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TR-8743A
Michael J. Domino, President OF S0(/ryo Town Hall Annex John M. Bredemeyer III,Vice-President �� lQ 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold, New York 11971 A. Nicholas Krupski • Q Telephone (631) 765-1892 Greg Williams O Fax(631) 765-6641 IyCOU�,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1459C Date: April 3, 2018 THIS CERTIFIES that the abandonment of existing sanitary system, and demolish and remove existing dwelling, At 2793 Cox Neck Road, Mattituck Suffolk County Tax Map #1000-113-8-7.6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated February-l9, 2016 pursuant to which Trustees Administrative Permit#8743A Dated March 23 2016,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the abandonment of existingsanitary system and demolish and remove existing dwelling,; The certificate is issued to Justin&Allison Schwartz owners of the aforesaid property. e Authorized_Signature 4 i y^ Michael J. Domino,President OF SU!/ryo Town Hall Annex John M..Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A. Nicholas Krupski G • Telephone (631) 765-1892 Greg Williams �O C0U�, Fax(631) 765-6641 Iy ��.` BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction % constructed Project complete, compliance inspection. INSPECTED BY: G - G o IJ Sri I COMMENTS: 01K - p'Ca )a4A O< }o iSSue C o CERTIFICATE OF COMPLIANCE: r John M.Bredemeyer III,President 0� ®g soU�yQl Town Hall Annex Michael J.Domino,Vice-President fi . 54375 Route 25 P.O.Box 1179 Glenn Goldsmith cry ; , Southold,New York 11971 A.Nicholas Krupski �`�, ® y0 Telephone(631)765-1892 Charles J.Sanders of Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 30, 2016 Robert E. Herrmann En-Consultants 1319 Forth Sea Road Southampton, NY 11968 RE: JUSTIN & ALLISON SCHWARTZ 2793 COX NECK ROAD, MATTITUCK SCTM#: 1000-113-8-7.6 Dear Mr. Herrmann: The Southold Town Board of Trustees reviewed the survey prepared by Kenneth M. Woychuk, Land Surveying, PLLC last dated January 28, 2015, and determined that the proposed dwelling, swimming pool, drainage system, and sanitary system are out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. 2 This determination is not a determination from any other agency. If ypu have any further questions, please do not hesitate to call. Sincerely, john, M. B-r demeyer, III, President Board of Trustees JMB:dd WE HAVE READ THE FOREGOING AND AGREE TO IT CONTENTS: J IN SCH AR ALLISON SCHWARTZ �x-ruz: John M. Bredemeyer III, President ;yo�oSUFFOtx�,G c Town Hall Annex Michael J. Domino, Vice-President h �� yam`, 54375 Route 25 Glenn Goldsmith � z t P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders ti;v�iol ��� '� Telephone (631) 765-1892 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 complete,lete liance inspection 1 p com p p John M. Bredemeyer III, President O��OF SD�ryOl Town Hall Annex Michael J.Domino,Vice-President ® 54375 Route 25 P.O. Box 1179 Glenn GoldsmithCOO Southold,New York 11971 A.Nicholas Krupski ® �@ Telephone (631) 765-1892 Charles J. Sanders OI�COU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8743A Date of Receipt of Application: February 19, 2016 Applicant: Justin & Allison Schwartz SCTM#: 1000-113-8-7.6 Project Location: 2793 Cox Neck Road, Mattituck Date of Resolution/Issuance: March 23, 2016 Date of Expiration: March 23, 2018 Reviewed by: Board of Trustees Project Description: Abandon existing sanitary system, and demolish and remove existing dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated January 28, 2015, and stamped approved on March 23, 2016. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. John M. Bredemeyer III, President Board of Trustees ,.�, — �, f► _ #tee',:; �.r��,�. 'r .�. 1 .. •���' 4., `-r _ - yam. '- ��.,. or- 41 '10 w l �•.�i.4 x +"3.+� 1s� �•� ���� ti' - A1C'.� �1.;,� '�` _ ..- ''91R�'�`^'-!:� � IPAle wAs Y - �� ! .�` ».T�q,:..�` ��- _"�'.L.tr7-��c.._ ` ' y _•fir,• ..��. � - :. �.,. � ` — /��► ... �t "' �: t +'E_';'' � . . ��.',r,� r; �'',-r 1'.�s�'y{ .;� � ti..w i� ,�I'�'f`.�,'�„ � rte-;- • ,�.. y, GooSlc Bart ■.:�IY,r.�r s� _ +�i.. �- �,+��#I-�.irk 4.s"' �'�i. ,-.�,'W i;-. - �'.:;.r•;�,�1�.. �',�" • i Nook A Y ; 71, JL ,4 Go,j(gl(! earth feet 400 meters 100 Google earth , i John M. Bredemeyer III, President �A 14, Town Hall Annex Michael J. Domino, Vice-President - ���o 2y 54375 Route 25 Glenn GoldsmithN = ' P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders 4,, Telephone (631) 765-1892 �� ��+''✓ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: --3116 A , 4' G Completed in field by: G1ei)n430'd S.-P I '� En-Consultants on behalf of JUSTIN & ALLISON SCHWARTZ request an Administrative Permit to abandon existing sanitary system, and demolish and remove existing dwelling. Located: 2793 Cox Neck Lane, Mattituck. SCTM# 1000-113-8-7.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� 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: _n �toc" ��M�,�,�o d►c� oe;,o� a bot c�t�o n r'1 e;�� . Present were: J. Bredemeyer ./P M. Domino kZG. Goldsmith N. Krupski /C. Sanders Other Page 1 of 2 t P John M Bredemeyer III, President ; ��SUFFOIK�o Town Hall Annex Michael J Domino, Vice-President 54375 Route 25 Glenn Goldsmith o ` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J..Sanders �i,'y,�j0 ao� Telephone (631) 765-1892 rl�6r Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: ) 1 Completed in Work Session by: , En-Consultants on behalf of JUSTIN & ALLISON SCHWARTZ request an Administrative Permit to abandon existing sanitary system, and demolish and remove existing dwelling. Located: 2793 Cox Neck Road, Mattituck. SCTM# 1000-113-8-7.6 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 J/� 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 UI..m,.e ., I � ,t,Nmm,.,n I v+4 —___—I s.e tm --P--I,nv.roweuv--wx--I „.nwaE •w TIO PEAo1MN1FNPERtaAV00Of TBE .�� -"-. A •�. ._.-...,.,. 21 Nc1 I IPR EATYtA%6EMICEAOENCYI h W 019TWCT N9 �pLb.,. +uAacr•` P - �' PROPERTY MAP Pt.1r �• • MATCH A'2 AAAI-) SEE SEC NO 106 SEFSEC NO 198 m E S UN AOAl-)_ 15A1-) E 9EE.EC NO'oT� w MATCH UNE MATCH LIN a� !� Y '4+_�+c\ NATC I1NF N -- ZZ-- T. 'V FOR PCL NO i�r j A FOR PCL NO SEE SEC NO ' + -) SEE SEG N 10.401-003.1 4 13•`t, $ 0 17A1c) 4 L 108-419 FOR PCL NO M1 c ! 4Q'+. M1+,�'l 5 •F i? a+0° u s; A i✓ M13 1 , d 4 IE SEES EC NO A Im 5 MAI-) y 6 S ,`s, /� M11 4 FOR PCL NO ds AQ ii+9A11 P Z m 3s 1442U912SEE SEC 0. 195-91-098 3 F, b'.Q s „p T 2 • y O_ m �/ +~ + O +lPl-) Q+F cb � n 2 P1 1v f 9 $ -� 98N.) •Oy't+o L O •£`S tm� tm Pn _ml _ , n0 9 tout +2g %!�o z 2 ® s ,,,2�4 s �LANDINc £ 4 •/ 0�' /-- � m '� • m� m w- � �w9 gg n ' � � N SOS - _f / NIIRT - Q 16 121 314A PCm9tAA9RniAol4t�A[q n°p ~\\ a,?AA/C, OP m/ o + �• � r e. o q �\_ �•ate t m��o,.PO 91pld , $ Qa QD ® All i `,v. 'b q m -bnm,• ,,�,.1°\ +sP+` 91 25 m O-� '11°p. I N sY ' .1 q `� 3•` `eN+t `'4 n AA 193 2a9A 8.9A + t,p r, •1t 1% IiN' y4+- d'''1 `` `c°�`5 6'�(``+ ^' a• 1194 20 nl s e^i' 'T I FOR PCL NO y �� y 7. tm\ +`^t`d 4.c1 u-) 21 SESEC NO � 3 $ 1sA� ® °g�..9s9 c Aq� '+'° 16 m�� 1',m;+1 ypt 1''®;� ��t°�' +iy��� •�'3�p ,n 1�`\ 'mo ° c°• $ � d � s y 1q�,p 1 - tA' `° + 't �' ®° �'-�a,�` aP'�: 1i^ P i P �• `!_'d, 'P a 4714-)-( /d 1i A 14 32A $ °11 B a n As it �<+ ,4 m 9�y11'E � £M1. ® tt Ast' • t111d1 II 0s . 3n gFP "s qT a a• + 1 P`'I I '�' S° 14 , A � 6 110P 1 19++ 18 �tN I'S ' > 1T OA ``• b ,a 156 24A(c) , ''s 3 a jg a- 1.16 M1+ 1926 O �1g z9 am.) Rrnm oFsanuaa y. \5tl\ •y M1 " ,d t •* alz: oAv¢wvENrRmrtL `d +924 2 oAlc) d 3 a t 191] 25 FOR ' 4 i SO23 A 19 N SEE SEC NO 1zn1-0oz s 1911,PP o d 24 SOA P S23A m am a` S a, 2 1 COUUNNTTYoEEARIetEI+EOF SUFFOLK +1+P i l SI 23 21 q P e•j4. FOR PCL NO 50P 5� n d SEE SEC NO 120-05-0°1 0 ye`1 LINE MATCH ---LINE 1 A ) a 1N°RTM p.0) SEE SEC.NO 121 °p SEE SEC NO 121 $ t A� ++ t2 p �.,R AB ..� M)ppl.E F L >mx.,. ero ., ^,. ------ o...,,.. --sc-- ,nom__:__ .aosmc NOTICE cOV COUNTY OF SUFFOLK © K t oa m+OE SOUT10L0 SECTION NO E121) i„IReal Property Tax ServlceAgency v E ..a,.�.. ----- w u. --- I»nr — -- cm.ty—.w —ad.Nr 1901 M t to wcE o. 113 2A .•.�atw=Iv1,A w —__— �� --.-- w... a t wcEACEucEO ''tigg.C" m P t 01 sTmc*uo t00o t2t 122 0 PROPERTY MAP Atc) mxvEP.woxa,cE a.svts f OT; _ �{ a _wti _ � � `�i -' ./ �d _, � a���3s;Y�•a ��i� t3 �; ,y�d�`=i aa, t 'b _ 4 •ter � �p �' i' 1� r „% ' � � I � i L I � .c � JUSTIN AND ALLISON SCHWARTZ,2793 COX NECK ROAD,MATTITUCK i-d,- j� tar } j f Figure 3. Looking south at easterly/waterfront side of existing dwelling and deck to be demolished and removed(Mattituck Creek to left). v, NO r ' s7, 1. N tr,. S', ' � a• Figure 4. Looking east toward Mattituck Creek from waterfront deck/dwelling to be demolished and removed. OFFICE LOCATION: SO SLING ADDRESS: Town Hall Annex '` P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) cn' Ac Southold, NY 11971 �- Telephone: 631 765-1938 ----- ------ LOCAL WATERFRONT R.EVITALIZAT] TOWN OF SOUTHOLD d' MEMORANDUM o-e— c— Ie_�r- To: John Bredemeyer, President ll Town of Southold Board of Trustees �� �eScrip on From: Mark Terry, Principal Planner LWRP Coordinator Date: March 14, 2016 i I Re- Local Waterfront Coastal Consistency Review for JUSTIN &ALLISON SCHWARTZ SCTM# 1000-113-8-7.6 En-Consultants on behalf of JUSTIN &ALLISON SCHWARTZ request an Administrative Permit to abandon existing sanitary system, and demolish and remove existing dwelling. Located: 2793 Cox Neck Lane, Mattituck. SCTM# 1000-113-8-7.6 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. FQ(Xdd James F.King,President ti Town Hall, 53095 Main Rd. Bob Ghosio,Jr.,Vice-President r P.O.Box 1179 Dave Bergen 'g Southold,NY 11971 John Bredemeyer ��/P� Telephone(631) 765-1892 Michael J.Domino Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Applicatio _Wetland Permit Application Administrative Permit Amendment/Transfer xtension Received Application: Zi '-+'��D Frr� _y M Received Fee: ®�(� s _ Completed Application SEQRA Classification. ; FEB 1 9 2016 Type I Type IIUnlisted ; Coordination: (date sent) r�LVW Consistency Assessment Form t Sau;Gi l f irvrS E CAC Referral Sent: Date of Inspection: 3 �� Receipt of CAC Report: Lead Agency Determination: Technical Review: Public Hearing Held: -2?i Resolution: Name of Applicant Justin&Allison Shwartz 166 East 35th Street,Apt.3G Address New York,NY 10016 Phone Number: aL71 917-509-0502 Suffolk County Tax Map Number: 1000 - 113-8-7.6 Property Location:2793 Cox Neck Road,Mattituck (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road, Southampton,NY 11968 Phone:631-283-6360 Board of Trustees Npplio;l dor, GENERAL DATA Land Area(in square feet): 117,102 Area Zoning: R-80 Previous use of property:Residential,single family dwelling Intended use of property: No change Covenants and Restrictions: Yes X No If"Yes", please provide copy. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept• Yes X No Does the structure(s)on property have a valid Certificate of Occupancy Yes No Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description (use attachments if necessary): Abandon existing sanitary system and demolish and remove existing dwelling located less than 100 feet from wetlands, as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated January 28,2015. All construction activities associated with the proposed dwelling,swimming pool,drainage system,and sanitary system will occur more than 100 feet from wetlands and thus outside Chapter 275 jurisdiction. oard of Trustees NppliceLti: WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To replace an aging dwelling and sanitary system located less than 100 feet from tidal wetlands with a new dwelling,associated structures,and sanitary system located more than 100 feet from wetlands and beyond Chapter 275 jurisdiction. Area of wetlands on lot: +/-3,910 square feet Percent coverage of lot: +/-3.4% °% Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? Yes If yes, how much material will be excavated? N/A cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): The portion of the proposed site redevelopment located within 100 feet of wetlands and thus requiring a Town Wetlands Permit includes 1)the demolition and removal of an existing dwelling and deck that is located 59 feet from wetlands and occupies roughly 1,100 square feet of the wetlands regulated area;and 2)the abandonment of the existing sanitary system located 68 feet from the tidal wetlands boundary. Outside Chapter 275 jurisdiction,a new dwelling structure to be equipped with a new drainage system of leaders,gutters,and drywells will be located at least 106 feet from wetlands;and a new,upgraded sanitary system will be located at least 165 feet from wetlands. Site disturbance during demolition will be contained by a project limiting silt fence on the waterside of the existing dwelling,and upon completion of demolition, a second silt fence will be installed along the 100'wetlands setback to limit all site disturbance associated with the new construction to the area located landward of Chapter 275 jurisdiction. Therefore,as a result of the project,there will be no longer be any residential structures or sanitary facilities located within 100 feet of wetlands;the control,collection,and recharge of site drainage will be improved;groundwater and surface water quality will be protected and improved;and there will be a net improvement to the environmental condition of the property with respect to the protection of the adjacent tidal wetlands ecosystem and tidal waters of Pettys Pond. 617.20 Appendix B 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 I based on information currently available.If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: Schwartz Residence Project Location(describe,and attach a location map): 279 Cox Neck Road,Mattituck,Town of Southold,Suffolk County,New York;property located on east side of Cox Neck Road,+/-455'north of Meday Avenue, maps provided. Brief Description of Proposed Action: Abandon existing sanitary system and demolish and remove existing dwelling located less than 100 feet from wetlands, as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated January 28,2015. All construction activities associated with the proposed dwelling,swimming pool,drainage system,and sanitary system will occur more than 100 feet from wetlands and thus outside Chapter 275 jurisdiction. Name of Applicant or Sponsor: Telephone: 917-509-0502 Justin&Allison Schwartz E-Mail: justin@sageay.com Address: 166 East 35th Street,Apt.3G City/PO: State: Zip Code: New York NY 10016 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.If no,continue to question 2. X 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: NYS DEC, SCDHS X 3.a.Total acreage of the site of the proposed action? 117,102 sf b.Total acreage to be physically disturbed? +/-28,200 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 117,102 sf, 4.Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ®Rural(non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 5.Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? X b.Consistent with the adopted comprehensive plan? X 6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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: X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 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: X 10.Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: A new connection to the public water X supply is proposed. 11. Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: A new SCDHS compliant sanitary X system is proposed. 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? X X 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? X b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply. ® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ® 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? X 16.Is the project site located in the 100 year flood plain? NO YES X 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? ❑NO❑YES X 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: X 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: X 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: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Rob4t E.Herrmann,Coastal Mgmt. Specialist Date: February 18,2016 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 I and other materials submitted by the project sponsor or otherwise available to the reviewer.When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 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, I waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may 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 I 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 pro osed action will not result in aficant adverse environmental impacts. Tn,1n signi -3-- JI-0-16 __—Name of Lead Agen ' -Da� Print or Type Je of Res onsible Officer in Lead Agency Title of Responsible Officer Sign re of Resp onsi e Officer in L Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 ao � Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Q� 1000 113 8 7.6 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK- PROPOSED CONSTRUCTION ITEM#/WORKASSESSMENf Yes No a What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within 117,102 sf Generated by a Two(T)Inch Rainfall on Site? / ❑ the Scope of work for Proposed Construction) (S F./Acres)) .LXX(Thus item will include all run-off created by site b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed -I-/-28,000 sf Site improvements and the permanent creation of construction activity? (S F/Acres) impervious surfaces) 2 Does the Site Plan and/or Survey Show All Proposed XF PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location?This item shall include all proposed Grade Changes and Abandon existing sanitary system and demolish and remove Slopes Controlling Surface Water Flow, existing dwelling located less than 100 feet from wetlands,as 3 Does the Site Plan and/or Survey describe the erosion X ❑ depicted on the site plan prepared by Kenneth M.Woychuk and sediment control practices that will be used to Land Surveying,PLLC, last dated January 28,2015. All control site erosion and storm water discharger.This construction activities associated with the proposed dwelling, Item must be maintained throughout the Entire Construction Period. swimming pool,drainage system,and sanitary system will occur more than 100 feet from wetlands and thus outside Chapter 275 4 Will this Project Require an Land Filling,Grading or ElExcavation where there is a change to the Natural jurisdiction. Existing Grade involving more than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the ❑ X Site?Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres:urludmg disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes ElX are part of a larger coirmion plan that will ultimately disturb one or more acres of lands; which Exceed Fifteen(15)feet of Vertical Rise to IndudingConstnicuonactivities involving soil disttnbanc-es of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges Q (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit O Will Driveways,Parking Areas or other impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off 1:1X 1.The SWPPP shall be prepared prior to the submittal of the NOI The NOI shall be into and/or m the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, 1:1X required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit In addition,the SWPPP shall Area?(This item will NOT mdnde the installation of Driveway Aprons.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges NOTE-If Any Answer to Questions One through Nine is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F &1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storni Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. g P P P ge ACheck Mark aid/orAns"w for each Question is fora leted cation STATE OF NEW YORK, COUNTY OF Suffolk------------------------SS That I, Robert E.Herrmann --------------------being duty sworn,deposes and says that he/she is the applicant for Permit (I�usofirAvidtalsgftDmx m1) And that he/she is the Agent --------------------------------------------- - ---------------------------------------------------- (Onra,Caitrada Aq�rt CaperateClfi—etc Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed.in the manners set forth in the application filed herewith. Sworn to before me this; 18th day of_February--------------------- -20 16 ---------------------------- -- ------- Notary Public _____ ___ _ ---- K_lM---d_.__S T EP N E N S -------------------- --- ---------------------------------------- ---- ------- ------------------------------- NOTARY PUBLIC nature of Applicant) FORM- 06/10 STATE OF NEW YuKr% COMMISSION NO . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 . 204- Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I Justin Schwartz residing at 166 E.35th St.,Apt.3G (print owner of property) (mailing address) New York,NY 10016 do hereby authorize (Agent) En-consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Ovune s signature),Is wartz Board of Trustees Application County of Suffolk State of New York Justin Schwartz BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature,Ju stin chwartz SWORN TO BEFORE ME THIS "I DAY OFC41N�y ,�( ,20� RY PU •` 0 , NG No.41ZE7 Exp.10125118125/18 � otary u lic se y0 FOF N�� 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Schwartz,Justin (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X 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 1 day,of 204 S Signature — Print Name ustin ScTwartD Form TS 1 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Allison Schwartz residing at 166 E.35th St.,Apt.3G (print owner of property) (mailing address) New York,NY 10016 do hereby authorize (Agent) En-Consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature),Allison Schwartz Board of Trustees Application County of Suffolk State of New York Allison Schwartz BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. �- Signature,Allison Schwartz SWORN TO BEFORE ME THIS t DAY OF T- C�VY\ ,20 15 p�Y PU rf G No.OlZE6229917 Exp.10125118 otary Public S TFOF NE�y APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Schwartz,Allison (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee �— 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 thik day of VL, 200 (S- Signature :!,-- Print Name Allison Schwartz- Form TS 1 Town of Southold - LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for perm its' including Town of Southold agencies, shall com plete this CCAF for proposed actions that are subject to the Town of Southold W aterfront Consistency Review Law , This assessor ent is intended to supplem ent other inform ation used by a Tow n of Southold agency in m a k i n g a d e t e r min a t i o n o f c o n s i s t e n c y. *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 icant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 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# 113 - 8 - 7.6 PROJECT NAME Justin&Allison Schwartz The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ❑ construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification: Nature and extent of action: Abandon existing sanitary system and demolish and remove existing dwelling located less than 100 feet from wetlands,as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated January 28,2015. All construction activities associated with the proposed dwelling,swimming pool,drainage system,and sanitary system will occur more than 100 feet from wetlands and thus outside Chapter 275 jurisdiction. Location of action: 129 Inlet Lane,Greenport Site acreage: 17,979 s.f. Present land use: Residential,one-family dwelling. Present zoning classification:R-80 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: Robert&Heidi Bailey (b) Mailing address: 16 Ryan Drive Ellington,CT 06029 (c) Telephone number: Area Code 860-565-2025 (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?NYS DEC,USA COE,NYS DOS 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 ® Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ®Yes ❑ No ❑ Not Applicable The proposed site redevelopment is consistent with Policy 3 to the extent that the removal of the existing dwelling located only 59 feet from wetlands and placement of the new dwelling landward of Chapter 275 jurisdiction will increase the open space and visual buffer between the residential development and Pettys Pond. 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 Consistent with Policy 5,groundwater and surface water quality will be both protected and improved as a result of the project due to the landward relocation of the dwelling and associated sanitary system outside Chapter 275 jurisdiction and the installation of a new drainage system of leaders,gutters,and drywells. 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 LWRP CONSISTENCY ASSESSMENT FORM ADDENDUM FOR JUSTIN &ALLISON SCHWARTZ 2793 COX NECK ROAD MATTITUCK,NY SCTM#1000-113-8-7.6 Policy 6 The proposed site redevelopment includes 1) the demolition and removal of an existing dwelling and deck that is located 59 feet from wetlands and occupies roughly 1,100 square feet of the wetlands regulated area; and 2) the abandonment of the existing sanitary system located 68 feet from the tidal wetlands boundary. A new dwelling structure, which will be located more than 100 feet from wetlands and beyond Chapter 275 jurisdiction, will be equipped with a new drainage system of leaders, gutters, and drywells; and the new,upgraded sanitary system will be located well outside Chapter 275 jurisdiction, at least 165 feet from wetlands. Site disturbance during demolition will be contained by a project limiting silt fence on the waterside of the existing dwelling, and upon completion of demolition, a second silt fence will be installed along the 100' wetlands setback to limit all site disturbance associated with the new construction to the area located landward of Chapter 275 jurisdiction. Therefore, as a result of the project, there will be no longer be any residential structures or sanitary facilities located within 100 feet of wetlands; control, collection, and recharge of site drainage will be improved; groundwater and surface water quality will be protected and improved; and there will be a net improvement to the environmental condition of the property with respect to the protection of the adjacent tidal wetlands ecosystem, all consistent with the goals of Policy 6. See attached. 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 ❑ 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. F-1Yes F1 No® Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's ....ger-de endent uses and promote si of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 5� 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. ❑Yes ❑ 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 ® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PREPARED BY TITLE Coastal Mgmt. Specialist DATE2/18/16 Robert E.HerrifiarNO Amended on 811105 4; AM EN-CONSULTANTS February 18,2016 RF,QUR T FOR AN ADMINISTRATIVE WETLANDS PERMIT Town of Southold Board of Trustees 54375 Main Road Post Office Box 1179 Southold,New York 11971 Re: Justin&Allison Schwartz 2793 Cox Neck Road,Mattituck SCTM#1000-113-8-7.6 Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Three(3)Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization&Disclosure Forms; 2. , Site plan prepared by Kenneth'M.Woychuk Land Surveying,PLLC, last dated January 28,2015. 3. One(1)set of site photographs. 4. Application fee of$100.00. 5. Three(3)LWRP Consistency Assessment Forms including: a) Site plan(as referenced above). I trust this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sincerely, Robert E. Herrmann IF Coastal Management Specialist h FEB 19 2016 f` f . 1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.encbnsultants.com environmental consulting S.C.T.M.# DISTRICT: 1000 SECTION: 113 BLOCK: 8 LOT: 7.6 & 7.8 ELEV. 13.3 SM BROWN APPROVED BY FFL EL(21.6) I SILTY SAND TYPICAL SILT -4' BOARD OF TRUSTEES FOUNDATION SCREEN SECTION Q WALL C.I. LOCKING GEOTEXTILE FABRIC Q SP BROWN FINE �� O� `s PALE 0 COVER TO GRADE CELLAR SLAB Et(f15) FINISH GRADE SUPPORT POSTS �_ SAND WOOD OR METAL DATE im 1'MIN-2'MAX (Q g FLOW DIRECTION 6" COVER 6" COVER EXCAVATED AND ELEV 2.7 -10.6' 6" lV 6" SCAB BACKFILLED TRENCH UUU INVERT-/ INVERT h0.0) WATER IN n (10.45) (i0'2J)INVERT INVERT EXISTING GROUND SP PALE (9.75) (9.87) BROWN UPON COMPLETION OF DEMOLITION FLOW 8'0 3' COLLAR _ _ - °a' SAND SILFINE OFT FENCE WILLL BE INSTALLED ALONG BAFFLE MI POOL CLEAN �:x`'. �� - THE 100' TIDAL WETLANDS SET BACK LINE `} COARSE _ I I I� •I ~r: I I I� ��I I G PRIOR TO NEW CONSTRUCTION. SAND & 3'-8" GRAVEL =TI ' I��-I I t TANK 3'MIN -� 4• z'MINIMUM 17' I 71E LINE DIMENSIONS MCDONALD GEOSCIENCE 1 1�j ALONG HIGH WATER LINE. USE 4" DIA APPROVED SEWER PIPE JAN. 20, 2015 TO BE DEMOLISHED 00' -'--l\ r 1,000 GAL. S.T. (r;.o) 2 STY ERM. � ACK DWELLING r , q^'DS S /2793 1 W FFL 23.0G� WATER SERVICE DETAIL °`�GROUND 5� NE DRIVTINGEWAY OF 147 �Sz `---'' STONE DRNEWAY WATER EL 2.7 TO BE REMOVED. + MON. �U pNIF P �Np N/E v�P� ��."O&O's RE�p6 1X4 V00I,' SN 65' r n VF P SNp,N RE c4 2 \$ 16 t�`1 ` �-� J r r r ��-� r �• r DWELL NG TYPE "K" 1SOFT0PPER COPPERTINGUBING �PR�S�pEP W/PUBLIC1 WATER MON °"" 5 pNCE 150' 4.6N/� � I \ • O �^ or - 2� Za c> \. . _- _- _- EL(22. M TO DWELLING-►- J N_ MON. Ac16�Q _�,� __ _ y ""••"" .��2" PLASTC PIPE c .o PROPERTY LINE (605' RUNE) 37s� rrrr rr rr rr .- •� cs R'3� r r r r r SWAY - - :• '.::?w...:.�::: F• 11 \ / yr--'C�-� r r r r r . (S 26 u.P. o.;^. : •..: `:`. �a 16.0) 1 \I fy';`�`r��Sg r r r r RT p .. EXESPN- \ :::s:a.::. 'N - 1106 'ado N 1 Jp .F.v ltr r r INGRESS & EGRESS \ OIL FOCO/ epos LID 510 i U.P. "4..•;• 2� ::,;•; - y� ,1,': 1 2��ie.` -� , �' r RIGHT OF WAY per �,_�'' ,©2�rE . \'' •` '�•. ;:;`.`if; Pfr LEER 72370 PG. 357 �. Qo52 (ro ) i \';''�\• .':'.. .ij::ti{Si ;::. \a '•,Z „ •.r• ••• ::••'•"''""•• .) b CKp TIDAL WEn ANDS BOUNDARY _ LPN OF MPVL i•• S� .;... 1 WE1J� .i �R ., 5:i:c:::.: ,, G j P�S EN-CONSULTANTSDI�17/f4 GORGE U.P. tln�" N 5 prKv' `T �� �' cF �1oT d ST y,TN=:.•..._ y ;: .. I�Or\F F.0 �0 �(./�� DWELLING 'Q2 E PROPOSED WATER SERVICEfy(110 :•'�Cj \ i G`` J� 805'* RUN • ' n W/WELL WATER 7052 -� 0"31 Zc0`L91* 1'TAP W/2"SUPPLY LINE PROPOSED EX !P � ,QO <S P AREA OF DISTURBANCE 1 LP N1 LP 28,200 S.F. :plfo J nPROPOSED , . Ao �.•' �,�FENCE ��� (O F 5-81 SYSTEM S (5}8 OIAx4'DEEP LP. U. U.P. Op �-' �.,� PROPOSED P� ptlE �� o' „E 112• .. o. 4'DIAx4'DEEP ON C PROPOSED MONN 77o . o s°yo.3N r Pool MY WELL POOL EQP.1S30. LAND N/F :�s50•em..:•..;•:`":.8.0' . 3N ::.:. . o'. ~ OF 101 ::...:.:P.00.::::. . :::: ` LOT 58 9s COYOTE PROPERTIES LLC l �i(d Q �lyrL FENCE 113.2'Q DWELLING 7 Q 1 •et „ W/PUBLIC WATER � C11 , 0.5'E S77o 16'30 W PROPOSCE U .Z 0.1'N AREA OF RE-GRADING 4' E STES FEN ` O w N FROM ON SITE EXCAVATION WILL MILIZE OF PROPOSED DWELLING do POOL 1 `� v d w N t----,LOT 59 I'� TOWN OF SOUTHOLD LOT COVERAGE (UPLAND AREA LANDWARD OF TIDAL WETLANDS BOUNDARY) (113,192 SQ.FT. or 2.60 ACRES) O PIPE !"1ON• EXISTING PROPOSEDDWELLINGS3 HOUSE: 815 SF 1,869 S.F. \\ 112 QQ' W/ WELL WATER FRONT PORCH: 46 S.F. 68 S.F. LOT 60 BRICK STEPS: 47 S7_TN_7A) 10() REAR DECK W STEPS: 327 S.F. 652 S.F. ^� P A : 5,700 S.F. (N/A7 950 S.F. ' L07 61 POOL PATIO: 1050 S.F. (NIA)277 S.F. (NIA) FEB 1 9 2016 LOT 62 1,188 S.F. 3,539 S.F. or 3.1% �, , MEDWAY AVENUE OR 1.05% 28.2$ 000 #'75 OCL DWELLINGS W/PUBLIC WATER MON. MpP OF LOT 63 150' . NYSDEC LOT COVERAGE Z (UPLAND AREA LANDWARD OF TIDAL WETLANDS BOUNDARY TO ELEVATION 10.0) 14i FIRM ZONE MAP #36103CO481 H DRAINAGE CALCULATIONS: (36,050 S.F. or 0.83 ACRES) 5A,10" o EXISTING PROPOSED Fc, S72e LOT 64 THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL 0 A) PROPOSED DWELLING W COVERED PORCH: 1,913 S.F. HOIISF: 815 SF NAI 1.869 S.F- (NIA) o:2 w PIPE LOCA77ONS SHOWN ARE FROM FIELD OBSERVATIONS / FRONT PORCH: 46 S.F. (NIA) 68 S.F. (NIA) �i MON AND OR DATA OBTAINED FROM OTHERS 1.913 x 0.16'DEE 55 < 318=3 REQUIRED I STEPS: 4 N A / ,f LOT 65 f R.O.W. 13,985 SQ.FT. or 0.32 ACRES (1) 8'DIA x 8' DEEP DRYWELL=338cf PROVIDED AREA: 117,102.18 SQ.FT. or 2.69 ACRES ELEVATION DATUM: NGVD 1929 REAR DECK W STEPS: 327 S.F. N A 652 S.F. (N/A) B) UPPER DRIVEWAY=2,200 SQ.FT. P A 1,180 S.F. (N A LOT 66 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY 2,200 x 0.166=36366=1 10'DIA x 6' DEEP== 410cf PROVIDED SWIMMING POOL: (NIA) 950 S.F. � MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN B) LOWER DRNEWAY=3,500 SQ.FT. POOL PATIO: 1050 S.F. ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS7777JTION 3,500 x 0.166= 581.0< 581cf MASONRY WALK: 277 S.F. LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. (2)10'DIA x 5' DEEP= 684cf PROVIDED ALL EXISTING STRUCTURES 2,277 S.F. or 6.3% PROPOSED COVERAGE THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE C) SWIMMING POOLS SHALL BE EQUIPPED WITH APUMP-OUT ARE LANDWARD OF ELEV. 10.0 NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS AND MINIMUM 4' x 4' DR E E Q FOR POOL DISCHARGE. EXISTING COVERAGE 0.0% AND/OR SUBSURFACE S7RUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: JUSTIN SCHWARTZ; EXISTING SANITARY LOCATION ZONED R-80 MAP OF: GRAPHIC SCALE (TO BE ABANDONED AND BACK FILLED ALLISON SCHWARTz; WITH CLEAN COARSE SAND.) FRONT YARD: 60'MIN FILED: FIDELITY NATIONAL TITLE INSURANCE COMPANY; POINT A' POINT `8" REAR YARD: 75'MIN 40 0 20 40 so Iso S.T. 20 28SIDE YARD: 20' MIN (45' TOTAL) SITUATED AT: MATTITUCK is I LP 11 25, 41' TOWN OF: SOUTHOLD L_P.f2 28' 35.5' KENNETH M WOYCHUK LAND SURVEYING, PLLC - LP.13 28• 27.5' SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design ( IN FEET ) * P.O. Boz 153 Aquebogue, New York 11931 1 inch = 40 ft. TOPOGRAPHY, SEPTIC LOC. & WETLANDS 01/28/15 FILE # 14-11 SCALE: 1"=40' DATE:AUG. 1, 2014 PHONE (631)298-1588 FAX (631) 298-1588 N.YS. LISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk