�o��,. d�, I I�'/�� IPS Form,36,00j,Auqus1t.2.006 See Reverse for Instructions • . U.S. Postal ServiceTm CERTIFIED MAIL. RECEIPT Ln CERTIFIED ■ e. #Iaih?r� Insurance Coverage Provided)- COr%- otnestic Mail Only; Provided) C3 SOUT15P O i19 1; . 50UTHOL> N11 ?13 �► M a m Postage $ f3.45 ppr __ rmtl Postage $ 43.45 ®(v!� Certified Fee "a'1"'t C .79 Certified Fee r e r9 j O . � 5 Postmark ,P J C3 Retum Receipt Fee . �@ Here d L Postmark �0 (Endorsement Reqwred) Return Receipt Fee , ere t-n O (Endorsement Required) �� c Restricted Delivery Fee ! i X101 7 Postmark) O p (Endorsement Required) Restricted Delivery Fee / (�,'s 0/07/2015 (Endorsement Required) !07/ „, Total Postage&Fees S1039 $ Total Postage&Fees � DSPs- Sent To M ru S - �C�V �c tai 1} Sent To ----- - - - - flJ q 0 Street,Apt.No.; �} �\ ^r^�,1a o 0 ,�-_C Yr ---- - [`- or PO Box No. Q v �Y�r-V i V.[_W ll� pStreet Apt.No.; L� S._ ------------------------------------------------------ r%- - - --- --- ---- ----------- C3 .-C Box No. f�J --S �t�1�V�U2/ Crty,State,ZIP+4 City,State,21P+4 s I� 1^ -� - - - i PS Form :00 rr. See 9eveme.for Inst ru cti ons :r� 6r. See Reverse for'lnstru6t:i.ns 16/07/2015 14:01 6317656641 SOUTHOLD TRUSTEES PAGE 01/01 John Bredemeyer, President to Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 James P. King P.O. Box 1179 Dave Bergen Southold, NY 11971 Charles J. Sanders , Telephone(631)765-1892 Fax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES:TOWN OF SOUTHOLD -----------------------------------T-------®-------------- ln the Matter of the Application of WAL'T'ER&BARBA►RA FITZGERALD COUNTY OF SUFFOLK) STATE OF NEW YORK) ! AFFIDAVIT OF POSTING 710 BE COMPLETED AFMR POSTINGBEAMINS INPLACE FOR EIGHT A.AYS Creative Environmental Design PO residing at/dba, B®x I60 11 • 9 being duty sworn,depose and say: — That on the 7 day of t)L4at?zr ,2015 , I personally posted the property known as by placing the Board of Trustees of ici poster where it can easily be seen,and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing.Date of hearing noted.thereon to be held Wednesday,October 21,2015. r Dated: f o-1 lam—i S J - f - Sworn to before me this Cs /41 1 day of oc7, 20IS- Notary Public, DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK ' No. OID147559,3 Auclifled In Suffolk County My Commission Expires April 30, 2019 i ,NUTILL: Uim HtAKING 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: WALTER & BARBARA FITZGERALD SUBJECT OF PUBLIC HEARING : To install a 16'x30' gunite swimming pool with cartridge filter system; and install pool enclosure fencing. Located: 8915 Soundview Avenue, Southold. SCTM## 1000-59-6-27.3 TIME & DATE OF PUBLIC HEARING : Wednesday, October 21, 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 B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Bc I of Trustees �l�ca mon Cotuity of Suffolk State of New York �J��i��-4� ;r'.$) s"✓1� �'... i`'�i•f�'-r�`�����JI - l BEING DULY SWORN DEPOSES AND AFFIRMS THAT'AI /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 WORD 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 COIMPLETING 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. Signa SWORN TO BEFORE ME THIS DAY OF CtrU�-N ,20 UNTotary Folic Jeanne Sweet Bartos NOTARY PUBLIC,State of New York No.01BA6210083 Qualified in Suffolk County Commission Expires August 10,20 I r A Boa of TrustGGS tpPlIcation AUTHORIZATION (where the applicant is not the owner) residing 4 (mailing address) (Print owner of ProPertyy David Cichanowicz, Pres. -W—k j, do hereby authorize (Agent) Creative Environmental Design to apply for permit(s) from the southold Board of TO'AmTrustees on my behalf. (Owner'si.diatul�-) 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. YOUR NAME: �f ��L�W'�yi r9 :L`Z— c)1A (Last name,first name,middle initial,unless you are applying in the name of someone else or other e' ty,such as a company.If so,indicate the other person's or company's name.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance ✓ Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business,including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If No,sign and date below.If 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 that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation) C)an officer,director,partner,or employee of the applicant;or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this (0 d VA 20 t �r Signature Print Name t.c;L� 09/16/2014 08:46 516759.• MIXIT PAGE 01 APPLICANTIAGENT&x.PRESNTAUV TRANSACITONA 318a,0g g d' s ide' fold r on R o ' ow YOUR NAME. {r name,fttuarilliddls irtitwal,ttn[ess you at"APPlyut$id the vao�of sotneont:olm or WIM aft such as a campany,if so indicate the oth., PeMtt'sor'costspauy's ) ' NAME OF APPLICA37ON: (Check ail tint apply,) Tax grievance Building Variance `-- g Varia Change ofZone � A�tprovai ofPhu Coastal Erosion Exempliott flrom plat or oflcial mooring MV p Other lanning —,""— Of"Other,RMW the activity.) Do you personally(or through your comPmw,spouse,siblhV,Parent,or child)have a ttltttiaWg wins orthe Town of Southold' -Relationship"includes Wood, p 'oE' e�rployee inciudin a P r e ntarrlage,or busitress itaterest,`Business interest"means a busiol S partnership,in which the town officer or employee has eves a partial Ownership of(or errrployment by)a corttoration W'which tlt0 town o6sxr or employee owns more than`S'iti oo e shores. { - 3� - '�1rS NO l;_vol answered"YES",complete the balance of this form and daze and sign,where iztdicna,& NOW of person employed by tln Town of Southold rFft bf position of that person [� ttel�the relationship betwetnyoursClfflba appli=Vagentlrepr+esEntative)and the 10m officer oremployee-Either check dic appro}rriate line.A)thrOugh D)and/or desctibc in the spate provided. -the town*Wwenr or etuptoyee orhis or iter**use;Ahlinp„par*A o c'hilt is{check all tWvppVy A}tlto owner 4f greatertim 5%of the shares of tho corporate stock oftht:appl"t (when the applicant is a Corpotation): [3)lire legal or benatleial owner of atry;nmrsst in a rwn cpr{sat$teentity{wh*r►the applicant is m9a corporation); C)an officer,director,partner,or employee of the applicant;or I�)the actual applimt. DESCRIPTION OF RELATIONSHIP 'SubmitW this lb dtty cif=' mJ7Pr0$1 Sipatum x r Print dame r2rt4- Form TS 1 S Creativ6 Environmental 6317347924 p.2 69703/2015 05:52 631765�—Ti SOUTHOLD TRUSTEE — I PAGE 03/03 Town of Southold LWI�P CONS'ISMCX A,SSFSSNMNT FORM A- INSTRUCTIONS 1. All appti=ts fnr permits* including Town of Southold agencies, shall oomplets this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. Trois assessment is intended to supplement other information used by a Town of Southold ag=q in making a determination of consistency. 'Except minor exempt adiom including]$te hibig.permits and othw mbdsm d permits not looted w0in the Coastal Erosion Find Area. 2.. Before answering the questions in Section C,the prepater of dais form should review the exemp[ minor action lisp policies and explanations of each policy contained in the Town of Southold Ltacal Waterftnt Revitalizadon Program. A. proposed action 'will be mmluated as to its significant beneficial and advorso effects upon the coasW area(whieb includes all of Southold Town). 3. If any question in section C op this form is answered"yes",then tho proposed action may affect the achievemeiit of the LWRP policy standards and conditions contained in the consistency review law. Thus, the action should be analyzed in more detail and, if iac=sary, modified prior to snaking a deterwination that it is consistent to the maximum exWrtE practicable with the LWRP policy standards and conditions_ It`an action carmot 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 follog places: online at flee Town of Southold's website($outlioIdtown.nortls#orrk.ne*,the]laird of Tnisbms Office, the Plamft Department,all local hbraries and the Town Clerk's office. B. DESCRII nor(OF SITI+;AJ fD PROPOSED ACTION SCTMA The Application has been submitted to(check appropriate response): �J Town Board [3 Play Wag;Dept. [I Building Dept Board ofTrustees Ud I. Category of Town of Southold agency action(check apprppriatc response): (a) Action undertaken directly by Town agency(e.g_capital construction,planning activity,agency regulation,land trdnsacdon) (b) Financial assistance(e.g.graM loan,subsidy) (c) Pcrmh,approval,liocnse,cereification: Nature and except ofaction: c l 0 Poo 1 tri 1 C1 i- -fir;k'n. � V Location of action: Site acreage: Present land use: Pi-L{o Present zoning classification: 140 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: L,��► a- 1 ��Gji;, t l (b) Mailing address: - ; , 41�A_ i (c) Telephone number:Area Code (d) Application number, if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? 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. Oyes ❑ No ❑ (Not Applicable-please explain) t�— 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 1E Yes ❑ No I' (Not Applicable-please explain) . e/ Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies ages 6 through 7 for evaluation criteria Yes 0 No (Not Applicable—please explain) 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 `—Policies Pages S through 16 for evaluation criteria Yes 1E No 0 (Not Applicable—please explain) 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 of Applicable (N —please explain) 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 In—Policies; Pages 22 thr7es2 for evaluation criteria. R No E (Not Applicable—please explain) 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. See Section III—Policies Pages; 34 through 38 for evaluation criteria. Yes D No (Not Applicable—please explain) 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. 1E Yes ❑ No (Not Applicable—please explain) PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yep n l No (Not Applicable—please explain) Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No U� (Not Applicable—please explain) Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town Ovate s. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria. EaYes1:1 No Not Applicable—please explain Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65for Ea Yes 1:1 No evalu tion criteria. Not Applicable—please explain Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies;Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No /Not Applicable—please explain