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HomeMy WebLinkAboutTR-8866 Michael J.Domino,President O�*Qf SU(/fyol Town Hall Annex John M.Bredemeyer III,Vice-President h O 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith ® aQ Telephone (631) 765-1892 A.Nicholas KrupskiolyCOU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1394C Date: September 29, 2017 THIS CERTIFIES that the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq ft roof over existing landward porch; construct new 243.25sg.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town Code Stormwater Management; and to remove the trees that are flagged; trim trees on the bank to not less than 4' in hei t• At 160 Lakeview Terrace, East Marion Suffolk County Tax Map#1000-31-9-17 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 15, 2016 pursuant to which Trustees Wetland Permit 48866 Dated August 17, 2016,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing_garage and to add new window in south facing wall; on the existing dwelling construct a 99 6sq ft roof over existing landward porch, construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town Code Stormwater Management; and to remove the trees that are flagged; trim trees on the bank to not less than 4' in height. The certificate is issued to ROBERT & CHRISTINE HEMPEL owners of the aforesaid property. Authorized Signature c �pF SO(/lg, Michael J.Domino,President ��� Old 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 ® �� Telephone(631) 765-1892 A. Nicholas Krupskioco Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: /,, //-7 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction % constructed complete, compliance Project comp inspection.p INSPECTED BY: J, Ac COMMENTS: Z) 7 fJ�� / �,�✓�� Y P(4 9 07 CERTIFICATE OF COMPLIANCE: F01 John M Bredemeyer III, President }o��` Town Hall Annex Michael J. Domino, Vice-President t yam', 54375 Route 25 Glenn Goldsmith o ?r` P O Box 1 179 A Nicholas Krupski 'c,o ® Southold, NY 11971 � �, o� .� Charles J Sanders Telephone (631) 765-1892 r<.L- 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 I" day of construction Y2 constructed Project complete, compliance inspection 9 WJ1J;,,9­ T USTEES HOARD OF R SOUTHOLD TOWN I SOUTHOLD,NEW YORK 'M N PERMIT NO. 8866 DATE: AUGUST 17, 2016 .: MA. ISSUED TO: ROBERT & CHRISTINE HEMPEL PROPERTY ADDRESS: 160 LAKEVIEW TERRACE, EAST MARION f,;,f SCTM# 1000-31-9-17 k., 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 August 17, 2016, and in consideration of application fee in'the sum of$250.00 paid by Robert&Christine Hempel and subject to the nits Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: d window in south:facing wall; on Wetland Permit for the existink-g4rage an ,to add new roof over existing landward porch; construct the existing dwelling construct a 90.6silst. new 243.25sq.ft.,screened7in,,seasonaddition .over additio .over existing deck; install gutters to leaders to drywells to contain- - roof,runoff, an I d I in accordance with Ch'. 236 of the'-Town Code Stormwater Management; and to remove the trees that are flagged;'trim trees on the bank to not'less thanAin,height;:and as depicted on the site plan prepared by Robert I. Brown, Architect, P.C. dated March 28, 2016, and stamped approved on August 17, 2016. 6) .......... IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these p 't6 be subscri*be ' d'by,a majority of the said�Board,&of this,date. resents SJJF FDJ �V 41- (1131431, A T TERMS AND CONDITI®NS The Permittee Robert&Christine Hem el residing at 160 Lakeview Terrace East Marion 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 dainages, 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. That the said Board will be notified by the Permittee of the.completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title,or interest in real or personal property held or vested in a person not a party to the permit. John M.Bredemeyer III,President ®f S®t1j", Town Hall Annex Michael J.Domino,Vice-President ,`O l0 54375 Route 25 ,yam P.O.Box 1179 Glenn Goldsmith "�►' Southold,New York 11971 A.Nicholas Krupski ® @ Telephone(631) 765-1892 Charles J.Sanders �® a Fax(631) 765-6641 �ycOUNTy,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 17, 2016 Robert 1. Brown, Architect P.C. 205 Bay Avenue Greenport, NY 11944 RE: ROBERT & CHRISTINE HEMPEL 160 LAKEVIEW TERRACE, EAST MARION SCTM# 1000-31-9-17 Dear Mr. Brown: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, August 17, 2016 regarding the above matter: WHEREAS, Robert Brown Architect, P.C. do behalf of ROBERT & CHRISTINE HEMPEL 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 July 15, 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 August 17,'2016, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ROBERT & CHRISTINE HEMPEL for the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq.ft. roof over existing landward porch; construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town Code Stormwater Management; and to remove the trees that are flagged; trim trees on the bank to not less than 4' in height; and as depicted on the site plan prepared by Robert I. Brown, Architect, P.C. dated March 28, 2016, and stamped approved on August 17, 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 John M. Bredemeye; _._, President �p�� Comma Town Hall Annex Michael J. Domino, Vice-President `�� �>k 54375 Route 25 Glenn Goldsmith _ ;.. "` z w P.O. Box 1179 'A. Nicholas,Krupski y Southold, NY 11971 Charles J. Sanders ``A��( , �a�l Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: �E� I � 2i [ j Lti �I� 0 e®eT 1WOW , . Please be advised that'your application d ted �19L �f has been reviewed by this Board at the regular meeting of AVUS7 1:4 7eib and your application has been approved pending the completion of the following items checked off below. Revised-Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) Y2 Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement (complete original form enclosed and submit to Board of Trustees Office) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re=application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: TOTAL FEES DUE. $ \50 BY: John M. Bredemeyer III, President Board of Trustees John M. Bredemeyer III, Presidento UFFOZ o Town Hall Annex Michael J. Domino, Vice-President ��� y 54375 Route 25 Glenn Goldsmith o d` P.O. Box 1179 A. Nicholas Krupski o ® Southold, NY 11971 Charles J Sanders y o� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD p 1 G 0 �QD 1 Completed in field by: L ri�,/I l� S L7(hw Date/Time: �� 6 �" ,�� cam_ Robert Brown Architect, P.C. on behalf of ROBERT & CHRISTINE HEMPEL request a Wetland Permit for the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq.ft. roof over existing landward porch; construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town code-Stormwater Management; and to remove the trees that are flagged. Located: 160 Lakeview Terrace, East Marion. SCTM# 1000-31-9-17 1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 VfHCh. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment L---Wetiand Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review�consultant/application completeness/comments/standards: + n �Q Present were: J. Bredemeyer u M. Domino �-' G. Goldsmith N. Krupski C. Sanders ZOther Page 1 of 2 John M Bredemeyer III, President �'So Fat A'CO Town Hall Annex Michael J. Domino, Vice-President "° ° Gym 54375 Route 25 Glenn Goldsmith o ` P.O. Bqx 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders ,4, o�� Telephone(631) 765-1892 of �a Fax(631) 765-6641 �zizrd� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Robert Brown Architect, P.C. on behalf of ROBERT & CHRISTINE HEMPEL request a Wetland Permit for the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq.ft. roof over existing landward porch; construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town code-Stormwater Management; and to remove the trees that are flagged. Located: 160 Lakeview Terrace, East Marion. SCTM# 1000-31-9-17 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 ISSUES/ REVISIONS + 22 . 1 ' N s4°s3, 39 oo/�"F BASED ON SURVEY BY: I + 22 . 5' PECONIC SURVEYORS, P.C. DATED I DECEMBER, 2015 1 3 . 5CTM 1000-31 -09- 17 j % 10'-3 11211 AREA: 9,809 5F TO TIE LINE I I A G VEL I A3 DRI SWAY I Z � - - - - NEW ROOF OVER z EXISTING PORCH p O I ❑ N 13DECK ID p° REMOVE EXISTING c� VJ � DECKING AND , NEW WINDOW IN. N REPLACE WITH NEW x C9 V� p '�5OUTH FACING/WALL7771 1 - I w CF i 1 � I +22, 1' N G4 05,3, i 33 S SO" TIMBER WA � II �'O I +22.5' EXISTING KITCHEN I 3. ZONE 3 , I 14.2' REPLACE EXISTING PAVING I I I c VEL STONES WITH LOOSE 1111 ewAv EXISTING 0 01 CRUSHED SHELL WALKWAY IGARAGE N I DRAINAGE CALCULATIONS Z n NEW SIDING TO ZO j E 1 MATCH HOUSE I qZONE 1 : 5 1 2 5F x 0. 1 7 = 87. 1 CF W� I 7 3/4" RISE I I NEW WINDOW IN � PROVIDE ( I ) 6' DIA. x 4'0"D DRYWELL (89.3 CF) I0" RUN (p O SOUTH FACING WALL I ZONE 2: G35 5F x 0. 17 = 107.9 CF j 13 RISERS N/OI PROVIDE ( 1 ) G' DIA. x 5'0"D DRYWELL ( I I I .G CF) � NE ROOF LINE I TIMBER WALL ZONE 3: 350 5F x 0. 17 = 59.5 CF ANG CALITRI BEI 11 PROVIDE ( 1 ) G' DIA. x 3'G"D DRY/VELL (78.2 CF) I N 46° 16' 10" E I \\\\\\\\\\ I I \NEW ROOF OVER 24. 17' EXISTING PORCH THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE THE INFRINGEMENTS WIILLR E PTY OROS CUTEDiTECT. I I N 2014 ALL RIGHTS RESERVED o�� N R oP LINE l o g I CONCRETE 1 N 4G°I G'10" E �O ��' WALKWAY 1 O _o ,NEW ROOr OVER 24. 17 _ �9 ;Exi�TiNGPORCH, 4.4 j I I v CO 26.3' I coNCRETE _ NO 1 5 N 11 O WALKWAY Robert 1 . Brow n w ( J — - 30 IU FX15TING 1 Y2 4 � 1 Z I Z o O % I ' Architect P.C. 1 5 �.e HOUSE O a n I u- EXISTING LIVING � 205 Ba Ave. Green ort NY r�orAIL O a � rn y � PROPANE ROOM APPROVED BY yy p A/C ' I F i OARD QF TRUSTEES admin@falrweather-brown.com F _ A/C UNIT Z WN OF SOUTHOW (;31 -477-0752 N/O/F I e.5' N/O/F / I I DA 1 A 0&uu�T- 17 �,6 CARLETON RAAB / I KEVIN ELIZABETH FEE I _ i 1"' IT 15 A VIOLATION OF THE LAW FOR ANY PERSON, i NEW ENCLOSURE •��,_ UNLESS ACTING UNDER THE DIRECTION OF A p I 12"CONCRETE ror or BANK DECK 4' ` ` I TH15 DRAWING IN ANYWAY, ANY AUTHORIZED ' / I — 1 —� LICENSED ARCHITECT, TO ALTER ANY ITEM ON p � ZONE 2 ALTERATION MUST BE NOTED, SEALED, AND RETAiNtNc WALLz / DESCRIBED IN ACCORDANCE WITH THE LAW. 5< NEW ENCLOSURE _ O a I OVER EXISTING DECK I y I___-5 _ O EXISTING STEPS 12" CON E TOP C / rl ZONE X BOTTOM OP BANK RETAINI G NEVI/SGR N D R REMOVE EXISTING O AT S E ROOF AND WETLANDS /BUFF R i --1 P -� _ _ I — �ST�UCTU�RE/ -I L L_ I _--1-0 - o CLIENT/OWNER PROPOSED SCREEN s 5 33 ENCLOSURE, 0 INCLUDING ROOF � - ROB $ CH R15 H EMPEL 2°4O� „� 6j 14, SHORELINE ON EXISTING DECK 160 LAKEVIEW TERRACE I DRAINAGE AN- EXISTING DECK NEW INTED.COLOR DETERMINED ZONE A E EL. 7' RE TO p _ BE PAINTED. x EAST MARION, NY 1 1 939 O N Lq MARION LAKE3 _ 1 I_ ZONE X Bor G„ BY OWNER I E PLAN PROJECT TITLE SCALE: I " = 20' - WETLANDS PORCH ` (G) ANDERSON - - - �� - - - - - - - - - — — — — — — _ FLOC 400 SERIES WTR 2415 RENOVATION S _ A I ABOVE A3 EQ - EQ � DRAWING TITLE I FIRST FLOOR PLAN 171- 1011 51TE PLAN - SCALE: I/4" = 1' FLOOR PLAN njD DD S 52040'33 ! .'�-- 61 . " W -� JUL 1 S 2016 28 MARCH, 2016 SCALE A5 NOTED 4 51- d So th Id Tom 1 DRAWING NO. ISSUES/ REVISIONS R€PLACE EXISTING NEW CONSTRUCTION FACIA AND GUTTERS ON EXISTING DECK PATCH EXISTING 13'-G° ROOF AS NECESSARY 12 2 - — — a 2 Yz 212 REPLACE EXISTING (G)ANDERSON i FACIA AND 400 SERIES GUTTERS WTR 24 15 i I i i I I �7EW STAINED -IVfVV STAINI=D- -- - - A FnAR S NEW STUCTURE TO ED R5t31NGLF tilNG 1.E_— SIDING 1 I NG A - 5 D BE PAINTED. — NEW STAINED MIN O - NEW STUCTURE TO E COLOR DETERMINED m - BE PAINTED. A SHINGLE W i CEDAR Y OWN B � - COLOR DETERMINED 51DING f� OWNEIL R ER PROPOSED SCREEN a PROPOSED SCREEN ENCLOSURE ON ENCLOSURE ON EXISTING DECK EXISTING DECK NEW 18" FRENCH DRAIN NEW SCREEN DOOR TO MATCH SCREEN PANELS SOUTH ELEVATION WEST ELEVATION SCALE: 114" = 1' SCALE: 114" = P THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF THE ARCHITECT. INFRINGEMENTS WILL BE PROSECUTED 2014 ALL RIGHTS RESERVED Robert I . Brown Architect, P.C. 205 Ba Ave. Greenport NY admin@falrweather-brown.com G3 1 -477-0752 IT 15 A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED ARCHITECT, TO ALTER ANY ITEM ON THIS DRAWING IN ANYWAY. ANY AUTHORIZED ALTERATION MUST BE NOTED, SEALED, AND . NEW CONSTRUCTION - DESCRIBED IN ACCORDANCE WITH THE LAW. ON EXISTING DECK 13 REPLACE EXISTING PATCH EXISTING FACIA AND ROOF AS NECESSARY { - 12 GUTTERS 2 PATCH EXISTING PATCH EXISTING ROOF AS NECESSARY ROOF AS NECESSARY 2 ;m REPLACE EXISTING — FACIA AND GUTTERS __ CLIENT/OWNER — - -- - _ ROB CHR15H EMPEL REPLACE 45TN —G i FRONT D OR WITH 16 LA I 0 KEV EW TERRACE SIMPSO N - NEW STUCTURE TO CRAFTS SER€5 - O EAT A STAINED S MARION, NY 1 1 9 9 NEWS 3 - ' A SHINGLE 37662 PANEL BE PAINTED, m CEDAR S SIDING COLOR DETERMINED � TA1Cn1 - NEW DO R TOB - DAR St LNG ----.- Y WNE B O R PAINTED. S:D♦N COLOR I fTERMNEi� BY OWN E PROPOSED SCREEN PROJECT TITLE ENCLOSURE ON EXISTING DECK PORCH EXISTING BILCO DOOR PROPOSED ROOF RENO VAT I O N S TO BE PAINTED. ON EXISTING DECK COLOR DETERMINED BY OWNER DRAWING TITLE NORTH ELEVATION EAST ELEVATION ELEVATIONS SCALE: 114" = 1' SCALE: I/4" = I' SCALE 28 MARCH, 201 G 114" = 1' O" DRAWING NO. ISSUES REVISIONS PATCH EXISTING ROOF AS NECESSARY 12 2 12 = 2 O ....... ................ ...... .. ... ... ................ .............. ...... ........ .... ........ ... ...... NEW STUCTURE TO . . ........ ............. BE PAINTED. ........... COLOR DETERMINED BY OWNER Y.i .......... ............. PROPOSED SCREEN ENCLOSURE ON EXISTING DECK N N N N N N N N N N N N N . . . . . . . . . . . . . . . . . . . fMr7=h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X, . . . . . . . . . . . . . . . . . THESE PLANS ARE AN INSTRUMENT Of SERVICE 5ECT ION A AND ARE THE FROPERTY OF THE ARCHITECT. . . . . . . . . . . . . . . . . . . . . INFRINGEMENTS WILL BE PROSECUTED SCALE: 114" = P 2014 All RIGHTS RESERVED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 . 1 . . . . . . . . I . - . . . . . . . . . . . - I - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1 /2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Robert I . Brown Architect, P.C. 205 Bu Ave. Greenport NY admin@falrweather-brown.com G3 1 -477-5752 IT 15 A VIOLATION Of THE LAW FOR ANY PER50[1, UNLESS ACTING UNDER THE DIRECTION Of A ril LICENSED ARCHITECT, TO ALTER ANY ITEM ON THIS DRAWING IN ANY WAY. Y AUTHORIZED ALTERATION MUST BE NOTED, SEALED, AND DESCRIBED IN ACCORDANCE WITH THE LAW, F-D ARC D ETAI L I IJ- 5CALE: I " = I ' CLIENT OWNER\ K05 $ CHRIS HEMPEL I GO LAr\EVIEW TERRACE EAST MARION, NY 1 19313 PROJECT TITLE PORCH RENOVATIONS DRAWING TITLE SECTIONS SCALE 28 MARCH, 201 G AS NOTED DRAWING NO. 155UES/ REVISIONS NEW WINDOW AND REPLACE SHINGLE ROOF FRAMING - REPLACE 5HINGLE ROOF REPLACE SHINGLE ROOF REPLACE SHINGLE ROOF CV NEW-ANDERSON 400-SERfES _L82.3 w/ CHECKRAIL I EXISTING GARAGE NEW SIDING TO NEW SIDING TO — NEW DC G NEW SIDING TO OVERHEAD TO BE NEW 51DING TO MATCH HOUSE MATCH HOUSE _ MATCH HOUSE PAINTED. MATCH HOUSE -E:JCOLOR DETERMINED BY OWNER SOUTH ELEVATION WEST ELEVATION NORTH ELEVATION EAST ELEVATION SCALE: 114" = P SCALE: 114" = I' SCALE: 114" = I' SCALE: 114" = f EXISTING EXCEPT AS NOTED EXISTING EXCEPT AS NOTED EXISTING EXCEPT AS NOTED EXISTING EXCEPT AS NOTED THESE PLANS ARE AN INSTRUMENT OF SERVICE AND ARE THE PROPERTY OF Th If ARCHITECT. INFRINGEMENT5 WILL BE PROSECUTED 2014 ALL RIGHTS RESERVED Robert I . Brown Architect, P.C. 205 Bay Ave. Greenport NY admin @falrweather-brown.com G3 I -477-9752 IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNI-f-55 ACTING UNDER THE DIRECTION OF A EXISTING GARAGE LICENSED ARCHITECT, TO ALTER ANY ITEM ON OVERHEAD TO BE THIS DRAWING IN ANYWAY. ANY AUTHORIZED PAINTED. ALTERATION MUST BE NOTED, SEALED, AND COLOR DETERMINED I �- I ODE5CRIDED IN ACCORDANCE WITH THE LAW. BY OWNER ���R�D ARchi �� RTL 6Ho Tin NEW 51DING TO NEW ANDERSON MATCH HOUSE 400 SERIES LD TWT 1823 w/ CHECKRAIL � ui1 (V CLIENT/OWNER civ 2x8 @ I G" O.C. ROP $ CHRIS HEMPEL I GO LAKEVIEW TERRACE EAST MARION, NY 1 1 939 NEW SIDING TO MATCH HOUSE PULL DOWN LADDER TO STORAGE PROJECT TITLE NEW DOOR IN EXISTING FRAME I IP R H RENOVATIONS S E C T I O N DRAWING TITLE ANDERSON 400 SERIES SCALE: 1/4" = P GARAGE PLAN � TWT 1823 ABOVE EXISTING EXCEPT AS NOTED � EQ EQ ELEVATI ONS 14'-0" SCALE F L O O R P L A N 28 MARCH, 201 G 114" = P-0" DRAWING NO. SCALE: 114" = P EXISTING EXCEPT AS NOTED 4 - 11 1 SURVEY OF PROPERTY CE A T EAST MARION TE PME�t TO WN OF SO UTHOLD OFSP o�E SUFFOLK COUNTY, N. Y, �'�ij� 2� R 'J9 p0 EOe�•Z2�i����P — — L� 5o°E s 1000 31--09 17 N6�•5� �5 R.R nF ,�R`�3�. SCALE. 1 —30 DECEMBER 1 2015 `IES e1221 s R. nF Os ' OF P P 00 m Yaccaro 12/01/2015 ED v�P �A �F 0,1 155 o c'p 8 03 0 o'Q'� �Fo9� Z s ZG� ti art •o'A ,�'h3, ST°o e\k-ON - 0 �p J� X010�,E` ��• �P���I G 9, X06 0 20 �� \�F �0��� 8_��� 16 � F �P.�• �,�pQP N ti O��Pv� Gp Q� ���� ,8 5 O��p Op 'J 6 C�OP� : o> << 0 E �. p �pz\ It b JUL 15 2016 ok O p Sauthotd town 'Q �� / '�� 0� I L„•.o�.�r �td�Tt�ste—es_� ,� FLOOD ZONE FROM FIRM MAP NUMBER 36103CO177H O ELEVAT7ONS & CONTOUR LINES ARE REFERENCED TO N.A.VD. DATUM. g0� �� \o� �O 009 S�p� ■= MONUMENT F� ` •= PIPE - Y ®= DRILL HOLE N. LIC. N0. 49618 ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A WOLA77ON I PECONIC SURVEYORS, P.C. OF SEC77ON 7209OF THE NEW YORK STATE EDUCATION LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CERTRCARONS AREA�8o9 SQ. F'. TO -nE LINE (P 0.>BOX 909 0 FAX (631) 765-1797 HEREON ARE VALID FOR 7741S MAP AND COPIES THEREOF ONLY IF + SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRA VELER STREET 15-,209 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 11 r t offlie , ! s ` � I �qtd s 10.0 ov ■ - "� 40 y v i e - _ s i► 4 >a I'Y•i ia°r'T ..}.•.� 'r.. 1 'l, f "�C► ; - -tPE.. 1 rr NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 4 SUNY @,Stony Brook,50 Circle Road,Stony Brook,NY 11790 P (631)444-0365 1 Fr(631)444-0360 www.dec,ny.gov June 30, 2016 p E -!E] ° Mr. Robert G. Hempel P.O. Box 1213 Brentwood, TN 37024-1213 LJUL 5 2016 RE: Permit No.: 1-4738-04464/00001 outholdTnwn Ti Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit for the referenced activity. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit, If you are unable to comply with any conditions please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather and a Notice of Commencement/Completion of Construction. Please note, the permit sign and Notice of Commencement/ Completion of Construction form are sent to either the permittee or the facility application contact, not both. Sincerely, 6 r7 1 Claire K. Werner Environmental Analyst CKW/ls "lTYORK Departmentof �P�ppRTUNiTY Environmental Conservation r NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION a Facility DEC ID 1-4738-04464 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: Facility: ROBERT G HEMPEL HEMPEL PROPERTY PO BOX 1213 160 LAKEVIEW TERJSCTM 1000-31-09-17 BRENTWOOD,TN 37024-1213 EAST MARION,NY 11939n �a ti r ' Facility Application Contact: ROBERT I BROWN ARCHITECT PC J U L 1 5 2016 205 BAY AVE GREENPORT,NY 11944 (631) 477-9752 Sourro;tl TQY�Ii a fT Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: East Marion - - Facility Principal Reference Point: NYTM-E: 723.749 NYTM-N: 4556 Latitude: 41'07'28.1" Longitude: 72°20'04.7" Project Location: 160 Lakeview Terrace - Watercourse - Marion Lake -FWW# GP-1 Authorized Activity: Enclose existing rear deck, install roof over existing porch and install drywells. All authorized activities must be in strict conformance with the attached plans stamped NYSDEC approved on 6/28/16. (CKW) Permit Authorizations Freshwater Wetlands-Under Article 24 Permit ID 1-4738-04464/00001 New Permit Effective Date: 6/30/2016 .Expiration Date: 6/30/2021 NYSDEC .Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations,and all conditions included as part of this permit. Permit Administrator:ROGER EVANS,Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY a Stony BrookJ50 Circle Rd Stony Brook,NY 11790 -3409 Authorized Signature: CCDate -7/ S' I Ito Page l of 6 AM NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04464 Distribution List ROBERT I BROWN ARCHITECT PC Habitat C.,AIRE K WERNER Permit Components NATURAL RESOURCE PERMIT CONDITIONS Flu i JUt 1 5 2016 't GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS Souiho{d Town NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS B f Trus e NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: FRESHWATER WETLANDS 1. Area Limits The limits of clearing, grading and ground disturbance line is equal to five feet downslope of the top of the bank, as shown on the approved plans. 2. Work Area Limits Any work, disturbance, and or storage of construction materials shall be confined to within the limit of clearing and ground disturbance as described above. 3. Materials Disposed at Upland Site Any demolition debris, excess construction materials, and/or excess excavated materials shall be immediately and completely disposed of on an approved upland site more than 100 feet from any regulated freshwater wetland. These materials shall be suitably stabilized so as not to re-enter any water body,wetland, or wetland adjacent area. 4. Equipment Storage 100' from Wetland,Water Body All equipment and machinery shall be stored and safely contained greater than 100 feet landward of the regulated wetland or water body at the end of each work day. This will serve to avoid the-inadvertent leakage of deleterious substances into the regulated area. 5. Seed,Mulch Disturbed Areas All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass, and mulched with straw immediately upon completion of the project, within two days of final grading, or by the expiration of the permit, whichever is first. 6. 'Temporary Mulch,Final Seeding If seeding is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed at the earliest opportunity when weather conditions favor germination and growth but not more than six months after project completion. 7. Minimum % Vegetative Cover Suitable vegetative cover is defined as a minimum of 85 % area vegetative cover with contiguous unvegetated areas no larger than 1 square foot in size. Page 2 of 6 k Aft NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04464 8. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the Farm must also be signed and returned, along with photographs of' the completed work. 9. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 10. Notice Covenant The permittee shall incorporate the attached Covenant(or similar Department- approved language)to the deed for the property where the project will be conducted and file it with the Clerk of SUFFOLK County within 30 days of the effective date of this permit. This deed covenant shall run with the land into perpetuity. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be submitted within 90 days of the effective date of this permit to If E Regional Habitat Manager ` +i�_ 7 ID NYSDEC Region 1 Headquarters i " ;i �~`- SUNY @ Stony BrookJ50 Circle Rd � `", J U L 1 5 2016 ' Stony Brook,NY11790-3409 Seadx;id lu�a�i 11. Straw Bales Prior to commencement of any construction activities,' a continugy,?ry9w� �fe traw shall be staked end to end downslope of any areas of ground disturbance. 12. Straw Bales to Be Entrenched Straw bales shall be entrenched two to four inches into the ground. 13. Maintain Bales The bales shall be maintained, repaired and replaced as often as necessary to ensure proper function, until all disturbed areas are permanently vegetated. The average useful life of a bale is approximately 3-4 months. Sediments trapped by the bales shall be removed to an approved upland location before the bales themselves are removed. 14. Drainage Requirement All roof runoff must be directed to drywells as shown and noted on the approved plans. 15. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the•free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work,obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. Page 3 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04464 16. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 17. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 18. Conformance With Pians All activities authorized by this permit must be in strict conformance with the approved plans submitted lythe applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Robert I. Brown 1 sheet- Site Plan, last revised April 27, 2016. 19. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation,shall accrue from any such damage. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to EGL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department,issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. E C` JUL 1 5 2016 �J Page 4 of 6 1 Ask NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION "r Facility DEC Ill I-4738-04464 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal,modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Freshwater Wetlands. 5. Permit Modifications,Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e, noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute,regulation or another permit condition. Applications for permit transfer should be,submitted prior to actual transfer of ownership. 9n �= l JUS. 1 5 2016 i Soufhold Tcvrn Y B ar i T 190 Page 5 of 6 ado NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04464 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions,and damages, to the extent attributablelo the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions,or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees,agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: 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. JUL 1 5 2016 Southold Torn Boad of Trustees Page 6 of 6 1 , NOTICE COVENANT TO THE DEED DECLARATION THIS DECLARATION, dated day of , 201_, is made by , (hereinafter the "Declarant"), whose address is WITNESSETH WHEREAS, the Declarant is the owner of certain real property located in the Town of Southold, County of Suffolk, State of New York,Tax Map 4 District 1000, Section 31,Block 9,Lot(s) 17 which real property is more particularly described in Exhibit A annexed hereto (hereinafter referred to astthe "Property"); and WHEREAS,the Property is situated in or adjacent to regulated freshwater wetland GP-1 of the Greenport Quadrangle which has been inventoried and mapped by the New York State:Department of Environmental Conservation(hereinafter"Department"),pursuant to Environmental Conservation Law (hereinafter"ECL") Article 24 (also known as the "Freshwater Wetlands Act") and PaXt 664 of Title 6 of the New York Code of Rules and Regulations (hereinafter"6 NYCRR''); and WHEREAS,various activities conducted both in and adjacent to freshwater weilands are regulated by the Department pursuant to ECL Article 24 and Part 663 of 6-NYCRR and require written authorization from the Department prior to being conducted; i NOW,THEREFORE, in recognition of the Department's jurisdiction as set forth above, it is the responsibility of a party having any right, title, or interest in the Property, to obtain from the Department or any successor organization, a current description of all activities which are regulated pursuant to ECL Article 24 and Part 663 of 6 NYCRR, and to obtain written authorization from the Department prior to such regulated activities being conducted on the Property. Regulated activities include, but are not limited to clearing of vegetation; application of chemicals: excava ' grading and filling; and erection of any structures. _7 3 By: Jill L 916 STATE OF NEW YORK ) ss. : COUNTY OF ) On the day of in the year 201_, before me, the undersigned,a Notary Public in and for said state,personally appeared ,personally known to me or proved to me on the basis of satisfactory evidence to be the person whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the person or entity upon behalf of which the person acted, executed the instrument. NOTARY PUBLIC i NOTICE OF COMMENCEMENT OF CONSTI, mON AM RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0297 Bureau of Habitat-NYSDEC dohw 50 Circle Road Stony Brook, NY 11790-3409 PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Dear Sir: Pursuant to the special conditions of the referenced permit,you are hereby notified that the authorized activity shall commence on . We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions.We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions.The permit, permit sign,and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS A T LEAST TWO DAYS PRIOR TO COMMENCEMENT OF THE PROJECT AND IOR ANY ASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMIT AND APPROVED PLANS AVAILABLE AT THE WORK SITE FOR THE DURATION OF THE PROJECT MAY SUBJECT THE PERMITTEE ANDIOR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS Out along this line X X X X X _ X _ X NOTICE OF COMPLETION OF CONST N RETURN THIS FORM TO:COMPLIANCEOr 1 ' � �`- D 'Fax to: 631-444-0297 Bureau of Habitat-NYSDE r 50 Circle Road ` Stony Brook, NY 11790-34 Ilubw J U L PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: i CONTRACTOR NAME&ADDRESS: TELEPHONE: Pursuant to special conditions of the referenced permit,you are hereby notified that the authorized activity was completed on We have fully complied with the terms and conditions of the permit and approved plans. (Both dignatures required) I PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE, W1TH PHOTOGRAPHS OF THE COMPLETED WORK ANDIOR A COMPLETED SURVEY, AS APIPROPRIATE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DAYS OF COMPLETION OF THE PROJECT. Number of pages ; This document will be public record Please remove all Social Security Numbers prior to recording Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Sumps 3 FE ES Page/Filing Fee Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 SubTotai Notation Spec./Assit. ' or EA-5217(County) Sub Total Spec./Add 3 EA-5217(State) TOT.MTG TAX Dual Town dual bounty R.P.T.S.A. Held forAppolntment Comm.of Ed. S. 00 c Transfer Tax Affidavit • + Mansion Tax Certified Copy The property covered by tis mortgage is or will be improved by b one or two NYS Surcharge 15 00 family dwelling only. Sub Total YES orNO Other �- Grand Total If NO,see appropriate two,clause an page# of this instrvment. i 4 Dist. Section Block Lot S Community Preservation Fund I Real Property Consideration Amount$ Tax Service Agency CPF Tax Due $ Verification Improved Satisfactions +sc arges e - w ilingAddress j 6 R ` R�#0:�� Vacant Land a = I l TD J U L 1 5 2016 I TD—�--- 4 TD _ Southold Tawn I Mail to:ludwu PascaAg2&dWradnjtcierk----J 7 Title licompany Information 310 Center Drive, Riverhead, NY 11901 Co Name I i www.suffoikcountyny.gov/clerk Title# a Suffolk County Recording & Endorsement Page This page forms part of the attached } made by: (SPECIFY TYPE OF INSTROMENT) ; The premises hereini'(�situated in SUFFOLK COUNTY,NEW YORK l ` TO in the TOWN of i In the VILLAGE or HAMLET of BOXES6THRU 8 MUST BETYPED OR PRINTED IN BLACK INK ONLY PRIORTO RFCORDING OR FILING. OVef t I 95-20-1 (8187,)-9d New .York 'State o epartment of. Environmental Conservation Y' NW W i< NOW O G CLi L71 ' i � The Department of Environmental Conservation (DEC) has .Issued permit(s) -pursuant to the* Environmental Conservation Law for work - being conducted at this site. Forfurther information regarding the nature an.d . extent of ' work approved .and any Departmental conditions on it, contact the Regiona] Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number 3 9. - ROGER EVAN Expiration- Date NOTE: This notice is, NOT a permit BASED ON SURVEY BY. ?ECONIC 5URVEYOR5, P.0 DATED I DECEMBER, 2015 5CTM 1000-3 1 -09-17 i AREA, 9,809 SF TO TIE LINE +22 M1 raariac.c::c.,.�non, rhe 5. 5^.0I7=071 7 ! Pi,7:,Otz 1,A VA,a 07 J&rFW UO _ L t8.3 CF; 'I ^ JUL IJUL 1 5 2016 ot FR.),�Gt G'0 a.3 GU(MW-,L,78 2 CF, :i I ! dry,t4 I i Southold Town Board Trustees151I 4 Lo A. ZOUE 2 6341 ,. >Y•+Ivl•2 wT,l 5 - '�----- I � ^'GF SliE .::.="i7ANCE 4— ROB CHRI5 HEMPEL L 160 SAKE VIEW TERRACE, FAST MAR'ON, NY 5`+2•:043,Y ZONt A E tL 7' 27 APRL, 201 6 I MARION LAKE )Ar _E-114' NDSDEC bert I . Brown SITE PLAN APPROVED AS PER TERMS AND CONDITIONS OF hitect, P,C,SCA_[ I = 20' PERMITNO I—X73 -c'Y kq o DATEBay Ave. Greenport P1Y rlbrowrarchltect.com �77-9752 I - ti jb 40 � ♦M OF R S • i i if A 1 iP -` } `.•r - + SII♦\�. - ' " ,�~ * ♦ V'i •I' �.y � M or ve . M �..�r •�+r, s-,% - s r, t # Ia . �► X4 w: t ` V• S� •: h 86 .. a w � A• I 1 a��M•. .. a ,� • Vol44 • +. / y *46 16 bw ' �.��. �,�� w � •.� �• � ��� •� �� ,� lii��'!'e4 - Yds { St, t-e-&I)tt 1J'(Y !Sol L-f- Ik/A-fEV--D i--,5rt'P C'r's a4J1- h y t -f f i `.1 w• Ak - _ 4 'Z7, + _ - .tun •�- � .,,.a •y�� dry � � _-j ,Y.. ,�'s. J�.y-.J• 8! '. - _ - _ --.�•t°i s a `, ..✓-: Y�y _ . 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'f`'"A '4, r 9 �► t. �e!��?�.• _ � 'S - _ ;T� � ��' C ®-Southold,N fNfiaa4 L. x h&Teton of Southold Tax M_ x C' tos.maps.arr_gis.com'.,.�F� ;r�p;d=lb4ci46;a4eb-,44(2bl_: <.�e98eb3fi9,: Parcel: 1000-3l.-9-17 0.26 One Family Year-Roan,., , Residence f Medium Density , Residential R-40 t 0.05 f "':csosoR s sr kiERE iP^I Esn, HERE,D Inure !Fr" k OFFICE LOCATION: �®f S®UryO MAILING ADDRESS: Town Hall Annex �® l® P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) us Southold,NY 11971 ® �O� Telephone: 631 765-1938 ®lyC®UNT`I,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: August 9, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for ROBERT & CHRISTINE HEMPEL SCTM# 1000-31-9-17 Robert Brown Architect, P.C. on behalf of ROBERT & CHRISTINE HEMPEL request a Wetland Permit for the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq.ft. roof over existing landward porch; construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town code-Stormwater Management; and to remove the trees that are flagged. Located: 160 Lakeview Terrace, East Marion. SCTM# 1000-31-9-17 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action furthers the policy to the extent practicable and therefore is CONSISTENT with the LWRP policies provided the following: 1. Clarify the purpose of removing the flagged trees shown in the submitted photographs. 2. To prevent erosion, require that vegetation on the bank is not disturbed during construction of the screened-in seasonal addition. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. �gpFFO�►k bp Peter Young,Chairmany Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 i Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., August 10, 2016 the following recommendation was made: Moved by Keith McCamy, seconded by John Stein, it was RESOLVED to SUPPORT the application of ROBERT & CHRISTINE HEMPEL to install new windows on south wall and new siding on garage; new roof over pre-existing northerly porch; new screened seasonal enclosure over pre-existing deck; install drywells for stormwater run-off; and the removal of flagged trees. Located: 160 Lakeview Terrace, East Marion. SCTM#31-9-17 Inspected by: Peter Young, John Stein, Keith McCamy Vote of Council: Ayes: All Motion Carried BOARD MEMBERSSouthold Town Hall Leslie Kanes Weisman,Chairperson 53095®�® 53095 Main Road•P.O.Box 1179 Eric Dantes Southold,NY 11971-0959 Office Location: Gerard P.Goehringer Town Annex/First Floor,Capital One Bank George Horning ® y® 54375 Main Road(at Youngs Avenue) Kenneth Schneider ®I�CQUNV,�� Southold,NY 11971 http://southoldtown.northfork.net � • ZONING BOARD OF APPEALS UL -2 5 2Q16 TOWN OF SOUTHOLD Tel.(631)765-1809•Fax(631)765-9064 ' irthold Pox#Ale"rk j I FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF JULY 21,2016- j ZBA FILE: 6969 NAME OF APPLICANT:Robert and Christine Hempel PROPERTY LOCATION: 160 Lakeview Terrace,East Marion,NY SCTM# 1000-31-09-17 SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated May 23, 2016, stating that this application is considered a matter for local determination as there Appears to be no significant county-wide or inter-community impact. LWRP DETERMINATION: This application was referred for review under Chapter 268, Waterfront Consistency review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued comments dated June 23, 2016. Based upon the information provided on the LWRP Consistency Assessment Form submitted, as well as the records available, it has been determined that the proposed action for side yard setback of the new roof over existing(front)porch be EXEMPT from Coastal Consistency Review, and the `as built' porch (rear deck)to be enclosed within 100 feet from the top of bluff to be considdred INCONSISTENT with LWRP policy standards, and therefore, is INCONSISTENT with the LWRP with respect to the setback from the top of bluff to the front porch and the front porch not functionally requiring a location on the coast and is not water dependent. These two inconsistencies'are mitigated when recognizing that the subject front porch is on the northern side(Iandward)of the dwelling,the furthest part of the dwelling from the top of bluff/bank. The Coordinator denoted in his comments, Policy 4.1 which refers to management measures, that in order to minimize potential loss and damage, locate development and structures away from flooding and erosion hazard. The conditions imposed herein, recommended by Suffolk County Soil and Water,will mitigate the proposed seaward deck enclosure and will therefore be CONSISTENT with the LWRP TOWN OF SOUTHOLD, OFFICE OF THE ENGINEER: The application was referred to the Town Engineer for review. It was recommended in his response letter, dated June 1, 2016, that because of the close proximity of Marion Lake, the Board would require new drainage designs and installations for both the existing residence and the proposed porch improvements. The applicant's design professional designed a drainage plan that can be seen on Drawing No. AI depicting proposed drywells and a new 18"French Drain. SUFFOLK COUNTY SOIL AND WATER CONSERVATION DISTRICT: The application was referred for an evaluation and recommendation. According to the information provided in letter dated July 6,2016,and following an evaluation conducted on June 29, 2016, it was recommended that the trees on the bluff face be cut at the base leaving the root system intact, and that because the proposed deck will contribute to storm water runoff over the top r Page 2,July 21,2016 #6969,Hempel SCTM No. 1000-31-9-17 of the bluff, that the site plan includes gutters, leaders and downspouts to divert storm water to drywells. Also, in order to prevent degradation of the bluff area and minimize environmental impacts,the Soil District recommended that existing footings be used to construct the new deck and concrete block foundation and that construction be handled with care and done by hand wherever possible. PROPERTY FACTS/DESCRIPTION: The parcel is 9,809 square feet in the R-40 Zoning District which measures 61.14 feet along Marion Lake to the south, 39 feet along Lakeview Terrace (24 feet Right of Way) to the north, 207.40 along the easterly property line and over 200.00 feet along the westerly property line. The parcel is improved with a one and one half story single family dwelling and a detached accessory garage, all as shown on the Survey prepared by John Metzger,L.S.,dated December 1,2015. BASIS OF APPLICATION: Request for Variances from Article XII Section 280-116A(1)and Article XXIII Section 280-124,and the Building Inspector's May 11,2016 Notice of Disapproval based on an application for a building permit to construct a new roof over an `as-built' front porch and new screened enclosures over existing rear deck attached to an existing single family dwelling, at; 1)the proposed deck enclosure, `as built' front porch with proposed roof is less than code required setback of 100 feet from the top of the bluff, 1)less than the code required minimum side yard setback of 10 feet,2)less than the code required total side yard setback of 25 feet, located at 160 Lakeview Terrace,East Marion, SCTM#1000-31.-9-17 RELIEF REQUESTED: The applicant requests variances to 1) construct a new screened enclosure over existing rear(seaward) deck attached to an existing single family dwelling having a side yard setback of 4.4 feet where the code requires a minimum of 10 feet and 2) construct roof over as-built front porch deck having a single side yard setback of 2 feet where the code requires a minimum of 10 feet and 3) both rear deck and front porch having a combined side yard setback of 6 feet ,where the code requires a minimum of 25 feet, 4)both rear deck and front porch having less than the minimum of 100 feet from the top of bluff/bank, all as shown on the Site Plan prepared by Robert I.Brown,R.A.,Drawing No's.A1,A2 and A3 all dated March 28,2016. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on July 7,2016, at which time written and oral evidence were presented. Based upon all testimony,documentation,personal inspection of the property and surrounding neighborhood,and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law 6267-b(3)(b)(1). Grant of the variances will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The subject dwelling is located on a private R.O.W. (Lakeview Terrace) on one of several small, non-conforming lots in the neighborhood The as-built front porch deck (approximately 14' x 7') and the proposed roof over as-built front porch deck (approximately 11' x 7') will improve the appearance of the entry to the subject dwelling and will not be visible from a public street.Many of the seasonal cottages in the neighborhood have been similarly improved, over time. 2. Town Law 6267-b(3)(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. The dwelling exists entirely within the 100 foot top of bluff/bank setback, therefore any proposed construction to the dwelling will require a top of bluff/bank setback variance. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than area variances for a nonconforming single side yard and combined side yard. The as-built front porch deck and proposed roof over same is at the narrowest location on this parcel,which is less than 26 feet wide. Therefore any proposed, adequately functional, front porch addition will require area variances for a single side yard and combined side yard. r �r Page 3,July 21,2016 #6969,Hempel SCTM No. 1000-31-9-17 3. Town Law 4267-b(3)(b)(3). The variance granted herein for a top of bluff/bank setback is mathematically substantial, representing 48%relief from the code.However,the dwelling exists entirely within the 100 foot top of bluffibank setback, therefore any proposed construction to the dwelling will require a top of bluff/bank setback variance. Furthermore, improved parcels to the east and west appear to also have dwellings within the 100 foot top of bluff/bank setback. The variance granted herein for a side yard setback of 2 feet for the proposed roof over the front porch and 4.4 feet for the proposed enclosed deck with a combined side yard setback of 6 feet are mathematically substantial, representing 80% relief and 76% relief from the code, respectively. However, because of the location of the existing dwelling,the proposed enclosure of the `as-built rear deck and proposed roof over `as-built' front porch are unavoidably located at the narrowest location on this parcel requiring side yard variance relief. 4. Town Law 4267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town's Storm Water Management Code and the best practices recommended by Suffolk County Soil and Water. 5. Town Law §267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6. Town Law 4267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an enclosed rear deck and front porch with roof, while preserving and protecting the character of the neighborhood and the health,safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Schneider, seconded by Member Goehringer, and duly carried,to GRANT the variances as applied for, and as shown on the Site Plan and architectural drawings prepared by Robert I.Brown,R.A.,Drawing No's.Al,A2 and A3,all dated March 28,2016. SUBJECT TO THE FOLLOWING CONDITIONS: Compliance with Suffolk County SWCD recommendations set forth in letter of July 6,2016,which include: 1. Small trees on the bluff should be cut at the base leaving the roots intact 2. Install gutters, leaders and downspouts to divert storm water to drywells 3. Existing footings and concrete block foundation shall be used to construct the new seaward deck 4. Construction must be handled with care and done by hand wherever possible. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the survey, site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. Any deviation from the variances)granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future Page 4,July 21,2016 #6969,Hempel SCTM No. 1000-31-9-17 use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Pursuant to Chapter 280-146(B) of the Code of the Town of Southold any variance granted by the Board of Appeals shall become null and void where a Certificate of Occupancy has not been procured,and/or a subdivision map has not been filed with the Suffolk County Clerk,within three (3)years from the date such variance was granted. The Board of Appeals may,upon written request prior.to the date of expiration, grant an extension not to exceed three(3) consecutive one (1)year terms. Vote of the Board: Ayes: Members Weisman (Chairperson), Schneider, Dantes, Horning, Goehringer. This Resolution was duly adopted(5-0). Leslie Kanes Weisman, Chairperson Approved for filing �/Aa/2016 ©� SOUj John M. Bredemeyer 111, President Town Hall Annex�� yO Michael J_ Domino, Vice-President �� l0 54375 Main Road �a P.O_ Box 1179 James F_ King,Trustee lye Southold, New York 11971-0959 Dave Bergen,Trustee G Charles J_ Sanders, Trustee 'O Telephone(631)765-1892 l,Y`,oU�'�� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD D To: Southold Town Building Department JUL 15 2016 Re: Verification of Building Department Permit Requirements BUEWINGDEP'T. 'T® OF 5®MOB.D SCTM#: `31 � � 7 Property Owner Name: 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 the proposed project require a Building Permit? -CV Atom ill the proposed project require a variance determination from E e Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: - - - - ---- - ----- --- --- ------------- ---- --- r Signature of Reviewer Date p tI John M.Bredemeyer III,President SO �' '' Town Hall Annex Michael J.Domino,Vice-President ` 54375 Main Road P.O.Box 1179 James F.King,Trustee Southold, New York 11971-0959 Dave Bergen, Trustee ©� (,J, Telephone(631) 765-1892 Charles J.Sanders,Trustee '�'OUidl`t,��, f Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only oastal Erosion Permit Application Wetland Permit Application Administrative Permit / _Amendment/Transfer/E ension _ V/.,Received Application: 7'I - -� ,, ((�� ��/J+ r VReceived Fee: $ 2E0i E 11 5. l V ' I Completed Application: .[ _Incomplete: _SEQRA Classificatio JUL 15 2016 ; Type I Type II Unlisted __/Coordination:(date sent): g` �� 1/ LWRP Consistency As ss gt Form: Southold Town f` CAC Referral Sent: I �ar�of Date of Inspection: _Receipt of CAC Report: Lead Agency Determination: _--)Lead Review: —Public Hearing Held: Resolution: Name of Applicant: Mailing Address: 12-13, �/�/ 213 Phone Number: Suffolk County Tax Map Number: 1000- Property Location: 166 Z4X?P9?Z D � We ao (provide LILCb Pole#, distance t6 cross streets, and location) AGENT lab J (If applicable) Address: 24 ���� Phone: i�,31` X7.7- Board of Trustees Application GENERAL DATA Land Area (in square feet): Area Zoning: — Previous use of property: ' Intended use of property: Covenants and Restrictions on property? Yes �No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals?\ Yes No If"Yes",please provide copy of decision. Will this project r uire any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? �► Yes No *rior permits/approvals for site improvements: Agency Date &&-V �, �� No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes, provide explanation: Project Description(use attachments if necessary): ma dAW ZzyA4-, � - fiV/F714 W o-W / ROBERT I. BROWN, ARCHITECT P.C. 205 BAY AVENUE GREENPORT, NY 11944 631-477-9752 FAX 631-477-0973 info@ribrownarchitect.com Trustee's application. Hempel Residence 162o Lakeview Terrance East Marion, NY SCTM #: 1000-31.-9-17 Prior permits/approvals for site improvements: • Zoning Board of Appeals: #2344 - 9/27/1977 • Building Department: #Z-9629 - 8/1o/1979 • Building Department: #Z-20464 -1/10/1992 • Building Department: #Z-20465 - 1/10/1992 • Building Department: #Z-20466 -1/10/1992 • Building Department: #Z-20467-1/10/1992 • Building Department: #Z-20477-4/27/1992 • Building Department: #Z-25297 - 10/3/1997 • Building Department: Notice of Disapproval - 9/1/1998 • Zoning Board of Appeals: #4628 - 9/17/1998 • Building Department: Notice of Disapproval - 5/4/2o16 • ZBA- pending- Public Hearing 7/7/2o16 • DEC - Permit# 1-4738-04464/00001 (copy of permit enclosed) i Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /O ' - .42 J z I IF Area of wetlands on lot: square feet Percent coverage of lot: % �Z.s� isv�q f3. to �► �,�� Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: ��!5— feet Does the project involve excavation or filling? y No Yes If yes, how much material will be excavated? `�"� cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: 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): 971 Qy. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to fiu•ther verification, Complete Part l based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-PIroject and Sponsor Information Name of A tion br Project: Project Location(de cribe,and attach a location Wrap): EaA* I&0 ��.vt�� Ems"- / Q/yllJYl Brief Description o��posed Action: • t�Q,r 14,�rt�'(��3'C��$1,G7�1 w�fi IZ.�I.{� �b n� 2 rC�ZLd.Q.Name of Applicant Telephone: !- l D�7�„ E-Mail:hmO'n m j Address: City/P � State: Zip Code: 1.Does the prop sed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES' If Yes,list agency(s)name and permit or approval: 3.a.Total acreage of the site of the proposed action? QJ 14 -_-acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 21.7 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban 'QRural(non-agriculture) [:]Industrial ❑Commercial Residential(suburban) ❑Forest ❑Agriculture 'UAquatic ❑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: ND 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? ❑ 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: 11.Will the proposed action connect to existing wastewater utilities? LNOYESIf No,describe method for providing wastewater treatment• 12. a.Does the site contain a structuie that is listed on either the State or National Register of I Iistoric 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? 0 ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody9 ;❑ 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: "E Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional Wetland ❑Urban ❑Suburban A &4elt- 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.W ill the roposed a tion create storm water discharge,either from point or non-point sources? NO YES If Yes, a. Will storm water discharges flow to adjacent properties? �NO ❑YES EJ b.Will storm water discharges be directed to established conveyance systems(runoff aicwi storm drains)? If Yes,briefly d scribe: E]NO YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of _ NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: El 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: '\U F 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe:, I AFFIRM THAT THE INFORMATION PROVIDED ABOVE 1S TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE f Applicant/sponsor n `f e: Date: & 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 I. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 9 1] 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? 1 /� E 4. Will the proposed action have an impact on the environmental characteristics that caused the (E1 ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or I"7'y El existing infrastructure for mass transit,biking or walkway? �f 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate < L� _ reasonably available energy conservation or renewable energy opportunities? Ln L-1 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination ol'signiffcance. 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. Pail 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-tern, long-term and cumulative impacts. (-I Check this-box if you have determined,based on the information and analysis above,and any supporting documentation, L J t Itt he proposed action may result in one or more potentially large or significant adverse impacts and an nvironmental 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 environment impar Town of Southold-Board of Trustees 1 Nam Lead Agency Date President Prin or Type Name of Responsible Uffic in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Prepaier(if different from Responsible Officer) PRINT Page 4 of 4 NUTILk:' Ulm HLAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: ROBERT & CHRISTINE HEMPEL SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing garage and to add new window in south facing wall; on the existing dwelling construct a 99.6sq.ft. roof over existing landward porch; construct new 243.25sq.ft. screened-in seasonal addition over existing deck; install gutters to leaders to drywells to contain roof runoff, and in accordance with Ch. 236 of the Town code-Stormwater Management; and to remove the trees that are flagged. Located: 160 Lakeview Terrace, East Marion. SCTM# 1000-31-9-17 TIME & DATE OF PUBLIC HEARING : s Wednesday, August 17, 2016 — at or about 5:30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 t m -n , . a EA -11 EAST iMA- Qi1 Y\6'1' U 9> k `` �: i�97 Lrrl Certified Mall Fee $3.3101 � .' 06 rT1 Certified Mad Fee $3.341 Er" �• $ �` �- = $- r0 Extra S0NIC8S&FeeS(check box,add fee p D Extra Services&Fees(checkbox,a$fee �PprfNYrata) ®!7 r- -_,. 1a ❑Return Receipt(harcicopy) I'' y ❑Return Receipt(hardcopy) rJL° t� OSf fk [- ❑Return Receipt(electronic) $--� t ❑Return Receipt(electronic) $ Resin s,1'Iore - — v+ AU�j t�e�90�r � (� Certified McII Restricted Delivery $ I] ❑Certified Mall Restricted Delivery $ �- L U Q ❑Adult Signature Required $— +-rr- -^ 0 U Adult Signature Required $—i�lY ��— z 3 ❑Adult Signature Restricted Delivery$ �_ AUG 10,2016 -� l] ❑Adult Signature Restricted Delivery$ �� postage $�(�47 Postage �p C3 /x/2016 E3 $1�.47 Cl Y/ ( Ur] $ r;4 Ill $ Total Postage and F r. Total Postage and Fees �' $6.47 $ C3 $ SentT A[e11_ --- Sire tom_d t. ,or PQ Box IV Street and Apt or PO Box N. .___ C3 /�1 �, � F�`i'-� Cpl"State. C/fy, tate - +4 0 —_ U MA FkFk r'1' '� b1,', ,"? ,, 0 °Y1.16�1�}{•} I .il,a�° ,ji1;,ra^5'rV .nl. n `~ Y{f�~ i93� 9 �wz �( ti i PEL=NAM PlY 1 8il _ ;� Certified Mad Fee $3.3t) 11971 n17 A Certified Mall Fee 0r Extra Services&Fees check box,add fee prp te) j $3.30 09 Grrrpp MMaa ® / Er $ _ '"1776 � ❑Return Receipt(hardcopy) $ �i���'� t CO Extra Services&Fees(checkbox,add fee a$@q.rpgt+ate) >I D p� C3 ❑Return Receipt(electronic) $ `ry� oSifllarkl-, ❑a Serturn Receipt(hardcopy) $ U lr V �o{• Y r r ❑Certified Mall Restricted Dehvery $ �el l t�lrl-1 O Hard- E] are �..� 0 [:]Return Receipt(electronic) $ $11-�Ill _E=;�pgtptar 7j C3 ❑Adult Signature Required O E3 ❑Certified Mall Restricted Delivery $ �1, 1lfl_ v ?c--Here (fl []Adult Signature ResMcted Delivery$ O 0Adult signature Required $ ® � Postage $�./t7 [-]Adult Signature Restricted Delivery$ W`j• AUG 1 0 2016 -16o $ �'a 2r-11 O Postage $�147 r%_ Total Postage and"foo.47 v 2r C3 N Total Postage and Fees sv .0 �. 6 � Sent To C3 $6.47 (e5�+7 -- ----------- ------------------------ ------------------- Sent To � Street and Apt No.,or PO Box o --------------- -- ---- ---------------------------------------------------------- � r-qStreet----- -t No, rPOBoxNo Crty,State, + [�- &-.:-------------------------------------------- --- - ' City,S IP 4° V(JV L./ ham - ® VIIII`ata=" Cr °EAST M Certified Mad Fee $3.30 1 1971 jr $= 06 � Extra Services&Fees(check bax,add fee isapprdaiate) [IReturn Receipt(hardcopy) $ 111 11'1/1,1 C3 E]Return Receipt(electronic) $ • 11 I3 F_]Certified Mall Restncted Delivery $ $._00 J,t�-"r Pierre, 1] ❑Adult Signature Required $ O ❑Adult Signature Restncted Delivery$ g i IAUG 1 0 2016 r-3 Postage $1 .47 _ Ln $ °/10/211 Total Postage and F$eQ 47 O $ e Sent To ° �11 r•� •- - A ------------------ r` iCK, =------------------- Street a pt N TAY—ox IVo - ---ty,=--- ZI CrStat, P e e r °°e Wrdl➢C]dA:12e111C] M- 1,r e • 'OMPLETE SfiVTlOAfON• ■ Complete items 1,2,and 3. A. Sig VIture ® Print your name and address on the reverseAgent so that we can return the card to you. X �� /&ZAqdresseeL ( E Attach this card to the back of the mallpiece, �i��B. Received b� Printed ame) C. Dat ofelivery /� l� or on the front if space permits. / 1. Article Addressed to: D. Is delivery address different from item 1? 10 Yes If YES,enter delivery address below: ❑No _P'O Ouni-Y, 11RS� 3. Service Type ❑Priority Mad Express@ II I II I I II III I II I III VIII I II I I I I II I I I III ❑Adult Signature ❑Registered Mail ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mad® Delivery 9590 9402 1452 5329 3904 92 El Mail Restricted Delivery ElReturn Receipt for El Collect on Delivery Merchandise 9 Article_Number__rTransfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM isured Mail ❑Signature Confirmation Mail Restricted Delivery Restricted Delivery 7 016 0750 0000 8 9 4 3 7023 isured Wer$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt A. Signs ® Complete items 1,2,and 3. �� ❑Ag h16 ® Print your name and address on the reverse X �a ❑®A'. sea so that we can return the card to you. p B. e�eivedcp (ueg Nay�e) C. Date of Delivery ® Attach this card to the back of the mall iece, /J�'�,( r]J� f(�9 or on the front if space permits. .C� 1. Article Addressed to: [ D. Is delivery address different fro i ❑Ye If YES,enter dehve address :6L of I -PO 1wf DYb ) 3. Service Type 6( �1O orlW Mail Express® II III I I II III I II I III VIII I III I I I I I II III I I I ❑Adult Signature Registered MailTM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mail@ Delivery 9590 9402 1452 5329 3904 78 ❑Certified Mad Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM 2. Article Number(transfer from service label) _ ❑Signature Confirmation ?016 0750 0032 8 9 4 3 6996 Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt D • A.' gnature ® Complete items 1,2,and 3. AgentSul® Print your name and address on the reverse ¢ TgAddressee so that we can return the card to you. ecelved y(Prine) C. e of �i�ry ■ Attach this card to the back of the mailpiece, t D or on the front if space permits. s "ItG add r di re o de s 1. Article Addressed to: , If YES,enter delivery ad ss p No c COM 3. Service Type ❑Pnonty Mad Express@ II I'IIIII IIII III I II I III VIII I III I I I I II I III I III ❑Adult Signature ❑Registered MailTM E]Adult Signature Restricted Delivery ❑Registered Mail Restricted ❑Certified Mad@ Delivery 9590 9402 1452 5329 3905 15 ❑Certified Mail Restricted Delivery ❑Return Receipt for 0 Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationThO o art Bio nu,rr,hor rrrancfer from service label) — Mail ❑Signature Confirmation 7 016 0750 0000 89143 7009 JO)I Restricted Delivery Restricted Delivery Domestic Return Receipt PS Form 3811,July 2015 PSN 7530-02-000-9053 - - 1 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: STATE OF NEW YORK COUNTY OF SUFFOLK ffiYn� . r;`� being duly sworn, epo es and says that A the D day of 20�, deponent mailed a true copy of the Notice set forth in the Board of rustees 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 79' ,that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn t9,9efibre np this - Day o 20 .mo i Vj Notary P lie CYNTHIA M.CUSATI PIotary Public,State of New York No.01CU6100507 Qualified in Suffolk County Commission Expires Oct 20�—� John M. Bredeme er III, President QSUf 4& Town Hall Annex y 0 % Michael J. Domino, Vice-President _ .° � 54375 Route 25 Glenn Goldsmith y ? P.O. Box 1179 A. Nicholas Krupski y �Y Southold, NY 11971 Charles J Sanders wo ��® Telephone (631) 765-1892 ✓ Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of ROBERT & CHRISTINE HEMPEL 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 DA TE resi ' a Z /vv q5 being duly sworn, cfepose an6 say. That on the f �, 2010 I per onally posted the property kno n as by placing he Board of Trustees officia 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, August 17, 2016. Dated: (si atur Sworn tob fore me this //"-d ,of� 20 �� i'l/A Notar Pub is CYNTHIA M.CUSATI Notary Public,State of New York No.01CU6100507 Qualified in Suffolk County Commission Expires Oct 20� oil 01hoard of Trustees Appl cation AFFIDAVIT e—D BEING DULY SWORN DEPOSES AND AFFIRMS TCAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMJT(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 SO UTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARAILESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISINGUNDER 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 WITUTHIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUST EES ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PE 'IIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OFT E PERMIT. Si&mature of PrJX-ty Owner SWORN TO BEFORE ME THIS DAY OF A Or 1, 20 Notary fic CYNTHIA M.CUSATI Notary Public State of Nev'I'tork '7 No.OlbIJ6100507 Qualified in Suffolk County Commission Expires Oct 20_�Gi "oard of Trustees APF lica* AFFIDAVIT lv BEING DULY SWORN DEPOSES AND AFFIRR'i 3 THAT IIE/SHF 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 WITHTHIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature o Pro rty Owner SWORN TO BEFORE ME THIS _�_ DAY OF kLonj � _____ , 20__Iclp N ary Public CYNTHIA K_CUSATI Notary Public,State of New York No.01CU6100501 Qualified in Suffolk County Commission Expires Oct 201CA Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) residing at (print name of owner of (mailing address) do hereby authorize�' (Agent) LE2� �_to apply for permit(s)from the PO F )2-1� Southold Board of ToAm Trustees on my behalf. "pard of Trustees Applicfi* AUTHORIZATION (where the applicant is not the owner) 1, ____ residing at `Z4 0 �e (print name of owner of pro rty) (mailing address) do hereby authorize (Agent) � � l . •/�11 I _ :- to apply for permit(s) from the Southold Board of'Town 'Trustees on my behalf. it— (Owner's Nignaturtj APPLIOANUAGEIV'I REPRESEN'T'ATIVE ! TRANSACTIONAL DISCLOSURE FOIA The —de Gown of South o 'S.Co of Ethics ibi t1'ct f'nt' the o o r�and The u _se of t 'e fa i t vide i ian w ieb 'n ale them of `ble co 'ets of interest d allow it to take-wh tever ac i it I necessary to avoid same. i YOUR NAME: Y (Last name,first am ,Viddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) ! Tax grievance Building \ Variance \\ Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ Planning Other (If"Other',name the activity.) Do you personally(or througt:your company,spouse:sibling,parent,or child)have a relationship with any officer or employee of the*Pawn of Southold? "Relationship"includes by bl6o&nlardage,or business interest."Business interest"means a business, including a partnership,in which the town office r or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 51/10 of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. E Name of person employed by the Town of Southold_o,,:!� Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. ; The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A}the owner of greater than 5%of the shams of the corporate stock of llte opplicol-L (when the applicant is acorporatiuri), IIj the Idgal or beneficial a 'owner of any interest in non-+corporate entity(when the applicant is not a,corporation)-, C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this t 200'/� Signature Print Name Form TS 1 APPLICANT/AGENT/KEPRESENTATWE TRANSACTIONAL DISCLOSURE FORM The.Town of S iold'd ode of thics hi 't co flirts f'nterc t o o vn off d c The e f # fri "la 1q pnyide information w 'ch an ale tea" f sl le eo filets of serest d all w it o kc wh tevei a `on is necessary to avoid same. YOUR NAME: '(Last name,first name,Enida initial,unless you are applying imthe name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building?T_ Variance _ Trustee �l Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you perspnally.(or through your comparW,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,rnarriage,.or business interest."Business interest"means a business, including partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. { The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): I A)the owner of greater than 50A of the shares of the corporate-stock of the applicant (*hen the applicant-is a corlwation); 13)ft legal or bertcficial 'owncr of any interest in a non-corporate entity{when the applicant is not a corporation); C}an"officer,director,partner,or employee of tile applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th&/1'day of Zfi�11 Signature Print Nam Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Towyn of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emaloyees,The pumose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: __ VJd4MWeA (Last name,first name,rl-iiddle initial, uV ess you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ Variance mayTrustee 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 dour 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 buscncs,,, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by)a('orporatloll in which the town otf icer or employee owns more than 5%of the shares YES NO If you answered-YES",complete the balance of this for-rn and date and sign where indicated. Name of person employed by the Town of Southold I itle or position of that person Dewribe the relationship between yourself(the applican t/agtmt/representative)and the town officer or employee.Tither check the appropriate line A)through D)andlor describe in the space provided. The town officer or employee:or his or her spouse,sibling,parent,or child is(check all that appl)) A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); _ 13)the legal or beneficial owner of any interest In a non-corporate entity(when the applicant is not a corporation): C)an officer,director,partner,or employee of the applicant;or U)the actual applicant DESCRIPTION OF RELAT1ONSIHP Submitted thisJdayLo _ __2004 Sig natur _ Print Name - Form TS 1 APPL,ICAlYUAGENURElPRESENTATIVE TRANSACTIONAL.DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pum9se of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: _ (Last name,Amstame,.rtt' dle initial unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance _ "Trustee Change otZone Coastal Erosion_ Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other,name the activity) ----- Do ____.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,mamage,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 I f you answered"YES",complete the balance of this form and d-atto-and`sign where indicated. Name of person employed by the Town of Southold�'l.._A Title or position of that person____ _ Describe the relationship between yourself(the applicant/agt�nt/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); _I3)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); __C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP n Submitt this_�7 day of 204& Signatu Print Na Fortn TS I 00 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�ef-iects upon the coastal area.(yrhich includes altofSouthold 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-ex lained in detail listing both supporting and non» supnortinQ 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# PROJECT NAME WeeI241-�� The Application has been submitted to(check appropriate response): Town Board El Planning Board El Build ing Dept. L�J 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: 9 t Q,ud A"6dUd&rn7 LIM A)dy� I&a 99. �� 00 Location of action: Site acieage: Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: t-/Aam h? 'h"4',ofa-xhc (b) Mailing address: Zww (c) Telephone number: Area Code (d) Application number, if any: Will three action-bye directly undertaken,require funding, or approval by a state or federal agency? Yes ,❑ No!v 1 If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. IDEVELOPED 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 LW" Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ NoNot Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No"R Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No)�] Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Poli 'es Pages 8 through 16 for evaluation criteria Yes 1:1 No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes Nob Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑Notq Not Applicable Attach additional sheets if necessary Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes 1-1No u Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye�] NoE] Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III.—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑, No ] Not Applicable ` Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III— Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No IJ 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 ❑ NoNot Applicable PREPARED TITLE__ � ��DATE � ��