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Home My WebLink AboutTR-8707 John M Bredemeyer 111, President s�}FFQ(,�c Town Hall,53095 Main Rd. �G P_O. Box 1 179 Michael J Domino, Vice-President p 1110 1, 7.TV James E_ King �" x S"ut111,`�`..' `. ` 1.1971, Charles J_ Sanders ti qb o� Telephone(631)765-1892 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 '/Z constructed t/ Project complete, compliance inspection Wz Wqi 01 n BOARD OF 103OU'J'L'HOLD TOWN TRUSTEES SOUTHOLD,NEW YORK PERMIT NO. 8707 DATE: NOVEMBER 18,2015 V ISSUED TO: EMMA van ROOYEN PROPERTY ADDRESS: 575 HILL ROAD, SOUTHOLD. SCTM# 1000-70-4-29 V. AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on November 18,2015, and in consideration of application fee in the sum of$250.00 paid by Emma van Rooyen 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 301x141 swimming pool with an additional 6'x12' wide q entry stair; install a 639sq.ft.wood deck with steps and planters; install an irregularly shaped 1269s ft. blue stone paved patio; install a 41411x81011 outdoor shower on stone deck area; and construct a 2110"x8'3"wood pergola on stone deck area; with the condition that a non-turf buffer area is to be established and subsequently maintained within the entire area beginning at the Zone"X" line continuing seaward to the landward edge of vegetated wetlands; and as depicted on the survey as prepared by Nathan Taft Corwin,III Land Surveyor last dated December 2,2014, and stamped approved on November 18, 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. V, -i Rp %%%3f F01 Qlem4ev WA 'y TERMS AND CONDITIONS The Pennittee Emma van Rooyen residing at 575 Hill Rd., Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: i. 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 pen-nit, 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. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. 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. 11. 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. O �jg,� John M. Bredemeyer III, President ®F S® Town Hall Annex 54375 Main Road Michael J.Domino,Vice-President 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�if/c®UNT1 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 18, 2015 John R. Berg, Architect Berg Design Architecture 131 Varick Street Suite 913 New York, NY 10013 RE: EMMA van ROOYEN 575 HILL ROAD, SOUTHOLD SCTM# 1000-70-4-29 Dear Mr. Berg: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, November 18, 2015 regarding the above matter: WHEREAS, John Berg on behalf of EMMA van ROOYEN 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 December 23, 2014, 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 November 18, 2015, at which time all interested persons were given an opportunity to be heard, and, 2 1 , i 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 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 EMMA van ROOYEN to install a 30'x14' swimming pool with an additional 6'x12' wide entry stair; install a 639sq.ft. wood deck with steps and planters; install an irregularly shaped 1,269sq.ft. blue stone paved patio; install a 4'4"x8'0" outdoor shower on stone deck area; and construct a 21'0"x8'3" wood pergola on stone deck area; with the condition that a non-turf buffer area is to be established and subsequently maintained within the entire area beginning at the Zone X' line continuing seaward to the landward edge of vegetated wetlands; and as depicted on the survey as prepared by Nathan Taft Corwin, III Land Surveyor last dated December 2, 2014, and stamped approved on November 18, 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/dd f.• SofFotx`� John M. Bredemeyer III, President 00,-t. Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 James F. King y ? P.O. Box 1179 Dave Bergeny • �� Southold, NY 11971 Charles J. Sanders o �a f�' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: EMMA van ROOYEN c/o JOHN R. BERG, Please be advised that your application dated December 23, 2014 has been reviewed by this Board at the regular meeting of November 18, 2014 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project * Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1 st Day of Construction ($50.00) % Constructed ($50.00) x Final Inspection Fee ($50.00) - paid Dock Fees ($3.00 per sq. ft.) x The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 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: *Return of Citibank official check#113702960 made payable to Town of Southold In the amount of$50.00 — re: siltation fencing inspection fee. TOTAL FEES DUE: $ NONE BY: John M. Bredemeyer III, President Board of Trustees MA '1 I '=-HOLD'"DOCUMENT UP�TO�THE;CIGHT TO:.VIEW TRUE-WATERMARKs.^�_s_�z'''""p� = yT•r Y� ,• •"``=.HOLD:DOCUMENT UP TO THE'UGHT TO-VIEW-TRUE WATERMARK.�`f:: ,=oFFicia' -cKEct ;s J Citibank' - - 1137.0296-0, Citibank, N A _ 62_20 311 { AE C`, 0 d i'A ti 0<i r ,81..: �t�+i�, 01-i 1 O T yam` D T 034-r06 j-, 3702960 `FAY vf;*fi 4:FTF,T Y t;0LL AF.:,� = . $ Iie j •, ,I, • ".t '_ - IIS -. .r.n _'?.7..:i�. ,l„J��n'•c• f „` 1� �'.t .! �Ir,/`'�. %THE. k. wd,l fZl4l�' f1" ��tt�t tit11 £� r,;e mi; 'r.smy a -ORDER, ' `rNAME OFrREMITTER \f.i7G''~1 '4` Drawer- ttibank, , } _-ADDRESS -, v i t :tE{"u,YE� r Mi:sE}'iTilliifR;SI{_lF.t?ur>; E�iiiii TytPFi:li�i� �Yr Cihbank;•NA'One•Penn's Way,+ —�" :New Castle,DE 19720'` AUTHORIZE IGNATUR 11' L1370296011' 2:0 3 1100 2091: 3876292411' Elr-m Lj 0 � - NEW 4' HIGH ❑ - NEW 4' HIGH PPOOL FENCE OOL FENCE —IN / — cV \ — — — N m ' NEW 4'X 8' NEW TX6' IS ING H SE. NOMORK PAD FOR POOL EQUIP PAD FOR MISUBISHI SPLIT SYSTEM r I��I CONDENSER Ff fT I NEW OUTDOOR z SHOWER WOOD BENCH NEW WOOD oDECK 0 ❑ ❑ 3'-0" 0o 10 zy "� 8DN 1.W WOOD rr co o�Da C:)— �A E TEPS ❑ 11. 5'-10" / 9�-12SIN M = 16'-1" '-0' 17'-1„ LC) D D o��o�� X11,10" RUN��a X4-2„ DN= TREE DN ONaODaO� a �' c cNJ) �bl� 2V 7 NE N 18"HIGH PO [)EMASONRY I DCEDAR DD _ ;s � a oOS o a - �� D FC 2 3 201 € � _ NEW CEDAR WOOD NEW 18"HIGH 1'-0" a ��oa�oaD PERGOLA STRUCTURE MASONRY WALL W/ �� nOoDOCo INTEGRAL FOUNTAIN ��o (�� SIT F\ q a Tr N N J D0r oa D000a Q D NEW GUNNITE SWIMMING POOL DO N NEW MASONRY r D O0 If 1A 5 3 0 1 �0�� M0DoD � 2 o eU� )D�O PIZZA OVEN Ln AGOG A002 15'-02„ 30'-0" 6'-1" 4'-0" 15'-5" 3'-6" 74'-0" BERGDES GN 575 HILL ROAD PROPOSED POOL PLAN ARCHITECTURE SOUTHOLD, NY 11971 DATE: DECEMBER 18, 2014 A_001 SCALE: 1/8" = 1'-0" NEW WOOD PERGOLA STRUCTURE NEW STONE PAVING NEW WOOD/ PLANTER SHOWER EXISTING FIRST FLOOR HOUSE ELEV +16'-21/4" T WOOD DECK = _ - ELEV +15'-81/4" imp ' FOOL D 3C0 1/4, L�NEW POOL- - \ \\/ EAI r\ir\i M /rri/i�/i�ri\ri` ii\ri\/ri\ri\ri DECK i�i�i�i i� /\�i iii i ONOTUBE• + 11',- ' •. \\r\\r /,\\/i\\/,�\i\ \\\\i.\\\\i\\�\\ \ \ DECK FOOTING Nlj POOL SECTION 1 SCALE 1/8°=1'-0" � O 0///PERGOLA S T U/CT�� DEC 2 3 2014 / I I NEW STONE H I Southold To- FIRST FLOOR i i PAVING $ a 'irokes ELEV.+16'-21/4" i NEW WOOD W O T i i PLANTEROL C WOOD DECK — — ELEV +16-81/4" F — soD A�Fr _ N r/r/r �\i\\i\\ice\i�\i�y`\i�\i\\i\\ice\ir \/\/\r\/\/ SO O C �"� ;�•�<� �, �'�.,_i�� RM POOL DECK EXISTING u `-ri\ori\� \. o L� =r\�\\ri\\r/\\/i\\ri\\/\\r/\\ri\\/i\\ri\\r /\\r\\r\\i\\i\\/ :./\,/\/ NEW POOL :\,\/j\/,\i,\/,\/,\/,\/,\/j\/,\/,\/,\/,\/,\/,\/,\/,\ I G ELEV 113'-01/4" + 1 l; / /\\ \ bo POOL SECTIO `\\i\\i \\ri\\ 2 SCALE 1/8"=r-0° nx/x /�\/m/�\/��\/��\/��\��\/��\/�� BERGDEB GN 575 HILL ROAD SECTIONS ARCH TECTURE SOUTHOLD, NY 11971 DATE: DECEMBER 18, 2014 A_002 SCALE: AS NOTED I I John rTown Michael J. Domino, Vice-President ° SUFFo��°Gyp 54375 Route 25 James F. King y P.O. Box 1179 Charles J. Sanders • Southold, NY 11971 Dave Bergen 01 ,� �a Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 1/ o 3 S" John Berg on ehalf of EMMA van ROOYEN requests a Wetland Permit to install a 30'x14' swimming pool with an additional 6'x12' wide entry stair; install a 639sq.ft. wood deck with steps and planters; install an irregularly shaped 1,269sq.ft. blue stone paved patio; install a 4'4"x8'0" outdoor shower on stone deck area; and construct a 21'0"x8'3" wood pergola on stone deck area. Located: 575 Hill Road, Southold. SCTM# 1000-70- 4-29 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency -Pre-Submission Violation Notice of Hearing card posted on property: v Yes No Not Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: 7- ' f1J T Present Were: y J. Bredeme er M. Domino /J. Kin9 9. Ber en C. Sanders Y Bay Constable Other Form filled out in the field by W2 4L Mailed/Faxed to: Date: `AA 4 - - � ori• Z � t,.«I li rsI1M��=t'�. � - � - ..-. ,. a �+. .•! _""i' �•_ ,�,y�'"�-`v,.•�/ _�_i. •-.. �.,cyt�� • if M ' �► �' v ._ w. .:k .•✓ ` , <' .is 1t TSI +�:• _ .!-�+. ..;.��'F-.« .-t �.�y; �..�." �, ,w,zSt. ,y. •,R•.�-a,� , � :+ :C ,t,��, , -#' _ -f.�..�� .4 _ ,r ...N � 4 �.. ,,,• t'•• �l �_ r�" Va � � i..��.. ._ ri. 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) c� Southold, NY 11971 a� Telephone: 631 765-1938 Um, LOCAL LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: November 16, 2015 Re: Local Waterfront Coastal Consistency Review EMMA van ROOYEN SCTM# 1000-70-4-29 John Berg on behalf of EMMA van ROOYEN requests a Wetland Permit to install a 30'x14' swimming pool with an additional 6'x12' wide entry stair; install a 639sq.ft. wood deck with steps and planters; install an irregularly shaped 1,269sq.ft. blue stone paved patio; install a 4'4"x8'0" outdoor shower on stone deck area; and construct a 21'0"x8'3" wood pergola on stone deck area. Located: 575 Hill Road, Southold. SCTM# 1000-70-4-29 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 provided the following recommendations are considered: 1. It is recommended that a vegetated buffer(20'wide) comprised of native, drought and salt tolerant vegetation is established landward of the top-of-bank(bluff)to reduce turf areas dependent on fertilization and irrigation near the waterbody. Existing, beneficial vegetation should be incorporated within the buffer. 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 4 -� Town Hall,53095 Main Rd Lauren Standish,Secretary 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 Tues., November 10, 2015 the following recommendation was made: Moved by Jack McGreevy, seconded by Peter Meeker, it was RESOLVED to NOT SUPPORT the application of EMMA VAN ROOYEN to construct a new wood deck, new swimming pool with stone pool deck and wood pergola. Located: 575 Hill Rd., Southold. SCTM#70-4-29 Inspected by: Keith McCamy, Peter Meeker, Doug Hardy, Peter Young The CAC does Not Support the application because the site plan is insufficient and lacks important information. The CAC requests the requirement of a survey no more than a year old depicting the location of the proposed swimming pool and setback from the wetlands. Vote of Council: Ayes: All Motion Carried BOARD MEMBERSSouthold Town Hall Leslie Kanes Weisman,Chairperson ®� ®��° 53095 Main Road o P.O.Box 1179 Southold,NY 11971-0959 Eric Dantes3 Office Location: Gerard P.Goehringer Town Annex/First Floor,Capital One Bank George Horning Y® 54375 Main Road(at Youngs Avenue) Kenneth Schneider P jou,4i�1�1 1 3 a I http://southoldtown.northfork.net • ZONING BOARD OF APPEALS OCT 1 3 2015 TOWN OF SOUTHOLD a Tel.(631)765-1509•Fax(631)765-9064 A G 2 4 2015 FINDINGS,DELIBERATIONS AND DETERMINATIO Ptaolultthctla- nl MEETING OF AUGUST 20,2015 Clerk ZBA FILE#6871 NAME OF APPLICANT:Emma Van Rooyen PROPERTY LOCATION: 575 Hill Road(adj.to Jockey Creek), Southold,NY SCTM#1000-70-4-29 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 June 25, 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 July 24, 2015. The relief, permit, or interpretation requested in this application is listed under the Minor Actions exempt list and is not subject to review under Chapter 268. PROPERTY FACTS/DESCRIPTION: The property is a non-conforming 24,905 (24,063 buildable) square foot water front parcel located in an R-40 zone. The property has 107.41 feet of frontage along Jockey Creek. The parcel runs 226.34 feet on the West side, I05.00 feet along Hill Road, and 244.57 feet on the East side. The parcel is improved with a two story frame house with attached garage, a frame shed, and a wood ramp with attached floating wood dock. All is shown on a survey by Nathan Taft Corwin III L.L.S. dated June 13, 2014 and last revised December 2, 2014. BASIS OF APPLICATION: Request for Variances from Article XXIII Section 280-124 and the Building Inspector's June 1,2015 amended June 15, 2015 Notice of Disapproval based on an application for building permit to construct additions and alterations to existing single family dwelling, at; 1) less than the minimum code required side yard setback of 15 feet,2)less than the code required total side yard setback of 35 feet. RELIEF REQUESTED: The applicant requests variances to make additions and alterations consisting of a proposed deck, pergola,pool, and raised patio that will result in a side yard setback of+/- 10.5 feet and a combined side yard setback of+/-31.5 feet. The code requires a single side yard setback of 15 feet and a combined side yard setback of 35 feet. FINDINGS OF FACT/REASONS FOR BOARD ACTION: Page 2 of 3—August 20,2015 ZBA#6871—VanRooyen SCTM#1000-70-4-29 The Zoning Board of Appeals held a public hearing on this application on August 6,2015 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 5267-b(3)(b)(1). Grant of the variances will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The neighborhood is a waterfront neighborhood which consists of single family homes. The additions and alterations are proposed on the water side of the house and will not be visible from the street. The applicant is requesting the variance so that it may keep the proposed raised patio in a straight line with the house for aesthetic reasons. 2. Town Law&267-b(3)(b)(2).The benefit sought by the applicant can be achieved by some method, feasible for the applicant to pursue,other than an area variance. The applicant could make additions and alteration with a code conforming side yard setback. However, the existing residence already has a non-conforming side yard setback and combined side yard setback. The applicant is requesting a minimal increase to the already non-conforming single side yard setback. 3. Town Law 5267-b(3)(b)(3). The variances granted herein for the combined side yard setback is not mathematically substantial, representing 10% relief from the code. The variance granted for the single side yard setback is mathematically substantial representing 30%relief from the code. However,the existing residence has a combined side yard setback of 30.3 feet and the proposed setback of 31.5 feet is more conforming to code than what exists. The applicant's property has a single side yard setback of 10.7 feet. Granting a variance to decrease the single side yard setback to 10.5 feet is a minimal increase. 4. Town Law 5267-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 5267-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, deck, pergola, and raised patio 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 Horning, and duly carried,to GRANT,the variances as applied for, and shown on the survey by Nathan Taft Corwin L.L.S.dated June 13,2014 and last revised December 2, 2014 and the Architectural plans by Berg Design Architecture dated-December�l0, 2014 and labeled A00 through A3. Subject to following conditions; Conditions: 1. Evergreen screening. 2. Pool mechanicals shall be placed ia a sound deadening enclosure. 3. Drywell for pool de-watering shall be installed. t , Page 3 of 3—August 20,2015 ZBA#6871—VanRooyen SCTM#1000-70-4-29 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. 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 design 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 Horning, Dantes, Goehringer (Acting Chairperson) (Absent was: Members Weisman(Chairperson),Schneider) This Resolution was duly adopted(3-0). Gerard P.Goehringer,Acting Chai son Approved for filing 5 /02/ /20 NEST DILL ROAD _- � S 88 52'40" E— 451 00' s sB53SD„ SURVEY OF PROPERTY sTAT °°r ROA SOUTHOLD �� 33j95 4s�s\ \ D TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-70-04-29 All NN SCALE 1"=20' jO JUNE 13, 2014 I / DS•��, \ AUGUST 11 2014 ADD PROPOSED POOL / / \ DECEMBER 2.2014 REVISED PROPOSED POO. TOTAL AREA = 24,905 sq ft vi'-a / °•1 xJ%.J pR, u (TO BE LINE) 0 522 ac amD•n.cu.. ;"s.a ��I�Pica If I / /Ejj''° UPLAND AREA = 24,063 sq 11 EI / c G I �� > 5`ED }}••E@ f g •+s. h µ RECEIVED V/I`JUN 1 G 2015 io unnc•.vOc ar rusr y / ° ° I., U ZONING BOARD OF APPEALS SILLMIArL_nLTAT15 FC Cl o y / P pcaa°nQ..0 o Z R. NOTES oumD,p.•.rc.,xa,M°Nm.Iw c° �y Ev.� OEC m \x ° ,•. I �? ps Al 1 ELEVATIONS ARE REFERENCED TO N A V D 1988 DATUM EXISTING ELEVATIONS ARE SHOWN THUS so - EXISTING CONTOUR LINES ARE SHOWN THUS' -+---- nRE rfL- FIRST FLOOR 0 ��` D 4ti cR / \ I GIL- w rrincREAo ~— \ TF „ ❑ sJ2,P oa - RE-ar BDL.—D ppa a�RsFo �a 1 1 FINAL MAP Aw = RS;TOMo?`w<LL YFR 1 Z r.p s is";�rpw • y; ST *° REVIEW 2 FLOOD ZONE INFORMATION TAKEN FROM \\,h WEA g /�E FLOOD INSURANCE RATE MAP No 36103CO166H / `,v/f01—c OF qFG S4L ` ,X a A HOOSE&C4 \�� SEE DECISION# 88J'1 ZONE AE BASE FLOOD ELEVATIONS DETERMINED BICC 8,� / DATED ZONE%• AREAS OF 0 27.ANNUAL CHANCE FLOOD AREAS OF 1%ANNUAL O L,-t i LOOP W'17.1 ASC AGE DC TITS OF LESS TH&N 1 'COT Pr"" OR WITH UHAINAGE AREAS LESS THAN I SOUARE MILE, (NOTLTONRCALE) _Py / W / ",•VAI - - __ _ AND AR-EAS PROTECTED BY LEVEES FROM 1%ANNUAL CHANCE FLOOD } "! �V ZONE X AREAS DETERMINED TO BE OUTSIDE THE 027.ANNUAL CHANCE FLOODPLAN \�j PROPOSED IMPERVIOUS LOT COVERACE (FOOL DRCALE) 1 \ o[7 / ��=q OVER FJP1.AND LAT AREA (NOT TO SCALE) ?3v Ak \ �/ ° T•1 s Iaox CELT.z+v[d•sw_ ? ` �i� �,IryD 'z nNej e'1' yya 'gpp DESCRIPTION 1RCA X LOT COVERAGE -1 O�vA, o $ �/ TO©C OF�k / N+ �Yp EXIST HONsq SE 2,213 11 929 E a qC a o \ O ,Q ST �p {i EXIST (2)BRICK STOOPS 49 sq II 02X A9 I'— a ECC SS 14y \ / !ate o�Thp� E%IST SHED 100 aq IT 04% - \ �.Cq„v0 ALFA )q0 ry nnv• ZONE X��FF LASH - NE X. PROPOSED POOL 505 sq 11 21. -9 (� 1 PROPOSED DECK W/STEPS 639 sq 11 2 •exti• N f ` ➢\\ \``TR) AV!/��O Nr \ O 5 0 �'� ^\-i ��1 PROPOSED PATIO 1.269 fr�r•Oa s,c FFn xL �T NF / s9 11 55% W, •so ws `T p1 - o+ To. Dua C'\S'A �' EXIST DRIVEWAY 2.015 sq 11 6 aX o: C%ISTc k PROP 6,790 sq 11 28 2X .,ppi ] PREPAR_D IN AG[DRW.cC Nttx THE P'NMI.Y S'WW G—D WA,E. V928 1 .'_I\\ I d' Trt,E AG6cGUrox is s r D THE CS µGI[u_ED Ano T urvo OF Nep. °-°\"meq •n4•e,- \/ \\ c��°!'• ZOMr X. Pad ,tAFi COR•pf-:t /V AF(EL 6) ly == 2 *1 6424 46. 48, PL \ rQ OL/,n^T SV:T Lc Nn SO.fi] 33sp4,• \ �,° ya,,,x6s, � NG.DUR,NG Nathan Taft Corwin III C'Tr�� 2. NEI.=o9GREYOR6x.ED=uooERE° Land Surveyor Il"PRll.W oJ°EFnu1sNaclie1 io THC ,N.... rN Evtt A^0 Su_cersOr TO Slenl•y J Hc4zen Jr LS JcaeDN I I,1,—LS s, THE Ul+si�i`CAElarrg YE o�C� vEwmc rtm sor xn STe PI°ns- C—Ir.b.,Lcywl TO T PHONE(631)727-2090 Fp%(631)727-1727 1 IN ORSTCNcE Or RIC—Or wAr OMCES LOCATED AT NNLIMG ADDRESS ANO/OR EASEMENTS or RECORD•IT 1.96 Mq Roc4 PO Bc.16 ANY•NOT 9HOWN ARC NOT GUARANIE[D J—p°rt Nn York 11947 Jpmcsporl N•a Yo••11947 -10' PROPERTY INFORMATION I DRAWING LIST ENERGY NOTES A00 SREFUW LOGTWYRAN NOTES DFAWWGUST ENFAG Kom 5I5 HILLROID SOUTHOLD,W11T1 ADt OEMgIT10N PLW 1PL.WNSTRUCTONSHPLLWNFORMTNTHMEM UIREMEMSOFNEWSTATEEi MYCMSERVATIONWRTRUCTONWOEQAT EOITOp. GGRI TO A02 CONSTFIULTON PUNANO DETALS 2THEENG14 CERNFIESTHATTOTHE BEST OF HIS MCMEDGILWTTHE DRAWNGS COM0.YWRH THE WSTATE ENERGYWNSENYAMN MAP NO-t00D]60L2B PAT ELEVATIONS ANDLROSSSECTI0K9 CONSTRUCTIONCODE LDTAREA=20—SIF 3 FXT M OOORSAN0000RBTOGARAGESSXALLBE1h1BIM)L WINOQAS SUDMGU5S000RSAFIDALLGLA56SH—BEU.]8MOIL ROOK WINGLIL%IATEIVENOFROPoSFUADORpNMCLEARINO —WA RIH CENN4 RH6 ABBREVIATIONS PLLB111tDWG NATERWS COMPONENTSANDPSSEMSUES TINT PAECNPBLEOFABSORBWO NOISNRE SHI118E PROT:CTEO BYAYMY)R LOT COVERAGE CM TOu9 I BARKERLOCKIE0d1THE.1-11WARNSIDEOF—WSUTATON CUtA ACT ACOUSTIGLLCEIUNGTRE q9Y gSXVYPBXER MPl WNWUU SECT SECTON 91NSdAT10NSINLLBEWSTALLEOINAMWNERTHATPRPA0 MRfANiINUTYOFINSUTATIONATALLPLATEL RW AISTSANONLCORNE0.5 STRUCTURES EASTMGSF PROPoSED SF AFF PBOYEfPl161¢U FLOOR EIEV ELEVATgt ATID MWMEO SMMR SHEETNTAL ' BALL NOTANDCCID WATERRIVIC ANOALL DUCI9" LBE WSUUTEOASPEq WOE NG COYHUGE 21&SF(BB%) DBO%) BET BETWEFOI a0. 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SEEDATol y GENEMLNOTES � AN ITHEPUNS,NTHE BESTOF WRKNOVADGEWAWLVWIMTNEAPRIGBLERFONRENENi6OFTHENMWY STATEBJMNOCWE 1670I$ THECONTRALTORS—CWP NTTHTME REOUIREAlENI50FTHEBULLdN0000EOFTXE9TATEOF NEWYgtK 1ATESTf0ITI0N AN0 ALL APRICF9IE FEDEINL CWE9 STMIDARDS REGVIATI0N9 AN01AW3 2pyII,G�� NOTINDIGTEOONPARTOF DRAW WBWREASOW MtWUMTOSEWNW TOTHATSHOWNATCORPESP UN.P—.GHALLBEREPFATEG wA°°rPw AIFAW C/510E WNRICTGEITVFENIXENOTFS AIIDOETNLS.THE MOST RIGH REg11RFAEM65XALLWVERN WNl1iACi0R 5WILMN(E Np OENATION FRW DESK)NOMWINGSWITIIWTWRITTFN APPROVKOFTXEARCHRECT • S1HE CONTMCIORSHKLVERIFYALL dNF2410N6 AND WNDRIONS ANDCKKOINAIE WITXARLI9TECNRAI.OMWINGS.OMYANG9 FRDM OMERCON9ILTANi9 jpQ`4lYgS�te��B1lS�('T��\0O�,F f\BR\09,y��(�A\\�`;\�ice«��`-```l+' J�/v/�x/ve.aymo S]eSC;SAED FNEETTEYCPOAS NNBORENHIWECETg TE(ORSSWAOLTLEGACISHFTEHNEORIEOSPFOANdSI.IIBTiWFAi9DYISOTFA NCOOROENSTFPAEANEC0TTUgTOTt NAMADDAlTIL�INE1ERB5aUDFOREO9 AMNLLA LLSENND5A0U9MPE5ONS1EIIiLCF 5P11L CSWTNCONOETNS P0.AANCNOlNOBCRPEN6WOHAIJNLLgA3FTNUSTP'ANRLEISLGHgIRANAN TWUNDGNOTESORAWWNRDSRIOTERARIRSENECSCETORRDTiECHSTHGpGOAN&PT3EE0TMUROORTOI1�NFSEODfiWNHMNATTELLW0.BN EASWTCA S&OPN1EIIOCIETN0gL 0PYS PBAO—FlIJCONPiO-DIUTF— TO HEGONTR cAHlCSLLBECLLCPGETOWEEIGNADHNOBERESFORCWHOUN 01 OP BLL NWBANOWI-RUCTO51WNYNOWNFdMWMLLSF--TOCODOMODNC0LLFMERAEAOU0T9ANGJREDILTONOENPW M5EOTASLL WXOW3L BL0I0G0T1N0E0ON2WFWTT OM 10 WLSHAHMMtUSTMGWLLR .ENEOCOTM 12MRNNISTO HHEA700FWKKMATEHMDNMWD NW ISTO00 MOFIFFEUNDEFWIERSOIM ODEH-)WFDA%DI1EFCSNNl—DWOEDERKY SAWOEMTSFOMOp ��- fA WNOTSCALEDMVANG9 REFFATOWgrtTFNDWENSIONSCONNNCIORTOVERIFYALL EASTAq WNDGgNSAND OINENSiOrv9WMEFlEIDANO NORFYOWNEROFAW OEVIATON90RNn gFFlCULTESIN THEIAYOM / roAeu STHEWS]AMTDNOFALLFRODUCi9 SHlLLLBE NEW ANO SHPIIMEETPII W.NUFACi11RER96PEOFGTpN3 1S TI@ WNIMCTOft SHALL BE RFSPoNSIBLE PoRAOEOVATELV FAPLWOANDB(✓FAIONGCOLIAPSE dSTORTONPND NISNJGNAff1RACWR0INGMIILCO0E6,RATECTWOPILYIOW(DNUNG OEMOLTIIONANO WNSIRUCTNW AGNNSi STANDM0.5PN0 GWD RNODCE LOGPON OFNLSTRUGNRES ON PROPERTY IS NOTTHERESPON6RNt11YOFTHE OESIGNARCHITEGT ALLSETSACKUNEB AN091HIICNRE LOGTOHS SHMIBELOGTEOAND 6TAItEG BYOi11ERS 1SSTRUCNRALELEMEMSTNATAREUNL.FDVUd DURWOIXEFNSHOFRTE ONSTADTHATAREFWNDTO BEUNSOUNOORDANGERW95NALL SE MADETOWLPLYWITHTMEAPR1GBlEREWPiD.fENi90F HY9 RESDENTW.WOE SRE FlAV exv�\ ` , 19 ALLTANTRACT(81 PROPOSED MMFANL,FOfNREFRiVW OR FlM5N SU85TINilON9NBE PRFSENIFDTO AtGIOECTFORAPPRGJILBEFOREINSTA3ADq1 1Qy;:i rslY `'"�flO•"�o ° '9`S/ ACONIRA 0 RF:iONS ORO NTCSIICYWEATNERFRGTECTION STATS0F E05ATA00-0114 FpRSUSCONTRACidtS.CIEANUPAIID RENOJALOF EIBLpNIPlC1pRS1FASX ANOIB:MWALOFFAUL1Y fONPNEM \ SV •may 21 CON—ORTOALLMMAII—MORSFORINTERIOq.PAMat WA190F BENNACNNWREON FWL®GURFACE CONTRACTGq NNLOW FOR 2PNM COLORS FOR EMFNdt PNNT•2 WAi6 OF BENJAMIN MWRE GN PRIMED SURFACE BERGDES GN VAN ROOYEN/ABOUYEN RESIDENCE SITE PLAN,LOCATION PLAN,NOTES,DRAWING LIST,ENERGY NOTES �® ARCHITECTURE Be OLD5TONEHIGRWAV FASTNAMPTON NEW YORK Tel 917 575 HILL ROAD,SOUTHOLD,NY,11971 DEC30201< SCALE NON.10 GUS\l REF153 Cantrell, Elizabeth From: Cantrell, Elizabeth Sent: Thursday, August 27, 2015 12:58 PM To: john@bergdesignarchitecture.com' Subject: Van Rooyen application Attachments: 20150827114411.pdf Mr. Berg, Regarding the Emma Van Rooyen application, as we discussed on the phone earlier, I have sent the two checks back to you today. Attached is the form that the homeowner must complete. Please mail me the original when the owner has completed it. Regarding the fees,the Wetland Permit application fee is$250.00 made payable to Town of Southold. If you like (not necessary to submit now)you can also submit the final inspection fee ($50.00) and the fee to inspect(prior to construction beginning)the project limiting siltation fencing($50.00). "You may want to have the inspection fees written on two separate checks. If the Board does not require that they perform a silt fence inspection,the one check would be returned to you. The inspection fee checks will not be deposited until after the Trustee approvals. Again,the only check needed now is the application fee if you prefer to wait to see if the Trustees want a silt fencing inspection. If you have any questions, please do not hesitate to contact me. Senior Clerk Typist Town of Southold Board of Trustees 631-765-1892 1 John M.Bredemeyer III,President q so �o Town Hall Annex Michael J.Domino,Vice-President 'tQ f0 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G � y� Telephone(631)765-1892 Charles J.Sanders,Trustee �COY Fax(631)766-6641 s BOARD OFTOWN TRUSTEES F''' '_ `� �-� TOWN OF SOUTHOLD i Office Use Only DEC 2 3 2014 Coastal Erosion Permit Application ; Wetland Permit Application Administrative Permit _Amendment/Transfer/Extension '""' X Received Application: Xja3Sj1 V4 Received Fee:$ 95 Completed Application /9011 N157 Incomplete t�-�d, //� y _SEQRA Classification: Type l Type 11 Unlisted —Coordination:(date sent) LWRP Consistency Assessment orm ICAC Referral Sent: 8 l _Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: _ Public Hearing Held: 1 - Resolution: Name of Applicant rt e7. 6 kmAyA)i Mailing Address 5TIJX 117,-5 Phone Number:( ) G{ ? — 373 — 44?3 Suffolk County Tax Map Number: 1'000- :(2 — p Q- -- z4 Property Location: ? 5 H I��- 1Z I�• 56L9fHQjX> N Y. We (0"7 ��• �5� TO ELLS AWWV6 (provide LILCO Pole#, distance to cross streets, and location) AGENT: Z 6N At et k I Tr; 'f (If applicable) Address: '�_OM--�.��i6jA) pC1O4,0 1�i�A6 . 13 1 �-C—ac-5T 11 3 D�(lX 13 Phone: Lj "' J& f . sof Dj D 9 V E OCT 1 3 2015 B E R G®E S GN Southold town ARCM TECTURE October 6, 2015 Southold Town Board of Trustees Town Hall Annex Building 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: 575 Hill Road, Southold, Peconic, NY-Country Tax map no: 1000-70-4-29 To whom it may concern, The dimensional description of the proposed swimming pool, wood deck and stone pool patio is follows: Swimming pool - 30'-0" x 14'-0"with additional 6' x 12' wide entry stair.-Total sq. ft.= 505 Mahogany wood deck with steps and planters -Total sq. ft. =639 Blue stone irregular shape paved patio -Total sq. ft.= 1269 Outdoor shower(on stone deck area) -4'-4" x 8'-0" -Total sq. ft. = 34.4 Wood Pergola (on stone deck area) —21'-0" x 8'-3" Sincerely, John R Ber . (Architect) 131 Vanck Street Suite 913 New York 10013 917 328 3905 bergdesignarchitecture.com I Board of Trustees Application GENERAL DATA Land Area(in square feet): �� B2-&-- t Area Zoning: 0 Previous use of property: gil-W -L : 5(lm LO FAM l L`( 066� Gni e Intended use of property: sipsh t AU-5 0!E Fm i" orgg!iwNte 1,#n74 t(M tk)&i PcO L T Covenants and Restrictions on property? Yes _�No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? ✓ Yes No If"Yes",be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? —AZYes 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 * SXV, O-� W6K C-W 11Y' Does the structure(s)on property have a valid Certificate of Occupancy?—AZ�es No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? V/ No Yes If yes,provide explanation: Project Description(use attachments if necessary): NCU W00*J;P `p - SGvImm [Ill O PwL W!�LJE M, 126—W# WAD Pi�jDf� Board of Trustees"Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: IM45?'p ApenLIP DV: 5W_ AM 106 woo PSD to Area of wetlands on lot: ®� square feet - Percent coverage of lot: .6 Closest distance between nearest existing structure and upland edge of wetlands: q ? feet Closest distance between nearest proposed structure and upland edge of wetlands: ] feet ,Does the project involve excavation or filling? No _Yes If yes,how much material will be excavated?_� L) cubic yards How much material will be filled? r ZW cubic yards Depth of which material will be removed or deposited: 7 feet Proposed slope throughout the area of operations: 1 P 'Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): 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 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; N 15u7 5-wtKM W 61 PDO L Project Location(describe,and attach a location map): 615 KILL- V-P• 5o9V0t.1> N%(. Brief Description of Proposed Action: G(>NS'T2VC�Q r� c ivy G? N rJe tJ[AA W IP�D L Poo L TVC-Ck r WOO-P P&--k WOOP Pee4O7 A Name of Applicant or Sponsor: Telephone: 1 ??, 6A N Rio Y�tJ E- 1' M�tiL Address: 2-� PcG'0 o f-1 ST 0 City/PO: State: Zip Code: N•°�• 11Z3� 1.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 ® F 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 per it or a ro 1: ❑ El P cP -500rH01;D 901effR PG�''t l� 3.a.Total acreage of the site of the p oposed action? • NO acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban [I Rural(non-agriculture) ❑Industrial ❑Commercial JKResidential(suburban) ❑Forest ❑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? F1 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 1. ® ❑ b.Are public transportation service(s)available at or near the site of the proposed action? © F—] 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? 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: :CCU w ❑ n VNJ 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 National Register of Historic NO YES Places? I rpt ❑ b.Is the proposed action located in an archeological sensitive area? �I ❑ 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? ❑ rupt b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ® ❑ If Yes,identify the wetland or wateu body 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/grass lands El Early mid-successional X Wetland ❑Urban ❑Suburban 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.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either fi-om point or non-point sources? NO YES If Yes, rvl a.Will storm water discharges flow to adjacent properties? NO YES El b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: KNO AYES 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: X ❑ 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: F7 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ,J Applicant/sponsor name: r`S. MAAi, AN 1Z40k(C-N Date: 1 Z r C3 Z. 2®l 14 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of thefollowing 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? 2. Will the proposed action result in a change in the use or intensity of use of land? 2 E 3. Will the proposed action impair the character or quality of the existing community? 1H 4. Will the proposed action have an impact on the environmental characteristics that caused the ( ❑ establishment of a Critical Environmental Area(CEA)? l-1 5. Will the proposed action result in an adverse change in the existing level of traffic or i J— �I affect existing infrastructure for mass transit,biking or walkway? [3 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, F-1waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 i 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? 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. 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 Name of d Age cy Date (2 �Qf President Print or Type Name of espo 'ble Off er in Lead Agency Title of Responsible Officer Signa t r of Responsible Officer in Leadgency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 ARCHTECTURE November 16, 2015 Southold Town Board of Trustees Town Hall Annex Building 54375 Route 25 Southold, NY 11971 Re: Van Rooven Residence at 575 Hill Road, Southold, Peconic, NY Country Tax map no: 1000-70-4-29 To whom it may concern, Please find enclosed the following supporting documents pertaining to board of trustees hearing for the address above: • Notarized Affidavit of Posting • Notarized Proof of Mailing of Notice • Copy of Certified Mail Receipts (originals have already been sent to the Board of Trustees) • Copy of Domestic Return Receipts (originals have already been sent to the Board of Trustees) Sincerely, John R Berg. (Architect) NOV 11 2015 b 131 Varick Street Suite 913 New York 10013 917 328 3905 bergdesignarchitecture com John Bredemeyer, President �OguFFDk* Town Hall Annex Michael J. Domino, Vice-President ��° aye 54375 Route 25 James F. King 5 P.O. Box 1179 Dave Bergen y • Southold, NY 11971 Charles J. Sanders mai ,�, �a°` 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 EMMA van ROOYEN COUNTY OF SUFFOLK) STATE OF NEW YORK) AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS 1, J0 �� , residing at/dbaT?64�1 (6 90 M4 1If:Le it 6 being duly sworn, depose and say: That on the d � ' ay of , 201 , I personally posted the property known as A)i 6^ by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, November 18, 2015. Dated: �ST&-T'Ea- dF `N6w Yc)p-k- CWK7\-( ®F NEW (signat re) Sworn to before me this L �(p'Tay of t4bV 20 IT Notary is - MARYSARAGOUSSI Notary Public,State of New York No.01 SA6262738 Qualified in Kings County Term Expires May 29,2016 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Mlaa , ( (7o�y-'3o) 975 X1,11 N. SmI614 NY IIg71 KIC�rj Sklfrwo (70-4- 900 NII Rd. YoAoIJ NY )1871 Pav%C4 I 1ge1,r%41 (70-4- 19) 176 E• 77" 54. 4, IcA NY 10075 Wife J• klAk0c 00-+ 35Atrt, I(A►rvi{v 'VJ 07011 STATE OF NEW YORK COUNTY OF SUFFOLK RN MIA , residing at�t,��1?l� bean duly sworn, deposes and says that on the day of fl�DU 20 t k, 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 1 � _T( ' ae said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. ,S-W-VE�- (5'F 7,� YeRx Z-11;wlx�- COON-r( OF T / Sworn to before me this 16T11 Day of'I'0V6M13=IZ , 20 145- O otary Pu,li MARY SARAGbussi 1 !q tu`, u.b ic,State of NewYo& fJo0I SA6262738 Qu alified in Kings county�` a '' Expires May 29,2016 PostaliceTM t— Postal ► RECEIPT CERTIFIED ► o • rr —pornestic mait onty;mo insurance coverage Provided) C3 (Domestic Mail Only,No Insurance Coverage Provided) Ln r_q For delivery n visit we- o �_� •� {� • o f AFi 11T EW s �iJ •70'22.U IT {( . .✓ ' 14-5.R51 00583 1 � q CE] Postage $ m, Po S / 03 C3 Certified Fee $0.00 P s' r»� E3 Certified Fee $0.00 00 0 Return Receipt Fee $a,[IIS 001 I M Return Receipt Fee ■ a Endorsement Required 7 � ( ) � 18°► � (Endorsement Required) ��.�� 2 ,G] WORM Restricted Delivery Fee O +4 Restricted Delivery Fee $101'6101 CO p (Endorsement Requited) f p (Endorsement Required) lltVJ. �, $0. r" Total Postage&F s �1 201 �" Total Postage&Fees r_1 �� ,a $ 11/G4- 0 M Sent To (bis 3�d�\ m Sent To �� d ►_lt�h�=--------------------- ---- r-q1�>� � ,�t� - O Street,Apt No.; ye 1 0 O Street,Apt.tYo.; QG 11 �`ad1 or PO Box No. Y6a �++—�� ---------------- fti or PO 6ox No---�O ---�p� Ciry,State,ZIP+4 I a"71 Crry,State,ZIP+4 - ` <<„ 076ZZ P&Form 3800,August 2006 See Reverse for Instr tions PS Form 3800i August 2006 See Revdrse for In irudicins6 U.S. Postal Service,. CERTIFIED ' • MAILT. . ■ frl (Domestic Only; Ln i Ln r For delivery information visit our website at www.usps.comeD L � tY1fi1 A U �1 r� C3 u Ij I, .: �--� ¢¢ .17 w �$ co Postage- `P QN F I m PJAC, p �O�K N r0 Certified Fee $Q'00 C?CO Postmark�0 Certified Fee $Q■Qa O MI EM Z� Past r A E3 Return Receipt Fee $o.[I0 ,fro�'`� re ReturnReceipt Fee cv� {{ (Endorsement Required) %.�/j QJ O (Endorsement Required) $0.00 r O C JI� C3O I Restncted Delivery Fee Restricted Delivery Fee �'� A (Endorsement Required) 1 p C3 (Endorsement Required) �� a $0■ $0■ $ J� Total Postage Fees w Total Postage&Fees 1 ,a $6 w Sent To ,,11 I`, m Sent To r= phkia- J.IIL�A _ -------- 1 Street,Apt 0.; 7�i`l ('1 ------------ ------ O Street,Apt.No.; (�- or PO Box No. . r �- or PO Box No. `� ��- Of'R �y tool F1►__-1/�� 975- - ---------- ------------------_----------- Ciry,State,ZIP+4 Of7S Form :r. August 2006 See Reverse for Instructions PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: ,EJ., i •�'a .•yr X5..3" •F.rx - t .t• ''. ~$ _ •- .S`L_ "f,�} STATE OF NEW YO _ s COUNTY OF SUFFOL residing at being duly sworn, deposes and says that on the day of , 20__, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of ,20 : t i Notary Public i BERGDESM ARCHTECTURE November 13, 2015 Southold Town Board of Trustees Town Hall Annex Building 54375 Route 25 Southold, NY 11971 Re: Van Room Residence at 575 Hill Road, Southold, Peconic, NY Country Tax map no: 1000-70-4-29 To whom it may concern, Please find enclosed the following supporting documents pertaining to board of trustees hearing for the address above: • Certified Mail Receipts for mail containing `Notice to Adjacent Property Owner' and a site plan sent to the property owners of CTM 70-4-28, 70-4-30, 70-4-35, and 70-4-36 • Domestic Return Receipts for mail sent to the owners of properties at CTM 70-4-28, 70-4-30, 70-4-35, and 70-4-36 Sincerely, John R Berg. r (Architect) 1 NOV 16 2015 131 Vanck Street Suite 913 New York 10013 917 328 3905 bergdesignarchitecture.com ,NOTICE OF- 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: EMMA van ROOYEN SUBJECT OF PUBLIC HEARING : For a Wetland Permit to install a 30'x14' swimming pool with an additional 6'x12' wide entry stair; install a 639sq.ft. wood deck with steps and planters; install an irregularly shaped 1 ,269sq.ft. blue stone paved patio; install a 4'4"x8'0" outdoor shower on stone deck area; and construct a 21 '0"x8'3" wood pergola on stone deck area. Located: 575 Hill Road, Southold. SCTM## 1000-70-4-29 TIME & DATE OF PUBLIC HEARING : Wednesday, November 18, 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 Board of Trustees Application AFFIDAVIT VP CJ -F-c3yY�1""J BEING DULY SWORN DEPOSES AND AFFIRMS'THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)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 BOARD OF 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,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owne SWORN TO BE IS} D7 A-Ob( FORE ME THIS DAY OF C •'20 i J 1 otary Public j NNS,0Q. 1 11A50me QUa01itied 1n f' CO �n�eetor�t;,�ires Duty 2t. o►'� Board of Trustees Application 1�1 N 6S SCJ County of- lc State of New York C M M 1k Q Ik (\1 L= 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 Ow SWORN TO BEFORE ME THIS DAY OF 06 U+M(idl(t- ,20 1'4 Notary KibTic FNotary XANDER R JORDAN ublic - State of New York O 01J06259060ified in Kings Cou ty My Commission Expires 0_ 16 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) r, S.PMMA V'A jyop%m J residing at 231 M AZP6 N O(h R S (print owner of property) (mailing address) IF W . 11233 do hereby authorize -J'Q VW 7-• IM2* (AV-C- l I-Ma- (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM Tho Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The numose 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: '16 VW � �-- name of (Last name,first name,ipiddle initial,unless you are applying to the nam 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 Change of Zone Coastal Erosion Approval of plat Mooring I. 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'rown 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%orthe shares. YES NO X— I 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 shards of the corporate stock of the applicant (when the applicant is a corporation); I 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 actbal applicant. DESCRIPTION OF RELATIONSHIP I Submitted this�Stdday o � i 200 Signature Print Name ' Form TS 1 Town of Southold N Erosion, Sedimentation & Storni-Water Run-off/ASSESSMENT FORM � 2 o PROPERTY LOCATION: S,c.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Of y,1� STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN st eteco oc —Eo-t-- 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? n A a • 0 541, I Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within tie's i 5 Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (This item will include all run-off created by site b. What is the Total Area of Land Clearing clearing and/or construction activities as welt as all and/or Ground Disturbance for the proposed 17,5� •® Site Improvements and the permanent creation of construction activity? Acres) impervious surfaces.) / 2 Does the Site Plan and/or Survey Show All Proposed X El PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Needed) Drainage Structures Indicating Size&Location?This Item shall include all Proposed Grade Changes and Newty y)j Slopes Controlling Surface Water Flow. (�/ 3 Does the Site Plan and/or Survey describe the erosion �L and sediment control practices that will be used to control site erosion and storm water discharges. This El t item must be maintained throughout the Entire C% I�L�y.��6� n � Construction Period. 5HOW/iL— P I7iZAQV pL� 4 Will this Project Require any Land Filling,Grading or X/ Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities ® Encompassing an Area in Excess of Five Thousand Fye (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 a larger common plan that will ultimately disturb one or more acres of land, which Exceed Fifteen(15)feet of Vertical Rise to 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 1.The SWPPP shall be prepared prior to the submittal of the Not.The NOI shall be into and/or in the direction of a Town right-of-way? El 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 X 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 stone 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 betwoen 5,000 S.F.&1 Acre In area, component shell 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 i that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior Issuance of Any Building Permit. (NOTE A Check Mark(.�)and/or Answer for each Question is Required for a Complete Application) STATE OF NEW YORK, COUM Y OF......t4CW-..Y.A..............SS ?hJ..U..(Name individ at I,....... ....... ua:... ....... ..................being duly swoni,deposes and says that lie/she is the applicant for Permit, of l signing Document) And that he/she is the ............... '...... . .. .. .. .. ..... .............................................................. ............... ..... ............ ......... (Owner,Contractor,Agent,Corporate Officer,etc) Owner and/or representative of the Owner or Owners,and is duly authonzed to perform or have performed the said work and to i make and file this application;that all statements contained in this application are true to die best of his knowledge and belief;and that the work will be performed in the manner set forth in die application filed herewith. Sworn to before me this; ..................2_1.......................day o ....1`.°l, '°"6.` ............... ,`20!`l. i Notary Public: ... .. ................................................................. ••• ....... '••alure of App•- •" bAlififftItth ) C FORM - 06/10 Notary Public,State of New York Qualified In Bronx County No.01AL6290023 14 Commission Expires i oiro 2017 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. ' 2. Before answering the questions in Section C. the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its siwdficant beneficial and adverse effects upon the coastal area which includes altof,Southold Townl. 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- suuporting 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# -70 p PROJECT NAME �J' 5 R I U. �-P Sw LMM 100 f W�-- The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. Board of Trustees 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: C.oNs1w6RoN of NV-w 6001 SWIMML4211 000L, S)DW e0039*, (AD-02 WL& ANM (i1100��IP D?. . P Location of action: Site acreage: 'L�f, �D� �• �72— /� Present land use: S l Nin I EM I17p6p 1 ' Present zoning classification: a 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: tA!5 'EM MA VM 12V 5 0 (b) Mailing address: 7"5 �R Nil �`TT� �.`'��•1. �',Z33 (c) Telephone number: Area Code( ')[ 7 — 373 '— I+?3 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No D4 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. XYes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No K Not Applicable 1 ✓✓ Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See _ LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ,Yes ❑ No ❑ Not Applicable P.C' � A U6eNNS � ` 15S fneki, tie'4 Msk. 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 S through 16 for evaluation criteria Yes ❑ No ❑ Not Applicable 1 FWL w V129l0 , L#JenAp 5 A NAIV� Pf� N AV 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 • ;K Yes ❑ No ❑Not A plicable YKINIM . W114irc— AG60, v TLw 67 by 0* &ZMMAliZ !"JAJN W /Who 14kV 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. Yes No Not Applicable ry R, HAykAo ast vev� roiu r� Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ,� Yes [:] No Not Applicable Na -rn ge- &A RbUV �G r �A�s WI X vs civ tS Pf4,1�EO- C Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No R Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Yej:] No KNot Applicable 15 lc,pt.) PaWAW Attach additional sheets if necessary h ? 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,F�Zot Applicable 8z N 2. UNN��t 6Y `(7k1 Smz&rme. W4 eFTi£Z7- 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 ❑1 No❑ Not Applicable ` 19A02ax GV L A/ 1 r Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No KNot Applicab l- 1D�1�`1tA'l� 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 ❑ NoKNot Applicable PREPARED BY Q TITLE 1 11114 r iI ARCH LECTURE E E I V I October 6, 2015 OCT 1 3 2015 U1 "I { Southold Town Board of Trustees i Town Hall Annex Building SoutholdTown 54375 Route 25 Burd of Trustees P.O. Box 1179 Southold, NY 11971 Re: 575 Hill Road, Southold, Peconic, NY-Country Tax map no: 1000-70-4-29 Dimensional description of proposed structures. To whom it may concern, Please find enclosed the following supporting documents pertaining to board of trustees application for the address above: • Board of Trustees application affidavit. • Check for limited siltation fencing inspection fee- $50.00 • Check for Final inspection fee -$50.00 • Wetland Permit application fee- $250.00 • Dimensional description of proposed structures letter from Berg Design architecture dated October 6th 2015. Sincerely, John R rg. (Arc ' t 131 Vanck Street Suite 913 New York 10013 917 328 3905 bergdesignarchitecture.com BERGDES GN ARCH TECTURE December 22nd 2014 Board of Town Trustees Town of Southold u DEC 2 3 2014 Town Hall Annex 54375 Main Road P.O. Box 1179 Southold NY 11971-0959 TRANSMITTAL To whom it may concern, Enclosed please find application materials for a Wet Land Permit for the construction of a new swimming pool, wood and stone decking and a wood pergola at 575 Hill Road in Southold , NY. Enclosed please find originals and three copies of the following: • Completed Board of Trustees application • Short Environmental assessment form • Erosion, Sedimentation and Storm Water Run-off Assessment Form • Authorization Form • Agent Authorization • Applicant/Agent Representative Transactional Disclosure Form • LWRP Consistency Assessment Form • Project Plan and Side elevations • Application fee for wetland permit • Application fee for wetland permit & Coastal Erosion Permit • Original copies of property survey - • Current site photos 24 -3,// (Esg-Q-e w/ MOW Sincerely, i`n p.-j C C John Berg i Copy: file Path: 0163/Docs/trans122214 131 Varick Street Suite 913 New York 10013 917 328 3905 bergdesignarchitecture com TEST HILL ROAD S 88'52'40" E iv 451.00' EOceoF x�e SURVEY OF PROPERTY G�� S PA�f�,,ENr �/ a( r% 68.S3'so' � SITUATE' �� 14 #� Pope `��AA 0 /1 5OUTHOLD �q 15.6' s \ �� TOWN OF SOUTHOLD x C UND S3 So�� 14.4 \ x\S J NC MON `J O�£RHega ,13 SUFFOLK COUNTY , NEW YORK M ,5.5 � x :"t S.C. TAX No. 1000-70- 04- 29 \ ° MFTeR13.6 SCALE 1 "=20' ,2j JUNE 13, 2014 x 14.2 / / o 13.2 0 \ / 70S \ ° AUGUST 11, 2014 ADD PROPOSED POOL I ° •�� DECEMBER 2, 2014 REVISED PROPOSED POOL a 13.3 , > TOTAL AREA = 24,905 sq. ft. (TO TIE LINE) 0.572 CiC. x,4.8 I= ° 134 x13.3 �� a " UPLAND AREA = 24,063 sq. ft. STEEL OR WOODa p x I EXTRA STRENGTH FILTER FABRIC POST (TYP.) / ° REO'D. WITHOUT WIRE MESH SUPPORT I \ / 0 10' MAX. O.C. SPACING BOG ROlJO 14.8 0 W/ WIRE SUPPORT FENCEFXjST'4TjON5Fp 100, \ / aPy 6' MAX. O.C. SPACING W/0 WIRE SUPPORT FENCE ,- 12.7 SN 4 0� o O / x �•• .. ; Fd ° 013.6FLOV ^d' a 14.3 �- ATTACH FILTER FABRIC SECURELY O 74.54 '' TO UPSTREAM SIDE OF POST �4 • 4 � 0 \ NCE DETAILS 14. O< oCO SILT FER �O TTp� [1 �/ / � 0� ° t'e I 74.1 O A S NOT TO SCALE �V� y^"Y ("j� 41::) NOTES: x 14. 4 0 l=l P pS P p�FRG C O NOTES: SILT FENCE SHALL BE PLACED PARALLEL TO SLOPE CONTOURS TO '�• CJ Q `�` C7' ° 0 `S' r p/�MRtU/�/D ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM MAXIMIZE PONDING EFFICIENCY. INSPECT AND REPAIR SILT FENCE AFTER rO r^�� O ��y Z� \ ° 0 14.4 I F./2 T,q�k EXISTING ELEVATIONS ARE SHOWN THUS:_5-O - EACH STORM EVENT AND REMOVE SEDIMENT WHEN NECESSARY. REMOVED SEDIMENT SHALL BE DEPOSITED TO AN AREA THAT WILL NOT ALLOW h (n(/� 7 \ 0 ° 0 / 13.6 OFF-SITE TRANSPORT. �� cC, �' QO �' x I EXISTING CONTOUR LINES ARE SHOWN THUS: - -5- N O h O \ Q O 140 �C' APRpN 92o��F x F.FL. - FIRST FLOOR 7T y w 2 io ' O9l �. G.FL. - GARAGE FLOOR 36" HIGH POLE (MAX.) r.�`�4 �0 ry CFS ?q 4 9! "� B. - STEEL OR WOOD POST .'J 4 J � �a 14-35� / ❑❑ \ T.B. TOP OF BULKHEAD FLOW 0c'gTF ^ ❑�0 14.4 ❑ 1 I x12.8 �W. - BOP OF WALL OTTOM OF BULKHEAD k� B.W. - BOTTOM OF WALL OOOR sN�W R ry 2 14° °� 36S Rsr��SrooP wry 2. FLOOD ZONE INFORMATION AP KEN FRO1 M: 66H �„ o Ston FFA FLOOD INSURANCE RATE No. i\\j FRS 4Mf yo 136 1/ ZONE AE: BASE FLOOD ELEVATIONS DETERMINED 3. 24.s• , �S£ & Oh \ ZONE X*: AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1% ANNUAL Z / 4" X 6" TRENCH RF�OC S/��D \ c' 4° �'' R Q / w/ COMPACTED '9T�p q q�F nQ�wz 4`� CHANCE F' nOD WITH A.VER�.GE DEPTHG OF LE`✓`� Thi,�N 1 FOOT BACKFILL k �,� OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; q p ''' Op, N QYO / AND AREAS PROTECTED BY LEVEES FROM 1% ANNUAL CHANCE FLOOD. TRENCH DETAIL I RO SFD 2 W / ZONE X: AREAS DETERMINED TO BE OUTSIDE THE 0.2% ANNUAL CHANCE FLOODPLAIN. (NOT TO SCALE) 0 11. :...� 0 <gHrFR DFC� O�VO�C� I �2 2 z4 'S PROPOSED IMPERVIOUSOVEUPAND LATARE GOVERAGE OA r +n O Q �p (POOL DRYWELL) pR p�qN , AR osC Sly DESCRIPTION AREA % LOT COVERAGE (NOT TO SCALE) i $ 234' Opo X� s_�' / ONT`oN 1.8 y� CAST IRON INLET FRAME & FRAME �O \ O' S P_ -- �� bFC �Q EXIST. HOUSE 2,213 sq. ft. 9.2% FINISHED GRADEc`O cP 9 30.p, RFMo STS F�'Op EXIST. (2) BRICK STOOPS 49 sq. ft. 0.2% 8" SLAB (max.) 9� �(� \ , C/ \ / 10 (8bl p ORS EXIST. SHED 100 sq. ft. 0.4% PIPE FROM POOL EQUIP. 6+� " MATS O \ m on,x ZONE X �FFp KW 9S Y. J ♦` \ �R\Nb CSF 740 \ ry __._-- J N PROPOSED POOL 505 sq. ft. 2.1 2z e ��S �R/N / �" ZONE X* R c' G \ / / PROPOSED DECK W/STEPS 639 sq. ft. 2.6% 6 '00 CRUSHED 3/a" - 1-1/2" STONE ^ �o ` 9 5/`STA�FD p�,o J \ \�Op SoAK i / ��j PROPOSED PATIO 1,269 sq. ft. 5.3% 'v ALL AROUND ON FFI'C/ FCT \O G / 8 LEACHING RINGS goo' \ �GS �4 �� / EXIST. DRIVEWAY REINFORCED PRECAST CONC. V \ 2,015 sq. ft. 8.4% 4000 PSI ® 28 DAYS F \ \`\ \ \ \ \ \ ��V' \ \ '�� p 6f EXCLUDING SHED 3'-0" 3-0 00 TOTAL EXIST. & PROP. 6,790 sq. ft. 28.2% (min.) 4„ (min.) \ 4 ♦`\ \ \ / 75 7 PREPARED IN ACCORDANCE WITH THE MINIMUM /,j ��__ ___ .►� �/ STANDARDS FOR TITLE SURVEYS AS ESTABLISHED II, - \ / s a BY THE L.I.A.L.S. AND APPROVED AND ADOPTED o =� i $ \� � Pr z' + n a r FOR SUCH USE BY THE NEW YORK STATE LAND E Qo iT ��T ` \ �OQQ 1, y _� + -� y� ` TITLE ASSOCIATION. V/ b GROUND WATER I X Q .' �, all, p °F P `\ \ - �O s - s U 4S P T w 9 o q k l� lr i A S ^ 3 20�'t J� ' 0.9 A e0 •,C�gr�r M of �R0 � � ._ � x* DEC 2 � Wert a ak ;SNE qE 4° 2. ` .- 4 ' 4. 2 w 8 46Qg oz�'-40 48' all, . Y.S. Lic. No. 50467 ",:APPROVED BY �. ND �� TF o ., UNAUTHORIZED ALTERATION OR ADDITION 7j% o 60ARD OF TRUSTEES TO THIS SURVEY IS A VIOLATION OF RAMp� S90 \ \a ' n N � ESECTION DUCATION2LAWOF THE NEW YORK STATE Nathan Taft Corwin ill 4'4:1..-.. 36 1 \ ;,'-T , -SOUTHOID COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL Land Surveyor •S( , � r► EMBOSSED SEAL SHALL NOT BE CONSIDERED iyoaAr �/ v' t+"J;• � ` �:�QIS TO BE A VALID TRUE COPY. Dock RUN RLYIFTO ICATI ONTHESPERSONT ED FOR WHOM THEHEREONLSURVEY .U1 IS PREPARED, AND ON HIS BEHALF TO THE Successor To: Stanley J. Isaksen, Jr. L.S. r✓'/ TITLE COMPANY, GOVERNMENTAL AGENCY AND Joseph A. Ingegno L.S. LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. Title Surveys - Subdivisions - Site Plans - Construction Layout PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 34-108A