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TR-8805
Michael J.Domino,President O�*QF S(7UryDl Town Hall Annex John M.Bredemeyer III,Vice-President O 54375 Route 25 P.O. Box 1179 Glenn GoldsmithCA Southold,New York 11971 A. Nicholas Krupski �pQ Telephone(631) 765-1892 Greg WilliamsFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1494C Date: July 30, 2018 THIS CERTIFIES that the construction of a 62'6"x45' (2 812sq.ft.)two-story dwelling with attached 28'x32' (896sq ftgarage; and a 15'x25' (375sq ft.)deck attached to the seaward side of dwelling; install a septic system on landward side of dwelling; connect to public water; install a 1 890sq ft gravel driveway; and install a system of drywells to contain stormwater runoff; with the condition to establish and perpetually maintain a 30' wide non-turf buffer along the landward edge of wetlands with a 4' wide access path through same for shoreline access;an activity to remove invasive species in said buffer area will require the issuance of a permit; At 4145 Wells Road,Peconic Suffolk County Tax Map#1000-86-2-12.6 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 8,2016, pursuant to which Trustees Wetland Permit#8805 Dated May 18,2016,was issued and Amended on April 19,2017 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for construction of a 62'6"x45' (2 812sq ft two-story dwelling with attached 28'x32' (896sq.ft.)garage-, and a 15'x25' (375sq ft)deck attached to the seaward side of dwelling; install a septic system on landward side of dwelling,• connect to public water; install a 1 890sq ft gravel driveway' and install a system of drywells to contain stormwater runoff,with the condition to establish and perpetually maintain a 30' wide non-turf buffer along the landward edge of wetlands with a 4' wide access path through same for shoreline access,• any activity to remove invasive species in said buffer area will require the issuance of a permit. The certificate is issued to Charles&Brenda Grimes owners of the aforesaid property. Authorized Signature Michael J. Domino, President �� so�riyo Town Hall Annex 54375 Route 25 John M. Bredemeyer III,Vice-President h0 lQ P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Telephone (631) 765-1892 Greg Williams r.-, 04UMyFax(631) 765-6641 y ,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: -7L2-5 1 ) G Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection. INSPECTED BY: `ire `' COMMENTS: ✓o eL Cowl � e q.S �✓' � 5 CERTIFICATE OF COMPLIANCE: f - � Michael J.Domino,President Jf SOUJyO Town Hall Annex John M.Bredemeyer III,Vice-President �O lQ 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G � O Telephone (631) 765-1892 Greg Williams Oel, enu Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: �T Ch. 275 Ch. 111 -INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/ constructed Project complete, compliance inspection. �!•Lg E U 6P-�P� INSPECTED BY: COMMENTS: Gp-up?,CMq I I T+N 1 `iL AA- 2 A CERTIFICATE OF COMPLIANCE: IRM-�_-� i i LTill�•' - wi.' �' Ke, 1 s•1� f 2 fl� y��f� ` ��.. �; ��1 _ •--�� ""�-�'�12e..e�-:`' l � ..•.1a1 -4 J1. .. . "t�� _ '•fi1�''�yp'�! �sr��'"7��_ I K A; F }, a }jt.,,f�,.�.� F.�1. F i •� .- Ti. .i. •. � •,, , 'w-t'�'�' e+w; '_ _r2 tik.;Ll .. - - + �' ,` , 'f � lti� �•yVj��.'��5� � ..w•.y. .. '� � ` .iii •,,..� k.}47 f '. .may. 1Ir'�. .+ `,I/„� -+ ` r^^':. 7�►� Y A �'- I Y _ ^` ;! 4 ` 'H'lL,, `.1 .�It,..yi 'Y'��i'.�,5�r�''.sK '1 - ��1��Y� .,��r. •'. .",�._ yr::1. 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Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 23, 2018 Glenn E. Just J.M.O. Environmental Consulting Services P.O. Box 447 Quogue, NY 11959-0447 RE: CHARLES & BRENDA GRIMES 4145 WELLS ROAD, PECONIC SCTM# 1000-86-2-12.6 Dear Mr. Just: The following action was taken by the Southold Town Board of Trustees at their Special Meeting held on Friday, March 23, 2018: RESOLVED that the Southold Town Board of Trustees grants the One-Year Extension to Wetland Permit#8805, as issued on May 18, 2016, and Amended on April 19, 2017. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. Domino President, Board of Trustees MJD:dd J. M.O. Environmental Consulting Services January 17, 2018 JAN 29 2018 Mr. Michael J. Domino, President Board of Town Trustees Town of Southold Board Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Re: Property of Charles & Brenda Grimes 4145 Wells Road, Peconic S.C.T.M.No. 1000-86-2-12.6 Dear Mr. Domino: At the present time we are seeking to extend this permit which was originally issued to the E.G. Stein Family Trust c/o David Edelstein • Libby Goldstein on May 18, 2016 and then amended by Charles • Brenda Grimes on April 19, 2017. Please feel free to contact us at any time should you or any member of the Board of Trustees have any questions or comments regarding this request. R'Lesp: t ly, Gle EE. / j E. Phone (631) 653-0607 - Email Gjustl02l5@aol.com 121 Jessup Ave - 2nd Floor - P.O. Box 447 Quogue, New York 11959-0447 f �k__ Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, er\&Q. I- C\—'CIrA� vne-' owners of the property identified as SCTM# 1000- 86-2-12.6 in the town of Peconic New York, hereby authorizes JMO Environmental Consulting to act as my agent and handle all necessary work involved with the application process for permit(s) from.the Southold Town Board of Trustees for this property. Property Owner's Signature Property Owner's elbeU6 (� h SWORN TO BEFORE ME THIS v�l DAY OF AV _ , 20=__ Notary Public =COMMISSIONM97M Board of Trustees Application AFFIDAVIT `(1ck ��� � BEING llULY SWORNDEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED .HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDI'T'ION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. S rc of Pr ty Owner~ ibnAture of I' r y Owner SWORN TO BEFORE ME THIS t DAY OF AUCkU' V 1 Notary Public --- ^� ,.t =T'ACIE KESSLER '-"'COWWSSION#FM5gn �wot' `'�'=KES:Mmch28.2020 Michael J. Domino, Preside QSVFfO��'l' ice~ Town Hall Annex John M. Bredemeyer III, Vice-President h�0 Gy., `� 54375 Route 25 Glenn Goldsmith CM ti z P.O. Box 1179 A Nicholas Krupski 1O Southold,NY 11971 Greg Williams y ® p! Telephone(631)765-1892 �Ol �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time- Completed in field by: J.M O. Environmental Consulting on behalf of CHARLES & BRENDA GRIMES requests a One Year Extension to Wetland Permit#8805, as issued on May 18, 2016, and Amended on April 19, 2017. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or.gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence- 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Page 1 of 2 , Michael J. Domino, Preside o�OSUFFO('��oG Town Hall Annex John M. Bredemeyer III, Vice-President „� yam, 54375 Route 25 Glenn Goldsmith ti z P.O Box 1179 A Nicholas krupski Southold,NY 11971 Greg Williams y p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: J.M.O. Environmental Consulting on behalf of CHARLES & BRENDA GRIMES requests a One Year Extension to Wetland Permit#8805, as issued on May 18, 2016, and Amended on April 19, 2017. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams E. 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Y �A - 1 � •jai t '� � + I _ _ - ♦�� �• � _ f - • :f r t. - �... �'�-:' y d - ham:•. ,..'Gi.. { k � l a: ._� -. • ... r - - - _ it ` - - - Ir �• Ynr rcnda&Charles Grimes 145 Wells Road,Peconic • SCTM#_ 1000-86-2-12.6 (21/17 s RT f j PT �: .+>'��,�+' - •- - __'•�.!`. _ � � , _ = _ .:- f�'y`�,'�`y�•-�+.' sir-:�-,t"- -+�` - 01 vNW - - o- - W. K � > -. .... `,•_ _.�� .rst' r. r _ � e . s �.a y R. w _ nk �__ _� i _ _ '_��.ill►��,r ��_',. �i�14���._ a IMPL ir titf ♦• ,W •moi- ' 1.3 :r ♦ ..�,��'�$� ~�t��'` al,s '�`� _ � ,.'�'r.{',c. --� :t �` 4. • ^k �� � ll for 7, i •� r renda&Charles Grimes 145 Wells Road,Peconic SCTM#: 1000-86-2-12.6 /21/17 _ T3• r s 7 r - fie w f` i, 1 !r '� _,3, a t,., I "moo ,�•• ,_ r ' - F a w "'jcc''S: � .>..' .f'•3� r`l / f �.V` ,� f►jyR - a"�`r y.: f'!' _ t .. �.7�� ��'9,Y .A,°�" _ '�'�b-.7F5.. y. .,,; Ch���� _�a- ��yl i_ •` ..c �^ � `�x" - - t ../ � ��-.' J'bt -` 3�.�.�•- +Gs:. ....7'k Y�^ .�-.1G2�?' +"`.� ��A.r_�3 r �>stJ`.. ^ 1 __ �. �-' �� '� �� Y.: _- F„r 'St^�• - �S�'Y'� 1 .,� �,. �„t _� Jai !�«y' .�':�.i�: �.:, - .,ra 1•. � ,� ; rk' ti 's�, x,F�.i � J+ `` v..r._'i.Q... ��� _` ,.� �.c. � 4,, -, �"=rri:" '!�' ^^yam �Q4 ,'•rA. _ r r�. .' W-�����y �. a " y . F ��[[''+M -_ Dk+�y�tlt4'. .r ` 9 ,�i:'F.l 1�.�'.Y•y ''���,�. �!! �p-� ' t��s� �, .. a .r ,e i= .. _n r✓� . 1. "y_�w�C�•`,r W 'h`4 }dlasw �t Michael J. Domino, Presi a �Q C� Town Hall Annex John M. Bredemeyer III,Vice-1kesident �� Gym 54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith -Pry Southold,NY 11971 A.Nicholas Krupski ?� p! Telephone(631)765-1892 HCl [ �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �� ICompleted in field by: Frank Beta on behalf of CHARLES & BRENDA GRIMES request a Pre-Submission Inspection to discuss the proposed landscaping/re-vegetation of the cleared property seaward of the dwelling. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice f Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 00 a'6AjJy s'Qar 4 If fvice, Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski —7-C.,Sanders Other Page 1 of 2 Michael J. Domino, Pres O�p$1SFFQ(��oG � ' Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Charles J. Sanders y P.O.Box 1179 Ze Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski y ® p! Telephone(631)765-1892 ��� t Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Frank Beta on behalf of CHARLES & BRENDA GRIMES request a Pre-Submission Inspection to discuss the proposed landscaping/re-vegetation of the cleared property seaward of the dwelling. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause,saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: ' Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 � r $o �QF (/jy , Michael J. Domino, President �o� Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J. Sanders Southold, New York 11971 Glenn Goldsmith ® y� Telephone(631) 765-1892 A.Nicholas Krupski ol�C®U Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: GCG� s4 Za/7 J Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction Y2 constructed Project complete, compliance inspection. INSPECTED BY: 1 , COMM NTS: 4 kl'�— - 3 2 CERTIFICATE OF COMPLIANCE: ,r- s r_ �o+•.� � .R' .r. .� 4i�-� :.Y4;. ��!t��?c.�' - -+ - !,��•�,, '.'moi �.:-. } .M-0-- MOM ��G� _ 4'1 Baa,` �! -• �' _ Jt. - :-• a.1 w"� !"��.�� y� '� '+�•+'� .� _ �'q _-i _ � �y�.�,, .�._ .� .. T. - .,,�r�rl► C'�-�'s�r4�i� r. ,- ,s.3 -.� - s-i.`���'•. � -.aL�' j, ��'S <. ��'` �`s•-0IY' .,r _ • .. _ '� -,1{' i•'ir�d�,�q<, ' x,',1-`.: w€°��..,is�it".l,ngac��,,,�,•h�E�+aa'+l _« 'yam-'.'.,.� �- . .y ,•t.,,,~.-�� y 1 .Ci i_ 2 � ,✓ :+v, '� �. .' rY-•J.d �„'"5�;.' 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Y ��. � y�:t �e1`• � moi. -�.�� At 40 � ' V - � _�: �� � �.i'd- uy' - 7.'`• �„ 1.9� �h'�l- - '!�, �i.� y"¢jam, -kit ,'+::- ..A ,c+_ $�\ `_^"4. - ALO .,� ;,.> i •i.� \ �, R'k� �.`._, •\ y. *'vr:.�7 /� y* �© ao pov IJ tr —Lf\J r 410 lums ' ''fes '.'}+.slJir;~. �•� ++-A �I .�,../fie► �,, ���`~�' e,��� �` DMSUFFOLK SURVEY OF PROPERTY Soy, N A T PECONIC TO WN OF SOUTHOLD req° T°`` COUNTY N. Y. gNrJ °'� Southold Town B ar f rue 1000-86--02-12.6 SCALE lj�=301# JANUARY 14, 2015 Off. FEB. 16, 2016 (SITE PLAN) APRIL 7, 2016 (REVISIONS) p���F 11N6 MAY 24, 2016 (REVISIONS) rr JUNE 9, 2016 (REVISIONS) FOcFA� rAle,/C ,� °`��4,V�� OCT 28, 2016 (REVISIONS) 10 NOV. 04, 2016 p�oQ° `S9 q��FaT ��rFR FEBRUARY 7, 2017R(RESVISIONS) FEBRUARY 15, 2017 (REVISIONS) MARCH 6, 2017 (REVISIONS) <�,N'•••'C'J:<C`•,s ''�� ` MARCH 16, 2017 (REVISIONS) ' MARCH 28, 2017 (REVISIONS) ¢y�y�gN`yr`•�•«��sT,� Q�����e 1 �F ry �ocF�� �w O )/110 2 ' cp ~ TOTAL AREA TO TIE LINE SF— r 0e F� �, 8 38,595 sq. ft. Fyo F cq °� ,oeeo/ AREA 1, UPLAND = 28,297 sq.ft. WETLAND = 10,298 sq.ft. F R0.f1 o 1,I Co I.6 MOLS A R8 Vf4X A IAC. r`o �`` �° r�9�UND D►$�VQ$ANG , Z PROPOSED UPLAND A,<v v 4�r LOT COVERAGE Opp __�0 O v 3744128,200 = 13.3 9 13.3 90 PROPOSED COVERAGE RAIN RUNOFF CONTAINMENT F m HOUSE WITH GARAGE = 3494 SQ.FT. Z 3494 x 1 x 0.17 = 594 cu.ft. U GRAVEL DRI VEWA Y = 1120 sq.ft ALL Nf✓W UR`(k`1EW0 1120 x O.8 x 0.17 = 153 cu.ft �-- s t4US`f MAII.11-A14 VIINIKUM 747 cu.ft 122.21' WU SOAWIOA b-F 9¢' ree,-r EROSION &SEDIMENT CO OLS A 80V 6 G 900 00 W�$�IZo. 747 cu,ft./42.2 = 18 IIF Shall include but not be limited PROVIDE (5) DWs = 80 x 4' A well maintained Construction Entr ce, OR EQUAL Wire Backed Silt Fencing, stabilization& NO GRADING OR FILL PROPOSED Seeding of exposed and/or inactive soils. PRO vl06 2- a A Z'deeR CERTIFIED T0: ��gC�l� CHARLSE W. GRIMES 61 Lt BRENDA GRIMES S AK-R or- rive`�J� �p01�rS ]C SYSTEM DETAIL WG NATIONAL 77TLE INSURANCE COMPANY 'OT TO SCALE vse 10 t)w, FINISHED GRADE EL. 8' DRAINAGE INSPECTIONS ARE REQUIRED MR CHIMNEYS Y�SONARY CHIMNEY Contact TOS Engineering at 765-1560 before ' MAX MI 2Backfill,OR Provide Engineer's Certification CE�n ED CEO Cal 1Z UE3 L OW the drainage has been installed to Code. INV.EL. ME® ®a 3 0' 1/4" P R'foco to a ® EROSION&SEDIMENT CONTROLS MINIMUM ITCFr Shall include but not be limited to: MIN.4' DIA IPE 2' A well maintained Construction Entrance, (6) 2 feet deep gullies ---------- ------ _____ __________ INA TER EL o.7' Wire Backed Sift Fencing,stabilization & ng of exposed and/or inactive soils. %WAL OF STORMWATE A_ NAGEMENT TIC SYSTEM Cotft'OI P N = a n Co e _ p r 236 N. Y . LIC. NO. 18 WS) Date: '� Z7 / _ l?ECONIC SURVEYORS, P.C. EPTIC TANK 80 x 4' LIQUID��- •- - - 631) 765-5020 FAX (631) 765-1797 .0. BOX 909 sq.ft. = 3 EXP. GALLEYS) 1230 TRAVELER STREET SOUTHOLD, N. Y 11,971 15--225 CLEAN OUT DETAIL n E C EIE FOR USE WITH BUILDING EXTENSION/CONNECAON U SLATE OR OTHER STOPPER ENO AUG — 1 2017 \ I SUITABL COVER OR PLUG Southold TowF— ftard of Trustees A YACMiSEWER PIPE vmj oz- 1 30•ELBOW F `o�� FOSE SO' WY£ 00, s TEST HOLE DATA MCOMALD My -- as PAW erroW caw OL O PALE BMW SKr ML PALE&MW MX TO UEDNN SWID SP ` G 4 rt000ry WATER IN PALE BROW RNE R?AMMV SAND SP �F / � Noce wArER avcrorrNIERm&Q•Mow StlRFAX lb LANDWARD LIMIT OF 77DAL WETLANDS AS DETERMINED C BY SUFFOLK ENVIRON ON ENVIRONMENTAL CONSULTING,2 2015 1 (C�gss��� ® c G NO IF -02oo A 4 FOOT ACCESS PATH PERMITTED THROUGH NF(°�,.� o THE 30 FOOT NON—TURF BUFFER FOR PURPOSES OF SHORELINE ACCESS •Dc0 ,�� �`wooQ M wM ZOA E `c 23.38, �-nE A = STAKE S84'02'38"W ■ = MONUMENT - - m =• TEST HOLE �rrl►�J�/� S = WET LANDS FLAG, l [J 11 T,� AREA= 38,595 SQ. FT. TO TIE LINE ELEVA77ONS AND CONTOUR LINES ARE REFERENCED FROM NA VD 88 CONNECTOR AT PVC/CIG JOINT SEF FLOOD ZONES FROM FIRM J610JC0162H CLEAN OUT EL. 8' 7be location of public water, wells and cesspools shown hereon are 24", A.,MA., 3„ from Held observations and or from data obtained from others. INV EL. � 7 5 .... INV.EL. 12 .6 I AM FAMILIAR WITH THE STANDARDS FOR APPROVA,L AND HOUSE TRA 6.5' 6' 10, IN CONS7RUC77ON OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR6 SINGLE FAMIL-Y RESIDENCES AND WILL ABIDE BY TH /s" PER FOOTE CONDl710NS MINIMUM PITCH SET FORTH 7HEREIN AND ON THE PERMIT TO CONSTRUCT. MIN.4" DIA. PIPE $ 1200 CAL. 2 m LOT(2)s REFER TO "MINOR SUBDIVISION PLAT KNOWN AS RICHMOND CREEK FARMS" PRECAST SEPTIC--------- ---------- TO BE A PORRON OF 77-IE PREMISES CONVEYED TO THE GRANTOR TANK HEREIN BY DEED DA TED NOVEMBER 25, 1997, RECORDED IN THE SUFFOLK COUNTY CLERKS' OFFICE ON DECEMBER 9, 4997 IN LIBER 11866 CP 747, ANY ALTERA77ON OR ADDITION TO THIS SURVEY IS A VIOLA77ON PROPOSED SE OF SEC77ON 72090F THE NEW YORK STA TF EDUCA77ON LAW. , (3 BEDR EXCEPT AS PER SEC77ON 7209-SUBDIVISION 2. ALL CERTIFICA77ONS HEREON ARE VALID FOR 77/1S MAP AND COPIES THEREOF ONLY IF [1] 1200 GALLON PRECAST SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 300 sq.ft. LEACHING WHOSE SIGNA7URE APPEARS HEREON. [6] LEACHING GALLEYS (31 L Cantrell, Elizabeth From: Brenda Grimes <bgrimes@gandb.com> Sent: Tuesday,June 06, 2017 11:14 AM To: Cantrell, Elizabeth Subject: RE:4145 Wells Road Peconic Tree Removal Thank you Elizabeth,this is very helpful. Regards Brenda Grimes From: Cantrell, Elizabethfmailto:elizabethc@town.southold.ny.us] Sent:Tuesday,June 6, 2017 10:30 AM To: Brenda Grimes<bgrimes@gandb.com> Subject: RE:4145 Wells Road Peconic Tree Removal Good Morning Mrs. Grimes, Regarding your inquiry below, I spoke with Trustee President, Michael Domino &Vice-President,John Bredemeyer about your concerns of vegetation/tree clearing landward (towards the street) of the line of silt fencing&staked hay bales that will be set not less than 50 feet from landward edge of wetlands. They determined that any vegetation (including trees) located landward of the established line of silt fencing and staked hay bales may be removed without applying for a permit. From the line of staked hay bales&silt fencing towards the water(seaward)will require a permit from this office to do any type of landscaping/tree removal/vegetation removal/sod installation/sprinkler installation. We must advise you to also contact the NYSDEC regarding any landscaping modifications to this area as permits may be required from them as well. I hope this answers your question regarding the construction of your new dwelling. Sincerely, Elizabeth Cantrell From: Brenda Grimes [mailto:bgrimes@gandb.com] Sent: Friday, June 02, 2017 4:23 PM To: Cantrell, Elizabeth Cc: Charles W. Grimes; Brenda Grimes Subject: 4145 Wells Road Peconic Tree Removal Elizabeth: Thank you for taking the time to walk through the compliance requirements with us. Attached are the following documents in order: • Board of Southold Town Trustees Permit 8805 and Related Amendment • Page 3 of the DEC Permit#1-4738-04463 • Approved Site Survey Dated March 28, 2017 1 We need clarification regarding-removing trees which will impede on us buflding the two-story dwelling approved by the Board of Trustees per permit 8805 and the related Amendment. Furthermore,the attached DEC permit requires us to construct the row of stalked straw bales at the edge of the 30ft. buffer or at most 50ft from the tidal wetland boundary. We understand that the Southold Building Department will require the same. As such,to comply with protecting the wetlands we will need to remove trees which are in the path of the stalked straw protection barrier. Please speak to the Trustee to ascertain that permit 8805 provides the inherent authority to remove trees that impede the construction of the dwelling and the wetlands protection barrier. Regards Brenda Brenda M. Grimes, CPA brimes@gandb.coin www.gandb.com Grimes LLC 3501 Bonita Bay Blvd. Bonita Springs, FL 34134 Phone: (239) 330-9000 Fax: (239) 301-2215 FLORIDA I NEW YORK I CONNECTICUT Confidentiality:This message contains PRIVILEGED AND CONFIDENTIAL INFORMATION intended solely for the use of the addressee(s). Any disclosure,distribution, copying or use of the information by or to third-parties is strictly prohibited. If you have received this message in error,please advise the sender by immediate reply and delete the original message. Thank you. 2 l i i t N�` Our 4a� Ta k,.50 _ - - --- �oF souls Michael J.Domino,President Town Hall Annex John M.Bredemeyer III,Vice-President 254 54375 Route 25P.O.Box 1179 Charles J.Sanders cn Southold,New York 11971 Glenn Goldsmith � a� Telephone(631) 765-1892 A. Nicholas Krupski li�C � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 19, 2017 Charles & Brenda Grimes 3501 Bonita Bay'Blvd. Bonita Springs, FL 34134 RE: 4145 WELLS ROAD, PECONIC SCTM# 1000-86-2-12.6 Dear Mr. and Mrs. Grimes: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, April 19, 2017: WHEREAS, CHARLES and BRENDA GRIMES applied to the Southold Town Trustees for an Amendment to Wetland Permit#8805 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated March 1, 2017, 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 to be Consistent with the Local Waterfront Revitalization Program policy standards, 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, z NOW THEREFORE BE IT RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Wetland Permit#8805, to modify the size of the proposed dwelling to be a 62'6"x45' (2,812sq.ft.) two-story dwelling with attached 28'x32' (896sq.ft.) garage; and a 15'x25' (375sq.ft.) deck attached to the seaward side of dwelling; and as depicted on the survey prepared by Peconic Surveyors, P.C., dated March 28, 2017, and stamped approved on April 19, 2017. 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 This is not a determination from any other agency. Sincerely, Michael J. Domino, President Board of Trustees MJD:dd March 27,2017(via email) (transmitted herewith are copies of Exhibits A,B and C— four originals of Exhibit D will be hand-delivered) Board of Town Trustees Town of Southold Town Ha 11 Annex 54375 Route 25 D E (� PO Box 1179 Southold,New York 11971 RE:4145 Well Road Peconic MAR 3 0 2017 SCTM# 1000—86-2-12.6 Permit 8805 SelAW Town Boar Truses Dear Sirs and Mesdames: Please accept this letter as a formal request to amend permit number 8805 for property address 4145 Wells Road,Peconic,dated May 18,2016. Please see Exhibit A transmitted herewith,which is a copy of. (i)permit number 8805;and(ii)the survey dated June 9,2016 upon which the permit was granted. Permit number 8805 was originally, granted to E.G Stein,Family Trust. Charles and Brenda Grimes purchased the vacant unimproved property from the E.G.Stein Trust on December 12,2016 and the Board of Town Trustees,Town of Southold assigned permit number 8805 to the Grimes on January 18,2017. The Grimes now seek an amendment of permit number 8805,to allow construction of a modified two- story dwelling,garage and deck in accordance with the Exhibits B and C transmitted herewith,which were prepared by, the Grimes' architect,John Van Velsor. Exhibit B is a copy of the proposed Floor Plan. Exhibit C is.a:copy of the proposed Plot.Plan. The Grimes have engaged Peconic Surveyors,P.C.to provide an updated survey: Four originals of such survey,which will become Exhibit D to this letter,will be hand delivered. As reflected by the attached Exhibit B,the permit is requested to be amended to allow: Two Story Dwelling(gross approx.first floor dimension of 62'6"x 45' or 2812 Square Feet) Garage(gross,approx.dimension,of 28' x 32' or 896 Square Feet) Attached Deck(gross approx.dimension of 15'x 25' or 375 Square Feet) Total Lot Coverage approx.4,083 square feet or approx. 14.5% All other provisions of permit#8805 should remain unchanged. �V �1 Board of Town Trustees March 27,2017 Page 2 Please note the two-story dwelling is designed to fit within the restricted building envelope and set-back guidelines per section 280.124 and set backs of the New York State D.E.C. This formal request provides authority to the Town of Southold Trustees to enter-the property for purposes,of inspection in connection with consideration of this request. We have previously submitted a check for$50. Please advise if a supplemental or additional fee is, required and I will make the necessary arrangements for its immediate hand delivery to you. For your'convenience,my contact,information is as follows: Charles Grimes 3501 Bonita.Bay Blvd Bonita Springs,Florida 34134 Cell Phone 4203-253-9890 9,rimes@gandb.com Should you have any questions,I can be reached using the contact information noted above. S' c ly, Charles W.Gnm Exhibit A—Copy of Permit 8805 and Original Survey dated June 9,2016, Exhibit B—Floor Plan dated March 27,2017 Exhibit C—Plot Plan dated March 27,2017 Exhibit D—Updated Survey—dated March 201.7-to be hand delivered D � CEIIfE MAR 3 0 2017 So�ihold Town Boar Tru toes Michael J Domino, vice-Preside 54.175 Main 1 P O Sox 117979 Jaynes F. King, Trustee Id, New York 11971-0959 Dave Bergen, Trustee �1 G, Telephone(631)765-1892 Charles J. Sanders,TrustceFa_e(631) 765-6641 BOARD OF TOWN TRUSTEES D C�GOI� TOWN OF SOUTHOLD D To: Southold-Town Building Department MAR s 2017 Re: Verification of Building Department Permit Requirements BUILDMGDEPT. TOWN OF SOUTHOLD Property Owner blame: - Date Sent to Bldg_ Dept__ The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Departibent`s permitting requirements stated below: YE NO Will the proposed project require a Building Pen-nit? 7eIf the proposed project require a variance determination from Zoning Board of Appeals? Wi[[ any part of this application be considered as Demolition as 'described under Town Code? COMMENTS: c 1� �v�Spapyodl, c �! Y M, '�J�h -grlature of Reviewer Date Cantrell, Elizabeth From: Charles W. Grimes <grimes@gandb.com> Sent: Monday, March 27, 2017 3:45 PM To: Cantrell, Elizabeth Cc: Brenda Grimes;John Van Velsor; peconicsurvey@optonline.net Subject: Grimes' Request for Amendment to Permit#8805 re 4145 Wells Road Attachments: Grimes Letter-Amendment of 4145 Wells Road Permit#8805.pdf, Exhibit C - GRIMES PLOT PLAN.pdf; Exhibit B -GRIMES FLOOR PLAN.pdf, Exhibit A- Permit#8805 and Original Survey.pdf Elizabeth: Thank you so very much for your help and kindness in connection with our efforts to amend permit # 8805 which was previously authorized in connection with the 4145 Wells Road property. As I have indicated, we have come up against "issues" with the DEC and so have decided to revise our amendment request in a manner that alleviates any "issues" with the DEC. I am sending you as an attachment to this email a new amendment request letter and the Exhibits A, B and C which are referred to in the letter. We are having four originals of an updated survey prepared by Peconic Surveyors, P.C. (referred to as Exhibit D in the letter). Those will be hand delivered to you this week (I am told that they should be delivered on Thursday). As an aside, we are having Peconic Surveyors also address certain questions which the health department raised last week regarding the required distance between the galleys and ST, drains and 1,200 gallon tank. To avoid confusion, I suggest that you simply discard the previous amendment request letter (and everything else that was previously submitted). Please acknowledge receipt of this email and call me on my cell phone (203-253-9890) or email me if there is anything else that needs to be submitted. Once again, your help and kindness as we try to make our way through the permitting process is greatly appreciated! Sincerely, D ` E 11 V7 E Chuck u�� MAR 2 7 2017 Southold Town ar Tru ees 1 Charles W. Grimes, Esq. 4 primesCxgandb.com www.,P,ai-idb.com Grimes LLC 3501 Bonita Bav Blvd. Bonita Springs, FL 34134 Phone: (239) 330-9000 Fax: (239) 301 2215 FLORIDA (NEW YORK I CONNECTICUT Confidentiality:This message contains PRIVILEGED AND CONFIDENTIAL INFORMATION intended solely for the use of the addressee(s) Any disclosure,distribution, copying or use of the information by or to third-parties is strictly prohibited If you have received this message in error,please advise the sender by immediate reply and delete the original message. Thank you. s MAR 2 7 2017 ` .1101n?own dill„ r%S ees 2 JRVV U e W04 Fm I > F. §� / 3 j— JANUARY Z. RFVISIONS o z1 2U17 x Q CA ARCMRxin,Dm1 I , I / LSCY•i� I � / W I ! _ ! wo DEC. i z b / /mom O I p Q � /'1 ]STORY M FRAMED DWEOJND ; a VJ 1/1 W z k . W W L a v O j a W W a a U ti WELLS ROAD SREEE RRS PROPOSED PLOT PLAN PROPOSED PLOT PLAN revised#3 S 1 Lu o CV7-4 c VV 94-6• � U � C bu 37-0 16-D• I6-8• 8-4' i6-6• aa�e K 3E"m 6 e -_ 2 F, tlE-e 'y x i W=u O = 15-10 7 NO y z - DECK > r^~ �• � _ C 3 zYW3 z o6oW 00 IDE MASTER DEORWM 6W SL OP vy O ¢ SH WERa 4% ]o I6'-e' 12LVISIONS or z o P Rll L B EI IEI i 20 20 cf --- --- GREAT ROOM 31-6• 6_6• WADI-IN BIT 6fDR QD6ETSNOWED OO GARAGE 6-2 _ KITCHEN (S� 70 2 6 I-4 w � U Q HALL 0 Q O � 3 zfi z'o 20 FOYER W Lo z DINING RM FAMILY RINI o w W U So O m LAUNDRY RM TOILET PANTRY 0 O ll*%BN DH DR BP fW%8'N OH D I I-6• 6-D• ),-D_ 16-8• I I En r'�, U Jo T- � Z W Q x a U CET TRE 32-0' 41-10- 9-0• II-B" FIRST FLOOR PLAN FIRST FLOOR PLAN 3367 sl 6C.LLE.I/4 I-0' REVISED#3 °'« GRIMES LLC Intellectual Property Attorneys www.gandb.com 3501 Bonita Bay Blvd. Tel.: (239) 330-9000 Bonita Springs, Florida 34134 Fax: (239) 301.2215 Board of Town Trustees Town of Southold Town Hall Annex 54375 Route 25 ! f r �11 V L PO Box 1179 r - Southold New York 11971 r4)E; Ll' MAR � � 2017 RE: 4145 Well Road Peconic SCTM # 1000 -86-2-12.6 Southold Town Permit 8805 Roam.0t lm�t u __J Dear Sirs: Please accept this letter as a formal request to amend permit number 8805 for property address 4145 Wells Road, Peconic, dated May 18, 2016. Permit number 8805 was originally granted to E.G Stein Family Trust and the permit approved: (i) construction of: 37' x 50' (1,850 Square Feet) Two Story Dwelling (it appears that the second story square feet zvas omitted from the survey and the permit and only the first story square foot zvas included, theoretically a tzvo story dzvelling 37'x 50'zvould by 2x 1,850 square feet, or in this case 3,700 total dzvelling square feet) 24' x 24' (576 Square Feet) Attached Garage 12'x 62' (895 Square Feet) Attached Deck Septic System installed on Landward Side of Dwelling System of Drywells installed to Contain Storm Water Runoff (ii) conditioned on: Establishment and maintenance in perpetuity of a 30' wide buffer along the Landward Edge of the Wetlands With a 4' Wide Access Path Through Same for Shoreline Access Connecticut(203) 849-8300 • New York(914) 698-1305 Any Activity to Remove Invasive Species in Said Buffer Area Will Require the Issuance of a Permit as depicted on the Survey Prepared by Peconic Surveyors, P.C., then dated June 9, 2016 and stamped approved on July 8, 2016. Please see the attached Exhibits A and B which are a copy of permit number 8805 and the survey dated June 9, 2016, respectively. Charles and Brenda Grimes purchased the vacant unimproved property from the E.G. Stein Trust on December 12, 2016 and the Board of Town Trustees, Town of Southold assigned permit number 8805 to the Grimes on January 18, 2017. The Grimes now seek an amendment of permit number 8805 to allow construction of a one story dwelling (instead of a two story dwelling) within the Town's required guidelines and building envelope for the property, in accordance with attached Exhibit C (four copies),which is a revised survey prepared by Peconic Surveyors,P.C. dated February 15, 2017. As reflected by Exhibit C, the permit is requested to be amended to allow: One Story Dwelling with 3,571 Square Feet Garage 24' x 32' or 675 Square Feet Attached Deck 14' x 24' or 328 Square Feet Total Lot Coverage 16.5% All other provisions of permit#8805 should remain unchanged. Please note that the entire one story dwelling is designed to fit within the restricted building envelope and set-back guidelines per section 280.124. This formal request provides authority to the Town of Southold Trustees to enter the property for purposes of inspection in connection with consideration of this request. I have enclosed a check for$50. For your convenience my contact information is as follows: Brenda Grimes 3501 Bonita Bay Blvd Bonita Springs,Florida 34134 Cell Phone #239-777-4185 bgrimes@gandb.com Should you have any questions, I can be reached using the contact information noted above. Regards Brenda Grimes Michael J.Domino, uFF01 �'o� � • Town Hall Annex John M.Bredemeyer III,Vice-President {�® �!:,.i 54375 Route 25 Charles J. Sanders ® P.O.Box 1179 c» ae i Glenn GoldsmithSouthold,NY 11971 A.Nicholas Krupski Telephone(631)765-1892 wo1 � Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of CHARLES & BRENDA GRIMES COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING -TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST-SEVEN _ DAYS PRIOR TO THE PUBLIC HEARING DATE 1, fi eAm 1k 0 (--3-e4o, , residing at/dba Q0 being duly sworn, depose and say: That on the q7Aday of 1916111 , 2017, 1 personallyyosted the property known as , 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 19,2017. r Dated: 47'_/ ���� c;, '(signature) Sworn to before me this ift day of 2017 2017 &W/) 94� Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. O1 D1475593 Qualified In Suffolk County p My commission Expires April 30, 20 o PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: !C->u-s-ar) Hi91Iock P# 0' (26X1 a00 �Oh� f711,CarI 61--53 1�'� ��h �9T 9!9 woad A),Y. I 13 85 �'o y cue ?'VI S)<'LAJ-&ra Pe d l e.�r U�1 i Pecv h i c LLC 036 o,5' l�l .915' C LL4 �og e t,� STATE OF NEW YORK COUNTY OF SUFFOLK �tr C�yl �C )940 "a- , residing at o being duly sworn,deposes and says that on the day of_ Alk C i , 20JI, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at MA. ?ZC , IV, Y , that said Notices were mailed to each of said persons by CERTIFIED MAIL +T RECEIPT. i Sworn to before me this Day of Afk( _ , 20_�J_ Notary Public ! DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. OID1475593 Qualified in Suffolk County my Commission Expires April 30, 2023 s • • © ® ■ CERTiFIEO e .1L@ RECEIPT Er Ir D Er : Ln� •(( ' -s y �e��e {( Y o-x• •k ...• � »`-' I IdT, ;::i i1 ia" � C:: ts�'�«). •+e ;Sf 1.{ (e '*a"e' ib Ll ?.k t "Y Cerhfled Mail Fee + / gv��l O CerUfled Mall Fee ,i+,N. �ps�DU � / Q' $ ffi2 $ 11' Extra SeNlces&Fees(checkbox,add fee�s�opavnlete) O it Er Extra Services&Fees(check box,add fee l�ap eto) �3 + ��•+-VL. 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R ■ ■ Er IT •t V �' t( 4`."..'J U uia L:.:._.s -�-•,'" Lf'lUU 07 ';• in 7P E " e O Certified Mad Fee r, 3 CertrftedMallFee g`'1 0 $ $ Ir 0 Q-e ti Extra Services&Fees(check box,add fee�,goppipdate) ^ Extra Services&Fees(check box,edd fee@@pate) Fri.`` 44..�rrtJJ �' Off` ❑Return Receipt(hardcopy) $ V+Elul `\ C3 ❑Return Receipt(hardcopy) $ • ' ❑Retum Receipt(electronic) $ (� PXark _ ❑Return Receipt(electronic) $ + ( �tmark. ❑Certified Mail Restnoted Delivery $ "' ere I ❑Certified Mail Restricted Delivery- $ �bil Qr[l ( J) A/Here - ❑Adult Signature Required $ Cn C0' r3 [:]Adult Signature Required $ Adult Signature Restricted Delivery$ f� [:]E]Adult Signature Restricted Delivery$ ' F]Adult � . C3 Postage $ 49 r ��� �' ! O Postage $1_1.49 1 $ 0,/(1�,� 6201 Q' ir Total Postage and Fes Total Postage and fSas�� L�4l�fi/21U17 .59 •� Sent To � Sent To a c¢s _u_1-�max'------------- a t�h �__---•--1^ccrw-cA,=-- --------------- Streetand A t N----- Boz IUo O Street and Apt.No. PO ox No O 6 M1 p f r- {� ?-OX------a9--------------------- --------- ------------- - ' 1 ` City,State,Z/P+ a Giry State,ZIP+4® C (�!� 1 gzic C D l l`i I ! 0 1 1 1 1 e I I :1 1 a a. 111•1 J I PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: _ C;2 — b '� STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn,deposes and says that on the day of .20__, deponent mailed a.-true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED L/RETURN RECEIPT. I Sworn to before me this Day of , 20 i Notary Public H 'tAKING NUTI -Lt Uim 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: CHARLES & BRENDA GRIMES SUBJECT OF PUBLIC HEARING : For an Amendment to wetland Permit #8805 to modify the size of the proposed dwelling to be a 62'6"x45' (2,812sq.ft.) two-story dwelling with attached 28'x32' (896sq.ft.) garage; and a 15'x25' (375sq.ft.) deck attached to the seaward side of dwelling. Located: 4145 wells Road, Peconic. SCTM# 1000-86-2-12.6 TIME & DATE OF PUBLIC HEARING : Wednesday, April 19, 2017 — 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 i t_v , �L%%,%IFF01 Peter Young,ChairmanH Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., April 12, 2017 the following recommendation was made: Moved by Peter Young, seconded by John Stein, it was RESOLVED to SUPPORT the application of CHARLES & BRENDA GRIMES to Amend Wetland Permit#8805 to allow the construction of a one-story dwelling, garage, and attached deck. Located: 4145 Wells Rd., Peconic. SCTM#86-2-12.6 Vote of Council: Ayes: All Motion Carried Michael J. Domino,Preside',, Fol 11�F®l�C® Town Hall Annex John M. Bredemeyer III,Vice-Pr,,-.5ident �� y,, 54375 Route 25 Charles J. Sanders a P.O.Box 1179 ca Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ®! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD ,Date/Time: `��S�1� Completed in field by: fl1V � � CHARLES & BRENDA GRIMES request an Amendment to Wetland Permit#8805 to modify the size of the proposed dwelling to be a 62'6"x45' (2,812sq.ft.) two-story dwelling with attached 28'x32' (896sq.ft.) garage; and a 15'x25' (375sq.ft.) deck attached to the seaward side ofAwelling. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notic 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: pnl ►SS✓� Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 Michael J. Domino,Presidej, O�Q �'®� Town Hall Annex John M. Bredemeyer III,Vice-President �� �� 54375 Route 25 Charles J. Sanders q P.O.Box 1179 CO2 ZZ Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski $ p! Telephone(631)765-1892 od Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD --Date/Time: Completed in Work Session by: CHARLES & BRENDA GRIMES request an Amendment to Wetland Permit #8805 to modify the size of the proposed dwelling to be a 62'6"x45' (2,812sq.ft.) two-story dwelling with attached 28'x32' (896sq.ft.) garage,; and a 15'x25' (375sq.ft.) deck attached to the seaward side of dwelling. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. 525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 CLEAN OUT DETAIL SURVEY OF PROPERTY FOR USE WITH BUILDING EXTENSION/CONNEC110N A T PECONIC SLA SU�ABL COVER OR PUC OR OTHER STOPPER END s0�ryo N% 7'' �� <o ToF TOWN OF SOUTHOLD 101 gogN�) �� OP ;%' SUFFOLK COUNTY, N. Y.r4 lGd- A YAGC.ARINO 1000-86-02-12.6 oz-oa-zotY / � SEWER PIPE SCALE.- 1 r=JO. < 30'ELBOW JANUARY 14, 2015 0� FEB. 16, 2016 (SITE PLAN) APRIL 7� 2016 ( 3�S �wS F SFA w �cqN O REVISIONS) \\-150* wrE 00, 9�� \w �j� T�0011 MA Y 24, 2016 (REVISIONS) JUNE 9, 2016 (REVISIONS) srq�ti �,�., Foc \�'O(i � OCT 28, 2016 (REVISIONS)F � TEST HOLE DATA y F�. e ���5, oFA9 �'� NOV. 04, 2016 (REVISIONS) Mme'°1,15 Cf 9 AROpOs SS9 FEBRUARY 7, 2017 (REVISIONS) DARK BROW LOAM a ��,pG > sFp� ¢`S30 -� ST O FEBRUARY 15, 2017 (REVISIONS -- 03' �� 1 1 .;F%''• : > F �� �F MARCH 6, 2017 (REVISIONS) ) PALE BROW SILT ML � ,<� 10�ti� MARCH 16, 2017 (REVISIONS) PALE BROOM!FINE TO AIEDIUM SAND SP `' L� � �1 °��' . c''�, S \� gs MARCH 28, 2017 (REVISIONS) -- 6.6' �h$ ��/' A `�yOSSAN° ;pie `ST,i p`��ovP Oo�F/Ty FOOE o \ 'ZOG�P WATER IN PALE BROW FINE RT MEDIUM SAND SP qP11, AlP; �� h �� C 1 oSFQ q,: `off t O I,. �� %� fr1511 � �SF� sT o TOTAL AREA TO TIE LINE NOTE WATER ENCOUNTERED 6.6'BELOW SURFACE �� � r � Fti � �a F� ��� � J8,595 sq. ft. AREA LANDWARD LIMIT OF TIDAL WETLANDS AS DETERMINED o �F.q,�, °° �'�'gcF UPLAND = 28,297 sq.ft. WETLAND = 10,298 sq.ft. BY SUFFOLK ENVIRONMENTAL CONSUL TING, INC. V ON SEPTEMBER 24, 2015 . °<o Q •o O NOTE. �O O O ND A 4 FOOT ACCESS PATH PERMITTED THROUGH NF THE 30 FOOT NON—TURF BUFFER FOR PURPOSES OF SHORELINE ACCESS. Dp �2� ��q90, PROPOSED UPLAND 42F � 2oNF �' ,AR v � LOT COVERAGE F°fie 2� 30, �-•. A1 _,��� o V 744/28,297 = 13.2 9 NO ,�O Q p0 Jam" 13.2 % PROPOSED COVERAGE MHWM \ ZEN we>LgNDs R i RAIN RUNOFF CONTAINMENT �,v N 104:2215 �_ �I \ Fier #F m r HOUSE WITH GARAGE = 3494 SQ.FT. W ` \ rIf Ne Y/ 11^I m� 3494 x 1 x 0.17 = 594 cu.ft. H \ \ MHWM = ��, GRAVEL DRIVEWAY = 1120 sq.ft KEY 23,38+ _�- _ �TIELINEF APPROVED B , 1120 X 0.8 x 0.17 = 153 cu.ft 747 cu.ft. _ -j S84'02'38"W � -- — #S A = STAKE 122-21' BOARD OF 1 RUSTEES 747 cu.ft./42.2 = 18 VF ■ = MONUMENT TOWN OF SOUTHOLD R0WDE (5) DWs = 80 x 4' m = TEST HOLE RIC-HM n j DATE- R EQUAL O-� y D ��IL 1� ZG�/7 0 GRADING OR FILL PROPOSED = WET LANDS FLAG CREjek AREA= 38,595 SO. FT. CERTIFIEDCHARL TO TIE LINE BRENDA GRIMES FLEXIBLE SUPPORT RING SEPTIC SYSTEM DETAIL WFG NA77ONAL T7TLE INSURANCE COMPANY ELEVA77ONS AND CONTOUR LINES ARE REFERENCED FROM NAVD 88 CONNECTOR AT PVC/CI. JOINT NOT TO SCALE VAR 3 0 2017 FLOOD ZONES FROM FIRM J6103C0162H F,F, EL. 11.0' CLEAN OUT EL. 8' FINISHED GRADE Sc thrid leWn EL. 8' i 24" , 1MIN. MASONARY CHIMNEYS ar Tru °e The location of public water, wells and cesspools shown hereon are till ,� 3„MAX . MASONARY CHIMNEY NV.EL �' 6VIN. 1' MIN. from field observations and or from data obtained from others. I 75. �� ~ �� 12', ...6. � 2' MAX 6 SEL. 6' 10 HOUSE TRA /NV.EL. ® ® ® ®� ® �4;�`�,..-�• M" ,P}' I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL AND •: 6' INV.EL. ® ® ®N 3.0' Z CONSTRUCRON OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR 118" PER FOOT 1/4” P R,(�0 ® ® � ® SINGLE FAMILY RESIDENCES AND WILL ABIDE BY THE COND177ONS MINIMUM PITCH MINIMUM IrC1f M, c SET FORTH THEREIN AND ON THE PERMIT TO CONSTRUCT. MIN.4" DIA. PIPE $4" MIN.4" DIA IPE 2' min. 1200 GAL. P 9 PRECAST SEPTIC----- - ------- ____ _ _ - WATER EL-0.T 2 2' 6 2 feet dee allies LOT s REFER TO "MINOR SUBDIVISION PLAT KNOWN AS RICHMOND CREEK FARMS" - - ----------------------------------- TO ----- - `'E 4 ® TANK ' - ----------- ,;� �� C,„,�! -,.::_.,._...-- .,�"•. TO BE A PORT70N OF THE PREMISES CONVEYED TO THE GRANTOR HEREIN BY DEED DATED NOVEMBER 25, 1997, RECORDED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON DECEMBER 9, 1997 IN LIBER 11866 CP 74Z PROPOSED SEPTIC SYSTEM N. Y. .: LIC. N0. ANY ALTERATION OR ADDIT70N TO THIS SURVEY IS A VIOLATION (3 BEDROOMS) PECONIC SURVEYORS, P.C. OF SECT70N 72090E THE NEW YORK STATE EDUCA770N LAW. EXCEPT AS PER SECT70N 7209—SUBDIVISION 2. ALL CERTIFICATIONS [1] 1200 GALLON PRECAST SEPTIC TANK 80 x 4' LIQUID DEEP (6J1) 765-5020 FAX (6J1) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 300 sq.ft. LEACHING P.0. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR [6] LEACHING GALLEYS (318 sq.ft. = 3 EXP. GALLEYS) 1230 TRA VELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 15-225 Michael J. Domino, President SpFFO(,�ea, Town Hall Annex John M. Bredemeyer, III, Vice-President y- 54375 Route 25 Charles J. Sanders N x P.O. Box 1179 Glenn Goldsmith • Southold, NY 11971 A. Nicholas Krupski 41 , �ao� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 18, 2017 Charles & Brenda Grimes 3501 Bonita Bay Blvd. Bonita Springs, FL 34135 RE:, 4145 WELLS ROAD, PECONIC SCTM# 1000-86-2-12.6 Dear Mr. and Mrs. Grimes: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, January 18, 2017: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit #8805 from E.G. Stein Family Trust c/o David Edelstein & Libby Goldstein to Charles and Brenda Grimes, as issued on May 18, 2016. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, -P�pov-"� - Michael J. Domino, President Board of Trustees MJ D/dd I December 14, 2016 Southold Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971 Attention Diane DiSalvo RE: Permit Number 8805 &5893 Dear Ms. DiSalvo: We have recently purchased 4145 Wells Road in Peconic. The property currently has two trustees permits that we would like to transfer. Permit numbers 8805 & 5893. The Sellers are DAVID EDELSTEIN and LIBBY GOLDSTEIN, CO-TRUSTEES of the E.G. Stein Family Trust dated 8/7/11 The Buyers are Charles and Brenda Grimes 3501 Bonita Bay Blvd Bonita Springs, Florida 3414 (239) 777-4185 We give permission to the trustees to enter the vacant land and inspect the property. Enclosed is a check for $100.00 to transfer both permits to our name. Please let me know once the permits are transferred and if I could obtain a copy for my records that would be great. Enclosed is a self-addressed stamped envelope for the copy. Sincerel Brenda Grim ;i '-I DEC 192016 f Southold Tarn Board of Tr.s ees .�...---1 John M. Bredemeyer III, Pres �6 QS�FFo14'�0 , Town Hall Annex Michael J. Domino, Vice-Pres Bent r���o �y54375 Route 25 Glenn Goldsmithy z P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J Sanders �,� o� Telephone (631) 765-1892 �l � Fax (631),765-6641 s-r<a'LY7� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: I '7III j� �"T � P Completed in field by: CHARLES & BRENDA GRIMES request a Transfer of Wetland Permit #8805 from E.G. Stein Family Trust, c/o David Edelstein & Libby Goldstein to Charles and Brenda Grimes, as issued on May 18, 2016. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material:.100,feet TOP OF BLUFF: 1: Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 " Ch. 111 SEQRA Type: I II Unlisted Action . Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: M. Domino G. Goldsmith N. Kru Present were. J. Bredemeyer ski p C. Sanders Other Page 1 of 2 John M. Bredemeyer III, Presi ��SUFFO(�-�o Town Hall Annex Michael J. Domino, Vice-Presi ent 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski o Southold, NY 11971 Charles J. Sanders y% �ao�y TelephoFax(631) 765-664892 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: CHARLES & BRENDA GRIMES request a Transfer of Wetland Permit#8805 from E.G. Stein Family Trust, c/o David Edelstein & Libby Goldstein'to Charles and Brenda Grimes, as issued on May 18, 2016. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the,proposed activity and the extent to which the proposed activity requires a shoreline location:, B. Is not likely to cause a measurable increase in erosion at the proposed site and at other- locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 v_ 1 z: John M. Bredemeyer III, President �o�o 0. Town-•; Town Hall Annex Michael J_ Domino, Vice-President ; ti�.r 54375 Route 25 Glenn Goldsmith N i P.O. Box 1179 A. Nicholas Krupski "�� Southold, NY 11971 Charles J Sanders ' �*ol Telephone (631) 765-1892 Fax (631) 765-6541 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 '/2 constructed 7 compliance Project complete, inspection 1 P gg BOA-RD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK ti PERMIT NO. 8805 DATE: MAY 18, 2016 ISSUED TO: E.G. STEIN FAMILY TRUST c/o DAVID EDELSTEIN& LIBBY GOLDSTEIN PROPERTY ADDRESS: 4145 WELLS ROAD, PECONIC SCTM# 1000-86-2-12.6 AUTHORIZATION Pursuant to the provisions' of Chapter 275 of the Town Code of the Town of Southold and in ' accordance with the Resolution of the BoArd of Trustees adopted at'the meeting held on May 18,2016, and in lo consideration of application fee in ib"sum of$,2!),U,.U0'paid'by E.G:'Stein Family Trust c/o David Edelstein& Libby Goldstein and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a 37'x501 (1,850sq.ft.) two-story dwelling with a 24.x24'(�76* ft.)-hitii�li�&'g"la-'r-"ag-'e'-a""'dI_'A':121i62'(805i'_jt.)`att�c_ install a q n q li'ed'dec* in a septic system on landward side of dwelling-co' hheci"to public water; install a 1'890sq.ft. k. gravel driveway; and install,a system of Arywells to contain storinwater runoff, with 3'0;" the condition-to,establish andperpetually maintain a,, , , wide non-turf buffer along the landward,edgq of,wetlands with,a 4'-wide access,path through,same for shoreline access; any activity;to remove invasive species in said buffer area will require the issuance of a permit; and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated June 9, 2016, and stamped approved on July 8,2016. IN WITNESS WHEREOF;the said Board of rusteos hereby causes its Corporate Seal to be affixed, r 7z and these presents to be subscribed by a majority of the said BoarVdf this date. co OR "FAIJAX.,ilk TERMS AND CONDITIONS The Pern7ittee E.G. Stein Family Trust c/o David Edelstein&Libby Goldstein residing at 4145 Wells Road Peconic,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause 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 coYnpietion 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. John M.Bredemeyer III,President ��®� S®�/Tyo Town Hall Annex Michael J.Domino,Vice-President '`® l® 54375 Route 25 P.O.Box 1179 Glenn GoldsmithCA Southold,New York 11971 A.Nicholas Krupski ® aO� Telephone (631) 765-1892 Charles J. Sanders Fax(631) 765-6641 OUNTIi BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 18, 2016 Bruce Anderson, President Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: E.G. STEIN FAMILY TRUST c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN 4145 WELLS ROAD, PECONIC SCTM# 1000-86-2-12.6 Dear Mr. Anderson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 18, 2016 regarding the above matter: WHEREAS, Suffolk Environmental on behalf of E.G. STEIN FAMILY TRUST c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN 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 April 8, 2016, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory, Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 18, 2016, at which time all interested persons were given an opportunity to be heard, and, 2 i WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of E.G. STEIN FAMILY TRUST c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a 24'x24'(576sq.ft.) attached garage and a 12'x62'(895sq.ft.) attached deck; install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft. gravel driveway; and install a system of drywells to contain stormwater runoff; with the condition to establish and perpetually maintain a 30' wide non-turf buffer along the landward edge of wetlands with a 4' wide access path through same for shoreline access; any activity to remove invasive species in said buffer area will require the issuance of a permit; and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated June 9, 2016, and stamped approved on July 8, 2016. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, John M'. Bredemeyer III President, Board of Trustees JMB/dd ELEVATIONS AND CONTOUR LINES ARE REFERENCED FROM NAVD 88 11,00 SURVEY OF PROPERTY FLOOD ZONES FROM FIRM 36103C0162H p0T ' '0�p A T PECONIC ti0Z TO E A PEFER TO OR77ON OF/NOR SUTHE PR EMISESON PLAT KNOWN AS CONVEYED TO E GRANTOR RICHMOND CREEK FARMS" �VgCgN rp�iy iTO WN OF SOUTHOLD HEREIN BY DEED DATED NOVEMBER 25, 1997, RECORDED IN 77-IE SUFFOLK COUNTY T) OF HOLD CLERK'S OFFICE ON DECEMBER 9, 1997 IN LIBER 11866 CP 747. SUFFOLK COUNTY, N. Y. i i 1000-86-02-12.6 i SCALE- V=30' (�q J JANUARY 14, 2015 c4N O FEB. 16 2016 SITE PLAN 00. E �e APRIL 7, 2016 (REWSIONS)MAY 24, 2016 (REWSIONS) yJUNE 9, 2016 (REWSIONS) SOSgNp/ �° tiq �Ap 441 �Osrs�� T $ r.p F { s Rj �,�� Q��Q� .-.� .�-�:• •s � JULJUI. R- r '" o RQO ; �G *P �$ FOS Sou!hold Town p, O• F Q Q� O�0' �'cq� �•_ _ Q:7+fir'�r T. F, 1 S�SO V C <. Q- � U�!CCS z0 61 C ,h^O A R°• 9 LANDWARD LIMIT OF TIDAL WETLANDS AS DETERMINED gssj O sEo BY SUFFOLK ENVIRONMENTAL CONSULTING, INC. ON SEPTEMBER 24, 2015 vK NA 4 FOOT ACCESS PATH PERMITTED THROUGH r� �L4cll' THE 30 FOOT NON—TURF BUFFER FOR PURPOSES rF, '9ti'T OF SHORELINE ACCESS. •��p0 ZpNF . ' rA11 °F F N �'e��pF stip)ptiF`< o�"-yn- ' 2 y ' 'k, ��FR) MHWM 6 Oka feet Nos r� /V74 -nEUNe pm�2 7hW Z H m MHWM TEST HOLE DATA 23.38• --___ — 'E un,E -------------------------------------------- 1V McDONALD GEOSCIENCE #S 10/15/15 S84'02'38"W ---------------- DARK BROWN LOAM OL 122.21' 0.5' PALE BROWN SILT ML 4' r/ll OND .:APPROVED 6Y WAW�OFTRUST PALE BROWN FINE TO MEDIUM SAND SP S 6.6' � OF, SOUTHOLD DATE_ �� gr �j� SEPTIC SYSTEM DETAIL f WATER IN PALE BROWN FINE TO MEDIUM SAND SP NOT TO SCALE F.F. EL. 11.0' EL. 8' lo f3' CAST IRON FRAMES AND COVERS TO GRADE FIN/SHED GRADE NOTE.• WATER ENCOUN7ERED 6.6' BELOW SURFACE EL. 8' j 24"U 1"MIN- MASONARY CHIMNEYS MASONARY CHIMNEY = STAKE INV.EL. " 12,••.•6 6VIM 2' MAX 5' INV.EL. 1/4" PER FOOT 6.5' 6' )0 /NV.EL. ® ® ® ® ■ = MONUMENT MINIMUM PITCH 6' INV.EL. ® ® ®a 2 .- MINA" DIA. PIPE 1/8" PER FOOT .� �. m = TEST HOLE MINIMUM PITCH 5.6'- 0® ® N I �}i= <,• , . ++ MIN.4" DIA. PIPE WETLANDS FLAG +min 2' (6)2 feet deep gallies 1000 GAL.PRECAST SEP 7ICTANK WATER EL=0.7' . F APE //�� ee���� /1PEA- NO,%S 80. FT III II II ui TO TIE UNE ..._ul 1 Mlit <, q ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A VIOLATION RAIN RUNOFF CONTAINMENT N. Y. .`�t 1C.;'NO..` OF SEC77ON 7209OF THE NEW YORK STATE EDUCA77ON LAW. DWELLING & DECK = 3321sq.ft. PECON1C- ,S_UR.VEYORS, P.C. EXCEPT AS PER SECT70N 7209—SUBDIVISION 2. ALL CERTIFICATIONS 3321 x 0.17 = 565 cu.ft. (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES 77-IEREOF ONLY IF 565/42.2 = 13.3 VF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR provide 4 DWs = 80 x 4' 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 15-225 John M. Bredemeyer III, r-resident }o�oS�FFatKcoG_ _ Town Hall Annex Michael J_ Domino, Vice-President �� �< 54375 Route 25 Glenn Goldsmith o * P.O. Box 1179 A_ Nicholas Krupski :�y ® ter:'+ Southold, NY 11971 Charles J. Sanders 01 ��° Telephone (631) 765-1892 �r Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD elQ -SVFa,c E�06'M6NTA1__ TO: Please be advised that your application dated HK L 9 has been reviewed by this Board at the regular meeting of Mk f' ,Wil(® and your application has been approved pending the completion of the following items checked off below. RevisedPlans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) _AA '/2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: ./ �plu. , TOTAL FEES DUE: $ � 15 2�q BY: John M. Bredemeyer III, President Board of Trustees John M Bredemeyer III, President �cpFFOt Y Town Hall Annex Michael J. Domino, Vice-President ;�� ���� �G� 54375 Route 25 Glenn Goldsmithy z P.O. Box 1179 A. Nicholas Krupski o ® �i Southold, NY 11971 Charles J. Sanders 4,' p n' Telephone o (63192 Fax ) 765 6-18 BOARD OF TOWN TRUSTEES I TOWN OF SOUTHOLD Date/Time: S/i II I S`I fir^ Completed in field by: bl.gf4Sk Suffolk Environmental Consulting on behalf of E. G. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN request a Wetland Permit to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a 24'x24'(576sq.ft.) attached garage and a 12'x62'(895sq.ft.) attached deck; install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft. gravel driveway;'and install a system of drywells to contain stormwater runoff. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet .3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted:(6 N Ch. '275 Y 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: Oju I) 0"d 10 SIS- Foc' looks- 06d , +0 �TLbo Present were: ✓ J. Bredemeyer tl M. Domino ✓G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 John M. Bredemeyer III, President �ogUEFO(�-�O Town Hall Annex Michael J. Domino, Vice-President �o Gym, 54375 Route 25 Glenn Goldsmith o '` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders y�jo ao�� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Suffolk Environmental Consulting on behalf of E. G. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN request a Wetland Permit to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a 24'x24'(576sq.ft.) attached garage and a 12'x62'(895sq.ft.) attached deck; install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft. gravel driveway; and install a system of drywells to contain stormwater runoff. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: 'Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment=* A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. s25% Expansion/Calculation Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos/Neg Declaration CAC: LWRP: Additional information on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 ELEVATIONS AND CONTOUR LINES ARE REFERENCED FROM NA VD 88 SURVEY OF PROPER T Y FLOOD ZONES FROM FIRM 36103CO162H SOO)yp Nip i� A T PECONIC 40 �F i LOT®s REFER TO "MINOR SUBDIVISION PLAT KNOWN AS RICHMOND CREEK FARMS" IrVgpTpwN i TO WN OF SO UTHOLD TO BE A PORTION OF THE PREMISES CONVEYED TO THE GRANTOR gNrJ pF i� HEREIN BY DEED DATED NOVEMBER 25, 1997, RECORDED IN THE SUFFOLK COUNTY SUFFOLK COUNTY N. Y. CLERK'S OFFICE ON DECEMBER 9, 1997 /N LIBER 11866 CP 747. i� 1000-86-02-12.6 OT SCALE- 1"=30' JANUARY 14, 2015 FEB. 16, 2016 (SITE PLAN) `3�SC0 � Fob �e APRIL 7, 2016 (REVISIONS) X10 Ir SOS N a� SSg. �cFo�A IvgTc�� APR - 8 2016 0 qN H 01'� �° A�oO ¢530, q`�'r,�'�,r N S OBJ pOopos�oo, o Q�oo� O.00' OA-°ghn 5 4�° a okk- F c►i,� C� .01 c� A so . �' o LANDWARD LIMIT OF TIDAL WETLANDS AS DETERMINED � �F� RoAo o0 0 'ryo ;o�% BY SUFFOLK ENVIRONMENTAL CONSULTING, INC. Foy- p ON SEPTEMBER 24, 2015zo ZCq 00 Dc WLF #' �'' M R FRS N 0 , ro r F Marc ti 07�13p2016 �\ �F WL ti tvq�J SIJ ZpN o WLF RJ F MHWM _ F�' 6 AF #3 feet 1V NOS y�P�1� m T 23 - ----- MHWM nE LI TEST HOLE DATA •38. ` - - _ NE �1 C pt `I McDONALD GEOSCIENCE 1 ),� f ---_--- WIJ �V J ' I 10/15/15 884'0238"W --- --- DARK BROWN LOAM OL 122.21 4 0.5' ] �- PALE BROWN SILT ML /-y 4' / Z7]'� PALE BROWN FINE TO MEDIUM SAND SP 6.6' SEPTIC SYSTEM DETAIL WATER 1N PALE BROWN RNE TO MEDIUM SAND SP NOT TO SCALE F.F. EL. 11.0' EL. 8' 13' CAST IRON FRAMES FINISHED GRADE NOTE.• WATER ENCOUN7FRED 6.6' BELOW SURFACE AND COVERS TO GRADE EL. 8' �IIII—III _ I 24" 1 M/N•I MASONARY CHIMNEYS Jill- IIII X . MASONARY CHIMNEY INV.EL. 6MIN. 1' MIN. ♦ = STAKE 75' 12' 6 2' MAX INV.EL. 1/4" PER FOOT 6.5' 6' 10 /NV.EL. ® ® ® ®a „� e,lr•x ■ = MONUMENT MINIMUM PITCH 6' 1/8" PER FOOT INV.EL. ® ® ® 2 m = TEST HOLE MINA" DIA. PIPE 5.6 MINIMUM PITCH ® ® � I 'C "�-r •',"r' MIN.4" DIA. PIPE = W 1000 GAL. +4 1111 min. 11=_ 2' (6) 2 feet deep gullies WETLANDS FLAG ]fl L PRECAST J= WATER E =0.T : SEP 77CTANKAll I /'1fEA- 38,M 80. FT. 40II�I III III TO 11E UNE RAIN RUNOFF CONTAINMENT N��Y` >����-L'��,r'`NO. 49618 ANY AL7ERA770N OR ADDl170N TO THIS SURVEY IS A VIOLATION DWELLING & DECK = 3321sq.ft. PECONIC SURVEYORS, P.C. OF SEC770N 72090E THE NEW YORK STA 7E EDUCATION LAW. 631 0.17 = 565 cu.ft.x EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS 3321 JJ21 x.2 = 3 VF ( ) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 13. P.0. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR provide 4 DWs = 80 x 4 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 15-225 4 WJ Rk - i k �4i -: 1 i •mak.. 1���� � ar�.. �I '• R _ 7R.- � - _ .'s.�le__ �.,_ • •� � + tet . * '� - .R 1 ��� } � '-'' r . � � • tea. ... 1 • = �n • �+; _� .. A - � `� � low Jr .. - s.,,, if iIc r • Y � _ e��� � 'w 1 1 1 • +4 .. ^/��. / k �. ./ x..41 - ,..:T yyii 1� _- ' r•3' r! VIL 44 doo " yI S"+ d . ��L !r• ,`�.- y'�'-•'i S• p�' -4--DIY' •[ s.FMY il. ,. "i i N N ,may +M ♦, '� �, '�.,'�,.���.yf{, b-al•wy. _ 'ttiiYl��....t ' 1� .-' _ ._� •V �r Re two } �'/*f �� 'w f Y s ��.Y wr !�. �`.�.�1,, t '•.� f .1>.,Fr .fit 1.fi •� c �"�"` d` -l�!{.•S,w� � - ~� .mac.: A ate � �'. �" '7 .� �..+. r A•. � ,�- t, ` ' .F.:.+f_.w S \ 1 •�^'R�~� ... VIA; f.. ...� ;..y�•., - � r Ws .1i1 �A'�� w.l'rte 1 }i. , �r� ..{_r�� -- �` ��j'�.� '�r< ~��. �J►���d���'� _sr_ �E� -.`� �',,. �� 7'�' » h-. W' r ""•� . •�K .�i •'� *, �•� ',r ` `q�l � -1�- c . r�_ «.- y! '�� �* ���1J•lf�-}'*• - ..�'v'CT�d ,• � {��_'Y �� � �•• • .,_fie io lop STEIN E. G. FAMILY TRUST Property Situate: 4145 Wells Road ■ Peconic ■ Southold ■ New York SCTM #: 1000 — 086 — 02 — 012.006 V' {�Soutllold x � E X' �1 �s SUBJECT "PROPERTY 0111 ..�• F.LL`fa �� .;FLlb h.L �z3_a•;eu�Rn e HELL,RL 4FLL`RFS fr ELL`.H fJ SUBJECT 11 LL R.1 yr _ r PROPERTY AlroELL<rr / 400MLLSRL, ,.. ?-2"..ELLS RD r .. � 4455 WELLS RD 43Q-5 HELLS RD — j % 4136 WELLS RD t 7�u5 ELLS RD . W t a 3�i5?oELLS RD _ I I � � 1 � • I • �p s '�,per L. r � �'� � -tom ��^' w I t t. s VIA a f - 1 f n k ^jV � 4 VIP w • � a" i STEIN E. G. FAMILY TRUST Property Situate: 4143 Wells Road ■ Southold ■ New York SCTM #: 1000 — 086 — 02 — 012.6 �. (Photo taken on March 9, 2016) C Photograph indicating the staked out location of the southwesterly corner of the proposed Deck R (left — foreground) and the southwesterly corner of thero osed Dwelling center mid-ground). p P g ( ° Photograph taken from the central section of the property, facing northeast, towards Wells Road. . a Y STEIN E. G. FAMILY TRUST Property Situate: 4143 Wells Road ■ Southold ■ New York SCTM #: 1000 — 086 — 02 — 012.6 - (Photo taken on March 9, 2016) .k Y'x Si d R Photograph indicating the staked out location of , the southeasterly corner of the proposed Deck (right — foreground) and the southeasterly corners . of the proposed Dwelling (center back-ground). Photograph taken from the central section of the property, facing northeast. A F�f ilf a4 toe `s ,� � �� � 'ems � �. �, � � • ► r , > , "'fir' ! ; g STEIN E. G. FAMILY TRUST Property Situate: 4143 Wells Road ■ Southold ■ New York SCTM #: 1000 — 086 — 02 — 012.6 (Photo taken on March 9, 2016) Photograph indicating the staked out location of the southeasterly corner of the proposed Garage. OF 19 Photograph taken from the central section of the . =... � . property, facing northeast. . F'ffi•s t � �it r y,I/jiII II i` i. ,s STEIN E. G. FAMILY TRUST Property - � Situate: 4143 Wells Road ■ Southold ■ New York SCTM #: 1000 — 086 — 02 — 012.6 (Photo taken on March 9, 2016) } u e r { Photograph indicating the flagged wetlands boundary (circle). Photograph taken from the southeasterly section of subject property, facing southwest overlooking Richmond Creek. A t *` r. t F t STEIN E. G. FAMILY TRUST Pro ert p y Situate: 4143 Wells Road ■ Southold ■ New York T . SCTM #: 1000 — 086 — 02 — 012.6 (Photo taken on March 9, 2016) _' Y Photograph indicating the flagged wetlands ; boundary (circle). Photograph taken from the southeasterly section of subject property, facing southwest, overlooking Richmond Creek. x t k11- Al > ; 71, ^ ...r *• _i�. mak � *�f' �'�, .er �� r „. 'i'6' g5jy'd PR _ F uslRicl xo tuuu —PROPEP YTA%sERNCEAGENC Vry OPERTY MAP D.� - ��-•. ���tz,Acm>a1A ___ _. _ �' _ mxvenwNo tE osm.mn - - - - sE-E sE .+o. ""��`E' +-. " �� ]O r SEE SEG NO OFv SEE SEC NO OTS E .a -xo.mb _ -• w N„ SEE SEG HO O>s MATO —�uxe. - B P ___LZ_ --__--_1.12 --IINE _ _ _—_ --- --_ --- Q q.Z'Q, M1A e• G ,.• g I mt FOR PCL NO FOR PCL NO FOR PCL NO UNE 40A SEE SEC NO SEE SEG NO SEE SEC NO FOR PCL NO 075080661 W`r0600]2 4c SEE 290A b y$ C 0]SdT-0p61 ,.p,'p AAP ryy &6 fToMo sam au 14 m I ti 5 6EYEE6PNEM�RS, 22A(a QQI S a 3t M1 m NYE6EINEOAI6A 1� ISA QO ]6A(.) DP \an m6A � A t N t ?'mb1 '•�' 21A1o) 20N \ dF $ O 93 6T 3A �a 1 np1 M� SN .8 e9 mT O ROH,+oFswmroln 26A1) B \ esunm F a OEVEioftmn/ur+n51 \ MA 1�P 9 ,7f` Y � y�. 4• n16 �z titre 1, $ $ a° � 3 425 75 Vic) 15A(c) 13 13A ,9 mn , Ajd x1 -413m 24A 09` m,8 W m rFELIX40 tANOlALG1 b $ 6 \ R n e b m 16 >+ 2. is xP ( 6 m je o• 1, .u�t ,6 Iwd ➢ � EECOracwm ,02 Z�cl $ • b,6 ° • FE 1ma.i ¢ $6'°' \ n owxoF rsp 3I .p � � s 6 .$ 1�\ PECOMc29A 4 � e 9� \\ • �//\ ° LAxOtnusr 1n1 ,3 \\ 2B a o e \ z \ y TOMOFSO OU) Alµd, �1t.2,o v° sn ,yyplcl t p \\ BOA(.) . &M(4) 9 x '°' t 6, y5p11 y RYCHA]Ory0 CREEK \ / I � r I FOR PCL NO [[,I SEE SEC NO m• 1 6A(c) u L 0 ( \\ b 35A1) Szs2 0 t in(c) / 9 u s (e) 1�\ 116 p 6g 6`x1 a ,� e,glc)11z M •` D74 fib "19 g 17A41 13A N 261 .( '$ 13 $ e 6 „x 18 N•NEG,` a 43A(c) 3 72 1SAW 6A 2, tiAlcl 11 gplA �9ib4'$ / G 143 TONx OF 5061N010^tea SEOmOSfdot4]t� '�'y2 �`\x 3 , m T4� O 9 `l 142 c� FOR PCL NOI --a LINEt d ' b ?•4{'� �� d2 tm 44A(c) 4 N 22A -- SEE SEC NO .• eo / ` ^n 095-01-0013 I A �Q,il>• 1U Fm Rt_x0 '~ / V ] u A Nat _ A MATCH —iZ--, s y. =-c SEG NO Mn1aF IIxE� e �.� UNCI EI ^ a H �"'NE SEE SEC NO 099 SEE SECC 96 NO 0 �i 43 2 1 9A ss, SEE SES NO o9e o, E u^•^�- --�— "° (21) O „ter~ __ _— e�. t --n-- ' wnsmr s NOTICE COUNTY OF SUFFOLK O I< G s... 2 a C E m4 ws 996 1— SOUTHOLD SECTION NO E Real Property Tax Service Agency 2I v 1.tr2iw —-� _—•-- ., --v,•, — @ Lounry Qnler WverAeaO,NY 11901 E ES 086 "• ai+asss> p W) Ose tp —u.o 1000 PROPERTY MAP - mNVExvwaTE r.zs,mu .T. OFFICE LOCATION: �*® ,s®���® MAILING ADDRESS: ® <, �® _ Town Hall Annex ���_A, -�'� -- P.O. Box 1179 54375 State Route 25 � � Southold,NY 11971 _� ,-�,�=;fir_ (cor. Main Rd. &Youngs Ave.) o. . Southold, NY 11971 P ";,.z:` Tele hone: 631765-1938 � � - a® coum 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: May 16, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for E. G. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN SCTM# 1000-86-2-12.6 Suffolk Environmental Consulting on behalf of E. G. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN request a Wetland Permit to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a 24'x24'(576sq.ft.) attached garage and a 12'x62'(895sq.ft.) attached deck; -install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft. gravel driveway; and install a system of drywells to contain stormwater runoff. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 The proposed action has,been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the _ LWRP provided the following is required for further Policies 5 and 6. 1. Require that a 15'+ vegetated, non-turf buffer which includes the existing trees be established landward of the wetland. Maintenance activities and access to the water should be outlined. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Stephen Kiely, Assistant Town Attorney r - ����g�}FFQ��-�aG Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary ,y P.O.Box 1179 �'F Southold,NY 11971 ,y �f Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., May 11, 2016 the following recommendation was made: Moved by John Stein, seconded by Peter Young, it was RESOLVED to SUPPORT the application of STEIN E.G. FAMILY TRUST to construct a 37'X 50' two-story dwelling with a 24'X 24' attached garage and a 12'X 62' attached deck, septic system, connect to public water, gravel driveway, and install four (4) drywells to contain stormwater run-off. Located: 4145 Wells Rd., Peconic. SCTM#86-2-12.6 Inspected by: John Stein, Peter Young Vote of Council: Ayes: All Motion Carried John M. Bredemeyer III, President �� SO(/ljy0 Town Hall Annex Michael J_ Domino,Vice-President �� l0 54375 Main Road P.O. Box 1179 James F. King,Trustee "' Southold,New York 11971-0959 Dave Bergen,Trustee Gr Q Telephone(631)765-1892 Charles J.Sanders,Trustee ���yCOUNT`i Fax(631) 765-6641 D BOARD OF TOWN TRUSTEES D TOWN OF SOUTHOLD APR ®�� To: Southold Town Building Department Re: Verification of-Building Department Permit Requirements BUILDING DEPT. TOWN OF SOUTHOLD SCTM#: '-z ✓ `a` Property Owner Name: ` viA e,6,, iW*uL4 I pws Date Sent to Bldg. Dept.: `$���° The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO �Will he proposed project require a Building Permit? the proposed project require a variance determination from th oning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: Signature o e iewer Date - Jahn ALBsedemeyes I1I,President ! Town Hall Annex u:; 54376 Main Road Michael J.Domino,Vaca-President P.O.Box 1176 9 James F.King,Trustee Southold,New''ork 11971-9959 Dave Bergen,'Trustee Y Charles J.Sanders,Trustees Y .. Telephone(631)765-1892 :+rf' Fax(631)766-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application X Wetland Permit Application Administrative Permit Amendment/Transfer/Extensio�n�� Received Application: `t Received Fee:$ 2.5'0100 Completed Application: . y _ Incomplete: r SEQRA Classi icatiojy. Type I Type II Unlisted I� Coordination:(date sent) = `` LWRP Consistency As ssment Form: APR 8 2016 CAC Referral Sent: ��! Date of Inspection: - Receipt of CAC Report: Lead Agency Determination n - Technical Review: Public Hearing Held: ! Resolution: STEIN E. G. FAMILY TRUST Name of Applicant (c/o David Edelstein & Libby Goldstein) Address 4300 Bellaire Avenue - Studio City - CA - 91604 Phone Number: ( 310 ) 291 - 2065 Suffolk County Tax Map Number: 1000—086—02—012.006 Property Location: 4145 Wells Road ■ Peconic - Southold - New York (provide LILCO Pole#, distance to cross streets, and location) AGENT: Matt D. Iyans. Suffolk Environmental Consulting, Inc. (If applicable) Address: P.O. Box 2003; Bridgehampton,NY 11932 Phone:—(631) 537—5160 �5 I� � 1 , 1 Board of Trustees Application GENERAL DATA Land Area(in square feet): 38, 595 square feet Area Zoning: R- 40 Previous use of property: Residential Intended use of property: Same Covenants and Restrictions: Yes X No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide a decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s)on property have a valid Certificate of Occupancy? Yes N/A No Prior permits/approvals for site improvements: Agency Date NYSDEC Permit#10-86-0848 March 24, 1992 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency9 X No Yes If yes, provide explanation: Project Description(use attachments if necessary): Applicant proposes to construct a 37' x 50' (1850 s. Q two story dwelling with a 24'x 24' (5 76 s. f. 'attached garage and a 12'x 62' (895 s. Q attached deck, septic system, connect to public water, a 1890 s. f. gravel driveway, and install 4 drywells to contain stormwater runoff. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed operations:Applicant proposes to construct a 37'x 50' (1850 s. Q two story dwelling with a 24'x 24' (576 s. Q attached garage and a 12'x 62' (895 s. £) attached deck, septic system, connect to public water, a 1890 s. f. gravel driveway, _ and install 4 drvwells to contain stormwater runoff. Area of wetlands on lot: 9, 081 square feet Percent coverage of lot: 8.6 f % Closest distance between nearest existing structures and upland edge of wetlands: N/A feet(Vacant Parceo Closest distance between nearest proposed structures and upland edge of wetlands: 70.3' feet(proposed Decking) Does the project involve excavation or filling? X No Yes If Yes,how much material will be excavated? N/A (cubic yards) How much material will be filled? N/A (cubic yards) Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A Statement of the effect, if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): Minimal to no effect will result to the proximate wetlands due to the substantial distance from the wetlands,and due to the utilization of common disturbance control actions (i.e., use of staked haybales & siltation fencing). i 9 ~ 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: STEIN E.G.FAMILY TRUST(c/o DAVID EDELSTEIN&LIBBY GOLDSTEIN)Project Project Location(describe,and attach a location map): 4143 Wells Road,Peconic;Town of Southold,New York Brief Description of Proposed Action: Applicant proposes to construct a 37'x 50'(1850 s.f.)two story dwelling with a 24'x 24'(576 s.f.)attached garage and a 12'x 62'(895 s f.) attached deck,septic system, connect to public water,a 1890 s.f gravel driveway, and install 4 drywells to contain stormwater runoff. Name of Applicant or Sponsor: Telephone: (631)537-5160 Matt D.Ivans-Suffolk Environmental Consulting,Inc. E-Mail: mdivans@optonline.net Address: P.O.Box 2003 City/PO: State: Zip Code: Bridgehampton NY 11932 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 ZF 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: ❑ ❑ New York State Department of Environmental Conservation. 3.a.Total acreage of the site of the proposed action? 0.87 acres b.Total acreage to be physically disturbed? 0.2+/- acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.87 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban [:]Rural(non-agriculture) ❑Industrial [:]Commercial m Residential(suburban) ❑Forest ❑Agriculture OAquatic E]Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑✓ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: ❑✓ ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES 7 ❑ b.Are public transportation service(s)available at or near the site of the proposed action? ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑✓ ❑ The proposed action will connect directly to public water availability. 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑✓ ❑ The proposed action will connect to a SCDHS approved system on-site. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? ❑ 13. a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline E Forest E Agricultural/grasslands [:]Early mid-successional m Wetland E Urban ®Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑✓ ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? NO EYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: W,NO EYES ; N/A 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: ❑ ❑ 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: V ❑ 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: Z ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Ya% Iv ns-Suffolk Environmental Consulting,Inc Date: April 7,2016 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 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 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 r No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage Elproblems? [$ 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. F] 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 environm nt impacts. Name of ead Agency �l"Date e;� Print or Type N Ye of Responsible Offic r in Lead Agency Title of Responsible Officer 1� ,n (`� Signature of Resp isno bel Officer in Led Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: STEIN E. G. FAMILY TRUST SCTM# 1000 — 086 — 02 — 012.006 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to conduct regulated activities: Applicant Proposes to construct a 37'x 50' (1850 s. Q two story dwelling with a 24'x 24' (576 s. f. attached garage and a 12'x 62' (895 s. Q attached deck, ' septic system, connect to public water, a 1890 s. f. gravel driveway, and install 4 drywells to contain stormwater runoff. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 4145 Wells Road • Peconic • New York 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: 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. PROPERTY OWNERS NAME: STEIN E. G. FAMILY TRUST MAILING ADDRESS: 4300 Bellaire Avenue • Studio City • CA 91604 PHONE #: AGENT: Matt D. Ivans (a)- Suffolk Environmental Consulting, Inc. MAILING ADDRESS: P. O. Box 2003, Bridgehampton, NY 11932 PHONE #: 631-537-5160 Enc: Copy of sketch or plan showing proposal for your convenience. i, .M.S. Postal Service,. IFIED ® ■ I `a ■ • [�- •. M r jCUP CO Ir PECOi�IC"N 1195$ •i ;. rr, u7Ln ZO r- c 6, N Postage $ $3.3CO Postage $ $3. ® 4� Certified Fee 093 j- I I O Certified Fee 093 1 C3 06 f tmark Z q Retum Receipt Fee �6 i9tmark Return Receipt Fee Q ®Here o .(Endorsement Required) r ere (Endorsement Required) Restricted Delivery Fee I � Restricted Delivery Fee / I O (Endorsement Required) O (Endorsement Required) ru ! o g 0�/O6 G�� i m . Total Postage&Fees $ �x/06/ Total Postage&Fees n n �•I BR�Q I m Sent To I I 8 I fTI Sent To r-4 RLO bra lozrl I/��e�tQ-�� 11 r� l f� Street,Apt.No.; C3 Street Apt.No.; r%- orPOBoxNo. r- orPOBoxNo. 3JoS— wetlS /log 3-720 W rzLs ----------------- City,State,ZlP+4 City State,ZIP+4- -- ----------------------------------•---------�- I n_ — -------• -- N�- --- --------^--`--....._ � ostal,Serviciew■ ■ 9 zGE ■ ® ■ ■ ■ ILT. RECEIPT Mallo i F-O C3 ffl. • i I Er I Ir ROW CUTC" i Y 1.1'93 �- ;. rw, � PECO C,�"NY.=•1145$ = f" .; 't;� �° t��# srs ►ti Postage $ $3.30 s� r- Postage $ $3• �O Ln 0 }- Certified Fee 0932 a Certified Fee IY I � ' C3 06�stmark M Return Receipt Fee 06 Pork C C Return Receipt Fee Here (Endorsement Reqwred) (Endorsement Required) Restricted Delivery Fee ® U Restricted Delivery Fee / `� (Endorsement Reqwred) C3 (Endorsement Required) Q ru .a ru 5/06/2016 Q` o /06016 mTotal Postage&Fees o��}N n I m Total Postage&Fees 932 �n5 4A L7 Sent To J m se.ro (� I r q S'o s r+,i E-1 va c t 0 C(2, rq gLLLEC�dt[N( T'eOD"tC- L LC_ j ---- - --_----_-_- Street A • - _ - --- ------------------------------- O Street,Apt.No.; O Street,Apt.No.; or PQ Box No. PO R.c' 2 c r- or PO Box No. 2 3(71 (��. Z s u _ r 1 - --------- City State,ZlP+4 - - -•___ __________t_�-_- - - - -' ,r -_- ty 3 -P-e l C.. { :ee ee. PS Form :ee Auctust 2006 See Reverse for lnstruction§� PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: a J - _ u_ STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn,deposes and says that on the day of , 20 , deponent mailed a-true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAEURETURN RECEIPT. i Sworn to before me this Day of , 20 i Notary Public PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Susan Hallock P.O.,Box 200 Peconic, NY 11958 Robert Mitchell 3905 Wells Road Peconic, NY 11958 Joyce Shwara 3720 Wells Road Peconic, NY 11958 Pellegrini Peconic LLC 23005 Route 25 Cutchogue, NY 11935 STATE OF NEW YORK COUNTY OF NEW YORK Bruce A.Anderson c/o Suffolk Environmental Consulting, Inc., residing at 2322 Main St.; Newman Village Suite E; P.O. Box 2003; Bridgehampton, NY 11932 ,being duly sworn deposes and says that on the _6 K day of #M!W ,201&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 Bridgehampton ,that said Notices were mailed to each of said persons by(certified) (registered) mail. Sworn to befo a me this 6� day of A, 2016 Nota P lic Matthew D Ivans NOtar Public of New York No 0 i 1Vlj0;3859 Qualified in Suflolk county COMInISSIN E>:pires January 22, 20�') NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: STEIN E. G. FAMILY TRUST SCTM# 1000 — 086 — 02 — 012.006 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to conduct regulated activities: Applicant proposes to construct a 37' x 50' (1850 s. f., two story dwelling with a 24' x 24' (576 s. f.) attached garage and a 12' x 62' (895 s. f.) attached deck, septic system, connect to public water, a 1890 s. f. gravel driveway, and install 4 dr)Dwells to contain stormwater runoff. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 4145 Wells Road • Peconic • New York 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: May 18, 2016 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. PROPERTY OWNERS NAME: STEIN E. G. FAMILY TRUST MAILING ADDRESS: 4300 Bellaire Avenue • Studio City • CA 91604 PHONE #: AGENT: Matt D. Ivans @ Suffolk Environmental Consulting, Inc. MAILING ADDRESS: P. O. Box 2003, Bridgehampton, NY 11932 PHONE #: 631-537-5160 Enc: Copy of sketch or plan-showing proposal for your convenience. Suffolk Environmental Consulting, Inc. Newman Village, Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President Hand Delivered May 10, 2016 Mr.John M. Bredemeyer, III, President Board of Trustees Town Hall P.O. Box 1179 Southold, NY 11971 Re: STEIN E. G. FAMILY TRUST Property Situate:4145 Wells Road ■ Peconic■New York SCTM#: 1000-086-02-012.006 Dear Mr. Bredemeyer, Attached herewith please find the Affidavit of Mailing in full satisfaction of the written notice requirements for the upcoming May 18th public hearing for the above referenced matter. Yours truly, k---- Bruce A.Anderson attach. cc: L.Goldstein John M Bredemeyer III, President G . Town Hall Annex Michael J. Domino, Vice-President f��� �;_ �� 54375 Route 25 Glenn Goldsmith 'y P.O. Box 1179 A. Nicholas Krupski y ���Y Southold, NY 11971 Charles J. Sanders ,�dl dao Telephone (631) 765-1892 � tl Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of E.G. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE AuA4r'"-- , residing at/dba 11,111C1LK ENVIRONMENTAL CONSULTING,INC. 5 uX21Cu BROGEHAMPTON,NY 11932-2003 being duly sworn, depose and say: That on the 9 i`day of UA-� , 201 &, I personally posted the property known as 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,May 18,2016. Dated: 5=/$- b I. (signature) Sworn to bef re me this / "'day of �2014C Notar lic Matthew D. Ivans Notary Public of New York No. 0I NG053859 Qualified in Suffolk County Commission Expires January 22, 2017 N-UTILEL. Uim HtAmilvING 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: E. D. STEIN FAMILY TRUST, c/o DAVID EDELSTEIN & LIBBY GOLDSTEIN SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a 24'x24'(576sq.ft.) attached garage and a 12'x62'(895sq.ft.) attached deck; install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft. gravel driveway; and install a system of drywells to contain stormwater runoff. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 TIME & DATE OF PUBLIC HEARING : Wednesday, May 18, 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 David Edelstein+Libby Goldstein ` ' BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SME IS THE APPLICANT FOR THE ABOVE DESCRIBED PE (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 HARMELESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY BIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature Si store SWORN TO BEFORE ME THIS DAY OF ,20____ i SEE ATTACHED CERTIFICATE �_�_-Notary Public - _._...�..�. . CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE§8202 1 See Attached Document(Notary to cross out lines 1-6 below) ❑See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signa(u e of ocument Signer No. 2 (if any) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of Ld5 A M6rVUe5 on this _ -rm day of MAa.(- )j , 20_1_(a_, by Date Month Year (1) DAVI10 E01CLSr E-)A] (and (2) k-\ &6'1 GrnL-Q5T-V--i N ), Name(s) of Signer(s) LISA PILLSBURY LORD Commission#2071089Z proved to me on the basis of satisfactory evidence c-t-ce Notary Public-California z a o e e rson s o �., Los Angeles County tbthe ( ) appeared bef me My Comm.Expires Jun 10,2018 Signatur c Signature of NoQy Public Seal Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s)Other Than Named Above: 02014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5910 I Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) We, David Edelstein and Libby Goldstein residing; at 4300 Bellaire Avenue (print owner of property) (mailing address) Studio City. California do hereby authorize Suffolk Environmental Consulting, Inc to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) I (Own 's si ature) i . fI APPLICANT/AGENT/REPRESENTATIVEj TRANSACTIONAL DISCLOSURE FORM � The Town of Southgld°s Code of Ethics prahibits eanflicts cf int:re t gn the arz cif the town ffl ers and emnl. jLppM;eff this form is _q provide information which can alertthe town 9 po�sue conflicts of intezest and altow it to lake whatever action is j necessary to avoid same. YOUR NAME: __ David Edelstein _ 1 (Last name,first name,middle initial,unless you are applying in the name of ( someone else of other entity,such as a company.If so, indicate the other ` person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other,"name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold`?"Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X i S 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 t Title or position of that person f Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check appropriate line A)through D)and/or describe in the space provided. i The town officer or employee or his or her spouse, sibling,parent,or child is(check all that apply): A) the owner of greater then 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. r DESCRIPTION OF RELATIONSHIP I Submittedthi day of _ 201 Signature Print name David Edelstein f APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL ISCLOSU FORM The I*VN�n of:outhold's 'ode of Etkc rohibitic inflicts cif interest an the na;x tirf the town officer anc4 rm lovmes The ur ose of ._ �p_2 this-bem fs tt ravicie i otmation which can al@ct the town-QP possible coal icier f`intr rest trnd allow it to Lz'c. whatever action is necessary to avoid same. g YOUR NAME: . LibbvGoldstein (Last naive,first name,middle initial,unless you are applying in the name of someone else of other entity,such as a company.If so, indicate the other person's or company's name.) NATURE 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°o of the shares. YES NO X i If you answered"`YES,' complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check I j 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): i 4 A) the owner of greater then 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); j C) an officer,director, partner, or employee of the applicant;or I)) the actual applicant. I € DESCRIPTION OF RELATIONSHIP I f 4 Submitted this day of _201 �Q Signature -6f .. �._ _ -- ___..__�____�_ Print name_ Libby oldstein ` . ... - r±� a frit ii n tfi�► A rm� tdr,, u - k" �i t `�`" w . Pie0PFi2T1' i ii it N: .S,C.t.AS.g: "ittE=FOLLOWING,Ac7tOtstS N9AY it QElElti= THE SUB&''-ISSION OF A 1000 086 02 012.006 .STOR -WATEE�,,GRAUI,Gi,DR,ErAGE AND,EROSION CONTROL-PLAN iw '' ate. r=> = CERTIFIED Y a�DESIGN PROFESSIONAL W THE,S ATE arFAFE�YORK., ,SC�JP t)F W0TK' PI�C��'OS �C)NSTi�irGTI�I+�' TI'�I°# �''WQRSIBI� "Y�s''"No . , rh�t tt; pt�t a or rh .'rr�jec%t�a€ is z 'Witr This Project Retain"A!I St;ar t tatoi aur;'Off {tgcltide"focal Hasa of ail Pareets taitsd Mritiitn 0.89 acres C��nerafeil by a Twa(2"�titch Ratrifalt Sri Site!, 1ht tc,q'pe of W,bik for 0iaposdd Coiist�uc�ian} s F i��3 (This 3tsrri evict irfciuci4'Ott.viii-otf cr�atad --11, site, b�' What is ttis�t otal�Arem of Land Clearinb --cieadhg 6ndtor cans'tructl+sn a6IM6es as"�li as ali , xll antPor'Gioiilid Ss',sturbaiit�for the Imposed < 0.2-acre. 6fe'tmprovci' is anis�;e rmanent;cr�yti Hof` consfruct pn actiyity7 ;dmpefviaus's rf ces:} ` 1'RQ!'VM BASF fzt JEO ,DlrSC tt;°ITON ntooA&ijt Pdgc�a�N, d} F�'"sQdes,thei Site Pian aridlor.SCirvtiy'Stio+rrAil fon'?rosed Dsainago StnacEures'Insiicatirsg size t ovation?This X itemshatt'indtucie ai!Proposed Gracfm Changes and ---� °Stapes!Gontr_aiUng;SurFe�Water,Fiow'' "" _- '.-•,`>� Applicant proposes to construct a 37' x 50' (1850 Does the.Site,Plari abdf6r,Stirvey cResoribe.(ha.t~msion s. f.) two story dwelling with a 24' x 24' (576 s. f.) an+ sedimen;"control`pr ctic slhatviiCtotisrrd'to 'cgiitrii!site'erosEon anct'stdrm Wi!4 dischargas,,`This, attached garage and a 12 x 62 895 s. f. attached - g g ( ) `itasrri rrtustbe maisita(ri�d litrodrghtitat,ltip,�n4sre deck, septic system, connect to public water, a Coiistiuctiori.Period.• 1890 s. f. gravel driveway, and install 4 drywells 4'Wli•this'`Priiii tik104e riyrtani#` itiiiig;'ta dirt o'r'. to contain stormwater runoff. = xcavatianu terotite=r t , cttan e.%ttia *P X ,. ,.,. .` Eat sAng diadOnvoh6g,stere ttadn 26_ ,CWb Yards .�. aYi+�ateriai w'ithiri-any parct~i?e - 5- UViii this'Appticatt2 Require i,and 0 turbing ActiviGes i Encampassing an Area tn'txcess&..FiveµThousand X (s;aoo S.F;pSquar ;�c�et of•Gn�tinci si�roa is tii`ere-a Naturet;lNaEer Cotarse'.Rurining'thraiagfi the; Site?'ts'this't?raact wriihin ttie [astees jarcisdictioti; X t d3enetet DBC §VuPf?P Ractutre_m stir: . 6 iAhiin 0iid,H6hd dd,(109)feet 06 Weitartd or' Stiiar+irsston or A swVPPP is requiters far all;Gazrstnaitan activltles htWotvTrig so; dl,tteebSnCes•calone(i)or`mosuogies; inaud?agdistutt nssofhissfhrioisv:pcthat -.V!}itchtkieiB,beSiteprptierhOti, 4tStigi� riie.StOpEts arepart 01'a taecjercbfi�i n ptan,that wi uilErei icly!iiishrrki`gha arsnare mcees'ofend, ti+rYiioh Emceed Flili (45j fctef bf Ver1igat kise'Ic €nCtttd egg t agsttalat€an activl&tS'ir rcaPvlt sail d vturtra%ces nt less than ane{tj oCcssvii ra Glee t its deed{i®Q')Gf HaYiZ®Ptf3lbii f�nc`c' thtapEChasticsteraiiinosi`tli ta�SPDES' El dx3rrtu'Estregiiirediorstornii�aater iseha!Eos {SWPPfi s Slizi9l reicat,ihc rAlntn%tirn t2agsltrorsisat aF tiia' t?U S't3�nerat`Porsiiit "Wili'Ctt ve�iayS, ttiig,Areas br'ot'her irtitpt rvitsEiS farySiotm Wlatcr Qlschatgas'iroen Cat9struattan ativtty'.t'ea�ttlt ri 'G �o-'4 as l.} 6a,rAtioi tie;Wpedlo Diroct 5t tri ,Vetsr Rt n•Ctff X 1.'rfi BWPPp ste6ii be piepared prior io`6 iubn*tsl,af th6 N&tate Nr�t stiaq tie. 'into andfe r in the diredt'6 of 6'7byvri rigiit-of vray? subrrutE€€d,6thebepartrrtenl;l to"t�;ecorisirre eiu ittati�atstavi fonartyEy." 2;,7ttri SWPPP'txh;FEi tldscribe the oioskati grrd sedfrnent cat+Cra pr i tfces and a hcrm Wilt this•P19jeet t'ei61iri3'the t?iacdrnentof Wteiraai,, imgtat€ed,past_cxiitsinrciltar'nlalra water'mdngg agent practt«;s tttgt wtti€�s"iEsvd aedlor Rein6vai,of Vegptad6h an&i.'ttia�'Consfmction Or aiiy X consvude to,redua +ttui ponutiit"s tri stoma water`r� cfiargas and is assure Storir Wit#iln tho`1 awim Right-gf #tay or Road 5tt(irtder boir 46ovAth'6} tetnsnndconiiliorLiVthis piimgt:!nsda!i n,'fhn`SVVPPPstzatl t�aa?,to;�'ssu�wtptcovt�sud®stfor,�r�ss iaonmto�s ' °r €dentify,Pot ntla€solaces or 0ii Uiran u,•mlcfi4,0y resasb4aw-tae expected tit atfeet the "Q 1 qus6EyotSdaV+altvatetdl^Chblges,'. MOTEL !f Any Aaisvr.;is440!DHs,dngttiroytjhNinais;ArisweiedviiihaCheckmiuk 9.Atl ?Pt�s'thbE rq+altis the t cattnictta ai sCoim waterratiageitierzt piraaatce in a fox¢n th®eyeinactl®til s€to ititurbanc€s fs koten 5,4'Utl S rr C�,Acre tit a taainporannt tata€sp be prepsred 6y"a ijuafiC d Dastgn Prates§inE l i icensed in,t ewYrsrk' toeza„vYatkr,G ding,`Cat lt#age_'+x ►aatgai Cantrut r Plan is Ftequlted ksj'the Torun br tPtat Es kiva molts tassbPe to rhe nn es and r" w of SEtaein W2tEgr bracts em�arit" Sauihotd,Siad bidet be Submtt d to tta4€s a Poor""ta lgcuapoe arAray Building Pa wt P" >'9 _ {EloiE ',`A d icerc htatk{t!}rina€t8r+ser ver for ,Civcsaron It Fto6irei#tssr a GoFta�PpCafaert} O F 'V TORK,,YOF SUFFOLK .,.$s BR> .ANSISO15 � � .. ENVIRONMENTAL CONSULTING, beim dtily swornelsle ,,depases and-says thadtiis`die'app4i a r kcrr ,. * rr�t :�t as viduar'snr„ ,aa aty v,_,. _. AGENT r rid,that'IieJskae is the ...:...::............................................................................ ............ .,CJ 4&,and/of r i0&-sehtative of the atv%ier vii:Ot nctdis;ttixd is dlilS;ai tlisarized ta'perfarna,or Piave perforined die's,as8 react;and to inai�e.sd fill`tliis,appkatibn,,'tliatA st;xtenient�cririt:tiried in t1i��a�p1i �Qii,�tre;ta�ie"to, 6;lie5t of lits kraa��tcitgd,atid�l)df;:iiid tliat;tli rvori:aviil`'bt prfot tirci3 in.`thc rr€atant r set fartti tit dee aplil►caiirari.tiMcdhere fS�i�arrtEo �rai�.ttis, An, 1c Nfatthm D Ivans .. l�rotary�'itbiie» - ........ : . . ...:a ...,... a .. .,......, 'saiuro or, �a�ip 'COMMISSion EX011BS January 22 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C,the preparer of this form should review the exempt minor action list,policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered"yes"or"no",then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail,listing both supporting and non- supporting facts.. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net),the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 086 - 02 - 012.006 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification: Nature and extent of action: Applicant proposes to construct a 37'x 50' (1850 s. f.) two story dwelling with a 24' x 24' (576 s. £) attached garage and a 12' x 62' (895 s. £) attached deck, septic system, connect to public water, a 1890 s. f. gravel driveway, and install 4 drywells to contain stormwater runoff. Location of action: 4143 Wells Road■Peconic■New York Site acreage: 0.87±acres Present land use: Residential Present zoning classification: N/A 2. If an application for the proposed action has been filed with the Town of Southold agency,the following information shall be provided: (a) Name of applicant: STEIN E. G. FAMILY TRUST (b) Mailing address: 4300 Bellaire Avenue■Studio City- CA■ 91604 (c) Telephone number: Area Code(310) 291 - 2065 (d) Application number, if any: N/A Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No ® If yes,which state or federal agency? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ® Yes ❑ No ❑ Not Applicable Subject proposal is consistent with the policy in that we are constructing a single-family residence within a neighborhood characterized by single-family dwellings. Accordingly, we believe that this project is consistent with this policy. 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 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 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal will not adversely impact the visual quality of the surrounding area in that the neighborhood is characterized by similar residential development. Subject parcel is a wooded lot whose character will remain after construction including a buffer to wetlands as appropriate. The siting, scale are compatible with the neighborhood. The remaining sub policies are 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 The proposed improvements are to be located beyond the Flood Zone Boundary. ti 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 Subject proposal incorporates compliant septic system and drainage control all of which will protect surface waters. 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 Subject proposal protects the quality by avoiding the loss of ecological components. In addition impacts relating to the proposed development are fully mitigated by septic design and placement, and drainage design, the expectation that a buffer will be established and suitable erosion control implemented. 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 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 Not Applicable. Attach additional sheets if necessary 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 Not Applicable. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable 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 Not Applicable. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Not Applicable. Attach additional sheets if necessary r Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O. Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President Hand Delivered April 7, 2016 ti APR " 8 2016 € p Mr.John M. Bredemeyer, III, President ! _ Board of Trustees Town Hall P.O. Box 1179 Southold, NY 11971 Re: STEIN E. G.FAMILY TRUST Property Situate: 4145 Wells Road■ Peconic ■ New York SCTM#: 1000—086—02—012.006 Dear Mr.Bredermeyer, This Firm represents the owner of the above referenced property, who is seeking all required regulatory approval to residentially improve thereon. In that the property is sited along Richmond Creek, approval from your Board is required. Please find enclosed: (1) Town of Southold Trustees Wetlands Permit Application (original and three [3] copies); (2) Erosion, Sedimentation& Storm-Water Run-Off Assessment Form (original and three [3] copies); (3) Town of Southold Local Waterfront Revitalization Program Application (four [4] sets); (4) Short Environmental Assessment Form (original and three [3] copies); (5) Location Map for reference (four [4] copies); (6) Photographs of the site indicating current conditions thereon (four [4] sets); L (7) Survey of subject property,prepared by PECONIC SURVEYORS, P.C., last dated February 16, 2016, indicating the conditions thereon (four [4] prints); and (8) Check made payable to the Town of Southold to cover the requisite application fee. Kindly review these items and schedule for the next available Board of Trustees' meeting at the earliest opportunity. Should you have any questions regarding this matter, or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. Ivans attach. cc: L. Goldstein