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HomeMy WebLinkAboutTR-8765 "SUFFOLx' ,. John M. Bredemeyer Ill, President : opo Coot Town Hall Annex Michael J. Domino, Vice-President ,:4= y� ?, 54375 Route 25 Glenn Goldsmith t' 'v Y' rf` ,., " P.O. Box 1179 A. Nicholas Krupski �,, `® r _,=r Southold, NY 11971 Charles J Sanders `:,'of .,�o Y� Telephone (631) 765-1892 `'J '' 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 1/2 constructed Project complete, compliance inspection ,0::z i' 4 vi, '. .:44ld.y'ia'le,' ;%; ' Y`�y a°aS.1: ft- ttl ti' ::SS--•, '�ii1T'°s'SSs.. ;t ".ti a.r , r`#d '� I ° 1S# .3 ''S��.,�..��--.--.--,:--can;<u� 3: F�f`8`•�,,.-..-'-;:'^--''.,�_.k+%ylt df.as} -`:}+� / o!,v.;a"—._.,•h ,.'ta�t! tifid,�`N �.,����+��°�8tk�!P +'' �."'��yl idflj'i°�^i( a'-- A i `,,5.,, .,, `* 'a�,.d` ''' y a�A yx,:..z T-1;r��'•-... b� -f , t.t-w. ,z,- tIlz;. t.:..... �}r �lY.. b'f v`,`"FtY'%:'.. N J� .."..... :S.zr;IS',' qy :..�jj f tJyf i , `'f? LzA`< m ,...i,,,:4,4„74,1,,,,.. t�RD OF SOUTHOLD TOWN TRUSTEES ! .'t: P F BOARD �$ � ;,,3,\ t y lt�i,q�. 1 ''+ie tit 4, " i SOUTHOLD,NEW YORK �(f •, . d;rff ; PERMIT NO 8765 DATE: APRIL 20, 2016 1 �.PVv ti ISSUED TO: DOMELUCA II LLC :k :� ti`7.,, .,-.:1.1:"N '111)1 1 ��\k,i,...'1..!: PROPERTY ADDRESS: 14895 ROUTE 25,EAST MARION 1:,,,,./4-'1;4'4,1,11; 11. 4 ;! SCTM# 1000-23-1-2.10 4,,„'h AUTHORIZATION 0 j ! itt-,::‘ � Pursuant to the provisions of Chapter 275 of the Town Code of"the Town of Southold and in 1 ii 5 TP ; accordance with the Resolution of the Board of Trustees adopted at the meeting held on April 20, 2016, and in :: �,4'r /-74,„-r I consideration of application fee in the sum of$250.00 paid by Domeluca II,LLC and subject to the Terms and %� f • -: '; ' Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the ”" ` x.`, following: 4 ..,4. }' Wetland Permit to demolish and remove existingdwelling, swimmingpool, and deck; "�' ;:. ,,�: ; ��rF construct new 2,130sq:ft. one-story, single-family dwelling`with attached=covered deck "' x Q ; and pavilion; a 20x84 swimming pool; a 25x36 deck; 4' high pool enclosure fencing; i,r„qq�, i' a 53'x56' basketball court, replace existing sanitary system with new; and install a '' drinking water well, with the condition'of the,installation of a pool drywell; and to fi , 1' ' establish and perpetually maintain a 15' wide non-turf buffer. landward of the topof "$f ' ig P P y :_ • --,i j bluff; and as depicted on the survey prepared by Kenneth,M. Woychuk, last dated May ,, - ;: , 17,2016, and stamped approved on May 27,2016. < IN WITNESS WHEREOF,the said Board of Trustees;hereby causes its Corporate,Seal to be affixed, ' r ier,i,1,, -I;: and these presents to be subscribed by a majority of.the said Board i of this date. ;::::ei.*:'' ').,t‘Al',. rialtil it ;fit t: 2 ll .r ,��'��Su c�- /714'4-.�� z .�/ ,, ;� µi- .,,4 .x t e�#q- i +�. i' .. , ?" PL"�v'i.,-^� a J?•�,C:S�.r-,r.�`J+f'-s 1.,,,,,, i (.4 ,.-.... .. ,....... , a 7 / ,,,, t .k .,:,‘',144.,..„,.yr• I `'°r 2 ' ', Av % ,rte 'ti'—.-.::—:_• :Efate j 6 -ik i ,..„,,---",,,.„..-- - 1 —/.."..4„\., r % 4:11",14-'11'111 f:1:3 i,,d77 ( 4�1 I 1:4*. :tit' APJ?'" ° tr : '=-=', f# D y t - $fl f .y Ast ..,•.• •••,. '" •v,u*t r. '.'''.1;',•:''',-": r ,'v 1x`.,."k __ .:litz:-. u:i.hTuPd. i t}'i�:'34i.}. . ...-e....:�..y. ^.vtr":ei.i.•-,.sf.u'i c: fl'sj.. ..:,XJaiiiY�.!? ih,3'Y' . a#�f"..JLSi.. •} .r,u"„ ries -.b t'.''+ C.,.. .,w^>:r,. ,.', �,. \r,.,�,'P`A#"�"I t.s i° ` �t: a�-����:,:. y..�4` .���' l :••y^s-`'.$—,tt:. �r'�. ...�y ;,�� .1i �A ;`�O p ,�r b#? ,, 7,,,,,z,51..<2.,Yt w ii ...� y�.. t `•' -"'vrr-� •�' Z'?:.r, •° '_ ✓ ! ,, r,, xmc.,;.,-,'smn✓ - dost 100,. Ily`:Y.' .l L"gvgn #a 4'A /411f 14%01:-----""-'- �d a.oi Y1'e!°` -':. .:,:k 8#6¢;$,,,1:1,,,,,,- ----:--- s,,,1:=,°',- .�---�"'41ye, i < dY`, Y JJ Sb5 tea. ` ,,,9r `�,..�e•'e. •2.S ,,., -te e • ,,,,,„,....,:.:4.–",,,,,.. �:: ,. ....;`.:a�.»,.w• `"'a=.":.`ti::i.°: �,y«m.•. TERMS AND CONDITIONS The Permittee Domeluca 11, LLC, 14895 Route 25, East Marion,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: T, Board of Trustees and Town of Southold are released from any and all 1. That the said the oii�iiv .� damages,or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if,in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with.the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. �„,,— II/ -- I John M.Bredemeyer III, President 111®&Bre4. Hall Annex Michael J. Domino Vice-President ® : 54375 Route 25 ' 1 P P.O.Box 1179 Glenn Goldsmith ; Southold,New York 11971 A. Nicholas Krupski ' �, P , ► y® �� Telephone(631) 765-1892 Charles J.Sanders :®�,`+® '� lll, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 20, 2016 Robert E. Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: DOMELUCA II, LLC 14895 ROUTE 25, EAST MARION SCTM# 1000-23-1-2.10 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on > Wednesday, April 20, 2016 regarding the above matter: WHEREAS, En-Consultants on behalf of DOMELUCA II, LLC applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 25, 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 April 20, 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, 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 DOMELUCA II, LLC to demolish and remove existing dwelling, swimming pool, and deck; construct new 2,130sq.ft. one-story, single-family dwelling with attached covered deck and pavilion; a 20'x84' swimming pool; a 25'x36' deck; 4' high pool enclosure fencing; a 53'x56' basketball court; replace existing sanitary system with new; and install a drinking water well; with the condition of the installation of a pool drywell; and to establish and perpetually maintain a 15' wide non-turf buffer landward of the top of bluff; and as depicted on the survey prepared by Kenneth M. Woychuk, last dated May 17, 2016, and stamped approved on May 27, 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: None Ve tr Jy yours, John M. Bredemeyer III President, Board of Trustees JMB/dd / / , /. S.C.T.M.# DIST: 1000 SEC: 23 BLK: 1 LOT: 2. 10 / / INTERTIDAL yip p1 TIDAL WETLAND BOUNDARY AS DELINEATED 1,�E MARSH AREA no p• %• BY EN-CONSULTANTS JULY 14, 2015 o f4 / / /— N62 as 9, FLOATING ZONE AE(EL 8) DOCK 4 MEAN HIGH WATER LINE 1$7.6 ,,. / / FIRM ZONE AE EL 8 r.• "`'- ' G __ FIRM ZONE BOUNDARY LINE _ ZONE X ��',' !! 1012 'I(§;C) § 4- - 144 o D� 4.;''' "' �� TOP OF BLUFF LOCATED / p / r LUFF 18 . . . .. Ar •" 4 . . . . . . , ► MARCH 16, 2016 PARCEL LOCATED OUTSIDE OF COASTAL EROSION HAZARD AREA / �� y`O' �� ..--..+. ♦•� .4.4...4.1... , •lt 20. . .♦d as SHOWN ON MAP PANEL X28 / / /. • ..•'•; � v� o ..�,"o.. PROPOSED AREA OF DISTURBANCE / WITH IN THE PROJECT LIMITING rd. w fir `J'1s �6____� W SILT FENCE: 33,800 S.F. * ./ ',�,' PROJECT LIMITINGNW . / /- •,♦ SIl7 FENCE TOTAL WETLANDS AREA: 37,300 S.F.f ,� / •'t•'♦ OL & DEXISTING k TOWN OF SOUTHOLD O POOL & DECK EXf$71Ne CESSPOOL 4, v, ', i {TO BE DEMOLISHED) ' TO 8E DONED EXISTING / / o"' ' , .`, 0 AND BA• FILLED �: , srY FRM. DRAINAGE CALCULATIONS: LOT COVERAGE � � / �p % FIRM ZONE X . -- w�TH a:' � sr ND. PRo :, NYS DEC LOT COVERAGE r '.', I -'' O 4 POOL DwEu1NO A) PROP. DWELLING, COVERED DECK & AREA SEAWARD OF CREST OF BLUFF AREA LANDWARD OF BCRESTOUNDARY: OF BLUFF ,' I '.', 15' WIDE NON—TURF I -)J (r'r.`. ^ FENCE 26 22'4 JEAN PROWE PAVILION 1,935 S.F. OR BELOW CONTOUR ELEV. 10 : 152,787 S.F.f & TIDAL WETLANDS BOUNDARY: 110,975 S.F.f • • BUFFER I I , �:� (To BE DEMOLISHED) / / / / 1 ••.+', "''� J I ' PR JEAN PROOP. IUVE & SURROUNDNG, COVERED CK 2130 S.F. 1,74% 1 • € - 22 24 1,935 x 0.166=321.2} < 322ct REQUIRED CONC. & GRAVEL DRIVEWAY 4.19% ���� 6400 S.F. FIRM ZONE AE EL 8 \i\. �_ , --s"' r '`• (1) 8'DIA x 8' DEEP DRYWELL= 338cf PROVIDED BARN & APRON 1984 S.F. 1.30% CELLAR ENT. 64 S.F. 0.06% , FRM.` ` NG 30. " HEDPORTION OF COLLAPSING SHED 74 S.F. 0,05% REAR DECK 923 S.F. 1,64% �' +♦• :• B) PROPOSED DRIVEWAY=},025 SOFT. 6458 S.F. 5,gy, PROP, POOL & COPING 1680 S,F. 1.51% / / /fj �'•� +'. :`:1 >: ;:r:: % 'ioa �' , 1.025 x 0.166=170.15 < 171cfTOTAL/ / /� �C�o `•.\� • �.•• ,NO• all', ;,: T mapmrn 1siy Tre, k (1) 8'DW x 4' DEEP DRYWELL= 177cf PROVIDEDSTEPS 70 BASKETBALL COURT 227 S.F. d.20% r •, , lc.' CK PROPOSED 1 511: ••.• ;;50,,',.,.,-.§7,T-, PAVILION ON DECK WELL BARN 1782 S.F. 1.60% DAM POND °�' \`� , •�•' 1• Ot s�eP r %::;::j'.S. :�.'1101170.6%MED TO HOUSE o 4, BRICK SHED108 S.F. 0.09% / / cI ti's"sEL(21.0) POOL WASTE WATER / / / ti'+ '.' L....... J 21.0) v.../..:4; ,;^ 4*, ,: tom DRY WELL EXISTING L P. ev+ h. t. ,.,. TING WELL ; �".1 3► '•::::.:.:,.: � . (TO BE ABANDONS^ ... •• •� 4: ;+! r''` 200'(" P FRAME SHED 123 S.F. 0.11% y , EE((( FRAME SHED(COLLAPSING) i , . �. L ""1::4'1 ri rl^. :;.; EEEE2Q��LLLL(((j�2r.0) 147 S.F. 0.13% f / / / . '.' 'EL 0, '''':::::?.::%:::::;r xIC•: 4 ,A6 .. --'0 '' TOTAL 7184 S.F. 6.5% LAND N/F / / / i 4 ',` 100.1' I .�,. .,��. .•, �o_ m� .. OF ! l I r®�iirs'��■r1�,� '�� aPaoP4°SBED�RooM TOWN OF SOUTHOLD / / / i �I RB 8.x1 � '+' 1 P WELL �� `� 1000 P41.S.L / / / ; . , . t`�` e'aAxe'DEEP 1T• r , tr)8 xr2'L P. BASKETBALL COURT 2968 S.F. N A « ��0 f �1 ►744'11 iillaril �� DRIVEWAY STONE & CONC. 8420 S.F. N/A / / / / / / 4.714 524 I 44t;CZ ty i '•+ UFF , +•v r•;•t•;•:",«.. i•a`61•. . (b�� ��► PORTK?N OF EXISTING q ., SS2 CK • '''::.;:::>:•:;;;',',,,,a0.,..'. «•Y:,`•.,:;.::. y•+,,,.'::r• EMIR ~ CONC. DRfVE1YAY �► I , - .pgS�p.? y JF.i�' 'f' BE REMOVED I •'•' PRd1E I ,,�,.;_�' � 84SIC TE 6WJ- + 'i s1r 'i 4] / ♦ • CTI UMRING vw Y; • /44.'., 'W 1 S / / / / / i •♦., SILT MICE _ COTjJ :�. t; �� ,� i , „,.:011 BRICK SHED �''`'t=;%i:", o; ;:r;,: ,(:..,::. �R��; W- i GRAvaLAND N/F Air :.>•'., ti• .`. a'.d• �f�x 1 C� PROPOSED 4 y. .. .rs flf 00 OF / / / / / / / / 00 ��C7 !� iirj =' � D 'd r.ra: .,..` a ,I ` AREA ' ...... �� ♦ DOMELUCA, LLC CID • `. • DWELLING / / / 0 ~ �� 80 PROPIVELIOSFD •12.2 FRM. `.N''% I W/WELL WATER / / / / \ -' +.'. ••' CONC. SHED `\ 1 ' �' • • ACTIVE \ - :: 52.5''f'RM. :.: :1: .w - P. . 8 BARN :: :: ;o WELL . �,« ::1*6.i .rn... GF 8;6 .."0,,,,q t1 o:::::36,4 ,:.• :...i6.1 SS ,P ,�' CAcO. ` roa �R/yam �`'6�0 / / / / p \'‘.++.%r• t , NO SANITARY qy s k...1. �� LAND N/F / / / / •� O ,, 1"DFALI Y CWAPSEO �,. J ‘..-<,r,+,,', 14.0 FRM. SHED. CP OOrJ OF .t '4 '.', 4 Es. 444+4444 TREASURE ISLAND COVE, LLC; v , . cn uilwoaA / / / / / . , ♦ s . , r . ' l''''„•. / / / ` .y�'•9. •••_�.•r•t�'-' :9,;,..9.+44..' + ' Q • U.P. 1 •.� 15' WIDE NON-TURF Z BUFFER � c1o O\ \ +. , \ 4 / / / / / / / / /_— ..4 .�.401•44414.44.611:441:14444 . ,�,�.�♦�, ,.'.', , . �� GFS WELL 44 .•,•. , •,•, , . 4 „ pal ti .° i:. F+ �•t o •�• "tet • ,M,� ,•♦ ♦ 4+4..♦ 4..♦ 'Y s,1 ,4 , o\ 6''O (INACTIVE) / / / / / / / / / , �r•••,, \'' ` �• ♦'+.'+'+++,+44+' V+ °°'j ly . , . , . , ♦ , , . �) LAND N/F / / / / / / / / / / /-- \ TIDAL WETLAND BOUNDARY AS DELINEATE, 4 "4,,..,, '\'. '''F FIRM ZONE X OF BY EN-CONSULTANTS JULY i4, 2015 ','.';'+ WELD r FlRJ�1 ,, �5,',♦.• sa•. �° • CHARLES CAMPBELL / / / / / / / / / / / / INTERTIDAL `'•. ' - POW ZONE MARSH AREA - 4 AE(�� o / / / / / / / '• ' ' ,.......... � 6..,,.. MON . �� bS8 01 ' `► , ` 1,4,„, 4a ,�/ / / / / / / 73,„h, - , ,,,, / / / / / /_____ ..., / / / / / / / / ry o' '1. APPROVED BY ''".:.'''.:•:4--i.-..'s,.: @OARD OF TRUSTEES / / / / / / / / / / / / / / / / / / �_ / ��2g MEAN HIGH WATER LINE ~ 3��`j8, \ '` / FP � oRi� U.P. \ �`"''. . TC ' ! OF SOU?'l�t� INTERTIDALyvgr MON.\ M/ / / / / / / / / / / / ARSH AREA ',...:.i.,.:.:',..„:":>:•./.):::.,` \ DATE. {1tia .a� at* 11.., \ It /3/jj,47ie) , / / / / / / / / / / / / / / / / / / / / / / / / / 0 , ` \ q�� DAM POND /- 4,880, °°� �° 1 8 ° \\\ -•1;Y. U.P. �6� yd / / / / / / / / / / / / / / B 3�, ,,. / / / / / / / / / / / / / / /'....' 3g,, ,;. tiro LAND N F 83 33''Y 3, P `\, / / / / / / / / / / / / ,ELT / .y '. '` • ` OF / / / / / / / / / / / / / / / / / / i--- b'i ` / TOWN OF SOUTHOLD �� 52, O0° rh • `:1 4 ��- \ �_ ELEV. ?9.5 / / / / / / / / / / / / / / / / / / / / / / / / + c) Co• ' 145'52. ,may i iikkill°6' • -/ OL BROWN ' ag`30 --4650" -'� u.- 2 8.00' SANDY LOAM 0.9' • 4 N. C4') 5g° mm �� '‘,...- P,) 6 °"44 L_36.05 U.P. ApRo b. BROWN �/ / / / / / / / / / / / / / / / / / / / / / / • " SM / / ' i,� S6344.0'508' 63°44 0$ W R0 A� LOAMY SAND 1.3' Al —/ / / / / / / / / / / / °�� .................._......_„_........-.....••-• Sa'a 25) ScBROWN e0)/ / / / / / / / / / / CS`R ,LAYEY SAND 2 2' / / / / / / ..','",,-.,:i..,.. ,.' DIRT BOAT 2',�`3 / / / / / / / / / / , ;: ''' M ..•.. L� / / / / / ;��; ^,.. RAMP. ..6 INTERTIDAL • ";:: :'��, / / / / / / / / / / / SP MEDIUM / / / / / / / / / / /-- MARSH AREA g,�`Z139$ TO • SAND COARSE —' / / / / / / / / / / / / / / / 'RECEIVE RECEIVE NO WATER �°55 ' '121 G • OF P,P �N1 n / / / / / / / / / / / / / / / / �� - ' ED ...J / / MAY 2 6 2016 17' / / / / / / / / / / - 2$`�•�5 c�:'JtoidicWll SEPT 4, 2015 road DlTrustee: K.WOYCHUK LS "/ / / �v _ TYPICAL SILT REVISED —'/ / / / / MEAN HIGH WATER LINE N5$°29'4 _ - - - ''r GEOTEXTILE FABRIC SCREEN SECTION 16 REVISED 03_24-16 REVISED 03 17-16 ��$ L .._ woos oR POSTS ELEVATION E RMAPAONELDATUM:OO64HNAVD 1988 REVISED THE WATER SUPPLY 02-03-1 WELLS, DRYWELLS AND CESSF - ' FLOW DIRECTION LOCATIONS SHOWN ARE FROM FIELD OBSERVAT/ON5 —' / / p�, -•-•''' AREA: 219,21 2.42 SQ.FT. or 5.03 ACRES AND OR DATA OBTAINED FROM OTHERS. o�i �° . - - EXCAVATED AND \ UNAUTHORIZED ALTERATION OR ADDIflON TO THIS SURVEY IS A WOLAVON OF SECTION 7209 OF THE NEW YORK STATE EDUCAVON LAW. COPIES OF THIS SURVE .•' BACKFILLED TRENCH MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RL • —/ �� 36' ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE mu- COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION ' O � EXISTING GROUND LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. INTERTIDAL ;'' THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FORA SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECVON OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMEN / N68o1'a2"E MARSH AREA �,;' 7,.. 5.,-)..0......._-.10.(0,,-.............-.... �1 — — — AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON 771E PREMISES AT 171E TIME OF SURVEY 03.i a' ''• � R. 1 I i� - 14-7111-fl� • ����,,Fi� I—I —'r'—� i�i i I r —"fir SURVEY OF 11 DESCRIBED PROPERTY 103.10' -.. �1� \S I I—III I� I "I i=rr 1i II—III _ r CERTIFIED T0: DOMELUCA II, LLC; �` I T — TTf 4• —Til— — MAP OF: FIRST AMERICAN TITLE INSURANCE COMPANY; • O �O+t O� PM�NC 2' MINIMUM FILED: '"' 1 Q 1 cs� g°5 �o�E 1 SITUATED AT: EAST MARION TO OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, LAND N/F -1 O - .•-•• rt?� SUFFOLK COUNTY, NEW YORK Professional Land Surveying and OF �•..'l� BROWN, HULSE, KALIN & OUINTAN,A./� �� yi $ Design ((`.dzim 4 P.O. Box 153 Aquebogue, New York 1193 FELE # 15-61 SCALE: 1"=50' DATE: MAY 7, 2015 PHONE (631)298-1588 FAX (631) 296-1888 N.Y.S. L/SC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth N. A( John M Bredemeyer Ill, President 4 , ? Town Hall Annex Michael J Domino, Vice-President 'a-' y",&o� yq :r 54375 Route 25 Glenn Goldsmith P H = ?. _ P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders /44 Telephone (631) 765-1892 siggx -y Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: //9 ://6. Completed in field by: En-Consultants on behalf of DOMELUCA II, LLC requests a Wetland Permit to demolish and remove existing dwelling, swimming pool, and deck; construct new 2,130sq.ft. one-story, single-family dwelling with attached covered deck and pavilion; a 20'x84' swimming pool; a 25'x36' deck; 4' high pool enclosure fencing;.a 53'x56' basketball court; replace existing sanitary system with new; and install a drinking water well. Located: 14895 Route 25, East Marion. SCTM# 1000-23-1-2.10 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OKI Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3.• Sanitary leaching pool (cesspool) 100 feet: '4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N' Ch. 275. Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: ftJewt, -,( a 4r Present were: J. Bredemeyer M. Domino 4—. Goldsmith N. Krupski . Sanders Other Page 1of2 --1 ,iii• John M. Bredemeyer Ill, President , ,��,oFFO( Town Hall Annex Michael J. Domino, Vice-President ��� �Gy�, 54375 Route 25 Glenn Goldsmith ; o °` . ` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders z '4 • - Telephone (631) 765-1892 =•j Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: En-Consultants on behalf of DOMELUCA II, LLC requests a Wetland Permit to demolish and remove existing dwelling, swimming pool, and deck; construct new 2,130sq.ft. one-story, single-family dwelling with attached covered deck and pavilion; a 20'x84' swimming pool; a 25'x36' deck; 4' high pool enclosure fencing; a 53'x56' basketball court; replace existing sanitary system with new; and install a drinking water well. Located: 14895 Route 25, East Marion. SCTM# 1000-23-1-2.10 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. 5525% 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. Bred,emeyer M. Domino G. Goldsmith N:Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 ',,,:. .1 : ' • . i ,..,i. ... y',. . ,-- ,„,j„- ':-. .., i' ,.,,,, ,..),,',..',...,,':',._,,i;,.1 ,. ' am l, / 4, "'� `t Ilp `• �� 'r��'Domeluca II,LLC '' ��si t r , 14895 Route 25,East Marion 4,.',.` . �.v ; 11SCTM#: 1000-23-1-2.10 �w,i / r3` `�� . �, ` 4/13/16 t� {}c�1 fl L j=aat. � r \5a ;111111 ':1/4 'Av • * _ • : -r�� � X45 • ,J , '} $',,'��ihl }Yi"r!1' S s<'P j!• ,jam.II �, , _.r f . , 4P3'A44440% ,.**,V 0,;.'; -4111:( " ' ASV di 14r- 41,1','•• .S.4-.6'.4.";att----' �.; c ^` x97 .' icic '4i'4, j�, ,y�'r/Uf. ,,,,,„,ft,...:'Ziff/ �:.s r r.- i IV ,t �' „ � el z•`k'tAte,, yeay�g � a .••• affjl fiyS .......,4& , {f .a p ' .. -lilt a - ; Q ir t -•. e �. ,ter+ w.. _ ', ✓ • .1 "•'\' �" '„ 1 T�. ✓.; l I -_ � ! -.,‘'.1,,-"" ' r � �,. } S'� w"�c �19��r�'r 'f� p •fY'(n�� .:1 }"° tlk \ fi y. ► rr y�.. ":LkE :'fir x = t{ iti: -,V-°.44618W -°.44 _ .t7.0-ii, I _ q -,`1#-"..1,......t.!i,I yfa W_ -.`4MWT''�IY`.•„'Mq� .,,v R ♦ - - ha Jam. _ �+,A_ -....-. r + ...."-"A”. _.� ✓•t•-45 - tiN "sem sb � e• "ri`•• `:atm;- ` rK. mak ea r r+i If 'F�• N. Wim, r b ,+A'f I� - , . **-• �y,..4, r , : .4`.. _ �r! y, .. • Irv.'• 1r4 .*Te,r, - . . w r r,' ,a' 7 ,:r!"L -, _ +r, a rt • r F, . ,ys �oJ kx, . ' t f. 1.'� M1 r, '� - o F' •, _ <[ -K.rte• .\ , +. - r p •. .fP ,4'k' ` n, Mr4 � 20� � �7- . s. �' 4. ' ` � :rte LAW OFFICE OF DAVID JUDE JANNUZZI 13235 MAIN ROAD P.O. BOX 1672 MATTITUCK, NY 11952 (631) 298-8065 (631) 298-4214 fax December 14, 2015 En Consultants 1319 North Sea Road Southampton,NY 11968 Re: Domeuca II—Pablo Salame To Whom It May Concern — Please accept this letter as an opinion of the counsel for the above referenced LLC. and its Managing Member, Pablo Salame. The LLC was formed on May 13, 2015 with the filing of the Articles of Organization with the New York Department of State. This office assisted in the preparation of the original Operating Agreement and do not know of any modifications made thereto. The LLC is n good current standing with the State of New York. The Operating Agreement authorizes Pablo Salame to act on its behalf in all matters benefitting the LLC. This would include any applications to municipal or other governmental agencies such as The New York State Department of Environmental Conservation. This opinion is given with the recognition that the information contained herein may be counted upon the entities mention above in establishing the authority of Mr. Salame to act upon the behalf of the LLC. Very truly yours, EC; EiV r a AI ; i David Jude Jannuzzi, Esq. i MAR 2 5 2016 r DJJ:vcg 1 Soudio d Town Board of Trustees DOMELUCA II, LLC, 14895 MAIN ROAD (S.R. 25), EAST MARION Mk /t t.. .••i \ 4i< i as, ,14 il%..��`, A yi A y a; °t': t� '4.ter` ,., , = ,� .„ ,/ 6 • v e�' y_ R , 4`.4.►, a d . + � s,.: -.. ,, a -.off, 4 PA Mk41 . I • T' ,, .iiia • Figure 1. Looking north from direction of wetlands on southerly side of property toward existing dwelling to be demolished and replaced with new dwelling. ) ' ; R ; 1 ,I71' 4) ,. ; y ' • ,.. i'A. , mt ' �z: MAR 2 5 2016 ...,4'`...741.1114,‘4 ti ,, A { \, ! C \' ,�1 I l 44,00-1-.4---1v,,, f.,,.,.. % 4,iy4t 1,,,,-, tv.. , - 1611110k efMt ._ _- 11111111 ar• t: --,e Air Figure 2. Looking south and downslope from direction of existing dwelling toward tidal wetlands associated with Dam Pond to south of property. DOMELUCA II, LLC, 14895 MAIN ROAD (S.R. 25),EAST MARION _ .... — Ni - ii -7 Ar,:,,,t4,1,•-,...,_•••,,, , ..,..0 -,- Apidt, CA.g...='ari4041001/'•-• ,--, -,.., _ 47/4//:: .r,i( :,-," 0 •-•' , i•- • ' s ' 4 4 , ''./. • ' lit.. \' ' •'' ' " :.„--, ' / •• 4/4"..; --Avwii;./A're."—# f2p. ..., ;4.•,,, _ , , -0---.4.,•:1,04,' -,'"e `.1. . .i. , r - 1 . 4-•t'" . ) ; 1 I 1 I , - 1 \ . ..-Jmilmemem---- ., - , . . • - - - . • . . - ,-4-(A.'' '4 , -"I4--IS7,4"'":"-:4*y-?•Vi"-. .-,-,-- -i . . -- - -. ._ -,. --.. .. . - - --'.---- • • --- -- i!--:A.,-/A4t- ,. p --4;f:: . ;.. ..-.4,. t •:,. _ . ..,, . k.,,. ... . .,-.,=-- ,. , • : -4;:i''',`-'': ..-^ . . , . .. ' • ... • .„ , . , • - ' . . ... , • , , „ 6 . . , Figure 3. Looking east from direction of top of bluff on west side of property toward existing dwelling and swimming pool to be demolished and replaced with new dwelling and swimming pool. •., , tr. .y 44" A , - , 1 —J.:\ , fr-, - - 1 :,--, r---„\ y •• * 1 ' L ,-- .- -'',A. , ktq 04 ,.,• „ ....4 • • • kV• , li- ,, ,it• leop;4.144 ...-0"4' i , ''' , - 414, MAR 25 2016 ''---- - ,; illittWilArich:0.1,4, A ii.li let 1.,,(AA' ,• ,,. ... ,,. ....o , -,...-..-,7is,s,„,=•:„.. .,+46: 1 ''.'k,..,.414 i kitywk4,, ., , .._:,,,, .. lenvitt.,_ i'fa,41. ,I.Ow-',..-7.. ik ‘ •ffl'4110 w 4.'"-irw, "." ".----#,A5v 1.4.--- • . ...--. .„ ..:.,••• • 0.-- —op . •,, ........ .- !: II"- b•sl P./ 1 I 44 J:1 -• .:''••..„ :_ ,'.1.t,dyrtr,.. .11•11f4if_ ,,,,_,.' . •.-..;,.- fr,,,,*. -m—ilraili..•.41w_ '--.-.... -1;;-'' "'' 4410. 4 Plili Si F A 40.4' 4,::,..i."---;'- •-:" ..4,17'1;•,..-' .,„;,:-.,.. ..,;:-,1 1.,,t -",.-'0 ,, ft. I 1 .; • --,p--444,4* -19%.1; ,11,fk,.* , ..67 7._ ...41.Agissii_ 4,iodrAVNT.,--qii,# me.. ,rirr47 _.-4.-:t. ,i4k , • ._ iiiiip__, orme — . • ,..,.•-•,-- _ _ ,.. 44:Aram;• - - : '"..111,1400444....• /00111.1011plippiLie • • '...161114.14 4411401.6101106.1011MOMPL-. • , • _ _ , . • ,„., • - .- . _. • - "'- ., • - .. , . . • . •• ' , . , . • - ' Figure 4. Looking west from east side of property at existing dwelling and swimming pool to he demolished and replaced with new dwelling and swimming pool;and toward bluff associated with Dam Pond on west side of property. DOMELUCA II, LLC, 14895 MAIN ROAD (S.R. 25),EAST MARION • t y .....• . lik • •-..., 4, 111 N1/4 ,' i 4STs r "tIP •0� [01111 , g 'N"'� -, y ,*i Ift Figure 5. Looking north over swimming pool to be removed toward top of bluff on north side of property ,- / .� � H- MAR ih 2 5 2016 ' � ,:'41111kWi:t‘ril:\411+ ''v .-- _- - ._ ------"No------....-----,4 -- v ' --- r•••-•'111". I -— =BM ; 1 ' kat..':Illhis' "Ilisilti • .4 -,, , } 4 ,'d! :11(1''' �'1 ,4 Ik.�1,,t',11‘ ,j�Y I.N` • �A'S �y 7 �' h r \ 'F f i ti9 +, \ h4 `e,7'q \ �� \. +\ 0 I,•{ f•)+;;pti+ ,,...%C�� 44,011,),.. ; 0� \fit •• '., o s,,,.+A 40, /4. S \'� 4k,01 ...re' it int. 104 1 Sri '4•77.' ••,tb, o I i� ...` ei .4, %. fi ( V s s + \ � 1 ,\? �� iib.. '; y 4,1 Its i'+,Ji+ i. "' a ♦• s^ A.7. ♦ . - 4 +V/P4. �\ki"'4 1 ti• '4! • +'4 �` 4•+' A4,�"�.t,. �.,� v ,11,-,,..A.,. '!� •�fr �' 6: �,' ,L � 'llr+ � ' � � l�`. 'F i•,' t r Iii .! d►v, '.'. `. + ` !) 1 + �a • a',.l. ,a' + , 1 I' e •i • ., .r. w• a 4;, • 1. a : r • - Figure 6. Looking north over top of bluff on north side of property toward Dam Pond and Long island Sound farther north. DOMELUCA II, LLC, EAST MARION v` 'tel� - 1 i- is - .� «'` !. '... . `s,.f •'r.:: .r AV .�a` •..e:;-;-40 , :jo '�,.. sem` ••*,'`• 0,' ..."..4. S/- 3" 4 ss a a�:.. i ..ii r '0, jA ` • • •:-* ."--.110 .'"—, -__•'"-7---- 1i i6 Figure 7. Looking south from top of bluff on north side of property toward existing dwelling and swimming pool to be removed and replaced with new dwelling and swimming pool. • "; IA ` , , • 1 r. i4, . ., *• _44 A, ►'_'` . , f .r..•it .e,-. r r i" - „„!.,,5-,,,,,,i..,� �i ib « — w �', i, , a',. I'm �l~ • - .y. ark'*' `,c ; .1"". °^'e?.r`"A 1 Figure 8. Looking south from Dam Pond shoreline at face of bluff slope on north side of property. f • • Form NY-019 Power of Attorney,Statutory Short Form,Effective 'FIDELITY NATIONAL TITLE INSURANCE COMPANY CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY POWER OF ATTORNEY NEW YORK STATUTORY SHORT FORM (a) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important document. As the "principal," you give the person whom you choose (your "Agent") authority to spend your money and sell or dispose of yourproperty during your lifetime without telling you. You do not lose your authority to act even though you have given your Agent similar authority. When your Agent exercises this authority, he or she must act according to any instructions you have provided or, where there are no specific instructions, in your best interest. "Important information for the Agent" at the end of this document describes your Agent's responsibilities. Your Agent can act on your behalf only after signing the Power of Attorney before a notary public. You can request information from your Agent at any time. If you are revoking a prior Power of Attorney, you should provide written notice of the revocation to your prior Agent(s) and to any third parties who may have acted upon it, including the financial institutions where your accounts are located. You can revoke or terminate your Power of Attorney at any time for any reason as long as you are of sound mind. If you are no longer of sound mind, a court can remove an Agent for acting improperly. Your Agent cannot make health care decisions for you. You may execute a "Health Care Proxy" to do this. The law governing Powers of Attorney is contained in the New York General Obligations Law, Article 5, Title 15. This law is available at a law library, or online through the New York State Senate or Assembly websites,www.senate.state.ny.us or www.assembly.state.ny.us. IF THERE IS ANYTHING ABOUT THIS DOCUMENT THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. (b) DESIGNATION OF AGENT(S): I, PABLO SALAME, residing at 66 Leonard Street, Apt. 9C,New York,NY 10003 , hereby appoint: name and address of principal DAVID JUDE JANNUZZI, ESQ., with offices located at 13235 Main Road, Mattituck,NY 11952 , as my Agent(s) name(s) and address(es) of AGENT(s) If you designate more than one agent above,they must act together unless you initial the statement below. ( ) My Agents may act SEPARATELY. (c) DESIGNATION OF SUCCESSOR AGENT(S): (OPTIONAL) If any Agent designated above is unable or unwilling to serve, I appoint as my successor Agent(S): name(s) and address(es) of successor Agent(s) Successor Agents designated above must act together unless you initial the statement below. I ► ( ) My successor Agents may act SEPARATELY. YOU MAY PROVIDE FOR SPECIFIC SUCCESSION RULES IN THIS SECTION. INSERT SPECIFIC SUCCESSION PROVISIONS HERE: (d) This Power of Attorney shall not be affected by my subsequent incapacity unless I have stated otherwise below, under "Modifications" (e) This Power of Attorney does not revoke any Powers of Attorney previously executed by me unless I have stated otherwise below, under "Modifications." If you do not intend to revoke your prior powers of attorney, and if you have granted the same authority in this Power of Attorney as you granted to another Agent in a prior Power of Attorney, each Agent can act separately unless you indicate under "modifications" that the Agents with the same authority are to act together. (f) GRANT OF AUTHORITY: To grant your Agent some or all of the authority below, either (1) Initial the bracket at each authority you grant, or (2) Write or type the letters for each authority you grant on the blank line at (P), and initial the bracket at (P). If you initial (P), you do not need to initial the other lines. I grant authority to my Agent(s) with respect to the following subjects as defined in sections 5-1502A through 5-1502N of the New York General Obligations Law: ( ) (A) real estate transactions; ( ) (J) benefits from governmental programs or civil or ( ) (B) chattel and goods transactions; military service; ( ) (C) bond, share, and commodity transactions; ( ) (K)health care billing and payment matters; ( ) (D) banking transactions; records, reports and statements; ( ) (E)business operating transactions; ( ) (L) retirement benefit transactions; ( ) (F) insurance transactions; ( ) (M)tax matters; ( ) (G) estate transactions; ( ) (N) all other matters; ( ) (H) claims and litigation; ( ) (0) full and unqualified authority to my Agent(S) ( ) (I) personal and family maintenance. IF YOU to delegate any or all of the foregoing powers to GRANT YOUR AGENT THIS AUTHORICY, I? any person or persons whom my Agent(s) select; IT WILL ALLOW THE AGENT TO MAKE ' ) EACH of the matters identified by the GIFTS THAT YOU CUSTOMARILY HAVE following letters A, B, D, E, F, M,N MADE TO INDIVIDUALS, INCLUDING THE You need not initial the other lines if you AGENT, AND CHARITABLE initial line (P). ORGANIZATIONS. THE AMOUNT OF ALL SUCH GIFTS IN ANY ONE CALENDAR YEAR CANNOT EXCEED FIVE HUNDRED DOLLARS; (g) MODIFICATIONS: (OPTIONAL In this section, you may make additional provisions, including language to limit or supplement authority granted to your Agent. However, you cannot use this Modifications section to grant your Agent authority to make gifts or changes to interests in your property. If you wish to grant your Agent such authority, you MUST complete the Statutory Gifts Rider. (h) CERTAIN GIFT TRANSACTIONS: STATUTORY GIFTS RIDER(OPTIONAL) In order to authorize your Agent to make gifts in excess of an annual total of$500 for all gifts described in(i) of the grant of authority section of this document (under personal and family maintenance), you must initial the statement below and execute a Statutory Gifts Rider at the same time as this instrument. Initialing the statement below by itself does not authorize your Agent to make gifts. The preparation of the Statutory Gifts Rider should be supervised by a lawyer. ( ) (SGR) I grant my Agent authority to make gifts in accordance with the terms and conditions of the Statutory Gifts Rider that supplements this Statutory Power of Attorney. (i) DESIGNATION OF MONITOR(S): (OPTIONAL) IF YOU WISH TO APPOINT MONITOR(S), INITIAL AND FILL IN THE SECTION BELOW: ( ) I wish to designate , Whose address(es) is (are) , as monitor(s). Upon the request of the monitor(s), my Agent(s) must provide the monitor(s) with a copy of the Power of Attorney and a record of all transactions done or made on my behalf. Third parties holding records of such transactions shall provide the records to the monitor(s)upon request. (j) COMPENSATION OF AGENT(S): (OPTIONAL) Your Agent is entitled to be reimbursed from your assets for reasonable expenses incurred on your behalf. If you also wish your Agent(s) to be compensated from your assets for services rendered on your behalf, initial the statement below. If you wish to define "reasonable compensation", you may do so above, under "Modifications". ( ) My Agent(s) shall be entitled to reasonable compensation for services rendered. (k) ACCEPTANCE BY THIRD PARTIES: I agree to indemnify the third party for any claims that may arise against the third party because of reliance on this Power of Attorney. I understand that any termination of this Power of Attorney, whether the result of my revocation of the Power of Attorney or otherwise, is not effective as to a third party until the third party has actual notice or knowledge of the termination. (1) TERMINATION: This Power of Attorney continues until I revoke it or it is terminated by my death or other event described in section 5-1511 of the General Obligations Law. Section 5-1511 of the General Obligations Law describes the manner in which you may revoke your Power of Attorney, and the events which terminate the Power of Attorney. (m) SIGNATURE AND ACKNOWLLI,kiMENT: In Witness Whereof I have hereunto t. ed my name ont/ 13. PRINCIPAL signs here: __> STATE OF NEW YORK, COUNTY OF SUFFOLK} ss.: On the 7 T day of&- die year 2013 , before me, the undersigned, personally appeared PABLO SALAME , personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. St Above and Affix Stamp 'DONNA M. ALM - lotary Public Q7B,StaSuffolk of Coup �y 01PA5 79, a 06 r (-ctNo. s December n. 1SSIGn EY'�`'� (n) IMPORTANT INFORMATION F1 THE AGENT: When you accept the authority granted under this Power of Attorney, a special legal relationship is created between you and the principal. This relationship imposes on you legal responsibilities that continue until you resign or the Power of Attorney is terminated or revoked. You must: (1) act according to any instructions from the principal, or, where there are no instructions, in the principal's best interest; (2) avoid conflicts that would impair your ability to act in the principal's best interest; (3) keep the principal's property separate and distinct from any assets you own or control, unless otherwise permitted by law; (4) keep a record or all receipts, payments, and transactions conducted for the principal; and (5) disclose your identity as an Agent whenever you act for the principal by writing or printing the principal's name and signing your own name as "Agent" in either of the following manners: (Principal's Name) by (Your Signature) as Agent, or(your signature) as Agent for(Principal's Name). You may not use the principal's assets to benefit yourself or anyone else or make gifts to yourself or anyone else unless the principal has specifically granted you that authority in this document, which is either a Statutory Gifts Rider attached to a Statutory Short Form Power of Attorney or a Non-Statutory Power of Attorney. If you have that authority, you must act according to any instructions of the principal or, where there are no such instructions, in the principal's best interest. You may resign by giving written notice to the principal and to any co-Agent, successor Agent, monitor if one has been named in this document, or the principal's guardian if one has been appointed. If there is anything about this document or your responsibilities that you do not understand, you should seek legal advice. Liability of Agent: The meaning of the authority given to you is defined in New York's General Obligations Law, Article 5, Title 15. If it is found that you have violated the law or acted outside the authority granted to you in the Power of Attorney, you may be liable under the law for your violation. (o) AGENT'S SIGNATURE AND ACKNOWLEDGMENT OF APPOINTMENT: It is not required that the principal and the Agent(s) sign at the same time, nor that multiple Agents sign at the same time. I/we, , have read the foregoing Power of Attorney. I am/we are the person(s) identified therein as Agent(s) for the principal named therein. I/we acknowledge my/our lega .s • ibilities. a AGENT(s) sign(s)here: __ AGENT(s) sign(s)here: => STATE OF 1 l`Y , COUNTY OF ss. On the day of S1.in the year 2 6/3 , before me, the undersigned,personally appeared DAVID JUDE JANNUZZI, ESQ. ,personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. DONNA M. PALMER C-I4 Yu Pf2kri_k_ NotaryPublic,State of New York Sign Above and Affrx Stamp No. 01 PA50o9978, Suffolk Count. ;ommiss:on Expires December 9, f / • , AFFIDAVIT OFEFFECTIVENLdi (TO BE COMPLETED BrA GENT(S) UPON DELIVERY OF THIS POWER} STATE OF ,COUNTY OF }ss. , residing at (each) being duly sworn do(es) depose and say that I am (we are) the Agent(s) under the above Power of Attorney and that the Power of Attorney is in full force and effect. That (a) I/we do not have, at the time of the transaction, actual notice of the termination or revocation of the Power of attorney, or notice of any facts indicating that the Power of Attorney has been terminated or revoked; (b)I/we do not have, at the time of the transaction, actual notice that the Power of Attorney has been modified in any way that would affect the ability of the Agent to authorize or engage in the transaction, or notice of any facts indicating that the Power of Attorney has been so modified, and(c) if I/we was/were named as successor Agent(s), the prior Agent(s) is no longer able or willing to serve This affidavit if given for the purpose of the Agent executing a [describe documents that are executed] knowing that , will rely upon the representations made herein as inducement to accept such instrument(s) and this Power of attorney as evidence of my/our authority to act AGENT Sworn to and Subscribed before me this day of (Notary Sign above and Affix Stamp) STATUTORY POWER OF ATTORNEY District (Pursuant to General Obligations Law§5-1513) Title No. Section Block Lot County or Town TO RECORDED AT REO_UEST OF FIDELITY NATIONAL TITLE INSURANCE COMPANY RETURN BY MAIL TO FIDELITY NATIONAL TITLE ® INSURANCE COMPANY Rne reetatedeFidelity .hence/ Member New York State Land Title Association � W Ow ELI0 az xo H U WO L:W il. 0 TAX MAP NUMBER: 1-1000-022-02.7 Real Prepcny Tar ServIce Agency 1000-023- SUFFOLK COUNTY CENTER DEED RECORDED IN LIBER,12825 PAGE 088 RIVERHEAD, LI, NY 11901 102 FORM rvr:• 1,` 1 3.2 g '� 2,8 2.9 nc 100 30 4," 2.3A 2,OA 9 ``s RAN 240 (301 205 �'. $ a 3.3 '' -OtJTHOLD '7 J� '.? 15 J '2 1.1 g 82 l,?S 186 ::: ' . 2.10 rar33ft 5.OA m. D. 608 � 3 °Art ,„ 223 N res tig4 ref° 0 III z FOR PCL.NO, tl. -1 -1 Sa SEC.NO OR-03-024 1 0 z IN Ci Z N 1- Q CO ILI C0 vkO- 2 w ve. - 1120s • 4* �u_et..c�.r.ca�s+tays m��rct• .r-nwiw.rz.«�saw^.�a.+,.fMxrmc.rc [IL E fr--N 0 250 500 1,000 LP r s .. ji t 1:L2 I MAR 2 5 2016 ASSEMBLED AND RETIRED 1000-422-03-038 AND 1000-023-01-2. 7. Board southold REPLACED BY 1000-023-01-2. 10. utees OWNER: DO ELUCA II LLC BY DEED 12825-088- MAPPER: J. de Blasi CHECKER: DATE: 10-07-2015 RPTSA 101 FORM ;.: ,-----,,,-..-;,-;..-.--„,..--;:r"..:-;`.:3.3.,•,,--."."-.5..,'.•-',:•-•-,.:...4'4,-,-,..;•-•-`,.•4--.--,4-•;:-',---_, •-;-,;:,"',"''-Y-4T••••'„..;•--7,,,°,;.;„.);,•1,1-,--..,'",--,'"'„.,.. -,-- ,...„4 4,-,„.., ,•--, - ;;•,•-;,....;-,• '.. :".;--3- - -,•,.., ...4; ,, •, -, . 3. -.2,- 4,4. . „.,,,-.,,, , -..'---,--- .--..,-'-.7;:`.. .3',-'''..--1.;.4,-1"-..,:, , „"-.- ..-.;,.....-:-..-.„--_-• -..=:;.-z;-',.-'„ --,-- , _ ../..-----,.-..- :.-...,-,,,,. -;,...,..--,r,,,.-.,...', ..,..,_--------"_ ',.- --:'' ilk dist----a: 01:4 -4-,S'i.ifctoo ' " °,, ',°."7„;,3.E1C10.':, •!4,000„ .:,, 501:10 Feet '7- ::. 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I \ \ Q I P ppe \ s t Ps' tpt: \ 0O+0W11,,,Q0 oR \ 1. „A _ • o FOS F•CL.NO 'l,'9 pxce �' � SEE SEC.. 2 v FE, ON PCL NO FON PCL NOS ems - SAO 6"'S' • OOtd4011 Y SEE EEG NO SEEEEC Np yT . owZ Q� I 1D0D013 ' 001-05008 MITI utE ® WTCN TINE WTH �-- L1NE WTCH E , }`2� xlsnoa SEE SEC NO W1• WTCN LINE `\ ON a4' SEE SEC NO 001 \ ? L 9.9.00 ..x.vua .. mw --x-- E ��r ra NOTICE Data COUNTY OF SUFFOLK ©`K 1.n r.r.„or. SOUTHOLD SECTION NO O.....,Wx. —�— mFx..... l?,1 ,..,, 0 —_ _—�_ „Nn x- ur0amox F.,9axINSMIPOIONOF MY PORROX co,e 3 E E --,• __„__ „x„.a.,.x.-- __ ,, Real Property Tax Service Agency v oa VILLAGE OE N ....�. Ma F..x.malrvm„vu ��.. —_— x.o.�. --._— „...,F®...--... .m,wa ` ,„.,.,„,.. \11y1 ee0mr Canter NNam"203 Wool ao n a: 022 o..m... *INS rev.. —____ e_.m... __F__ FEuwayxlr m FExnc9uExw I ��l�� p m9 mi III ,cr SO 1000 - PROPERTY MAP ,_f iiMMEINf EN-CONSULTANTS May 20,2016 John Bredemeyer, Chairman ry =2 rrti - Board of_Trustees D10 `` Town of Southold f (I J I P.O. Box 1179 - l MAY Southold,NY 11971 2 6 2016 &Lulu Town Re: Domeluca 11, 14895 Main Road,East Marion peen of Trustees Dear Mr. Bredemeyer: Pursuant to our discussion during the public hearing held on the captioned application on April 20, 2016, please find enclosed three (3) copies of a site plan prepared by Kenneth M. Woychuk Land Surveying, PLLC, last dated May 17, 2016, which has been revised to depict a proposed pool drywell and 15' wide nonturf buffer adjacent to the "top of bluff' and tidal wetlands boundary in the southerly portion of the property where the bluff topography is absent. Res'ectfully yours, Robert E. Herrmann Coastal Management Specialist 1319 North Sea Road I Southampton,New York 11968 I p 631 283 6360 I f 631.283.6136 wwwenconsultants.com - -- environmental consulting i OFFICE LOCATION: �i 4 ® MAILING ADDRESS: Town Hall Annex � '`® �® ; P.O. Box 1179 54375 State Route 25 SIP JigSouthold, NY 11971 (cor.Main Rd. &Youngs Ave.) it co % �� �� Telephone: 631 765-1938 Southold, NY 11971 iii LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: April 11, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for Wetland Permit for DOMELUCA II,•LLC SCTM# 1000-23-1-2.10 En-Consultants on behalf of DOMELUCA II, LLC requests a Wetland Permit to demolish and remove existing dwelling, swimming pool, and deck; construct new 2,130sq.ft. one-story, single- family dwelling with attached covered deck and pavilion; a 29'x84' swimming pool; a 25'x36' deck; 4' high pool enclosure fencing; a 53'x56' basketball court; replace existing sanitary system with new; and install a drinking water well. Located: 14895 Route 25, East Marion. SCTM# 1000-23-1- 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 LWFP 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 provided the following. 1. To further Policy 6 and-protect the water quality of Dam Pond, require a 50' wide, native vegetation buffer landward of the top of bluff and wetland. Areas where structures are removed should be planted as buffers. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. _ I ++; oFFQue. Peter Young,Chairman , ti Town Hall,53095 Main Rd. Lauren Standish,Secretary ,1-.%;* . ,r P.O.Box 1179 d ,1.1% Southold,NY 11971 y�/� `0,‘,:01 fl� 1 Telephone(631)765-1889 , �'' Fax(631)765-1823 Conservation Advisory Council Town of Southold 1 At the meeting of the Southold Town Conservation Advisory Council held Wed., April 13, 2016 the following recommendation was made: Moved by Peter Young, seconded by John Stein, it was RESOLVED to SUPPORT the application of DOMELUCA II, LLC to demolish and remove existing dwelling, swimming pool, and deck located less than 100' from wetlands; construct new, 2,130 sf. one-story, single-family dwelling with attached covered deck and pavilion, 20'X 84' swimming pool, 25'X 36' deck, and!53' X 56' basketball court, all located more than 100' from wetlands and 100' or more from top of bluff; replace existing sanitary system located less than 100' from top of bluff with new sanitary system located more than 100' from top of bluff; and install new drinking water well and 4' pool enclosure fencing. Located: 14895 Main Road, East Marion. SCTM#23-1-2.10 Inspected by: Peter Young The CAC Supports the application with the Condition the pool drainage system is depicted on the site plan. Vote of Council: Ayes: All Motion Carried John M. Bredemeyer III, President �,4Z,V SO0l�; Town Hall Annex Michael J. Domino,Vice-President Iol�O/40.4"' :.�10 54 75.O.Main 1oad 79 I :. • P.O. Box 1179 James F. King,Trustee , .'zh','k ..t: 'r°' ♦ Southold,New York 11971-0959 Dave Bergen,Trustee % co) t`''`•f .:.t..1.11.:6,::i. .i 1� Q IgNi D Charles J. Sanders,Trustee `�'Q - _%:: .� . i g Telephone (631)765-1892 lyL,i7Ul�, �� Faxl(.6..311� BOARD OF TOWN TRUSTEES 2 9 2016 TOWN OF SOUTHOLD To: Southold Town Building Department 11VfLDINGDEPT. — ""'"'N OF SOTJTBOLD Re: Verification of Building Department Permit Requirements i SCTM#: ` a 3— i--e2d I o POMELV� ti L-L-C- Property Owner Name:S . 1 Date Sent to Bldg. Dept.: 1 The Office of the Board of Trustees is forwarding the above verification of the Building Department's permitting require ']- 107-0- 3 -1-2,10 YES NO ( 'L I d ti !R 4114 • he proposed project require a B QTS ��6�'L� /kSSL( CF 2 h -I-t,,(.a'(_ Vii�.(:E( Will the proposed project require a v. - I illeie149 IP beP the Zoning Board of Appeals? Will any part of this application be co 22- -3S '''t- 23-1. c2,-7 described under Town Code? • COMMENTS: -- - / . 0/50/41 1 Signature of R wer Date /���fiis..��„— .-. ,� g�FFD�,,r John M.Bredemeyer III,President �' �¢ Town Hall Annex Michael J.Domino,Vice-President +4 ; 54375 Main Road P.O.Box 1179 James F. King, Trustee D " ; Southold,New York 11971-0959 Dave Bergen,Trustee ,= 4.fij �� i�� Charles J. Sanders, Trustee �� ' 9'1° Telephone(631)765-1892 . Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only /Coastal Erosion Permit Application It Wetland Permit Application Administrative Permit Amendment/Transfer/Extension / Received Application: 3,2547 /V Received Fee: 26DL07, ✓ Completed Application 3'2'3 go • Incomplete "' •� SEQRA Classification: _ Type I Type II Unlisted i/ s° Coordination: (date sent) MAR 2 5 2016 LWRP Consistency Assessment Form 14 g`ii° 7 CAC Referral Sent: 3'Z9• Date of Inspection: 4.1A/L `` 4mtE'; '• �'', _Receipt of CAC Report: 1� , __w e' '{==--- ... _Lead Agency Determination: Technical Review: ��ll /_ Public Hearing Held: Zts 2049 Resolution: Name of Applicant Domeluca H,LLC;Pablo Salame,Managing Member 'c/o David J.Jannuzzi,Power of Attorney Address ,P.O.box 1673,Mattituck,NY 11952 Phone Number: (631) 298-8065 Suffolk County Tax Map Number: 1000 - 23-1-2.10 Property Location: 14895 Main Road(S.R.25),East Marion (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 P5\ L ,,,I9I F rd of Trustees Applicatior GENERAL DATA Land Area(in square feet):219,212 sf(5.03 acres) Area Zoning: R-80 Previous use of property: Residential,single dwelling with swimming pool Intended use of property: No Change Covenants and Restrictions: Yes X No If "Yes", please provide copy. None known Will this project require a Building Permit as per Town Code? X Yes N o 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 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. X Yes No Does the structure(s)on property have a valid Certificate of Occupancy Yes No Prior permits/approvals for site improvements: Unknown. 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): Demolish and remove existing dwelling,swimming pool,and deck located less than 100 feet from wetlands;construct new,2,130 sf, one-story,single family dwelling with attached covered deck and pavilion,20'x 84'swimming pool,25'x 36'deck,and 53'x 56' basketball court,all located more than 100 feet from wetlands and 100 feet or more from top of bluff;replace existing sanitary system located less than 100 feet from top of bluff with new sanitary system located more than 100 feet from top of bluff;and install new drinking water well and 4'pool enclosure fencing,all as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying, PLLC,last dated March 24,2016. Boa of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To remove an aging dwelling and swimming pool located less than 100 feet from wetlands and construct a new dwelling, swimming pool,and related structures more than 100 feet from wetlands and at least 100 feet from the top of bluff. Area of wetlands on lot: +1-37,300 square feet Percent coverage of lot: +/-17 % Closest distance between nearest existing structure and upland edge of wetlands: +1-11 feet (existing shed Closest distance between nearest proposed structure and upland edge of wetlands: +/-112 feet (proposed dwelling Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? TBD cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: TBD feet(as needed for installation of dwelling,pool& sanitary system) Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Standard construction practices. 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 application proposes to demolish and remove an existing dwelling and swimming pool,each presently located less than 100 feet from wetlands,and construct a new dwelling and swimming pool more than 100 feet from wetlands and at least 100 feet from the"top of bluff'on the property,thus replacing preexisting nonconforming structures with code-conforming structures. The application also proposes to install a drainage system of drywells more than 100 feet from the top of bluff and to replace the existing sanitary system located less than 100 feet from the top of the bluff with a new sanitary system located more than 100 feet from the top of bluff. As a result of these proposed increases in wetlands setbacks to residential structures and sanitary system and the improvements in site drainage and septic treatment,the project will have a beneficial impact on the adjacent tidal wetlands and waters of the Town. 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: Domeluca Residence Project Location(describe,and attach a location map): 14895 Main Road(S.R.25),East Marion,Town of Southold, SCTM#1000-23.1.2.10,property is located on north side of Main Road,map provided. Brief Description of Proposed Action: Demolish and remove existing dwelling,swimming pool,and deck located less than 100 feet from wetlands;construct new,2,130 sf,one-story,single family dwelling with attached covered deck and pavilion,20'x 84'swimming pool,25' x 36'deck,and 53'x 56'basketball court,all located more than 100 feet from wetlands and 100 feet or more from top of bluff;replace existing sanitary system located less than 100 feet from top of bluff with new sanitary system located more than 100 feet from top of bluff;and install new drinking water well and 4'pool enclosure fencing,all as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated March 24,2016. Name of Applicant or Sponsor: Telephone: 631-298-8065 Domeluca II,LLC;Pablo Salame,Managing Member E-Mail: djjla@icloud.com Address: do David J.Jannuzzi,Power of Attorney,P.O.Box 1672 City/PO: State: Zip Code: Mattituck NY 11952 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 X 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: X Suffolk County Department of Health Services 3.a.Total acreage of the site of the proposed action? 5.03 acres b.Total acreage to be physically disturbed? 0.76 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 5.03 acres 4. Check all land uses that occur on, adjoining and near the proposed action. ❑Urban 0 Rural(non-agriculture) 0 Industrial 0 Commercial ®Residential(suburban) ❑Forest 0 Agriculture ®Aquatic 0 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: Name:Peconic Bay&Environs,Reason: Protect public health,water,vegetation& scenic beauty,Agency: Suffolk County,Date:7-12-88 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: Installation of a new well is proposed. X 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? X b.Is the proposed action located in an archeological sensitive area? 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. 0 Shoreline 0 Forest 0 Agricultural/grasslands 0 Early mid-successional 0 Wetland 0 Urban 0 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? YES If Yes, a. Will storm water discharges flow to adjacent properties? 0 NO 0 YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: 0 NO 0 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: 'Npert E.Herrmann,Coastal Mgmt. Specialist Date: March 25,2016 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, 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. 0 Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmenta imp cts. L,/ 0/ --7-,-;,,J-5/2, // Name of Agency -Date j oA retie! ey&c Print or Typ,/ ame of R• .e 'ible Offi ern Lead Agency Title of Responsible Officer _nature of Res,. sible Officer in Lead gency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: Domeluca II,LLC SCTM#1000-23-1-2.10 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Demolish and remove existing dwelling,swimming pool,and deck located less than 100 feet from wetlands;construct new,2,130 sf,one-story,single family dwelling with attached covered deck and pavilion,20'x 84'swimming pool,25'x 36'deck,and 53'x 56'basketball court,all located more than 100 feet from wetlands and 100 feet or more from top of bluff;replace existing sanitary system located less than 100 feet from top of bluff with new sanitary system located more than 100 feet from top of bluff;and install new drinking water well and 4'pool enclosure fencing,all as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying,PLLC,last dated March 24,2016. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 14895 Main Road(S.R.25),East Marion 3. That the project which is subject to Environmental Review under Chapters 96,111'and/or 275 of the Town Code is open to public comment on: DATE: Wednesday,April20,2016 @ 5:30 p.m. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. Domeluca II,LLC;Pablo Salame,Managing Member c/o David J.Jannuzzi,Power of Attorney PROPERTY OWNERS NAME: P.O.Box 1672 MAILING ADDRESS: Mattituck,NY 11952 PHONE #: 631-298-8065 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road,Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. PROO1 F MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Joseph Berov 177 Kensington Street Brooklyn,NY 11235 Treasure Island Cove 66 Leonard Street,Apt.9C New York,NY 10013 Jeffrey Hulse&Carol Kalin 3 N Harbor Down Miller Place,NY 11764 STA 1 k OF NEW YORK COUNTY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 , being duly sworn, deposes and says that on the 31st day of March ,20 16 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Southampton , that said Notices were Mai -d to each of said persons by (certified)( g e ed) mail. .._1.. Robert E.He -.nn Coastal Management Specialist Sworn to before me this 31st KIM H . STEPHENS day o March ,2016 NOTARY PUBLIC STATE OF NEW YORK �` , COMMISSION NO . 5015931 / QUALIFIED IN SUFFOLK CO,IJ,TY _ Nota 'ublic EXPIRES AUGUST 2 . 201 ,rr�g�fFO�A�, �, John M. Bredemeyer III, r'iesident roti oG Town Hall Annex Michael J. Domino, Vice-President ';r.k* yy� 54375 Route 25 Glenn Goldsmith N N �� P.O. Box 1179 A. Nicholas Krupski � �, '' � Southold, NY 11971 Charles J. Sanders `' if Charles �'74 �� 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 DOMELUCA II, LLC COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR NOT LESS THAN SEVEN DAYS I, Robert E. Hermann , residing at/dba En-C9nsultants 1319 North Sea_Road, Southampton,__NY 11968_ _ being duly sworn, depose and say: That on thel2 h day of April , 2016 , I personally posted the property known as 14895 Main Road (S.R. 25), Fast Marion, SCIM #1000-23-1-2.10 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,April 20, 2016. { Dated: ,fr' i (signature) Sworn to before me this 20th day of April 20 16 MIR 4116111,...41.1.1 . a Public % KIM H . STEPHENS NOTARY PUBLIC STATE OF NEW YORK COMMISSION NO . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 1 . 20Jq IUk.S. Postal Service "CERTIFIED MAIL° RECEIPT' " m Domestic Mail Only For delivery information visit our website at www.us s come. ra OFEFtiCEIAL USR 0 Postage $ m Certified Fee r'{j) C7 ' Postimark Return Receipt Fee C e :;:;e;:;:;; )) r9 Total F 11K rU Sent To Domeluca II, LLC p street do David J Jannuzzi,POA (ti or Poe P.O, Box 1672 City,Sts Mattituck,NY 11952 PS For - nzu n cu part rnrorrneFy u v TM U.S. P. .1 Service Q CERTIFIED MAIL® RECEIPT' fir, ra Domestic Mail Only la i% ) = For delivery information,visit our website,at www.usps.com°. r— Certified Mail Fee rii $ Extra Services&Fees(check box,add fee as aPProPr= `,Q'- Q 0 Return Receipt(hardcopy) $ �� ".----.. 134')k �V/Q Q 0 Return Receipt(electronic) $ lc( f \per rk , Q 0 Certified Mall Restricted Delivery $ / Q El Adult Signature Required $ "", C pp 0 Adult Signature Restricted Delivery$ 1 r G Q Postage ` `®,r� "i; mTotalPos'_ - ---- '''..c j_1 $ �`USP�f Sent Joseph Berov ----- r-. Street ani 177 Kensington Street City,State Brooklyn,NY 11235 PS FormWI. U.S. Postal Service"' -� r.iir`'!L" CERTIFIED MAIL® RECEIPT',Y-` ,, Domestic Mail Only �` r. For delivery information,visit our website at www.usps comm. rq OFF COAL USE Q CI m Postage $ i H M Certified Fee (.;/7----- � +� Q Return Receipt Fee **postmark 0 Q (Endorsement Required) ` *J d' re Q 1 ff Restricted Delivery Fee I `®/60 fru (Endorsement Requved) �Q�� ti- f�U Total Posta — -_— \`` `' 'sPS Sent To Treasure Island Cove - - — Q Street&Apt.i 66 Leonard Street,Apt. 9C N or PO Box Ale New York,NY 10013 City,State,ZI ' PS Form 380., .. . . - _• .ns Z U.S. Postal.Service"' ' CERTIFIED ��'�ry'"" �'` - ,,, MAIL° FCEIPT y, ,, ru Domestic Mail i; Only ,r; .�,: ,=- For delivery information,visit our website at www.usps.come. ri OFFfl 0AL USE Q mPostage $ m Certified Fee nun, �P� mReturn Receipt Fee ark Q (Endorsement Required) Restricted Delivery Fee ►, •• QL Q (Endorsement Required) im f 2016 ! j r9Total F 1 y sent To, Jeffrey Hulse&Carol-11 i. ri o Street&1 3 N Harbor Down coy,Sta Miller Place,NY 11764 I I 1 w.l.l• AU• 1 • � I 1 NUTILL OF ■ ARING 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: DOMELUCA II, LLC SUBJECT OF PUBLIC HEARING : For a Wetland Permit to demolish and remove existing dwelling, swimming pool, and deck; construct new 2,130sq.ft. one-story, single-family dwelling with attached covered deck and pavilion; a 20'x84' swimming pool; a 25'x36' deck; 4' high pool enclosure fencing; a 53'x56' basketball court; replace existing sanitary system with new; and install a drinking water well. Located: 14895 Route 25, East Marion. SCTM# 1000-23-1-2.10 TIME & DATE OF PUBLIC HEARING : Wednesday, April 20, 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 Board of Trustees Application County of Suffolk State of New York Pablo Salame, Managing Member, Domeluca II LLC 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 q SWORN TO BEFORE ME THIS AM DAY OFN ,20 otary Public DONNA M.PALMER Notary Public,State of New York No, 01 PA5069978, Suffolk County Qor rnlssion Expires December 9,... 6(-1/ Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) Pablo Salame, Managing Member Domeluca II LLC residing at 66 Leonard St,Apt.9C (print owner of property) (mailing address) New York, NY 10013 do hereby authorize (Agent) En-Consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) �! i _ 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. Pablo Salame,Managing Member YOUR NAME: Domeluca II LLC (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 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 /cSigSubmitted t 's, ' day of O..:4LiAL 2 246- Signature nature .)12/./.1 �, _`� . Print Name Pablo Sa ame, Man ing Member Form TS I Domeluca II LLC ��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 -obig :', 1000 23 1 2.10 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN ,,,,,' District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. I SCOPE OF WORK- PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT 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 5.03 acres Generated by a Two(2")Inch Rainfall on Site? the Scope of work for Proposed Construction) (This item will include all run-off created by site (S.F./Acres)) 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 Site improvements and the permanent creation of construction activity? impervious surfaces.) (S F/Acres) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location?This item shall include all proposed Grade Changes and Demolish and remove existing dwelling,swimming pool,and _ Slopes Controlling Surface Water Flow, deck located less than 100 feet from wetlands;construct new, 3 Does the Site Plan and/or Survey describe the erosion 2,130 sf,one-story,single family dwelling with attached covered and sediment control practices that will be used to deck and pavilion,20'x 84'swimming pool,25'x 36'deck,and control site erosion and storm water discharger.This 53'x 56'basketball court,all located more than 100 feet from Item must be maintained throughout the Entire Construction Period. wetlands and 100 feet or more from top of bluff;replace existing sanitary system located less than 100 feet from top of bluff with 4 Will this Project Require any Land Filling,Gradinor there Excavation where ere is a change to the Natural new sanitary system located more than 100 feet from top of Existing Grade involving more than 200 Cubic Yards bluff;and install new drinking water well and 4'pool enclosure of Material within any Parcel? fencing,all as depicted on the site plan prepared by Kenneth M. 5 Will this Apphcation Require Land Disturbing Activities Woychuk Land Surveying,PLLC,last dated March 24,2016. Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site?Is this Project withm 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 nmre acres.including disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes are part of a larger couuiuitplan that will ultimately disturb one or more acres of lands, which Exceed Fifteen(15)feet of Vertical Rise to Including Construction activities involving soil disturbances of less than one(1)acre whereOne Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for stormwater discharges_ 8 (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit Will Driveways,Parking Areas or other impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off \/ 1.The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? X. submitted to the Department prior to the commencement of construction activity. 2 The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit In addition,the SWPPP shall Area?(This item will NOT include the installation of Dnveway 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 aStorm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable m the principles andpractices of Storm Water Management Southold and Murk be and/or ns for Review Prior ti Issuance of Any pe edAp Permit. g P P g (NSE:ACharkMark QC)and/or Aistwerer for eachQuestionis Required for aComple6ed Apphcabon). , 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 inecfin icadualsigugDbanart) And that he/she is the Agent for the owner (O%rl r,Caitrada;Ag2rt Capnaleaffio3;do 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; - 25thda March ,20 16 Notary P : ' --- . _r' � KIM H . STEPHENS iJ NOTARY PUBLIC �a,.nature of Applicant) FORM- 06/10 STATE PF 14.1EVJ YU1tK commission) WO 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 . 20a Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. A 11 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 I, aw . This assessm eat is intended to supplem eat other information used by a Town of Southold agency in m a k i n g a d e t e r m i n a t i o n 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). 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# 23 - 1 _ 2.10 PROJECT NAME Domeluca II,LLC 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: Demolish and remove existing dwelling, swimming pool,and deck located less than 100 feet from wetlands;construct new,2,130 sf, one-story,single family dwelling with attached covered deck and pavilion,20'x 84'swimming pool,25'x 36'deck,and 53'x 56' basketball court,all located more than 100 feet from wetlands and 100 feet or more from top of bluff;replace existing sanitary system located less than 100 feet from top of bluff with new sanitary system located more than 100 feet from top of bluff;and install new drinking water well and 4'pool enclosure fencing, all as depicted on the site plan prepared by Kenneth M.Woychuk Land Surveying, PLLC,last dated March 24,2016. Location of action: 14895 Main Road(S.R.25),East Marion Site acreage: 219,212 sf(5.03 acres) Present land use: Residential,single family dwelling with swimming pool 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:Domeluca II,LLC;Pablo Salame,Managing Member (b)Mailing address: do David J.Jannuzzi,Power of Attorney P.O.Box 1672,Mattituck,NY 11952 (c) Telephone number: Area Code 631-298-8065 (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? SCDH 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 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 Because the application proposes to replace existing residential structures located less than 100 feet from the top of bluff with new structures located farther landward and more than 100 feet from the top of bluff,the project is consistent with Policy 4 to the extent that the proposed"landward retreat"furthers the goal of minimizing the risk of losing structures and natural resources to flooding and erosion. 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 In association with the removal of the existing dwelling and swimming pool and construction of new residential structures at least 100 feet from the top of bluff,the application proposes to install a drainage system of drywells more than 100 feet from the top of bluff and to replace the existing sanitary system located less than 100 feet from the top of the bluff with a new sanitary system located more than 100 feet from the top of bluff Therefore,consistent with Policy 5,water quality and supply will be both protected and improved as a result of the project. 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 The application proposes to demolish and remove an existing dwelling and swimming pool,each presently located less than 100 feet from wetlands,and construct a new dwelling and swimming pool more than 100 feet from wetlands and at least 100 feet from the"top of bluff'on the property,thus replacing preexisting nonconforming structures with code-conforming structures The application also proposes to install a drainage system of drywells more than 100 feet from the top of bluff and to replace the existing sanitary system located less than 100 feet from the top of the bluff with a new sanitary system located more than 100 feet from the top of bluff As a result of these proposed increases in wetlands setbacks to residential structures and sanitary system and the improvements in site drainage and septic treatment,the project will comply m all ways with the permit standards of Chapter 275 and contribute to the protection and restoration of the quality and function of the adjacent tidal wetland ecosystem,consistent with Policy 6 The proposed construction activities are also located entirely landward of the 10'elevation contour above mean sea level and/or the top of bluff and thus beyond the tidal wetlands junsdiction of the New York State Department of Environmental Conservation 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. Yes No Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of nvW water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. Yes No IX 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 fl 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 1><1 Not Applicable • PREPARED BY /Ay "TITLE Coastal Mgmt. Specialist DATE March 25,2016 Robert E. ,,101 ann Amended on 8/1/05 J EN-CONSULTANTS March 25,2016 • MAR 2 5 2016 Town of Southold - Board of Trustees { i�.=i { 54375 Main Road [; ' t,,t 5_ _—._-- -•-� Post Office Box 1179 �~ Southold,New York 11971 Re: Domeluca II,LLC 14895 Main Road(S.R. 25),East Marion SCTM#1000-23-1-2.10 Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization&Disclosure Forms; c) Attorney Opinion Letter d) Power of Attorney 2. Survey prepared by Kenneth M. Woychuk Land Surveying,PLLC, last dated March 24,2016. 3. One(1)set of site photographs. 4. Application fee of$250.00. 5. Three(3)LWRP Consistency Assessment Forms including: a) Survey(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, f /•i Robe E. Herrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road I Southampton,New York 11968 I p 631.283.6360 I f 631.283.6136 www.enconsultants.com environmental consulting