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Home My WebLink AboutTR-8748 ,,�-SufFotx`aTown Hall Annex Michael M- Bredemeyer III, President :!'o�� _ C�a�;_ �� t ti� Michael J- Domino, Vice-President 54375 Route 25 CD <<+ Glenn Goldsmith z P O- Box 1179 A. Nicholas Krupski w o ® Southold, NY 11971 f'f'e Al Telephone (63 1') 765-1892 Charles J- Sanders 1 , ,;: Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 10/-7/b Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction Y constructed Project complete, compliance inspection. INSPECTED BY: )V, Kfues COMMENTS: PO pp ama fe dq, I P Cd( CI((�G{cl ea/6k Fd, IrU pldC P CERTIFICATE OF COMPLIANCE: John M.Bredemeyer III,PresidentO� SO /y®lO Town Hall Annex Michael J.Domino,Vice-President 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold, New York 11971 A.Nicholas Krupski ® aO Telephone(631) 765-1892 Charles J.Sanders Fax(631) 765-6641 CCUNT i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1287C Date:November 9,2016 THIS CERTIFIES that the demolition and removal of the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged area; with the condition that if showers or toilets are ever proposed for the existingsed permits must be applied for; At 3575 Wells Road,Peconic Suffolk County Tax Map#1000-86-2-10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated January 8,2016, pursuant to which Trustees Wetland Permit#8748 Dated March 23, 2016,was issued and Amended on September 21, 2016 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 demolition and removal of the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged area; with the condition that if showers or toilets are ever proposed for the existing shed permits must be applied for. The certificate is issued to ROBERT SERLING owner of the aforesaid property. Authorized Signature John M.Bredemeyer III,President ��OF S�UTjy® Town Hall Annex Michael J.Domino,Vice-President �� l0 54375 Route 25 P.O.Box 11 Glenn Goldsmith B Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Charles J. Sanders Ola Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 21, 2016 Robert Serling 3575 Wells_Road Peconic, NY 11958 RE: 3575 WELLS ROAD, PECONIC SCTM#: 1000-86-2-10 Dear Mr. Serling: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting-held on Wednesday, September 21, 2016: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative ; Amendment to Wetland Permit#8748 to demolish and remove the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged _ area; and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated April 7, 2016, and stamped approved on September 21, 2016. 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, j John M. Bredemeyer III President, Board of Trustees JMB/dd APPROVED BY BOARD OF,TRUSTEES ' RAIN RUNOFF CALCULATIONS TOW OF p EXISTING HOUSE —894 SQ. FT. ': PROPOSED ADDITION —990 SQ. FF SURVEY OF PROPERTY ;p DATE TOTAL-1884 SQ. FT. r I M PROMDEO2 DW's.8 Z X 4 DEEP 2-7 s VF A T PECONIC 04 S N TOWN OF SOUTHOLD = ,�� , 6929¢ y ��iF,,os SUFFOLK COUNTY, N. Y. O ,y 1000-86-02-10 SCALE: 1'20' 0 FRT FEBRUARY 11, 2014 9 O � 140 C SC+ AUG. 28, 2014 (PROPOSED ADDI RON) o� -^� tiUp� JUNE 15, 2015REVISIONS) yy5`m ry4a-) R"FAp Res ;°s `' R APRIL 7, 2016 f REVISIONS) R41i \Sg S, � C E V E yG GRAVEL BEP — 9 2016 Z i �A�+S► J C7 Z ,46^yd Southoid Town tvo oposFo h 0iF 4 r --Rmrd of Trustees h v � Q• 4' - 'Do O } QI- + v 9o. ?t , d O. X20 • co,a 4D, No LOT COVERAGE EXISTING 894 SQ. FT. / oo� moo• Q�o� }QP / �v 0J �.�� 4� PROP. ADDITION 990 SQ-FT- TOTAL 1884 SQ.FT ` r,•�a AT COMPLETION OF CONSTRUCTION ry�y Op~ 1884/16419=11.5 � X = STAKE Ak = WETLANDS FLAG '9 �• EDGE OF WETLANDS, AHWM & ALWM BY JMO B� °Ropo3 ENVIRONMENTAL CONSULTANTSNzp *TIDAL WETLANDS STAKED 3/16/2015 1poB � '(YdY j,JI- 0 FIELD WORK WAS COMPLETED WITH 8" OF SNOW Ili oh COVER. WALKWAYS NOT SHOWN HEREIN. ( k'' n' ELEVATIONS REFERENCED TO N.A.V.D. 1988 FLOOD ZONE FROM FLOOD INSURANCE RATE MAP r F MAP NUMBER 36103CO162H SEPTEMBER 25, 2009 NO. 49618 ANY AL7FRA77ON OR ADD177ON TO THIS SURVEY IS A WOLA77ON d`` o`' PE 0 VEYOR , C. OF SEC770N 7209OF THE NEW YORK STATE EDUCA770N LAW. b. e� EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FICAIRONS AREA=16,419 SO. FT. �° '�� . a vNs (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IFyy� � P.O. BOX 909 SAID MAP OR COPIES BEAR 7HE IMPRESSED SEAL OF 7HE SURVEYOR TO TIE LINE 1230 TRA VELER STREET WHOSE SIGNATURE APPEARS HEREON. 14-00,2 SOUTHOLD, N. Y. 11971 OFFICE LOCATION: ®'eif s®��yOl MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) C Southold, NY 11971 Telephone: 631765-1938 ® Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: September 14, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for ROBERT SERLING SCTM# 1000-86-2-10 ROBERT SERLING requests an Administrative Amendment to Wetland Permit#8748 to demolish and remove the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged area. Located: 3575 Wells Road, Peconic. SCTM# 1000- 86-2-10 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action furthers the policy to the extent practicable and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. f' John M. Bredemeyer III,President �q S® �®l Town Hall Annex Michael J.Domino,Vice-President �® 54375 Route 25 r, P.O.Box 1179 Glenn Goldsmith ', Southold,New York 11971 A. Nicholas Krupski �� Telephone(631) 765-1892 Charles J. Sanders `,®UN Fax(631) 765-6641 r BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD Office Use Only ® �-' ( � � �� _Coastal Erosion Permit Application � Wetl Permit Application Administrative Permit SEP — 9 2016 e dme ransfer/E �nsion Received Application: Received Fee:$ /16 Southold Town Completed Application B f Tru _Incomplete _SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) )C LWRP Consistency Assessment Form /a (� _CAC Referral Sent: Date of Inspection: _Receipt of CAC Repo . _Lead Agency Determination: _Technical Review: Public Hearing Held: -t--Resolution- Name ` Resolution:Name of Property Owner(s) D b.e rte Address 357-5 ltl E L L S eP 0 6 6 FA C.b A,1I C, Phone Number#iq 3 53 — Z-15 9 2- Suffolk Suffolk County Tax Map Number: 1000 - 23& -2-1e) Property Location: ,sc�tie 0 -S 4 c (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Phone: f' -,pard of Trustees Applicata"— . � - GENERAL DATA Land Area(in square feet): �� J Area Zoning: Zo AIX X Previous use of property: -¢Q joiy- !a g Intended use of property: f^a0, tie.. / Covenants and Restrictions on property? Yes v 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? Yes ✓ No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? ,.---Yes No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency - Date .304 PC(oJ'-Sdu lhlaGcLr as , 97V8 A)- f-/r.,e le- C— o //s 473916),00-6 7 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? o Yes If yes,provide explanation: Project Description (use attachments if necessary): ewo 01"" 1 A4x'e--),e A c«v 0 o l s� -46C �� Pard of Trustees Applicat, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: )?e or®c.-p— <�-�r P5 JIL Area of wetlands on lot: d square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland S�e 5L,, edge of wetlands: feet Does the project involve excavation or filling? ll No Yesl�ic) If yes, how much material will be excavated? ? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: A lo A A le 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): 61Z20 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 1 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: 4�e&1b l t h 474 a 1 Jam/ le- Project Location(describe,and attach a location map): 3 575 wCZz--F A'> � ��'co Ale Brief Description of Proposed �Action: Q �.2 oe we 19"4 Name of A plicant or Sponsor: Telephone: P6 r,.. l[ E-Mail: •^CG/�, Address: / City/PO: e,e-ev, l(— & -1, -/ Statee � Zip / f 70 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 El El- may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned �� z or controlled by the applicant or project sponsor? acres cS�• �� 4. Check all land uses that occur on,adjoining and near the proposed action. ,[ ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial Ell residential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ❑ ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? Er ❑ 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: El FJ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? Ell❑ 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: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline El Forest ❑Agri cultural/grassland s El Early mid-successional ❑ Wetland ❑Urban D-5—uburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ET ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? e}'110 DYES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO [—]YES 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. ❑ Er 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 ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: he-,(— ,, Q—�" I• Date: A (44 Z�� 4W—d Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning11regulations? 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? El 4. Will the proposed action have an impact on the environmental characteristics that caused the Elestablishment of a Critical Environmental Area(CEA)? 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? E b.public/private wastewater treatment utilities? El� 11 8. Will the proposed action impair the character or quality of important historic,archaeological, n architectural or aesthetic resources? El 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 1:1problems? 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. F1Check 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. F] 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 Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT I Page 4 of 4 V yard of Trustees Applicata"') AFFIDAVIT i BEING DULY SWORN DE SES AND AFr4RMS THAT E/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND T1 1, T 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. i ature of PrwerA Owner SWORN TO BEFORE ME THIS -91 DAY OF92014- Notary 2014- Notary Public MATTHEW J. WEIPPERT NOTARY PUBLIC, state of New York No. 01 WE4851646 Qualified in Nassau County Commission Expires February 3, 20 card of Trustees Applicat', ` AUTHORIZATION (where the applicant is not the owner) Iresiding at 10 q d,�1C>y wtiC�� (print name of o er of propert ) (mailing address) do hereby authorize Y4 y zGtzleft (Agent) 0 4 to apply for permit(s) from the Southold Board of Town Trustees on my behalf. 1 (Oer's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoiZast YOUR NAME: ame,first name, ' e initial,unles ou are applying in the name of someone else or other entity,such as azo .m&y.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 Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 7 da of 5aO 200 l �o Signature Print Nam?'5 Form TS 1 f � e-P" � 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 significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# l000 PROJECT NAME �-��.�.d �t.T7 c)"1 O 7t--, 2,,.j 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 act o 0 e � I a e Location of action: S7 Jr U/E G LS Go-e( L Site acreage: Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: 6 4e (b) Mailing address: `� y �y1F'�'� Ae4�` cvc L'cJe l �e� �-e r (c) Telephone number: Area Code( ) S'4 — 3 53 — 4(J- 2 (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No �NotApplicable 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 1:1Yes 1:1No 13-Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ Noof Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No [ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ ❑ I-J Yes No Not Aw"cable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold.,See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in 'Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria., ❑ Yes 1:1a No U 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. ❑ Ye❑ No U Not Applicable Attach additional sheets if necessary 3 _r 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 Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ElYes 1:1 No No U Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 forevaluationcriteria. ❑ Yes 1:1 No FluNot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable . PREPARED BY TITLE d"44e P/ BATE 7 l(( John M. Bredemeyer III, PresidengI��S�FFO(K�; __ % Town Hall Annex Michael J. Domino, Vice-President'- ��rao� emay; 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders �yy �p�,f^ Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 9 �3 Completed in field by: N ROBERT SERLING requests'an Administrative Amendment to Wetland Permit#8748 to demolish and remove the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged area. Located: 3575 Wells Road, Peconic. SCTM# 1000- 86-2-10 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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: 1 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: Present were: -1. Bredemeyer M. Domino . G. Goldsmith N. Krupski �anders Other Page 1 of 2 UfFO(x�$, John M. Bredemeyer III, Presiden. ��pS Rio Town Hall Annex Michael J. Domino, Vice-President �,O Gym, 54375 Route 25 Glenn Goldsmith ® '` P.O. Box 1179 A. Nicholas KrupskioSouthold, NY 11971 Charles J. Sandersaper Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: ROBERT SERLING requests an Administrative Amendment to Wetland Permit#8748 to demolish and remove the remains of the fire damaged dwelling and foundation; and to install and maintain security fencing around the fire damaged area._ Located: 3575 Wells Road, Peconic. SCTM# 1000- 86-2-10 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 JET ENVIRONMENTAL TESTING, INC. 114 WEDGEWOOD DRIVE• CORAM,NY 11727 PHONE(631)331-38I1 •FAX(63I)642-7499 September 6,2016 Mr.Rob Serling D E E ' E 3575 Wells Road Peconic,NY 11795 z SEP - 9 2016 Re: Pre-Demolition Asbestos Inspection 3575 Wells Road � UUl11Ql IU9Jf1 Peconic,NY Boad of Trustees Dear Mr. Serling, On August 30, 2016, Jet Environmental Testing performed a pre-demolition asbestos inspection, at the above referenced'site. Richard Maniscalco, a NYS Dept. of Labor Asbestos Inspector#91-03836, performed the inspection. The inspection included sampling all suspect asbestos containing materials (ACM). Guidelines used for the inspection were established by the Environmental Protection Agency(EPA) in the Guidance for Controlling Asbestos Containing Materials in Buildings, Office of Pesticides and Toxic Substances, DOC#560/5-85-024 and 40 CFR Part 763. Field information was organized in accordance with the observation of homogenous materials. A homogenous material is defined as a suspect material of similar age, appearance, texture and installation. Each material was grouped together as a specific homogenous material and sampled. Bulk samples of suspect ACM were analyzed by Polarized Light Microscopy (PLM) with dispersion staining, as described in 40 CFR Part 763 and the National Emissions Standard for Hazardous Air Pollutants(NESHAPS). The New York State Department of Health has revised the PLM Stratified Point Counting Method. The new method, "Polarized Light Microscopy Methods for Identifying and Quantitating Asbestos in Bulk Samples" can be found as item 198.1 in the Environmental Laboratory Approval Program(ELAP)Certification manual. The State of New York ELAP has determined that analysis of Non-friable, Organically Bound Materials (NOB) are not reliably performed by PLM. Therefore, if PLM analysis of an NOB yields a negative result, Transmission Electron Microscopy (TEM) must be performed to confirm a negative result. All samples were initially analyzed by PLM. Samples which produced a negative PLM result and which are classified as NOB were then re-analyzed utilizing TEM methodology. The sample analysis was performed by EMSL Analytical Laboratories, Inc., 528 Mineola Avenue, Carle Place,NY 11514, ELAP#11469 for Polarized Light Microscopy and NVLAP#101048-0 for Transmission Electron Microscopic analyses of bulk asbestos. The inspection revealed no asbestos materials are present in the house. All materials are negative for asbestos content. Jet Environmental Testing, Inc. would like to thank you for the opportunity to provide asbestos consulting services to you on this project. Please contact us if you should have any questions or need any additional informational concerning this report. Yours truly, Richard Maniscalco Project Manager c PANZNER DEMO ABATEMENT CORP. Demolition Contractors 55 SAXON AVENUE, BAY SHORE NEW YORK 11706 D F (� � t( �r�r (631) 581-4151 (FAX) 581-4163 August 25,2016 j SEP Alan Schaefer 9 2016 P.O.Box 221 Islip NY, 11751 Southi;;�Tuvuii (631)416-2822 B a f Tus}ces Attention:Alan Email: ascilazfer(Ct,r reiiistiratice.coill RE: PROPOSAL 3575 Wells Road Peconic NY 11958 Dear Alan: Panner Demo&Abatement Corp. (PD&A) is pleased to present this proposal of the misc. demolition and the removal of debris at the above-referenced property. SCOPE OF WORK AND COST ESTIMATE PD&A will provide all the skilled labor with supervision, tools, equipment and materials necessary to perform the work described below. All demolition debris will be removed and legally disposed of. The site will be left neat. PD&A will perform the work in a professional and timely manner. PD&A provides Workman's Compensation and Disability Insurance. WORK TO BE PERFORMED Panner Demo&Abatement Corp.will demolish,remove and legally dispose of all of the following: DEMOLITION Obtain asbestos survey. Obtain demolition permit with related fees. Perform water disconnect(gas/electric disconnects to be provided by Owner). ! House Demolition Demolish and remove 1-2 story fire damaged house with basement approx.2,600 SF. Demolish and remove foundation with basement. Grade hole safe,no imported fill. Remove a 275 gallon above-ground tank. Pump out any remaining fuel and legally dispose of. Cut open and remove any remaining sludge and legally dispose of. Legally dispose of empty 275 gallon oil tank. Site Demolition _ Grade hole safe,no imported fill. CONTRACT AMOUNT: h PANZNER DEMO & ABATEMENT CORP. Exclusions: Gas and electric disconnects. Imported.fill. Asbestos removal,if any. Shed demolition. TERMS&INSURANCE PD&A provides General Liability and Umbrella coverage with A +rated insurance carriers. The Liability reflects a$1,000,000 limit, with an Umbrella limit of$5,000,000. PD&A will hereby furnish all materials and labor for the above scope of work for a total sum of--- ---- �-�-'- Dollars). L— Payment terms: Payment in full upon completion of contract. Should you agree with the scope of work, cost estimate and terms,please authorize this proposal by signing and returning it to our office. If you have any questions regarding this proposal, please feel free to contact our office. Very truly yours, 7-od&t" Todd Panner CEO The above prices,scope of work and conditions are satisfactory and hereby accepted. You are authorized to do the work specified. Payment will be in full upon completion of this project. u 4 Authorized%Zoure Date CM:sp _ it limb low j -'� yti. ��r �•a# .r.-•nig• � -�_ � .`. �., if .• ,fir ,® �V- wt r '* 1 4C Alt 10 74, t . y .r s..• jam._ --- �,` '•"�"'�,."R -*ret_.w., •,,.: < ^Jai' • +. ..'.W• . atti. Y as" rte 16 AC! _ 1. -'�3� •E �� 1 ..;�,�^"- a .+�k� ¢3C,.f; .lam•-�-.- ��y+( �i 4il.4rs -•_` _-_L�� i� r " T"� - /l "",,y�'r......yay,.�Y*r' d F awe,.,,-.,w, �/� •�.fj� 'S .�. y .b.., _ _ � .�l.��..�� ♦. j - " ,.7 I ' lip ♦.y.:/ r R T t r i JO <.. _. I AS { f .�I its. Vol • .,A� .. j) lid •Rti.,.a - __ f S® Town Hall Annex UP John M.Bredemeyer III,President ��® y® Michael J. Domino,Vice-President �® l® 54 Main Road P.O..Box 1179 James F.King,Trustee Southold, New York 11.971_0959CA Dave Bergen,Trustee Charles J. Sanders,Trustee < 0 ��(� Q MQ e_ 4 hods e DUNK, O'`a i BOARD OF TOWN TRl CdTc'k TOWN OF SOUTHC ctno_r -los s APPLICATION FOR AN AMENDMEN' �C''" k�`� `�`� (e s s � 7er W rr n R—am No DATE OWNER \ '� �'"��Ll dy PHONE 516- 353 -4592— MAILING 592—MAILING ADDRESS -:5575 W r-LL-S RD , , t— AGENT C&g4 LtWWtt&'3 PHONE 631 - -72-1 ` -]9 rl3 ADDRESS O 0, DK Oil g 1 0 q U-9- PROPERTY LOCATION 2�5 7 5 w kELO R0. '_P9ze--es ti, L-- TAX MAP NO. 1. `c3(6— 7-7 10 I/Ke G,"Lgf f request an Amendment to Permit# 0_1_42> — ZL $cam �WjUIV &Q0 vu"" E Signed By:C :� E � � E l�tow JUL 2 5 2016 xx outhold Town k Mrd of Trustees _,.,,� �� 9-7- 1 John M. Bredemeyer III, President Town Hall Annex Michael J. Domino, Vice-President �� y<�, 54375 Route 25 Glenn Goldsmith ` y 2 P.O. Box 1179 A Nicholas KrupskiSouthold, NY, 11971 tiy`h aTelephone (631) 765-1892 Charles J. Sanders o! 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, hay bale line 1St day of construction '/ constructed Project complete, compliance inspection 'BOARD OF SOUTHOLD TOWN TRUSTEES S'OUTHOLD,'NEW YORK ISSUED TO:' �ROBER,,TiSER,,L',ING,,t PROPERTY:ADDRESS::'3575-WEL'L-S,'ROAD,,PFCONliC- SCTM# 1000-86-2-10 oi :ursuanwo,,thqpr6yisions ofCha pter,275'of the Town Code of th�,,I?", of Southold and.in th the Reso ution.of."" accordance wi the Boardof Trustees adoptedat the meeting,held on March 23 2016,and in ra�A,11.j�-" 'J'�;4;�'4A 4-' �,IL)''4'j"J �I t "" ,'-I"-"'11 c".3"j,"'j 1, 4�" 1 I'Ijt- :"ih" '' - I* consideration j on of application fee in the sum of$250.00 paid Robert Sefling subject to e,T� sand Conditions as stated in the Resolution,the,Southold Town BVard''of'Tr"u"s'`t6e-s'autho:ri'z'es and`P`d-'n'ftI'tS`t'he following: o:7�o"y u!'o etland'Permitto ada'a itwo.�stotW-aa(tition"VAi6'�-ili"�'�iigtiiig�886s'qI W It. one-sror `dweHifig by removing the eiiiiiiij 3'2, construct" a 708§qj.AAiHt-II6or footprint.ar�ea;.a24.0s,q.ft-.,�attgehedfg seaward, 'okchiftcluding, ---d dditi6 JG hAlcon Ahe,,existing eftened pore secon story addition s q. ,;,and waterside 16.61x12l-bh=grade masonry,' atio to remain; with the condition p t on that'if shOvv,pri-iorLtc�dets-.areVOverpr,,opqs�ed,,,f6, �existingsjhed-� ,pipirniit�,,,must,�bp-�appifed foq jhe,, and-as depicted on the-siirvpy,prepared b 'Pikonic,Sur,,veyi)ts,�P,- .C�,;,lasi,,dittedJune 15, 'y 2QI5,,'-afid stampedprove ap -d"on March 23,2016. J -I 't, IN`Wl1NESSVH,ERE0Fi4if 's:-eaifl�6aid"ft le'*s,�'l�(e'r��eb'�y�'c"'a"u'-'s:'e"s�iis"C--6i�6idt6-s��l"t&-�6 affixed, and thesepresents to,besubsbrib&&673�'ail miaj-6-fi-tybfilid said BUdFd:9,'6fthisd T q7' O 7.7 .71 --w i!p TERMS AND CONDITIONS The Permittee Robert Serling, residing at 3575 Wells Road Peconic,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 r for revocation of this Pen-nit 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. LThat 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 pen-nits and consents that may be required supplemental to this pennit,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. o RAIN RUNOFF CALCULATIONS ® ' EXISTING HOUSE —894 SQ. FT. SURVEY r rAPPR®VEt� �T� ^--- i PROPOSED ADDITION —`�90 SQ. FT. a� UR 4y�}� �Y OF PROPERTY TOTAL-1884 SQ. FT. ° D OF TRUSTEES 1884X1X0.17=320 CU.FT. 320/42.2=7.6 VF I PROVIDE 2 DW's. 8 0 X 4 DEEP �EC®NIC J°S�� SUFFOLK CO U.NT Y, N. Y. 1006-66-02-10 cc- SCALE° 1 A 20' FEBRUARY 11, 2014 �Q � I c sc AUG. 28, 2014 (PROPOSED ADDI770N) JUNE 15, 2015 (REVISIONS) y ( ®� Df o s's PO/ GRAVEL Al OJ Otc iNpJ jf9 a (� p, ra GS h M• wJ cill o' DDC �M gypJ, o� �O°• oQ�i�ca� % of/ST ° /''T,� o�nyc �S`7• �'ha0ye, Q4 nlQCi i��/ � J k e w LOT COVERAGE 1� EXISTING 894 SQ. FT. PROP. ADDITION 990 SQ-FT- �hoo� \ I �� ` JJ`� 43 TOTAL 1884 SQ.FT. �� 6��, m AT COMPLETION OF CONSTRUCTION rV�y` 1884/16419=11.5% X= STAKE Fo0J �J .�,�� JAN - 8 2015 '1c A = WETLANDS FLAG EDGE OF WETLANDS, AHWM & ALWM BY JMO ENVIRONMENTAL CONSULTANTS *TIDAL WETLANDS STAKED 3/16/2015 (�v� FIELD WORK WAS COMPLETED WITH B OF SNOW COVER. WALKWAYS NOT SHOWN HEREIN. .45 :_ ELEVATIONS REFERENCED TO N.,�.V.D. 1988 FLOOD ZONE FROM FLOOD INSURANCE RATE MAP -= � 62H SEPTEMBER 25 2009 MAS NUMBER 35103CO1 N. .S LIC. NO. 49618 ANY ALTERA77ON OR ADD177ON TO THIS SURVEY IS A VIOLATION �i=IRVEYURS, P.C. OF SEC77ON 7209OF THE NEIN YORK STATE EDUCA770M LAW'---- �'� eG *:L'a EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FIC477ONS AREA=16,419 SO. FT. wQ '�;y�y aG ��S (�03 5020 FAX (6,31) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF �° �F�°01- P.O. BOX 909 SAID ANAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR TO TSE LINE' 12.30 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. 11 SOUTHOLD, N. Y 11,971 14®002 John M.Bredemeyer III, President �qa� S®Ul�® "rown Hall Annex Michael J.Domino,Vice-President ~® l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski ® �O� Telephone(631) 765-1892 Charles J. SandersDUIVTY, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 23, 2016 Chuck Thomas P.O. Box 877 Jamesport, NY 11947 RE: ROBERT SERLING 3575 WELLS ROAD, PECONIC SCTM# 1000-86-2-10 Dear Mr. Thomas: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, March 23, 2016 regarding the above matter: WHEREAS, Chuck Thomas on behalf of ROBERT SERLING 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 January 8, 2016, 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 February 17, 2016, and on March 23, 2016, 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, 1 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 ROBERT SERLING to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain; with the condition that if showers or toilets are ever proposed for the existing shed permits must be applied for; 'and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated June 15, 2015, and stamped approved on March 23, 2016. 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 1 - -.�fSUFF©(k ':gin John M. Bredemeyer III, President ,h'p�� 'oG;.* Town Hall Annex Michael J. Domino, Vice-President '�� y� 54375 Route 25 Glenn Goldsmith r ti P.O. Box 1179 A. Nicholas Krupski "y ® "Y Southold, NY 11971 Charles J. Sanders of , �� r Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 3e a's/to TO- koec-K 640C9 77f,*4tA;a Please be advised that your application dated T4_0114 9' -20/& has been reviewed by this Board at the regular meeting of —_ r—f 46d- a3 ! 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) 1/ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 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: TOTAL FEES DUE: $ �D� vo�� BY: John M. Bredemeyer III, President Board of Trustees �MT � I I I ARCHITECT I I I I I I I I 71•-� ' I I 65'-4' REVISIONS D E S C R I P T I ON I I NEW OVERALL I I 9/8/14 38'-2' I 29,_2• I _ EXISTING ADDITION '-0' B'-9' V-0 10/8/14 IF------In ±----B 1i1.�' Y-Y i -- L_1J L—J L— (3)2X12 ACCI GIRDER III . •i III ,Y0 SONO TUBE ON 0 O O NNE OF EXIST jl�c MIN 36'xLE FOOTING •j 18'-11• G OECI(R STAIRS III 1 MIN 38'BELOW GRADE a m TO BE REMOVED Ills (MUST BE MRGIN SOIL) O ANCHOR AND BOND TO EXISTING I1 Ts NTH/5 REBARS 012 OC VERTICAL Ijl $ 14'-9' ^ E%I S T I N G (TYPICAL) III —— 2•X10•ACCT LEDGER r— I — —————————————— s �—zaern 6 R E Q a 0 M ----------------- — ————— — © I III I 3._0. CRAWLESPACEi I I H 4•POURED CONCRETE SII I o OVER 6 MIL BARRIER ON HLEIE •i F I -—_—I-—- -—- O1 a COMPACTEDVAPOR POROUSI 12'-0' E X I S T I N G �x®� IM. II AT ICKNR..NOT TO AE LFID a-G oG — O—ocrcmm TMRE "ALL S."E15 III I I BRIDGNG TO BE 1•X3'SOLID WOOD OR METAL ( ) B'-8. ill 9'-6• rw 3-1 3/$X 11 T/B I I V MICRO_LA.GIRDER I E X I STI N G T�• -�IL -� I o - � -_-_- I L J-- --------_ L—J $ $$ ° IIIREMOVE I TING dF ¢ NI RpECK& T RS 3 1/2'STANDARD STEEL PIPE COLUMN �Rc3 I J Ur____ ,I ON A 30'%30'X,5•DEEP W E12 III HL----_Jjj POURED CONCRETE FOOTING (TYP) •e o. I Im Y 4 6• NP III 1 III ¢ I O O nl-y-'�--- o a Fu�L MOTKIil'I JU h 8 PO RED CONCRETE FOUNDATION I Io�o 'ml I WALL ON 8•X16'POURED CONCRETE I I �" .m I- 1 1 FOOTING ADJUST FOUNDATION v I t J FLOOR ELEVATION(TYPIICCIALE)1(IST.FIN. I i Q I SER I I 12• MAIN BOOR I _——————_J 'I F W I I Ld UP I I I r----- I a o Q � J Z EXISTING I I I •� I _ I r 1 r a LLV) R U ON I I I a- EXISTING 6'BLOCK REAS,.G WALL Z 4'POURED CONCRETE SLAB O OVER 6 MIL POLYETHLENE O I J VAPOR BARRIER ON Yhl1 •m I I I I 4'POURED CONCRETE SLAB I I U COMPACTED POROUS FILLI I I OVER 6 MIL POLYETHLENE I I I VAPOR BARRIER ON WELL cc W .I F I I I I COMPACTED POROUS FILL IL I I Ll.l I _ ------� I I d T----- ___ ------� I I I I ®I I I I I ®I I I DROP FOUNDATION WALL TO T SLAB --II 4 I I L— CONTINUOUMEES FOOTING I—J I _ I + I -44 B"• -4j Charles M.-Thomas e'-4' 12'-0' 3'-0' I a r c h I t e c t - II ADDITION PO BOX 811 JAMESPORL NY 11947 (631)721-7993 PROEGT I _ • IHHI o•"•^. {1r - r� _ � _ � 1 FOUNDATION PLA N U _ R_.�_.•_ W__.__,_" SCALE 1/4'= V-13" IiIAN _ $ 2010 M1 <s FOUNDATION PLAN Simpson Strong—Tie HDU v :e = TYPICAL TRHOUGHOUT ! 1ST & 2ND FLOOR - — - -- SCALE N TS. OW BY WA.NG BY - _ DAA 002 00 THESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS.AS INSTRUMENTS OF SERMCE,ARE THE EXCWSM:PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBUCATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED REUSE,REPRODUCTION OR PUBLICATION BY ANY METHOD IN WHOLE OR IN PART IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT TITLE TO THESE PIANS SHALL REMAIN NTH THE ARCHITECTVISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS __ __ �MT r � I I I I ARCHITECT 65'-4• I I cl I PROPOSED ADDITION 29'-2'-2• I REVISIONS D E S C R I P T 1 0 N I 5-1#• J'-1' WOOD STEPS TO GRADE 9/8/14 1 4• B• NUMBER OFISTEPS TO BE DETERMINEDION SITE 1 D/B/14 -------- 15'-0• I � - r----- •' a 'r-- --�U 14'-O• 3-12•ML HD 172 L HOR PER Mrs mDE _-_ _ -- -ZL____ U IIII ¢� zl P O R C H o nl S C R E E N II a P O R C H N® '3i1i 7-6• E X I S T I N G •i I'I M A S T E R m it ' 1iI FWD 120611 BEDROOM E X I S T I N G u`<>; __ __UNE OF WALL ABOVE_ D I N I N G 9�N 3-la•ML FLusH Hoa _ I — R 0 0 M2-74•ML HDR 05-onmon a FWH ISI I I 14._4. I b � I ` I 120611 III 2-14•ML HDR ISI 7y. Ili 111 I I 1 �� I II e it n u --71 4-2II I I1 9 I z-D - 9 R 14•TJI.-550 SERIES I g N - -rl-----n- AL WN E WL I V I N GE%I STI N C En IIRI I ROOM = •I Q EXISTING KITCHEN © z 11I C1LI 19'-0•CEIUNG HT I I - � O B E D R O O M I III UNE DFIDB6T1 , 1 CI Qs o9r'mov : 01-'--'DEorsi AIRS W UI TD BEIDVED ---I -----I I--- O O Nr--- a-I13/a x 1a HL__ GIRDER 1 1I II •i 11-5" a ® ® R�--F1 �I�ITYTO FLOOR J575 •I III 1 14•TJ,Igsrs 550 SEHI95 NB O IL Or J®�®� r D. r-----7�UP I I s is oc I I _ ' 2AuL-_ __JM 16R n I I I I- vJ > I I I r-2• I I I I •I E Q W > I OPEN o I I I I I Q J W ABDYE ©—B I i — I I W 4-D YSv4 F O U foo � — w E.2 ( z R� 1 ulpw LL I� �14'TJI 550 SE-1— O Lf 0 •I it O O O 18.OG n - N POWDER R-381NSUL LL ll _ "o i ROOM GARAGE 0- cc LlLO� W N79AC. RDER • IHR RATED € W V) '-05/8•TYPE X SHEETROCK •0 5 WALLS k COUNG b _T1-_ UNE OF WALL ABOVE_ •1z10R Ir-------- II 2•X10•CLO JOIST II I 1916.00.R-38 INSUL I - II 11 � II Il II 11 11'-4• I 2-Yd{"HDR II 9080 0 H.DOOR 3'-1• 3'-1• 2'-7• W-Y 6', 6'-0• B'-2• e'-4• 12'-0• S'-0• Charles M. Thomas a r c h i t e c t 29-8 PO BOX 677 JAMESPORT, NY 11947 (631)727-7993 PROPOSED ADDITION PRQFLT FIRST FLOOR PLAN SCALE 1/4"= 1'-0" FIRST FLOOR PLAN DAA 003 00 T THESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS,AS INSTRUMENTS OF SERVICE.ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBLICATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED REUSE,REPRODUCTION OR PUBLICATION BY ANY METHOD,IN WHOLE OR IN PART IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT VISUAL CONTACT WTH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS _ ARCHITECT REVISIONS DES C R I PT ION 9/8/14 29'-6' 10/8/14 ,2'-1' 91 PER NYS CODE _ _ BALCONY - _ " _ I SNGLE PLY RUBBER R0— _ OVER I5/ROOF FELT ON 3/4•CDX PL 91EAlW-PIG.AW—OIB'OC •j PITCH ROOF FRO.RESNENCE I 2'X10'RR 2'X10'RR 6 1fi'or O is"OC. -. PR41GD41R30 30 E FWC 150611 ECREss FWO 60611 _46 W-7 a-ra:•xDR a-raa•xox - - - •I � 11._D. 17_6. - N n _ J SI TTI N G N� X63 �p =oQ bo MASTER _ B E D R O O M _ o Z 0 V W Q � 00 � 0 € b 3088 P ,.�' '� iF AL PNIPS GH C OR WE � raw Y •� o W J W _ - "V O •� n -----— D—110N° �=I — UNNBELO r R L WW.I WTR 031 CLOSET T-6-OW /\ s 0 v V oZ � o SI-IoM I§ •� I U °p BATH 0-- W O 10.OC. W,, 1 I^ - a-D- - _ 9'-0• 7T_' •I //^ Ec ss 1 b I BRE UOW - ' I � . 3-1' 4'-4' 5.2 20._4. V_D' Charles M.-.Thomas 29'-6' _ a r c h 1 t e c t PO BOX 877 JAAIESPORT, NY 11947 (631)727-7993 CROSS- SECTION 1 ` SECOND FLOOR PLA N SCALE 1/4"= 1'-O' SCALE 1/4"= 1'-0" SECOND FLOOR PLAN DAGL 10/20/1 W—G ev CALT A 004 00 THESE DRAWINGS AND ACCOMPANYING SPECIFICATIONS,AS INSTRUMENTS OF SERVICE.ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THBR USE AND PUBUCA00N SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED REUSE REPRODUCTION OR PUBLICATION BY ANY METHOD,IN WHOLE OR IN PART.IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT TITLE TO THESE PLANS SHALL REMAIN WITH THE ARCHITECT VISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS �MT ARCHITECT REVISIONS DES C R IP T I ON 9/B/14 12 10/8/14 B� g-O-PIATE HEIGHT 6-B'TO jKNE W5 I I �OPEN� ------------------ POR NYS RAE PFA NYS CODE I I I I 016--RR 2'XIO"RR 00. I 016,OG I I I TO SECOND OOR Az TO VAN OWS 3 CE X I S T I N G I \♦ !NI // ROOF "� I IQ1 I W rrr 9 � I I b �o Zw 0 �\ I �- o m I FIRST FLO R Q _______________ O W _ Y x iY tam- _ _ I ZO Q � 0 gem P_ U) \ I E R I G H T S I D E E L E V A T 1 0 N DW V a p I 3 SCALE 1/4' =1'-0" Q J W o \�yp I Q J Z �® 1 �� I W P ----------------- I s,o� \� D II I oz U Z Lo 0 W Lo W p I I I W f� I o I R ' 21"X10 RR I f1 C1611 IQ. 016 D I I I I aB I I L ——————r B'_0'PLATE HEIGHT e'-B'TO WIN NS I ` OPEN I 2-X10IIR rl 2'X10'RR I03 OG 'pT O 16'OG I 2846 - I � I T O SECOND Charles M. Thomas I I I OR L----------J 8':"PLATE HT a r c h i t e c t PO BOX 877 JAMETORT, NY 11947 (631)727-7993 Y-0'T0.WIN WS ROOF PLAN SCALE 1/4" = 1'-0" - To FlRBT R ELEVATIONS D— PNm L E F T S I D E E L E V A T 1 0 N A005 00 4 SCALE- 1/4"=1--0" ' THESE DRAWINGS AND ACCONPANWNC SPECIFICATIONS,AS INSTRUMENTS OF SERVICE ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUBOCARON SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY HERE PREPARED REUSE.REPRODUCTION OR PUBLICATION BY ANY METHOD D1 WHOLE OR IN PART IS PROHIBITED EXCEPT BY WRITTEN PERMISSION FROM THE ARCHITECT TITLE TO THESE PLANS SHALL REMAIN PATH THE ARCMIIECTNSUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS T . �m ARCHITECT REVISIONS 0 E S CR IP T 1 ON 12 9/8/14 8 10/8/14 B'-D'PU_TE HOGHT ® El B_B•TQ W1NDOW5- I I I I - I 1 ® I TSECOND FLOOR _-------- ------ O I B'-0'PULE HT I PUTE HT ==H --�---- T CL KINDOWS FE�l FE] L --- --------- - -� I TO FIRST FLOOR TO FIRST FLOOR � - ------- ____ -- -- --- --- o W 0 Q z 0 PROPOSED ADDITION O I�Inn v/ E F R O N T E L E V A T 1 0 N W Q -1 SCALE 1/4•_ ,�-0' zW U_ ° z LoZ a to w W n � 0 R E] 8-0�PUTE HEIGHT - - 1 IFF B'-B•TO WINDOWS -— Charles M. Thomas r D SECOND FLOOR a r C h I t @ C t - 8'-0'PUTS HT PO BOX 877 AESPORT, NY 11947 (631)727-7993 ]-B•rD WINDows PP°�R ' I ELEVATIONS TO FIRST FLOOR -- r = ===7 07/23/14 1 I F SCUS �� REAR ELEVATION NA�001 00 z SCALE- 1/4' �— THESE DRAWINGS AND ACCOMPANYING SPECIFlCADONS,AS INSTRUMENTS OF SERMCE,ARE THE EXCLUSIVE PROPERTY OF THE ARCHITECT AND THEIR USE AND PUSUCATION SHALL BE RESTRICTED TO THE ORIGINAL SITE FOR WHICH THEY WERE PREPARED REUSE,REPRODUCTION OR PUBUCATION BY ANY METHOD,IN WHOLE OR IN PART,IS PROHIBITED EXCEPT BY WRITR'H PERM6510N FROM THE ARCHOECT TITLE TO THESE PLANS SHALL REMAIN WITH 7HE ARCHITECTVISUAL CONTACT WITH THEM SHALL CONSTITUTE PRIMA FACIE EVIDENCE OF ACCEPTANCE OF THESE RESTRICTIONS John M. Bredemeyer III, Presidenti S�FF�k Town Hall Annex Michael J Domino, Vice-President ,so�0 COG 4__ 54375 Route 25 Glenn Goldsmith o �� P O Box 1179 A. Nicholas Krupski o �, Southold, NY 11971 Charles J Sanders 4& p�� Telephone (631) 765-1892 �� ' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: , Completed in field by: Chuck Thomas on behalf of ROBERT SERLING requests a Wetland permit to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 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: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 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: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 John M Bredemeyer III, President UFFO(Kc Town Hall Annex Michael J Domino, Vice-President �o 54375 Route 25 Glenn Goldsmith o P O Box 1179 A Nicholas Krupski �o Southold, NY 11971 Charles J Sandersy�o �Q�^;, Telephone (631) 765-1892 b " Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: 1 �' Chuck Thomas on behalf of ROBERT SERLING requests a Wetland permit to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 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/Calcul ion 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: Zo 4J Date: Completed By: Present: "J. Bredemeyer M. Domino G. Goldsmith N. Krupski .Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 FORM NO.4 TOWN OF SOUTHOLD - - BUILDING DEPARTMENT � � � � �L� Office of the Building Inspector D Vii° EDD Town Hall Southold,N.Y. MAR - 2 2016 Certificate Of Occupancy Sautticld Torn of Trustees No. . . . . . . .Z104.61 . . . Date . . .. . . . . .Apr:U .17. . . . . . . . .. . . . .. 198-1. THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . Location of Property . . 75 -We 1.1.8 .Road . . . . . . .Peaoni¢ Bex• Yer3t• house 140. t Street r Ham%t County Tax Map No. 1000 Section . . . gg . . . . .Block . . . . . . . .2. . . . ..Lot . . . Oy I I. . . . . . .. . Subdivision. . . . .. . . . . . . . . . . . . . . . . . .. . . . . . .Filed Map No. . . .. . . . .Lot No. . . . . . . . . . . .. . conforms substantially to � i 'v � n�$ � �uf �l $�t}� e ,.t0 . . . . .April. . . . . .. . . , 195!.pursuant to whiz2rr8fnM=g'PdM1Md:cu . . . .. . 10461 . . . . . . . . . . . . dated . . . . .AprA 7, .IV. . . .. . . . . . . . . . 19 .$1,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 . . . . . . . . . Private One Family Dwelling with Bathouae. �a . , The certificate is issued to . . . . . . . .William .Danaker . . . . . . . . . . , . . . . (a wrier,lessL,teuavttL.. of the aforesaid building. Suffolk County Department of Health Approval . . . . N.1.R. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . UNDERWRITERS CERTIFICATE NO. . . . .NAR . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . . . . . . .. . . . Building Inspector iivv.1181 John M. Bredemeyer III, President 1 0�� ooG : _ l Town Hall Annex Michael J. Domino, Vice-President ti� , 54375 Route 25 Glenn Goldsmith - y ? P.O. Box 1179 A. Nicholas Krupski �y ��, Y Southold, NY 11971 Charles J. Sanders Telephone (631) 765-1892 = �r Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: o �' Completed in field by: Chuck Thomas on behalf of ROBERT SERLING requests a Wetland permit to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck, construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual/>_ _ "X" � 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 AJ 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 Setback waiver required ,c 0-0 Part of Town Code proposed work falls under: SEQRA Type /Ch. 275 Ch. 111 Type of Application: Pre-Submission Administrative Amendment Xetland Coastal Erosion Emergency Violation Survey <_ 5 years:a Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 7/1 <� Present were: /j,,,Bredemeyer /M. Domino /G. Goldsmith "- NKru ski p V C. Sanders Other Page 1 of 2 N ,� l ✓ t''- F r �° ii r��e a .di+�� f. Self ✓� ,�. r` 1; � � . ° •%M'� i� +} - '�'�,. f �, i j'1�. /j'Fr" +I1 � .��.sr• w__✓� a` �� 'l 3575 Wells Road,Peconic ` ♦Robert 1000-86-2-10 12/10/16 lit ft MAk iew NVIN IL r Ls. i �1x 4 iC' i , ,J� �J 41 �. �Ir Robert Serling 3575 Wells Road,Peconic �SCTM#1000-86-2-10 2/10/16 p (t - ---------- r , 1 p� f rF Q. 4 John M. Bredemeyer III, President j, broti ooMz Town Hall Annex Michael J. Domino, Vice-President �� 54375 Route 25 Glenn Goldsmith C4 P.O. Box•1179 A. Nicholas Krupski �� SoutholdcNY 11971 Charles J.,Sanders ��ol Sao r' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Y W0 Completed in Work Session by: Chuck Thomas on behalf of ROBERT SERLING requests a Wetland permit to add a two-story addition onto the existing•886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575,Wells Road, Peconic. SCTM# 1000-86-2-10 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: T Date: Completed By: Present- ,J'Bredemeyer M. Domino G. Goldsmith N. Krupski Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 .:AMNS . 'OF, PROPERTY 5Q. FT. )/42.2=7:6 VF• C®1 FP Ilo �E P' OF SOUTHOLD SUFFOLK COUNTY, N. r. Spy ALE 20' . FEBRUARY- 11, 2014 50 AUG. U�IE' �54 20�(PR�(RE�ISI,ONS)ADD1TION� Aar.'^: J JAN - 8 2015 Gyp •��'� ��=�'' ��~ c:, � .. £m LIG: NO., 49676 PERM S`UPVEYORS, RC`. (631) 765-=5024 FAX (631) 765='7�7 P:0. `BOX 909 y 1230 TRA,UELER _S73?EET sourHop, fl.Y 11971 14� 00 RAIN RUNOFF',' i EXISTING HOUSE - PI20POSED ADDITION - 09854X1X '.T-= 20"M'I PROVIDE` 2D1Ns. 'l�.;PI 0� :410tCT '4 \\ tea. 4F NYjcv " �� G�RyFAO WiR�,•� � GRAVEL Qv ?p q 0 211 O= ��/ F1is/ ry ��0. �� ,Nary/�;• ,LOT COVERAGE- EXISTING $94 'SQ. FT; PROP. ADDITION 9S0•'SQ.FT. y oQ TOTAL j6'84,.SQ.FT_, AT COMPLETION,OF CbNSTRUCTION . 1884/1613=11.5%. !0 ' X,=, STAKE ® = VUEILAPIDS FLAG EDGE OF WETLANDS; AtjWM & AMA BY JMO' EN'M'RONMENTAL CONSULTANTS s #TIDAL WETLANDS STAKED 3/15/201'5 `®® - ��TS. ��•2 a FIELD •'WORK, WAS COMPLETED WITH 8 OF SNOW cy •�g�, � COVER: WQLK�WAYS .NOT SHOWN HEREIN. G,o ELEVAl IONS REFERENCED TO N �.V.D. 1988 FLOOD .ZONE FROM- ;FLOOD INSURANCE RATE MAP MAS NUMBER 361.03,C01,52H S PTEMBER 25, 2009 AW ALTERATION OR ADD1770N TO 7H1S-SURVEY IS A V76LA710N OF•SECRON 7209,OF THE NEW YORK STATE-'EDUCA710N LAS! AREA=1 1�� o I "8 EXCEPT'AS;PER SEG770N„7203=SUBDIVISION,2. 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) cv� Southold, NY 11971 ® �pQ Telephone: 631 765-1936 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM ® E11 IVE f1l To: John Bredemeyer, President 1 FEB - 9 2016 t Town of Southold Board of Trustees From: Mark Terry, Principal Planner sc tf;cia i�':1n LWRP Coordinator Board olTr e Date: February 9, 2016 Re- Proposed Wetland Permit for ROBERT SERLING SCTM# 1000-86-2-10 Chuck Thomas on behalf of ROBERT SERLING requests a Wetland permit to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. G� Peter Young,Chairman ti Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone Fax(631)765-1823 5 -1889 23 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., February 10, 2016 the following recommendation was made: Moved by John Stein, seconded by Doug Hardy, it was RESOLVED to SUPPORT the application of ROBERT SERLING to construct a two-story addition to the existing residence. Proposed 708 sf. first-floor living area, 240 sf. garage, 282 sf. porch/screened porch and 774 sf. second-floor addition with 236 sf. balcony. Located: 3575 Wells Rd., Peconic. SCTM#86-2-10 Inspected by: John Stein Vote of Council: Ayes: All Motion Carried John M. Bredemeyer III, President ��®F SO Town Town Hall Annex Michael J. Domino,Vice-President ti0 l® 54375 Main Road �v P.O_ Box 1179 James F. King,Trustee IWISouthold,New York 11971-0959 Dave Bergen,Trustee G� ® �O Telephone(631) 765-1892 Charles J.Sanders,Trustee ��lyeoUldTY Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ! To: Southold Town Building Department JAN 12 2016 Re: Verification of Building Department Permit Requirements SCTM#: Property Owner Name: ' Date Sent to Bldg. Dept.: 1IZ1� The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? I►/ Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: Signature of R&iewer r Date Cantrell, Elizabeth From: cdthomas63@aol.com Sent: Friday,January 29, 2016 11:28 AM To: Cantrell, Elizabeth Subject: Serling Residence Elizabeth This email shall confirm that the grade level (16'-6"x 12'-0"0) masonry patio shall remain Thank you Chuck Thomas, Architect cdthomas63(aD,aol com (516) 702-351,9 cell (Can you please confirm by email that you have received this email.) John M.Bredemeyer III, President �®f �® Town Hall Annex Michael J.Domino,Vice-President h0 l0 54375 Main Road P.O.Box 1179 James F.King,Trustee �r Southold,New York 11971-0959 Dave Bergen,Trustee ® �O � Telephone(631) 765-1892 Charles J. Sanders,Trustee Cou TiFax(631) 765-6641 BOARD OF TOWN TRUSTEES �f TOWN OF SOUTHOLD JAN ® � ZO�6 Office Use Only -- --- --- _,'Coastal Erosion Permit Application Wetland Permit Application _Administrative Permit Amendment/Transfer/Extension ` r�/Extension 0 Received Application: j, `�R Received Fee: $ 260,0 >�Completed Application: /112 Incomplete: _SEQRA Classifica 'on: Type I Type II4 Unlisted Coordination:(date sent): .2•-5e�Gi rLWRP Consistency Assessment Form: CAC Referral Sent: b a-7.1& p/ Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: 171(, Resolution: Name of Applicant: W7LI'Q G� Mailing Address: 10 lr- J i LLC-- C'.e1y ::--- 1L i �-7 Phone Number: j `7 �L✓ �— Suffolk County Tax Map Number: 1000 - n( _ -7— r f Property Location: AJoln�L :5 V 60i-J;( (provide LILCO Pole#, distance to cross streets, and location) AGENT: (If applicable) Address: Zo FxX 0-7 Phone: -77 C'C" � I rd of Trustees Applicatio GENERAL DATA Land Area(in square feet): B(p, 471 Area Zoning: Pee, Previous use of property: oW Intended use of property: s,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? / 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. Will this project require any 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? / Yes No Prior permits/approvals for site improvements: Agency Date V/ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? V1 No Yes If yes,provide explanation: Project Description (use attachments if necessary): S7 R" A-9naION 7-0 ?VRVVw0 1"uIdU4 -24o sr- 4Av-A49-,, a�2, 15e V� / S& � o� Aw awri W ark- 23(,:, e,0,J� . E d of Trustees Applicatio, WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: �j/��, � t pe - Area of wetlands on lot: '23 square feet Percent coverage of lot: , o o l - % Closest distance between nearest existing structure and upland edge of wetlands: 15 1 1 feet Closest distance between nearest proposed structure and upland edge of wetlands: 'S 1. (p ' feet Does the project involve excavation or filling? No / Yes If yes, how much material will be excavated? cubic yards How much material will be filled? '10 cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: 01-1 II Manner in which material will be removed or deposited: �1CC�4VR- 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): 0001e - 617.20 Appendix E Short Environmental Assessment Form Instructions for Completing Part I -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 1 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: 5ey---11.1Gt �-7estv 6'e- Project Location(describe,and attach a location map): '�J-1 q! VJ 1 LL-5 i tLe o"It, Brief Description of Proposed Action: rA Lo -2-- sivil A-!V Mori -AV ,�[S LJ I gam Name of Applicant or Sponsor: Telephone: q 3 E-Mail:G d,.V �LI dkr7 L. �✓1. Address: City/PO: State: Zip Code: b J 1 cl 6r-7 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 may be affected in the municipality and proceed to Part 2. 1f no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 9Tx'F -q-110yJ vA� , 40110 124 05, 06c, A--A-- i — A-13 6 — d 1 5 21 / D000 3.a.Total acreage of the site of the proposed action? acres /(of 419 S-T-- b.Total acreage to be physically disturbed? acres CNS c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses th occur on,adjoining and near the proposed action. ❑Urban ral(non-agriculture) ❑Industrial ❑Commercial 'Residential(suburban) 11Forest WAgriculture N/Aquatic ❑ Other(specify): ❑Parkland Page ] of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the site of the sed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: �� 606mgngn 7V1"*" 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES a� 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? NO YES If the proposed action will exceed requirements,describe design features and technologies: Z 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? :NOYES 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? V77- 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: 14. Identify the typical habitat types that occur op,or are likely to be found on the project site. Check all that apply: Shoreline ❑Forest 9 A ricultural/grasslands ❑Early mid-successional C'Wetland 11 Urban L�}'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 from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? f/NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and g6rm drains)? If Yes,briefly describe: ❑NO YES ?� - 17(�QU kV Page 2 of 4 • \ 11 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: 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 ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE 1 Applicant/sponsor Date: L I L l9Dl 1 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning v 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 characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or 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)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? 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 sed agtion will not result in any significant adverse environmental impacts. ,Namelk,Y4 4 1-f ) /� of Led Agcy Date c � ^X"M Print or Type Naie f Res onsible Officer in Lead Agency Title of Responsible Officer Signatur espon ible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 Feb, 16. 2016 4;OOPM -- ERTIFIED ■ .No, 2661 P, 1 'r! ,, ra U1 PEGNif"19F�%l L 'ff CarhfiedMailFee 33.45 0947 - -�-- - -- ----- ---- ,m $ 06 JAMESPORT _- n (rJ ea9rcft%addfm 1451 ROUTE 25 ❑eenenFl 06FIV-00P» $ JAMESPORT o ❑F-MIW41(er�c+,04 s i�..:!.�0L aoe� NY d ❑Cerli WMadR.Irkiado rmy s a ","� Halo 119479700 (:3 QAdMianalemAnind s 00- 3541750947 ❑'�" '`a°per"'°'°°°m°"S 02/09/2016 (800)275-8777 2,50 PM � Postage W. 49 X 02/09/2016 Total Pesragcend Foos Final 46,74 Sale •-------�-------------- �=�== o Pro4`t1Ct rn son Descriptlon Qty Price ra 5(4UAA w 5e A Siroor ��11+R 0 tax ffa ------------------__....................... 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L, - - 3�� - - ' cry,stele, +a��•� `�rp ��os�FFOt� rown Hall Annex John M. Bredemeyer III, President dr Michael J Domino, Vice-President '_ til 54375 Route 25 Glenn Goldsmith NP.O. Box 1179 A. Nicholas Krupski ��y ® Southold, NY 11971 Charles J. Sanders t ��l , ��oy' 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 ROBERT SERLING COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS residing at/dba J�JA being duly sworn, depose and say: That on the 41 day of lr?j , 2016, I personally posted the property known as ter! w�� rte, l 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,February 17, 2016. Dated: ignature Sworn to before me this 14 day of�f.�j 20 Notary P lic MANCIS J,YAKABOSKI Npligy Public, State of New York No,g Qgolil<ied in Suffolk County t g�{FII'"Ibglgn Expires April 30, 19 k NOTILL OF HtAt< ING 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: ROBERT SERLING SUBJECT OF PUBLIC HEARING : For a Wetland permit to add a two-story addition onto the existing 886sq.ft. one-story dwelling by removing the existing 323sq.ft. deck; construct a 708sq.ft. first floor footprint area; a 240sq.ft. attached garage; a 282sq.ft. seaward porch including screened porch; second story addition to include a 236sq.ft. balcony; and the existing waterside 16.6'x12' on-grade masonry patio to remain. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 TIME & DATE OF PUBLIC HEARING : Wednesday, February 17, 2016 — 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 ri � ti{rY Vi iifiP VVOO sf�/k/.�riVakr d.V/ _ I ' r AUTHORIZATION (where the applicant is not the owner) 11 w �`�- residing at l,0 t�v.k, (print name o ner of prop •ty) (mailing address) do hereby authorize (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf, ( ner's signator ) w..v. Va. s, arwvva..a atrra...vw....r AFFIDAVIT j}z _� Lru C� 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 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. ;i ature a Prop rty Owner SWORN TO BEFORE ME THIS DAY OF ®V,5qA54, , 20 /6' Ealy Public ERT NOTARY PUBLIC,�S alteof New York No. 01 WE4851646 UQualified in Nassau County Commission Expires February 3, 20 I APPLICANVAGENTMPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics rolribits conflicts of interest on the part of town afffcers mid employees.The purpose of this form is LA pmvide inforination which can alert the town of possible conflicts of mtcrest and allow-it to take whatever actron is neto avoid some / YOURNAME.- (Last nam me,first name,.nt a initial,unlcs&x&are applying to the name of someone else or other entity,such as a company.If so,indicate the.other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance' Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship.with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"•means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO if you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSI4IP Submitted this ld day of VC 200 Signature Print Name l Fonts TS l 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 : 6&VAA —"2 I - ,-� (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) 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) 13)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 e Submitted this day of ,20 Signature Print Name f EI�1 tA� r 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 significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3: ;If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's 'website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# - d Z - 10 PROJECT NAME^ !S C7-1,l hl t1 tJ ez---rV r' The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees EK 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: Rr Nature and extent of action: Location of action: '�j r✓ �� GLLS Y10MO ��"?�ON l C- Site acreage: } (01 Present land use: Wq C'e— Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (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 EK If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ i 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 ❑ Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria dYes ❑ No ❑ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria 21 Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes ❑ No ❑Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. dYes ❑ No[:] Not Applicable 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. ffyes ❑ No ❑ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeJXNo❑ Not Applicable Attach additional sheets if necessary j 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. 9yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. RfYes ❑ No ❑ Not Applicable ' Attach additional sheets if necessary Policy 12. 'Protect agricultural lands in the Town of Southold. See LWRP Section III —Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No PrNot Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; P ges 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY� &&2E TITLE A" � DATE