The URL can be used to link to this page

Home My WebLink AboutTR-8880 Michael J.Domino,President ��OF soyoTown Hall Annex John M.Bredemeyer III,Vice-President hO l0 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A. Nicholas Krupski Ql �Q Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1437C Date: December 20,2017 THIS CERTIFIES that the construction of a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of dnMells• and to construct a landward expansion to proposed dwelling consisting of a 2'x12 5' extension of the dwelling footprint• and a 4'x12.5';covered porch with 3.5',wide steps to grade; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands,• establish and perpetually maintain a 10' wide 500sq.ft. non-turf buffer adiacent to and alongthe he top of the naturally vegetated embankment,• and to construct a 4' x±27' embankment stairway with a 4'x6' platform; At 1325 Bayview Avenue, Southold Suffolk County Tax Map#1000-52-5-13 Conforms to the application for a Trustees Permit heretofore filed in this office Dated August 22, 2016, pursuant to which Trustees Wetland Permit#8880 Dated September 21,2016,was issued and Amended on December 14, 2016, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for construction of a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps a 4'x5.6' platform and steps, and a 4'x6' outdoor shower,• install a drainage system of drywells• and to construct a landward expansion to proposed dwelling consisting of a 2'x12 5' extension of the dwelling footprint,• and a 4'x12 5'• covered porch with 3.5';wide steps to grade,• install a sanitM system and asphalt driveway more than 100' from landward edge of wetlands,• establish and perpetually maintain a 10' wide 500sq ft non-turf buffer adjacent to and alongthe top of the naturally vegetated embankment-, and to construct a 4' x±27' embankment stairway with a 4'x6' platform. The certificate is issued to CONSTANTINE&PAMELA STAMIDIS owners of the aforesaid property. p e aes � Authorized Signature �� SOury Michael J.Domino,President Town Hall Annex O� Ol0 John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith • �Q Telephone(631) 765-1892 A.Nicholas Krupski �ycouFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: ?.0 77 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction % constructed Project complete, compliance inspection. INSPECTED BY: �f ` COMMENTS: cta— G6 CERTIFICATE OF COMPLIANCE: .r CC# : C17-39811 COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 09/21/2017 under Liber D00012930 and Page 612 and, that the same is a true copy thereof, and of the whole of such original In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 09/21/2017 SUFFOLK COUNTY CLERK JUDITH A.f PASCALE SEAL 4s IIIVIII IIII VIII VIII VIII VIII iIIII VIII VIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 09/21/2017 Number of Pages : 5 At: 02 : 17 :46 PM Receipt Number : 17-0165287 LIBER: D00012930 PAGE : 612 District: Section: Block: Lot: 1000 052 .00 05 . 00 013 . 000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $25 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15 .00 NO TP-584 $0 . 00 NO Notation $0 . 00 NO Cert.Copies $6.25 NO RPT $200 . 00 NO Fees Paid $271 .25 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 1 r • , a F-11 F2-1 RECORDED 201" Sep 21 02a I i a 46 PM JUDITHA. FGSCC�LE Number of pages :LEER OF SUFFi tL}.. COUNTY L iJfjijOl'y930 This document will be public P 612 record. Please remove all Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17 (County) Sub Total —" Spec./Add. EA-5217 (State) TOT.MTG.TAX - - CQyyy,, R.P.T.S.A. Dual Town Dual County y714 � Held for Appointment Comm. of Ed. 5. 00 % m Transfer Tax Mansion Tax Affidavit '�+� ��' =" The property covered by this mortgage is Certified°:,Copy"'.:,. or will be improved by a one or two NYS Surcharge 15. 00 7 family dwelling only. Sub Total 1. YES or NO Other Grand Total ' / sIf NO,see appropriate tax clause on page# of this instru int. 4 Dist. "'--'- T n+ 5 Community Preservation Fund 3482026 1000 05200 0500 013000 Real Prop( P T Consideration Amount $ Tax Sery � DTY A IIIIIIIIIIIIIIIIIIIIIIIIIII Agenc, IIIIIIIIIIIIIIIIII CPF Tax Due $ Verificati 21-SEP-17 i, Improved Satisfactions/Discharges/Releases List Property Uwnelh ivlaning Address ' 6 RECORD & RETURN TO: Vacant Land �5'dl 1 yrs TD TD TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co. Name www.suffolkcountyny.gov/clerk Title# 8 Suffolk Countv Recording & Endorsement Page This page forms part of the attached C—c'L� 0 A made by: (SPECIFY TYPE OF INSTRUMENT) coAj�TYW 7-/#%1 e, /I - S� "�r"�. ,�,, ) 29 j S The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of In the VILLAGE or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104.10/0ekk (over) IMPORTANT NOTICE If the document you've just recorded is your SATISFACTION OF MORTGAGE, please be aware of the following: If a portion of your monthly mortgage payment included your property taxes, *you will now need to contact your local Town Tax Receiver so that you may be billed directly for all future property tax statements. Local property taxes are payable twice a year: on or before January 10th and on or before May 31 It. Failure to make payments in a timely fashion could result in a penalty. Please contact your local Town Tax Receiver with any questions regarding property tax payment. Babylon Town Receiver of Taxes Riverhead Town Receiver of Taxes 200 East Sunrise Highway 200 Howell Avenue North Lindenhurst, N.Y. 11757 Riverhead, N.Y. 11901 (631) 957-3004 (631) 727-3200 Brookhaven Town Receiver of Taxes Shelter Island Town Receiver of Taxes One Independence Hill Shelter Island Town Hall Farmingville, N.Y. 11738 Shelter Island, 'N.Y. 11964 (631) 451-9009 (631) 749-3338 East Hampton Town Receiver of Taxes Smithtown Town Receiver of Taxes 300 Pantigo Place 99 West Main Street East Hampton, N.Y. 11937 Smithtown, N.Y. 11.787 (631) 324-2770 (631) 360-7610 Huntington Town Receiver of Taxes Southampton Town Receiver of Taxes 100 Main Street 116 Hampton Road Huntington, N.Y. 11743 Southampton, N.Y. 11968 (631) 351-3217 (631) 283-6514 Islip Town Receiver of Taxes Southold Town Receiver of Taxes 40 Nassau Avenue 53095 Main Street Islip, N.Y. 11751 - Southold, N.Y. 11971 (631) 224-5580 (631) 765-1803 Sincerely, Judith A. Pascale SuffoWCoUnty'Ctlerk'1 - � J � r J 12-0104 06/06kd DECLARATION OF COVENANTS Q THIS DECLARATION made this 21 day of September 2017 by Constantine aW ss �9 A-" �; , , �� residing at156 Brixton Rd. Garden City, NY 11530 /� , hereinafter, referred to as "DECLARANT (S) " : W I T N E S S E T H WHEREAS, DECLARANT (S) is/are the owner (s) of certain real property located on 1325 Bayview Avenue f Southold , Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section �� , Block (2S-00 , Lot 0[1600 () which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of, Southold to undertake certain regulated activities; and WHEREAS, as a condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a 10' wide, 500 sq. ft. "non-turf buffer" adjacent to and landward of along the naturally vegetated embankment NOW, THEREFORE, the DECLARANT (S) do/does hereby covenant and agree as follows: 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and perpetually maintained along the naturally vegetated embankment 10' wide, 500 sq. ft. "non-turf buffer" as defined by Chapter 275 of the Town Code, to wit: "A designated area where turf grass, pesticides and fertilizers are not permitted." and as depicted on the survey/site plan lasted dated September 19, 2016 and stamped approved on September 21, 2016 , see Exhibit "A" attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANT (S) ; his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees. IN WITNESS WHEREOF, the owner(s) has/have du executed this instrument this day of SLy�, 2 0 17. Ga O IS SIGNATU �j STATE OF NEW YORK ) COUNTY OF ss: On the o�l day of , in the year 20-a; before me the undersigned, a Notary Public in and for said State, personally appeared 6-A. 6-amidts , personally known to me or proved to me on the basis of satisfactory evidence to be the individual (s) whose name (s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity, and that by his/her/their signature(s) on the instrument, the individual or the persons on behalf of which the individual (s) acted, executed the instrument. Notary Public Kim Watson (Votary Public, State of New York No. 04WA6335700 Qualified in Suffolk County Commission Expires January 25, 2020 2 No. STN-43166 Policy No. A75-2676024 Schedule A All that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being at Arshamomoque, in the Town of Southold, Suffolk County, New York, known and designated as lots numbered 49 and 50 -on a certain map entitled "Map Showing Subdivision of Property known as Summer Haven, belonging to William G. Herx, near Southold, Suffolk County, New York" : , filed in the Suffolk County Clerk' s Office July 5, 1933, as Map #1123 . FOR INFORMATION ONLY: SAID PREMISES known as and by 1.325 Havview Avenue southC1d, -a"ie'sa; -ork ytJR�rY nr I LOTS 49 is 50 ,vii, 4ROurrve av)ummr,rmv or rrow.im I _ I(NOri'\ AS SUMMER H,N%F\ _ - nsM••ri..'r m nu—,r m i i''I^t'All I ARSrn•+ouoqur _ - TOW. Or SOUTHOLD P"D C4Df:05 0_369 oCcr- ` SUFFOLK COUNTY NEW YORK I r01'0�� I $C TAX SCeCFIf1t/0'D52-OS-J3 x )a,S y iOiC!In:�l)n lel 0x11)+0 f \ ""'-i i �i••�_`'"�_G.—,—e:«. _--.__ maCyrt(_isn. ,I n. I b 11 ♦ X. ♦ -Ol .a -gin-[ •�• .+� o T co.rD:n uc seDwr,n,rs `} "�• \' r! t >,' '* i�[oU"+*you OF 1—.J,n niuuio`rs •m 11-0-11-0-va�: ou f o rr� �. D,uc.s '' fl<aE,Irr414v<f e' '1.� 1 '\Y♦ ' � Mvr DCUe n[v1fr."�wi•�i'Jrv-n�� r+v_,.rn). '��• v w r ur, - )fflG,..�-✓ ,x, / a e> a•,n i)oo uu^s (:ncouoo�a use,a me., smre.0, 1 .�.�<'rG'}�• .r :./.J F[ c -r°e. . './+' :.- '✓\.� a� +. ..,.......—°:Z_"`t+'"".:...�.„,,., n.,oa r - PM1NAcC'ItTTS31dlA;:.SL'^.Y `'+`!3�"-.�`''. !�«' ti y'-• :Fes. � r9Dv D[nj!...J,..Sio.r n9.m rn.[ '' j '+*'`�<<^. '•`:� :'t.`-„' 1, PAPPROMBY rr. - USTEESTNO1p J I �- 1 Is Nathan Taft Corwin III Land Surveyor _.,�•�-.-''� _v_ � .sem;-��z:.;.=;. :ir�r� — _ '- - c^,.a: _ _ —'- - _ I i ) John M.Bredemeyer III,President ��fif SOVA, Town Hall Annex Michael J.Domino,Vice-President ti0 l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G ® Telephone(631) 765-1892 Charles J. Sanders '® Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 14, 2016 Robert E. Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: CONSTANTINE & PAMELA STAMIDIS 1325 BAYVIEW AVENUE, SOUTHOLD SCTM#: 1000-52-5-13 Dear Mr-.-Herrmann: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, December 14, 2016: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8880 to construct a landward expansion to the proposed dwelling consisting of a 2'x12.5' extension of the dwelling footprint; and a 4'x12.5' covered porch with 3.5' wide steps to grade; and as depicted on the survey prepared by Nathan Taft Corwin III, Land Surveyor, last dated October 25, 2016, and stamped approved on December 14, 2016. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sin r ly, X John M. Bredemeyer III President, Board of Trustees JMB/dd John M Bredemeyer III, Presid4 � �Ff�g11FFOl,�C Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 Glenn Goldsmith N P.O. Box 1179 A. Nicholas Krupskio ® Southold, NY 11971 Charles J. Sandersja �p`� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: b `'� Completed in field by: QT En-Consultants on behalf of CONSTANTINE & PAMELA STAMIDIS requests an Administrative 'Amendment to Wetland Permit#8880 to construct a landward expansion to the proposed dwelling consisting of a 2'x12.5' extension of the dwelling footprint; and a 4'x12.5' covered porch with 3.5' wide steps to grade. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-52-5-13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2., Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Present were: �' J. Bredeme er M. Domino G. Goldsmith N. Kru ski Y p ri S C. Sanders- Other 1 Page 1 of 2 John M. Bredemeyer III, Presic ) �OSUFFo1,�C0 Town Hall Annex Michael J. Domino, Vice-Presiaent �° Gy 54375 Route 25 Glenn Goldsmith oma` P.O. Box 1179 A. Nicholas Krupski oV Southold, NY 11971 Charles J. Sanders y�j0 ao�� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: En-Consultants on behalf of CONSTANTINE & PAMELA STAMIDIS requests an Administrative Amendment to Wetland Permit#8880 to construct a landward expansion to the proposed,dwelling consisting of a 2'x12.5' extension of the dwelling footprint; and a 4'x12.5' covered porch with 3.5' wide steps to grade. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-52-5-13 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 SURVEY 0]F LOTS 49 & 50 MAP SHO WING SUBDIVISION OF PR OPER T Y KNOWN AS SUMMER HAVEN _ - BELONGING TO WILLIAM G. HERX FILE No. 1123 FILED JULY 5, 1933 SI T UA TE C 0A' 0- ARSHAMOMOQUE TOWN OF SOUTHOLD PROPOSED STAIR SECTION SUFFOLK COUNTY, NEW YORK SCALE 1" = 10' S.C. TAX No. 1000-52-05- 13 SCALE 1 "=20' +27' STAIRWAY APRIL 7, 2015 6' PLATFORM JUNE 29, 2016 REVISE PROPOSED HOUSE JULY 26, 2016 ADD PROPOSED BEACH STAIRS SEPTEMBER 29, 2016 REVISE PER HEALTH DEPT. NOTICE 4' STEPS OCTOBER 25, 2016 REVISED PROPOSED HOUSE 12 TOTAL LOT AREA = 10,317 sq. ft. 10 _-STING 6R,AB€ (TO TIE LINE) 0.237 ac. l $ UPLAND AREA = 10,044 sq. ft. �s 6 ,- 0.231 ac. FsAG�� 2 APP(��✓ r �✓ � � TOTAL LOT COVERAGE BOARD OF 1 RUSTEES UPLAND AREA = 10,044 sq. ft. O. �y 0 4' x 6" x VAR. LENGTH SUPPORT POSTS .•':,,TOWN OF SOUTHOLD DESCRIPTION AREA % LOT COVERAGE o OPOSED HOUSE 1 ,225 sq. ft. 12.2% o o " :, �F. MQ �- (�� 'C�' & COVERED PORCH 'I. __ ,, � W OPOSED DECKS 296 sq. ft. 3.0% = Z OJy Z � 'ti' '? P OPOSED OUTSIDE 24 sq. ft. 0.2°° o D g OWER M 3 D TOTAL 1 ,545 sq. ft. 15.4% ° ; NOTES: 0 1 . ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM o� EXISTING ELEVATIONS ARE SHOWN THUS: xx,x ,o F EXISTING CONTOUR LINES ARE SHOWN THUS: - - -XX- - - \ x yo42 PROPOSED CONTOUR LINES ARE SHOWN THUS: 2. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD CO, AFF GAG° '114 OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. 3. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 36103CO159H s ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); a� < �Q �O s c� rBASE FLOOD ELEVATIONS DETERMINED �I 4 + <<1 `� � � J'` ZONE X : AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1% ANNUAL o 7.3 1 �o° °� Q sem` CHANCE FLOOD WITH AVERAGE DEPTHS OF LESS THAN 1 FOOT �5J3? �P `��OL o< \ x 4 r \r�FF �� OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 1% ANNUAL CHANCE FLOOD. F "br!' X a 4. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1 ,200 GALLONS. s o o, _U x 1 TANK; 8' DIA. 4' LIQUID DEPTH ks, �frt .: a 5. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. �+ o, �. -1- �sd� � �` a" 6 LEACHING GALLEYS, 2' DEEP (8.5' x 4.75') a s V � WKCI x q` k Y Y.>I PROPOSED 50% FUTURE EXPANSION GALLEY \ �,\�y PROPOSED 8.5' long x 4.75' wide x 2' deep LEACHING GALLEY p'�S� SOG� ,d� ,._•.\y '.G <'IO a... .�Gn'Z,g '�v yF,. 9 5:0.'/.' ( Qe a F �.:., a I' aoPy PROPOSED 1,200 GALLON SEPTIC TANK t...9 .� :.. ?S . k Pie �. �S, O� . �p TEST HOLE DATA P � Ile- '.a % . o �, Fs 6. APPROXIMATELY 200 cu. yds. OF CLEAN SAND FILL TRUCKED IN FROM AN UPLAND oJgk ,L ' q O :•'•'• O Q�0 �� 4el e F (TEST HOLE DUG BY McDONALD GEOSCIENCE ON FEBRUARY 10, 2015) SOURCE SHALL BE NEEDED. O . '.'.:'.'.'.'. '.'a Q o GP EL. 8.7' 0' 2F Go \ �i ��.':'�� P` ' :.•.•%s, DARK BROWN LOAM OL 7. AREA OF NON-TURF BUFFER IS 500 sq. ft. o F� �' O ` �• 1' AREA OF DISTRUBANCE IS 7,485 s ft. f. ee :..Q ' \� \0' ::... 0 �� c�y9y BROWN SILT ML a�� ¢ x ��..a..` ��g� lC\'�\.' :' ..... v' o t'o�?°� of 4y 3 BROWN FINE TO COARSE SAND SW F� \ x ...... (� C S \ ........ �<`' O/ QOC EL. 1.6'..: 7.1' ...�..: \. - ---9 Nab C �< 113 OO 0') p 8.5 ��Orr-- .�� \ x \` \O� ��0 + WATER IN BROWN FINE `J t -10.0 `/ ` ^yJ ¢ I� TO COARSE SAND SW - s �s DRAINAGE SYSTEM CALCULATIONS: � ROOF AREA: 1 175 s ft. q iso � 1 ,175 sq. ft. X 0.17 = 200 cu. ft. �z � � o X' Roy' �� ' o�'QJ�° I� ��y�� 200 cu. ft. / 42.2 = 4.7 vertical ft. of 8 dia. leaching pool required PROVIDE (2) 8' dia. X 3' high STORM DRAIN POOLS v'�� S 4� DRIVEWAY AREA: 1 ,200 sq. ft. � 00 1 ,200 sq. ft. X 0.17 = 204 cu. ft. o \ x204 cu. ft. / 42.2 = 4.8 vertical ft. of 8 dia. leaching pool required 9 � \ "°• " CP FF PROVIDE (2) 8' dia. X 3' high STORM DRAIN POOLS '77 GO S tir 0 �i 9 noZ� J Fpc �G� • F `�° PREPARED IN ACCORDANCE WITH THE MINIMUM o� vy�s STANDARDS FOR TITLE SURVEYS AS ESTABLISHED ��oo 02 D L� Q � E TBYTHE ORSITLE L.LCIA. pgOVED AND ADOPTED 1 a , FOR SUCHB}.�,�1I� =YQRK STATE LAND �s PROPOSED CONC. RETAINING WALL DETAIL r (NOT TO SCALE) , �\ 4 L 1 29010r, ��1 8 J HOUSE PROPOSED SEPTIC SYSTEM DETAIL FINISHED GRADE I_ 'I F.FL 13.0, (NOT TO SCALE) G.FL.. t= \y _ FINISHED GRADE FINISH GRADE SOUtk!d IOWn I "- P `= ELEV. 9.0' ELEV. 9.0' _ No.4 REBAR � Board of Triistees -1' MIN. TOP EL 7.2 ' TOP EL. 8.0' 1' MIN. No.4 REBAR MIN. 4" DIA. 6• 0 2'O.C. .,D•' FINISHED CRAOE .. SEPTIC LEACHING T 3' CLEAN +�`)`� APPROVED PIPE APPROVED PIPE LEACHING INV. EL. TANK GALLEY �? SAND ✓ MEMBRANE wATERPRooFlNc min. PITCH 1/4"/1' min. PITCH 1/8•/1' GALLEY io , SEP SYSTEM SIDE 7 4 INV. EL _ INV. EL. 6.4' COLLAR INV. EL. 7.0' �� }--8.s -j Zu N.Y.S. Lic. No. 50467 UNAUTHORIZED ALTERATION ADDITION Nathan Taft Corwin iii BOT. EL 4.7' GROUND WATER TO THIS SURVEY IS A VIOLATION OF ELEV. 1.s' SECTION 7209 OF THE NEW YORK STATE I'-e a SEPTIC TANK (1) EDUCATION LAW. No.3 REBAR a 12• COPIES OF THIS SURVEY MAP NOT BEARING Land Surveyor D.C. 1. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1,200 GALLONS. LEACHING GALLEY (6) THE LAND SURVEYOR'S INKED SEAL OR 1 TANK; e' DIA. 4' LIQUID DEPTH z . , 4 u•: •2` 2. CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 psi AT 28 DAYS. 1. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 250 sq ft SIDEWALL AREA. TO BE A VALID TRUE COPY, I EMBOSSED SEAL SHALL NOT BE CONSIDERED " 3. WALL THICKNESS SHALL BE A MINIMUM OF 3", A TOP THICKNESS OF 6" AND A BOTTOM THICKNESS OF 4". 6 GALLEYS; 2' DEEP, (8.5'x 4.75') ALL WALLS, BOTTOM AND TOP SHALL CONTAIN REINFORCING TO RESIST AN APPLIED FORCE OF 300 psf. 2• LEACHING GALLEYS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE (OR EQUAL) CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isoksen, Jr. L.S. �' '• �� 4. ALL JOINTS SHALL BE SEALED SO THAT THE TANK IS WATERTIGHT. LEACHING STRUCTURES, SOLID DOMES AND/OR SLABS. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. N.3 REBAR 0 is•D.C. 5. THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A MAX. TOLERANCE OF f1/4") 3. ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE (OR EQUAL). IS PREPARED, AND ON HIS BEHALF TO THE ON A MINIMUM 3"THICK BED OF COMPACTED SAND OR PEA GRAVEL. 4. A 10' min. DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE MAINTAINED. 3'-0• 6. A 10' min, DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED. 5. AN 8' min. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MAINTAINED. TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 FOX (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF THE EXISTENCE OF RIGHT WAYS 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 JamesPort, New York 11947 35-032B John M Bredemeyer III, President +0�4` �o� Town Hall Annex Michael J Domino, Vice-President �-`� � '°=-.: �� 54375 Route 25P-0- Box 1179 Glenn Goldsmith A. Nicholas Krupski y ® o�rr. Southold, NY 11971 Charles J. Sanders =�01 yam;; Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1St day of construction ��Y2 constructed �'�"'' Project complete, compliance inspection 9.: 06 W. ': ,iih gra; c�.r r't'e r i° :,'•° PR �-;'r •'r.;.� .!'s� ,:- zP.. �,. .�-. rte-. ,.�;: �� .��',.� F�`� °r�.x ,�,�� „��//��// '� `f��;1, (fin- 'l' �.i•.r.•. 'i M•�. :tis" lrY"1•i, � r�t � ..�3 ,�-. ti ' ',• ,� �.. Utter � c ��' •a1r •' •St'•'t : r .r. Pfr BOARD OF SOUTHOLD TOWN TRUSTEES t s SOUTHOLD,NEW YORK i PERMIT NO. 8880 DATE: 'SEPTEMBER 21, 2016 y ISSUED TO: CONSTANTINE & PAMELA STAMIDIS Ct - PROPERTY ADDRESS: 1325 BAYVIEW AVENUE,'SOUTIfOLD' SCTM# 1000-52-5-13 AUTHORIZATION;. . i f]. °r 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:Tiustees'adopted`at'the irieetingaield:bn Sentember:'21, 2016, `I •o PP a 2 'P Y �'.. '•� and�in-consideration of'a` lica'tion'fee` iri ttie'sum�of _50.00 aid'b Constantine.-& 'Pamela",Stamidis and subject to the Terms and Condition's''as stated'in=the°.,Resolution;! the,^,Southold„T;owp.Board,,of Trustees a„ authorizes and permits the following: 'n � .Y ift` "s( ;.� '+` �i ;:; ` •- , + ,:-; :'- i .:_ J ,7.` +:._ iF;[' E:;'' .;;j ';xsi' ;)i",it1 ;F>.i p' t" '4 Wetland Permit to construct a two-story,single-family dwelling with attached;garage,a.nd 10'x25' first and second-story decks with 3.5' wide steps,a 4'x5.6' platform and steps,and a 4'x6''outdoor sh6wer;'instAl1 a'drairiage system of drywells;instaIl;a,sanitary system•and asphalt driveway more than 100' from landward'.edge of wetlands; establish-and;perp,etually maintain a 10' wide,500sq.ft. non-turf buffer adjacent to and along the top of the naturally ' ” vegetated'emliankne,' `and10 coiistruct`a'4''x.f27' embankment_stairway with a,4'x6' platform;and as'depicted`on`the'sarvey prepared by Nathan Taft Corwin;III,Land Surveyor, a, �- las't;dafe l Ju1y16;2®16,'and'stamped approvedion September..21;'-2016: .{'r I:'vfn P L IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and`these'presents to be subscribed by a inajority of the.said.Boar assof`this=date:', `• „ ,-J _ , . , { =biz It2 s'.•. :3: si co COD o411. s r; „ iii 17 ;L�'a�" �r�mm'"'f3z��z 't `�."_.�. ,,�•� �" N" q�..rR �. ....••'� �::1 i t y7 ::'.: t° e0t. "s'° �.,' •�N .Ax '�i:,n.. :nfi'- S Y �'°$ TERMS AND CONDITIONS The Permittee Constantine&Pamela StanUis residing at 1325 Bayview Avenue Southold, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant,request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low.water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the. location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work ; shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit,which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. John M.Bredemeyer III,President ��OF SO&PZ, Town Hall Annex Michael J.Domino,Vice-President �O l0 54375 Route 25 P.O.Box 11 Glenn Goldsmith ii Southold,New York 11971 A.Nicholas Krupski G ® Telephone(631)765-1892 Charles J.SandersD a Fax(631) 765-6641 NT`I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 21, 2016 Robert E. Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: CONSTANTINE & PAMELA STAMIDIS 1325 BAYVIEW AVENUE, SOUTHOLD SCTM# 1000-52-5-13 , Dear Mr. Herrmann: The Board of Town Trustees took,the following action during its regular meeting held on Wednesday, September 21, 2016 regarding the above matter: WHEREAS, En-Consultants on behalf of C'ONSTANTINE & PAMELA STAMIDIS 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 August 22, 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 September 21, 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 CONSTANTINE & PAMELA STAMIDIS to construct a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps, a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of drywells; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands; establish and perpetually maintain a 10' wide, 500sq.ft. non-turf buffer adjacent to and along the top of the naturally vegetated embankment; and to construct a 4' x ±27' embankment stairway with a 4'x6' platform; and as depicted on the survey prepared by Nathan Taft Corwin, III, Land Surveyor, last dated July 26, 2016, and stamped approved on September 21, 2016. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: None Very truly yours, NMI John M. Bredemeyer III President, Board of Trustees JMB/dd SURVEY OF LOTS 49 & 50 MAP SHOWING SUBDIVISION OF PR OPER T Y KNOWN AS SUMMER HAVEN BELONGING TO WILLIAM G. HERX FILE No. 1123 FILED JULY 5, 1933 SITUATE _ ARSHAMOMOQUE TOWN OF SOUTHOLD PROPOSED STAIR SECTION SUFFOLK COUNTY, NEW YORK SCALE 1" = 10' S.C. TAX No. 1000-52-05- 13 col'o� SCALE 1 "=20' +27' STAIRWAY APRIL 7, 2015 JUNE 29, 2016 REVISE PROPOSED HOUSE 6' PLATFORM JULY 26, 2016 ADD PROPOSED BEACH STAIRS 4' STEPS TOTAL LOT AREA = 10,317 sq. ft. (TO TIE LINE) 0.237 ac. UPLAND AREA = 10,044 sq. ft. 12 0.231 ac. 10 ��XISTING GRADE 8 6 4 TOTAL LOT COVERAGE UPLAND AREA = 10,044 sq. ft. 2 DESCRIPTION AREA % LOT COVERAGE 0 4' x 6" x VAR. LENGTH SUPPORT POSTS PROPOSED HOUSE 1 ,150 sq. ft. 11 .4% G ° PROPOSED DECKS 326 sq. ft. 3.3/ e 1`10_1 �G�` _ 5 o PROPOSED OUTSIDE •� %,tic Z D SHOWER 24 sq. ft. 0.2% Az 9�FP 1 o TOTAL 1 ,500 sq. ft. 14.9% o ;a z � D TTI O 0^ 9LF�FNOTES: m, 0 1 . ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM G EXISTING ELEVATIONS ARE SHOWN THUS: XX.X sFs°sem EXISTING CONTOUR LINES ARE SHOWN THUS: - - -XX- - - \ x A�G2o PROPOSED CONTOUR LINES ARE SHOWN THUS: �'�• x" o ,� 2. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD TEFF ` GAG° 9OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS. �p 4- 3. FLOOD ZONE INFORMATION TAKEN FROM: 4 FLOOD INSURANCE RATE MAP No. 36103CO159H 0 0o rLO ' 94\ I u'>eys� ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION); p \ 1 sO yO_ P�� BASE FLOOD ELEVATIONS DETERMINED ZONE X : AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1% ANNUAL 73 , �o, •�Q'�O�j CHANCE FLOOD WITH AVERAGE DEPTHS OF LESS THAN 1 FOOT X � OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; A -62 f AND AREAS PROTECTED BY LEVEES FROM 1% ANNUAL CHANCE FLOOD. 4. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1 ,200 GALLONS. X . X 1 TANK; 8' DIA. 4' LIQUID DEPTH . 5. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA. 6 LEACHING GALLEYS, 2' DEEP (8.5' x 4.75') n--�7 S`�`��cX O Q• m '. X PROPOSED 50% FUTURE EXPANSION GALLEY cis +R, <s �`�o O' �� r ° �s \ PROPOSED 8.5' long x 4.7'5' wide x 2' deep LEACHING GALLEY \ OPROPOSED 1,200 GALLON SEPTIC TANK S t'•' 9. / P �P` ° no� �p TEST HOLE DATA 6. APPROXIMATELY 200 cu. yds. OF CLEAN SAND FILL TRUCKED IN FROM AN UPLAND Jr„ti s ' v a 0;. . _• e 11?_XJ� �G� V FP (TEST HOLE DUG BY McDONALD GEOSCIENCE ON FEBRUARY 10, 2015) SOURCE SHALL BE NEEDED. Co �.. �( _ a DARK BROWN LOAM OL 7. AREA OF NON-TURF BUFFER IS 500 sq. ft. �, �.. .. 1 �. /2.. .. :.... ?F ° AREA OF DISTRUBANCE IS 7,485 sq. ft. it �F BROWN SILT ML X 7.4 -�,:,� �:•••••.i:�� BROWN FINE TO COARSE SAND SW O \ 1 x .. (k 7.1 �O OO °O 8.5 ' ..9 �� 1 0 C,J �� WATER IN BROWN FINE e n p, 1 f x \, \ 0 �S@ TO COARSE SAND SW DRAINAGE SYS GjV e �. i 10.0 ,Z TEM CALCULATIONS: ° +� ROOF AREA: 1,150 sq. ft. y %i' 1 ,150sq. ft. X 0.17 = 196 cu. ft. 4 04¢x,Q .� 4¢�P\ S, ��va �5 196 cu. ft. / 42.2 = 4.6 vertical ft. of 8 dia. leaching pool required xl i �� o��° 'o �QJ�IpI ��$�yA PROVIDE (2) 8' dia. X 3' high STORM DRAIN POOLS 0 ¢4 k� p4�, DRIVEWAY AREA: 1 ,300 sq. ft. 1 ,300 sq. ft. X 0.17 = 221 cu. ft. y�y`� \\ x� �•� �� '�� , \ �Z� 221 cu. ft. / 42.2 = 5.3 vertical ft. of 8' dia. leaching pool required ��F � '•' / I CP A PROVIDE (2) 8' dia. X 3, high STORM DRAIN POOLS 9��n9Co y \�N \�`•' 9 X; tic��c, APPROVED BY "se0.1 \ � \ -• + '0.2 o° `-� F�oJC�ARD OF TRUSTEES s \ ��o " TC� V OF SOUTkOtfl o �I I, ��°� X �' \ 1-110. OD r� ,i °2 +* 0. Z% G S 0^ <9yrt1 PREPARED IN ACCORDANCE WITH THE MINIMUM r� �� STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.S. AND APPROVED AND ADOPTED 2o�Gy ► n// FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATION. ]D E `� PROPOSED CONC. RETAINING WALL DETAIL ,<T' 4r Pt lS (NOT TO SCALE) [ c1 r, � , e HOUSE PROPOSED SEPTIC SYSTEM DETAIL SLP 19 2016 ,�'� \ FINISHED GRADE F.FL 13.0' (NOT TO SCALE) ,tom `1• \•1 �.. G.FL.. 10.0' FINISHED GRADE FINISH GRADE C p '! ELEV. 9.0' ELEV. 9.0 jp4 •� ?, d I ' IREOAR 0 z' Southold Town ` 1 •;;;, o O.C. TOP EL. 8.0' �-1' MIN. TOP EL 7.2 ' 1' MIN. No.4 REBAR MIN. 4' DIA. e 2'D.C. ep•' FINISHED GRADE SEPTIC LEACHING T 3' CLEAN APPROVED PIPE TANK APPROVED PIPE LEACHING ,,, �Af INV. EL. min. PITCH 1/4'/1' min. PITCH 1/8'/1' GALLEY GALLEY r SAND MEMBRANEfICASySfEMSNE INV. EL. 7.0' INV. EL �'. `"`'-�.,; r„ 7.4' INV. EL. 64' o COLLAR L1 / `f�-.•• •",r,�14 S. Llc. No. 50467 r u UNAUTHORIZED ALTERATION OR ADDITION Nathan Taft Corwin o BOT. EL 4.7' GROUND WATER TO THIS SURVEY IS A VIOLATION OF 1•-e• :•>� e• s: ELEV. 1.6 III SECTIO ON209 OF THE NEW YORK STATE SEPTIC TANK (1) Land Surveyor Na.3 REHAB a 12' � COPIES OF THIS SURVEY MAP NOT BEARING D.c. 1. MINIMUM SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1,200 GALLONS. LEACHING GALLEY (6) THE LAND SURVEYOR'S INKED SEAL OR 1 TANK; 8' DIA. 4' LIQUID DEPTH EMBOSSED SEAL SHALL NOT BE CONSIDERED p e. p•'. •Z: 2. CONCRETE SHALL HAVE A MINIMUM COMPRESSIVE STRENGTH OF 3,000 psi AT 28 DAYS. 1. MINIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 250 sq k SIDEWALL AREA. TO BE A VALID TRUE COPY. I y 3. WALL THICKNESS SHALL BE A MINIMUM OF 3', A TOP THICKNESS OF 6•AND A BOTTOM THICKNESS OF 4'. 6 GALLEYS; 2' DEEP, (8.5'x 4.75') ALL WALLS, BOTTOM AND TOP SHALL CONTAIN REINFORCING TO RESIST AN APPLIED FORCE OF 300 pst. 2, LEACHING GALLEYS ARE TO BE CONSTRUCTED OF PRECAST REINFORCED CONCRETE (OR EQUAL) CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. L.S. I. '• •A• 4. ALL JOINTS SHALL BE SEALED 50 THAT THE TANK IS WATERTIGHT. LEACHING STRUCTURES, SOLID DOMES AND/OR SLABS. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. 1e'O.C.No.3 REHAB ( 5. THE SEPTIC TANK SHALL BE INSTALLED AT LEVEL IN ALL DIRECTIONS (WITH A MAX. TOLERANCE OF t1/4') 3. ALL COVERS SHALL BE OF PRECAST REINFORCED CONCRETE OR EQUAL). IS PREPARED, AND ON HIS BEHALF TO THE O ON A MINIMUM 3"THICK BED OF COMPACTED SAND OR PEA GRAVEL. 4. A 10' min. DISTANCE BETWEEN LEACHING POOLS AND WATER LINE SHALL BE MAINTAINED. s' D 6. A 10' min. DISTANCE BETWEEN SEPTIC TANK AND HOUSE SHALL BE MAINTAINED, 5. AN 8' min. DISTANCE BETWEEN ALL LEACHING POOLS AND SEPTIC TANK SHALL BE MAINTAINED. TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 Fax (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 35-032A John M. Bredemeyer III, President S f 014, Town Hall Annex Michael J Domino, Vice-President; G,� A 54375 Route 25 Glenn Goldsmith a ` -P.O. Box 1179 A. Nicholas Krupskio Southold, NY 11971 Charles J. Sanders 4,, � oo�� Telephone (631) 765-1892 Fax (631) 765-6641 �zrrrux= BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: S ' ' ®� l Completed in field by: CAAQy ,P� En-Consultants on behalf of CONSTANTINE & PAMELA STAMIDIS request a Wetland Permit to construct a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps, a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of drywells; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands; establish and perpetually maintain a 10' wide, 500sq.ft. non-turf buffer adjacent to and along the top of the naturally vegetated embankment; and to construct a 4' x ±27' embankment stairway with a 4'x6' platform. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-5275-13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet . ;� 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment V"_Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Y Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: �nz 0 c"W—n--t aT\-A I i�J c� /fv As Present were: !/ J. Bredemeyer LM. Domino c G. Goldsmith ��N. Krupski C. Sanders t""Other Page 1 of 2 John M! Bredemeyer III, President Town Town Hall Annex Michael J: Domino, Vice-President a°� °G 54375 Route 25 Glenn Goldsmiths x P.O. Box 1179 A. Nicholas Krupski �, AY Southold, NY 11971 Charles J Sanders Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: En-Consultants on behalf of CONSTANTINE & PAMELA STAMIDIS request a Wetland Permit to construct a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps, a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of drywells; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands; establish and perpetually maintain a 10' wide, 500sq.ft. non-turf buffer adjacent to and along the top of the naturally vegetated embankment; and to construct a 4' x ±27' embankment stairway with a 4'x6' platform. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-52-5-13 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. Adve'r`sely 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: 1'. 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 .s CA — ,X f �p.A ti��+ z T • •• _ k�. .-.r�,+, `}. b b 1V,��7°�' � ��.4��r, .R, N.w��i.• _ �� w� i � .. •, . 5-1 t tl+ �.�✓ `� } 1i.', iR}. �". � d�'"P b��•4.y�1Yr � '+M ,y�q� 'f y. ;' ��_ r 1 .,. �.� r,d�_;.•4+��_.'i: -� � --• ��. `i b'V v� �. J�' � {� -'0• B:/'�-(" x�.� Jf^.+oKY� •�� .." R •. �� - - A +J•' >4• -� `,: • +, ^s /� �'+yam , s. ' k r ,+'y�q.,�.y� "L f l' ,,,��.^///IJl7r ��r 1'� _ :+•1 Vie.• .+.►• y ' f, _ ', 41 14 t � �y,� � • .r S %r\a ►„ � ,� 111 .', .t'. '�Jp��j�,' ':.r•` .•.o `ir•�1. t'R �°�9�,�{�'�,'4.��a +. .� •.<• � �� +a, .,` 11 'r;.];"'� n�r•i .i '%% .•`. fir.. f,.r _ � « ��. .'ty ,,,,,. 5�.:..: Vt J! r•i i +�1~^ x~fV++ �a � {L- �� ) / i � � i� r,.• ,/ !. f -!�'�!,r"s. ��,-„ �S-.'�,�F ..1 �t�,;"�wl •i ��!�N�,'y�'#'T��,� ��•• i{ �� _ I '� �7 � .ro ,1'�/1'�,�..� t,�.i I. y rib ik -t �G+ a .. .tea ' , s� � � �`` ,- � - � �• Y..;` r• tµ �f ;��_ Il^�•'�Mli'+N�++q .. �y .. ... f yc..,f:�,..�w ffi 4w �,� ��e• p"�` �,,,;�. r � '�R•r ,+�i+a�». ^ ��,•,:�...^M16,r"9#� . It: R•�s,�,jk'' i b Al, ��e ,Y. � f7 .I � �i a r t Oe• /• - .. . r ';. f �. F, Y ' f �,1,� �• ASA ,+. , r d ,°yi ..r :;F7 •>T d,� a t-i4:a.t` i _ e •� {• *� ,. + l` �� f. 'fir fry ' S. s,. � A:' •,�,�� •. _ „*.��, .. ,.+ra. .,� t+. -4i•�� }, Af .,1., `�i ", �`'• Y`yl�:, � L! ,� Oft� r' CONSTANTINE AND PAMELA STAMIDIS. 1325 BAYVIEW AVE.. SOUTHOLD - .Iony -. J 1325 Bayview Ave JGOO f , r IC • Imagery.- Figure 1. Aerial image of subject property and surrounding developed shoreline on May 11,2016. Photo by Google Earth. Figure 2. Looking southwest from road toward Arshamomoque Harbor and over subject property to be improved with dwelling. r , .is. qiippp 1! pp .may s'NEn WV d/ Opp �� ♦/.mgr;� r x`�.' r �•H�. !..� y ;!!�•�;x% v— !%��1, r a+c,; f � `�{\ f�, �Y.. x j!'��_�_.. *,. a'.�,i.y., 3isj i,_��.�'o��: ✓ .a:. ��yC,�y-.,�v.�� `: � t�;'��tIA�•�r,".,��r„a::-+�e rs.r,w`t�} jP�r r - k `rs+�jar. Y+` •. ai ��c f_;� �P I - FR If IF Y 4V AV Aw O ,1. E. � J �IMPeJq =A , zTn OA4.) 99 14 i Oa PCL NO21 1 e 13 (RESERVED FOR PARK 4 SM,) ei AND YGROUND) 4 129A(c) 2 Ss2 1 w4c) I axes" 583 1670A(c) w 5 13M TOWNOFSOMOLD AS 12 T -"7 < 9j39 78lAi(.) PECONIC70TRUST Sv. Of -10\ A) o I 13 Im- FORI�N 'man MRI�.O NO F- SEE SEC 0 �r o wtxaSEESEC NO �24 N, OP \ "A -Z-—————--UYN EE —— z ————— —— ----2Z----- ——————————-- —— ————— —_---- ImTCH —————-- UNE SEE SEC NO M SEE SEC NO 050 NOTICE K SOUTHOLD SECTION NO Real Property Tax Service E ....�gency y L COUNTY OF SUFFOLK ° County Center E G rg' 052 M _N D A-1 myrut 14Z&W, P m—o 1000 PROPERTY MAP I or, EN-CONSULTANTS September 16, 2016 John Bredemeyer, Chairman Board of Trustees Town of Southold P.O Box 1179 Southold,NY 11971 Re: Pamela& Constantine Stamidis, 1325 Bayview Avenue, Southold,SCTM 1000-52-5-13 Dear Mr. Bredemeyer: We recently filed an application to construct a new dwelling and small stairway to the shoreline on the captioned property, and a public hearing before the Board is scheduled for this coming Wednesday, September 21, 2016. At the time the proposed structures were staked on the property, it was noticed that the originally proposed stairway location would require the removal of a tree on the embankment. Therefore, the proposed stairway location was relocated approximately 9 feet to the north where it would not interfere with any trees and where it was staked for your inspection. Therefore, assuming the Board did in fact inspect the site during your monthly field inspections, you viewed a stake-out of the modified stairway location, which is now also depicted on the modified site plan prepared by Nathan Taft Corwin III, last dated July 26, 2016, three (3) copies of which are enclosed herewith. Respe tfuIly yours, Robert . Herrmann Coastal Management Specialist Enclosures D E ® 2 a V E SEP 19 2016 Sozold Town 1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 f 631.283.6136 wwwenconsultants corn environmental consulting d OFFICE LOCATION: ®��®F Ol MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 �p� Tel 631 765-1935 O Fax: 631765-3136 enum LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: September 14, 2016 Re: Local Waterfront Revitalization Program Coastal Consistency Review for CONSTANTINE & PAMELA STAMIDIS SCTM# 1000-52-5-13 En-Consultants on behalf of CONSTANTINE & PAMELA STAMIDIS request a Wetland Permit to construct a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps, a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of drywells; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands; establish and perpetually maintain a 10' wide, 500sq.ft. non-turf buffer adjacent to and along the top of the naturally vegetated embankment; and to construct a 4' x ±27' embankment stairway with a 4'x6' platform. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-52-5-13 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP provided the following is required to further Policy 6: 1. Preserve the existing vegetation adjacent to the tidal wetland and include in a vegetated, non- turf buffer. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary +Zft P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., September 14, 2016 the following recommendation was made: Moved by Greg Williams, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of CONSTANTINE AND PAMELA STAMIDIS to construct a two-story, single family dwelling with attached garage and 10'X 25' first and second-story decks with 3.5' wide steps, a 4'X 5.6' platform and steps, and a'4'X 6' outdoor shower; install a drainage system of drywells; establish a 10' wide, 500 sf. non- turf buffer adjacent to top of the naturally vegetated embankment; construct a 4'X +/-27' embankment stairway with a 4'X 6' platform; and install a sanitary system and asphalt driveway more than 100' from wetlands. Located: 1325 Bayview Ave., Southold. SCTM#52-5-13 Inspected by: John Stein, Keith McCamy Vote of Council: Ayes: All Motion Carried John M Bredemeyer III, Presid( C O��o �TyQI a Town lull 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 G . Charles J. Sanders, Trustee 'Q �O Telephone(631)765-1892 I,Yco Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF-SOUTHOLD To- Southold-Towh Building Department D Re: Verification of Building Department Permit Requirements AUG 2 6 Nis SCTM#: �2—�� ZJII,DIl°Z�Dom• pp ® 0-Y LD 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? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: -ON J d'4all, gnat LTe or vi wer Date ®g16FFD�,,�L' John M.Bredemeyer I11,President � Town Hall Annex Michael J.Domino,Vice-President - 54375 Main Road ti P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Q Telephone(631)765-1892 Charles J. Sanders,Trustee Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit —Amendment/Transfer/Extension Received Application: T'22i Received Fee: MOD vr:Completed Application 121W _ Incomplete ��', [J _SEQRA Classifica on: 1— off Lt� Type I Type II Unlisted Coordination: (date sent) �•�,�� AUG 2 2 kLWRP Consistency Assessment Form 2016 CAC Referral Sent: I&3CIIb j Sate of Inspection: - l ii Southold Town _Receipt of CAC Report: L. _f�p�r�Qf Trusted _Lead Agency Determination: Technical Review: Public Hearing Held: Resolution: Name of Applicant Constantine&Pamela Stamidis 156 Brixton Road Address Garden City,NY 11530 Phone Number: 51 750-5286 Suffolk County Tax Map Number: 1000 - 52-5-13 Property Location: 1325 Bayviw Avenue,Southold (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road, Southampton,NY 11968 Phone:631-283-6360 Board of Trustees Apr-, ation GENERAL DATA Land Area(in square feet): 10,317 Area Zoning: R-40 Previous use of property: Vacant-residential Intended use of property: Single-family dwelling Covenants and Restrictions: Yes X No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept. Yes X No Does the structure(s)on property have a valid Certificate of Occupancy Yes N/A No Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes, provide explanation: Project Description(use attachments if necessary): Construct a two-story,single family dwelling with attached garage and 10'x 25'first and second-story decks with 3.5'wide steps,a 4' x 5.6'platform and steps,and a 4'x 6'outdoor shower;install a drainage system of drywells;establish a 10'wide,500 sf non-turf buffer adjacent to the top of the naturally vegetated embankment;construct a 4'x+/-27'embankment stairway with 4'x 6'platform; and install a sanitary system and asphalt driveway more than 100 feet from wetlands and outside Chapter 275 jurisdiction,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated July 26,2016. Board of Trustees Applic� Dn WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To improve presently vacant parcel with single family residence for use by the applicant's family. Area of wetlands on lot: +/-273 square feet Percent coverage of lot: +/-2.6 01/0 Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: 75 feet Does the project involve excavation or filling? No X Yes (as required for installation of dwelling foundation If yes, how much material will be excavated? TBD cubic yards and sanitary system) How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Standard construction practices. Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): See attached addendum. WETLAND/TRUSTEES LANDS APPLICATION DATA ADDENDUM FOR CONSTANTINE & PAMELA STAMIDIS 1325 BAYVIEW AVENUE SOUTHOLD,NY SCTM#1000-52-5-13 ,Wetlands Statement of Effect The proposed project consists of the development of a presently vacant parcel situated along a heavily developed stretch of shoreline associated with Arshamomoque Harbor. The subject shoreline is characterized by numerous existing dwellings and accessory structures that are located less than 100 feet from wetlands, including the adjacent northerly and southerly dwellings,which are located approximately 30 and 50 feet from wetlands,respectively. Nonetheless,the applicant's project has been designed to minimize impacts associated with property development and maximize the protection and restoration of the adjacent tidal wetland ecosystem. Specifically, the proposed dwelling, which is located in a FEMA designated Zone X, has been designed with a minimal footprint of 1,150 sf and attached 10' wide waterside deck set back at least 75 feet from wetlands. This proposed design and positioning of the dwelling allows just enough room for placement of a drainage system more than 75 feet from wetlands and a sanitary system in the front yard where it will be situated approximately 150 feet from wetlands and well beyond Chapter 275 jurisdiction. The dwelling will also be situated landward of the neighboring dwellings,thus meeting and exceeding the requirements of§275-11(3). The dwelling will also conform to all zoning requirements pursuant to Chapter 280, and as a result of the project,total Town-defined lot coverage will be limited to 1,500 square feet, or 14.9% of the 10,044 square feet of buildable land on this 10,317 sf parcel. In addition to the proposed drainage system of leaders, gutters, and drywells to collect roof runoff,the potential for increased surface water runoff will be mitigated by a 10' wide, approximately 500 sf nonturf buffer to be established in place of the presently cleared lawn area adjacent to the top of the small embankment along the shoreline. Together with the naturally vegetated embankment to remain undisturbed, this buffer area will serve both as a sink and filter for stormwater runoff and contaminants, thereby mitigating both the quantity and quality of potential runoff reaching the harbor. The potential for temporary runoff and site disturbance during construction will be contained by a project limiting fence. For all of these reasons,the project will not have any adverse impacts on the adjacent tidal wetlands or waters of the Town. i 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available.If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: Stamidis Residence&Embankment Stairs Project Location(describe,and attach a location map): 1325 Bayview Avenue,Town of Southold,Suffolk County,NY, SCTM# 1000-52-5-13;property is located on west side of Bayview Avenue+/-229'south of Colony Road,location map attached. Brief Description of Proposed Action: Construct a two-story,single family dwelling with attached garage and 10'x 25'first and second-story decks with 3.5' wide steps,a 4'x 5.6'platform and steps,and a 4'x 6'outdoor shower;install a drainage system of drywells;establish a 10'wide,500 sf non-turf buffer adjacent to the top of the naturally vegetated embankment;construct a 4'x+/-27' embankment stairway with 4'x 6'platform;and install a sanitary system and asphalt driveway more than 100 feet from wetlands and outside Chapter 275 jurisdiction,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated July 26,2016. Name of Applicant or Sponsor: Telephone: 516-746-0491 Constantine&Pamela Stamidis E-Mail: estamidis@optonline.net Address: 156 Brixton Road City/PO: State: Zip Code: Garden City NY 11530 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2.If no,continue to question 2. X 2.Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: NYS DEC X 3.a.Total acreage of the site of the proposed action? 10,217 sf b.Total acreage to be physically disturbed? 7,485 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 10,217 sf 4 Check all land uses that occur on, adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 5.Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? X b.Consistent with the adopted comprehensive plan? X 6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 7 Is the site of the proposed action located in,or does it adjoin, a state listed Critical Environmental Area? NO YES If Yes, identify: Name.Mill Creek,Peconic Bay&Environs,Reason Significant coastal fish&wildlife habitat,Protect public health,water,vegetation&scenic beauty,Agency Town of Southold,Suffolk County,Date-3-9-90,7-12-88 X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No, describe method for providing potable water: A new connection to the public water supply is proposed. X 11.Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: A new Suffolk County Department X of Health compliant sanitary system is proposed. 12.a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X b.Is the proposed action located in an archeological sensitive area? X 13. a.Does any portion of the site of the proposed'action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? X i b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14.Identify the typical habitat types that occur on,or are likely to be found on the project site.Check all that apply. ® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ® Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 16.Is the project site located in the 100 year floodplain? NO YES X 17.Will the proposed action create storm water discharge,either from point or non-point sources? YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO❑YES i b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES i Page 2 of 4 ii 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: X I I 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: X 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: ROL E.Herrmann,Coastal Mgmt. Specialist Date: August 16,2016 Signature: Part 2-Impact Assessment.The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer.When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? / 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11.Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance.The Lead Agency is responsible for the completion of Part 3.For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part I Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts.Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude.Also consider the potential for short-term,long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Q, Check this box if you have determined,based on the information and analysis above,and any supporting documentation, YY that the proposed action will not result in any significant adverse environmenta imp cts. 11\),�.� I I T 16 _ Name ofhead Agency Date Ay\ o Print or TypelVame of Re nsib e Office in Lead Agency Title of Responsible Officer Signa e of Resp nsible Officer i Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: Constantine&Pamela Stamidis SCTM#1000-52-5-13 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a two-story,single family dwelling with attached garage and 10'x 25'first and second-story decks with 3.5'wide steps,a 4'x 5.6'platform and steps,and a 4'x 6'outdoor shower; install a drainage system of drywells;establish a 10'wide,500 sf non-turf buffer adjacent to the top of the naturally vegetated embankment;construct a 4'x+/-27'embankment stairway with 4'x 6'platform;and install a sanitary system and asphalt driveway more than 100 feet from wetlands and outside Chapter 275 jurisdiction,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated July 26,2016. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1325 Bayview Avenue, Southold 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: Wednesday, September 21,2016 @ 5:30 p.m. You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. Constantine&Pamela Stamidis PROPERTY OWNERS NAME: 156 Brixton Road MAILING ADDRESS: Garden City,NY 11530 PHONE #: 516-750-5286 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road, Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. f PROOF OF MAILING OF NOT ATTACH CERTIFIED MAIL RECEIPTS Name: Address: Maria Prois 111 Cherry Valley Avenue Garden City,NY 11530 Gus&Anthippe Vasilakis 645 Roxboro Court East Meadow,NY 11554 Myrna Schein 95 Crestwood Boulevard South Farmingdale,NY 11735 Anthony&Margaret McDonald 629 Main Street Greenport,NY 11944 S'L'ATE OF NEW YORK COUNIY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 , berg cb-Ay sworn, deposes and says that on the 13th day of September '2016 , deponent mailed a true copy of the Notice se't forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Southampton , that said Notices were Mailed to each of said persons by (certified)(s mail. Robert E.Herrmann Coastal Managment Specialist Sworn to before me this 13th K I M H , STEPHEN S day of September ,2016 STNOTARF NEWLIC TE OYORK COMMISSION N0 , 5015931 QUALIFIED IN SUFFOLK COUNTY Notzft Public EXPIRES AUGUST 2 , 20-/7 Postal Service TM Postal !• I Domestic M m 00 FNCLAL U 3F US 's Certified Mail Fee Certified Mail Fee _ A] $ r (1 CO $ ( appropriate) -� � Extra Services&Fees(checkbox,add tee as appropriate) Extra Services&Fees check box,add tee as M E]Return Receipt(hardcopy) - $ bat z m El Return Receipt(hardcopy) $ 0 ❑Return Receipt(electronic) $ rQ)� Poem �� O [IReturnReceipt(electronic) $ Post�i ark 0 ❑Certified Mail Restricted Delivery $ C- Her (r, [:1 Certified Mall Restricted Delivery $ t.-- a Q E]Adult Signature Required $ ,,,..t p []Adult Signature Required $ []Adult Signature Restricted Delivery$ -0 Bim' x [:]Adult Signature Restricted Delivery$ .,.� C3 Postage (f c O Postage - - - �� $ - - -- --� l® { $ C3 Total Posta) - - p 1.0 Total Post Ln $ ent To Maria Prios iV J.P $8017tTO : Gus&Anthippe Vasilakis 111 Che Valle :--- o S7eefand, 645 Roxboro Court _ � Sf�eefandA �' y Avenue ----- r` Garden City,NY 11530East Meadow,NY 11554 I r` 56779,&E, ------ SO WRIL ■ I ■ i CERTIFIEDRECE.IPT ■ ® rJ Er I• I m I• I ■ -0 rn M �- 6t7 4.. 19 Zt"ti G l'>n3 • . . , BS CI rz'L, € t`*,`., 7 S Certified Mad Fee r` Certified Mail Fee -0 $ ru $ Extra Services&Fees(checkbox,add tee as appropdate) //\/y (l Extra Services&Fees(check box,add tee as appropriate) M ❑ReturnRetuReceipt(hardcopy) $ ' 'p' -1�v\�� p E:1 Return Reeelpt(hardcopy) $ E]Return Receipt(electronic) $ b rtat (,® t3 ❑Return Receipt(electronic) $ St-a C3 ❑Certified Mall Restricted Delivery $ ! ere Q ❑Certified Mall Restricted Delivery $ ❑Adult Signature Required $ (:3 ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$ ❑Adult Signature Restricted Delivery$ p Postage A a rr3 Postage CO Total Postage -- —---- - - �L,o' I Total Poste0 AN � OMAN Ln Sent To Myrna Schein ar-q Sent To Anthon &Mar an Meon d a. O SfileefandAp 95 Crestwood Boulevard --- C3 Sfieefand, 629 Main Street StateSouth Farmingdale,NY 11735 -- 1 Greenport,NY 11944 ------------ City, ,Z r Gty State, -'-'-- � i John M. Bredemeyer-iii, President ,}'opo Town Hall Annex Michael J. Domino, Vice-President � �� yam , 54375 Route 25 Glenn Goldsmith y e P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sandersa� :f' .� � , Telephone (631) 765-1892 y Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of CONSTANTINE & PAMELA STAMIDIS COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, Robert E. Herrnnmi ,residing at/dba a-Consultants 1319 North Sea Road, Southampton, NY 11%8 being duly sworn, depose and say: That on the day of §6ptember , 2016, I personally posted the property known as 1325 Bayview Avenue, Southold. :SCIM #!000-52-5-13 by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, September 21 2016. Dated: (signatu Sworn to before me this 21st/day of Sept.2016 ar licir KIM H. STEPHENS NOTARY PUBLIC STATE OF NEW YORK COMMISSION NO . 5015931 O_UALIFIEO IN SUFFOLK COUITY EXPIRES AUGUST 2 , 20.17 ,NUTILL Uim HEL. A 'KINC 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: CONSTANTINE & PAMELA STAMIDIS SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a two-story, single-family dwelling with attached garage and 10'x25' first and second-story decks with 3.5' wide steps, a 4'x5.6' platform and steps, and a 4'x6' outdoor shower; install a drainage system of drywells; install a sanitary system and asphalt driveway more than 100' from landward edge of wetlands; establish and perpetually maintain a 10' wide, 500sq.ft. non-turf buffer adjacent to and along the top of the naturally vegetated embankment; and to construct a 4' x ±27' embankment stairway with a 4'x6' platform. Located: 1325 Bayview Avenue, Southold. SCTM# 1000-52-5- 13 TIME & DATE OF PUBLIC HEARING : Wednesday, September 21, 2016 — at or about 5 :30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Pamela Stamidis residing at 156 Brixton Road (print owner of property) (mailing address) Garden City, NY 11530 do hereby authorize (Agent) En-Consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature)Pamela Stamidis Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Constantine Stamidis residing at 156 Brixton Road (print owner of property) (mailing address) Garden City, NY 11530 do hereby authorize (Agent) En-Consultants to apply for permit(s)from the Southold Board of Town Trustees on my behalf. ( s si ature)Constantine Stamidis Board of Trustees Application County of Suffolk State of New York Pamela Stamidis BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WIT VIEW OF THIS APPLICATION. Signature Pamela Stamidis SWORN TO BEFORE ME THIS / I DAY OF 20 I Notary Public JANIS D. NOTARY PUBLIC,stateVAIL of Near York No.01 VA6188702 Qualified in Commission Expires June County216 Board of Trustees Application County of Suffolk State of New York Constantine Stamidis BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REV S PLICATION. r i eConstantine Stamid+s r SWORN TO BEFORE ME THIS DAY OF 20o � Notary Public JANIS D.NOTARY P BLIC,Sta VA lof New York No.OIVA61702 Qualified in Nassau County Commission Expires June 9,2016 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Stamidis, Pamela (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO !z 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/agenttrepresentative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of A,f"r 209(. Signature �—C.�-- Print Name Pamela Stamidis Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The 122vpose 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 some. YOURNAME: Stamidis,Constantine (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO z _ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this,,n5 day of "1 ► �1� 20jf& Signature Print Name �"VCorgfantine Stamidis Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL.DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The 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: HPrrmarm Rnix,rr F - (Last name,first name,middle initial,unless you are applying to the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest.``Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person_ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant,or D)the actual applicant. DESCRIPTION OF RELATIONSHIP dr Submitte:this ®day of vi 209 Sia ature Print Name Bert E. HerntraM Form TS 1 ao � Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM `b PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Q� 1000 52 5 13 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN i� Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK- PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No a.What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within 10( . ./Acres)) 317 sf Generated by a Two(T)Inch Rainfall on Site? Elthe Scope of work for Proposed Construction) s F (Phis item will include all run-off created by site b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 7,485 sf Site improvements and the permanent creation of construction activity? (S F./Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed X PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location?This item shall include all proposed Grade Changes and Construct a two-story,single family dwelling with attached Slopes Controlling Surface Water Flow, garage and 10'x 25'first and second-story decks with 3.5'wide 3 Does the Site Plan and/or 6' Surveyy describe the erosion XF steps,a 4'x 5. platform and steps,and a 4'x 6'outdoor shower; and sediment control practices tiiat will be used to install a drainage system of drywells;establish a 10'wide,500 sf control site erosion and storm water discharger.This non-turf buffer adjacent to the top of the naturally vegetated Item must be maintained throughout the Entire Construction Period. embankment;construct a 4'x+/-27'embankment stairway with 4'x 6'platform;and install a sanitary system and asphalt 4 Will this Project Require an Land Filling,Grading or ElExcavation where(here is a change to the Natural driveway more than 100 feet from wetlands and outside Chapter. Existing Grade involving more than 200 Cubic Yards 275 jurisdiction,all as depicted on the site plan prepared by of Material within any Parcel? Nathan Taft Corwin III Land Surveyor,last dated July 26,2016. 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Tousand Ix (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site?Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres-mcluduig disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes ❑ X are part of a larger common plan that will ultimately disturb one or more acres of lands, which Exceed Fifteen(15)feet of Vertical Rise to Including Ganstruchon activities itwolving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges, p (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit O Will Driveways,Parking Areas or other impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X 1.The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2 The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ElX required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit. In addition,the SWPPP shall Area?(This item will NOT include the installation or Dnveway Apmns.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges NOTE If Any Answer to Questions One through Nine is Answered with a Check Mark 3 All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F &1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management (N EolAd and Must Submitted for Review Prior to Issuance of Any Building Permit. (X and/or Ansitier for each Question is Faluired for a Cornpleted icahon). STATE OF NEW YORK, COUNTY OF -Suffolk-uff ------------------------- SS That I, Robert E.He=anri being duty sworn,deposes and says that he/she is the apphcant for Permit, cfir amd-dsgn'gDm rmt) And that he/she is the Agent-for-the-Owner -------------------------------------------------------------------------------------------------- (OA—Ccrft-e -Agzit CaFcrateCff—etc. Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed.in the manners set forth in the application filed herewith Sworn to before me this; -----------------16th Au ust - ,20 16 NotaryPu i -------- -- ----------- - ------------------------------------ (signature of Applicant) FORM - 06/10 STATE OF NEW YORK COMMISSION NO . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 . 20-/7 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for perm its* including Town of Southold agencies, shall com plete this CCAF for proposed actions that are subject to the Town of Southold W aterfront Consistency Review Law . This assessor ent is intended to supplem ent other inform ation used by a Town of Southold agency in m a k in g a d e t e r m in a t i o n o f c o n s is t e n c y. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant icant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 52 - s 13 PROJECT NAME Constantine&Pamela Stamela The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ❑ construction, planning activity, agency regulation, land transaction) ❑ (b) Financial assistance (e.g. grant, loan, subsidy) (c) Permit, approval, license, certification: Nature and extent of action: Construct a two-story,single family dwelling with attached garage and 10'x 25'first and second-story decks with IT wide steps,a 4'x 5.6'platform and steps,and a Tx 6outdoor shower;install a drainage system of drywells;establish a 10'wide,500 sf non-turf buffer adjacent to the top of the naturally vegetated embankment;construct a Tx+/-27'embankment stairway with Tx 6'platform;and install a sanitary system and asphalt driveway more than 100 feet from wetlands and outside Chapter 275 jurisdiction,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated July 26,2016. Location of action: 1325 Bayveiw Avenue,Southold Site acreage: 10,317 sf Present land use: Vacant-residential. Present zoning classification: R-40 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: Constantine&Pamela Stamidis (b) Mailing address: 156 Brixton Road Garden City,NY 11530 (c) Telephone number: Area Code 516-750-5286 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ® No ❑ If yes, which state or federal agency? NYSDEC C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III -Policies; Page 2 for evaluation criteria. ❑YesNo ® Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III-Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III-Policies Pages 6 through 7 for evaluation criteria ❑Yes ❑ No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ❑Yes [:] No ® Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III - Policies Pages 16 through 21 for evaluation criteria ®Yes ❑ No ❑ Not Applicable See attached addendum. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22 through 32 for evaluation criteria. ®Yes ❑ No ❑ Not Applicable LWRP CONSISTENCY ASSESSMENT FORM ADDENDUM FOR CONSTANTINE & PAMELA STAMIDIS 1325 BAYVIEW AVENUE SOUTHOLD,NY SCTM#1000-52-5-13 Policy 5 & 6 The proposed project consists of the development of a presently vacant parcel situated along a heavily developed stretch of shoreline associated with Arshamomoque Harbor. The subject shoreline is characterized by numerous existing dwellings and accessory structures that are located less than 100 feet from wetlands, including the adjacent northerly and southerly dwellings,which are located approximately 30 and 50 feet from wetlands,respectively. Nonetheless,the applicant's project has been designed to minimize impacts associated with property development and maximize the protection and restoration of the adjacent tidal wetland ecosystem. Specifically,the proposed dwelling, which is located in a FEMA designated Zone X, has been designed with a minimal footprint of 1,150 sf and attached 10' wide waterside deck set back at least 75 feet from wetlands. This proposed design and positioning of the dwelling allows just enough room for placement of a drainage system more than 75 feet from wetlands and a sanitary system in the front yard where it will be situated approximately 150 feet from wetlands and well beyond Chapter 275 jurisdiction. The dwelling will also be situated landward of the neighboring dwellings,thus meeting and exceeding the requirements of§275-11(3). The dwelling will also conform to all zoning requirements pursuant to Chapter 280, and as a result of the project, total Town-defined lot coverage will be limited to 1,500 square feet, or 14.9% of the 10,044 square feet of buildable land on this 10,317 sf parcel. In addition to the proposed drainage system of leaders, gutters, and drywells to collect roof runoff,the potential for increased surface water runoff will be mitigated by a 10' wide, approximately 500 sf nonturf buffer to be established in place of the presently cleared lawn area adjacent to the top of the small embankment along the shoreline. Together with the naturally vegetated embankment to remain undisturbed,this buffer area will serve both as a sink and filter for stormwater runoff and contaminants,thereby mitigating both the quantity and quality of potential runoff reaching the harbor. The potential for temporary runoff and site disturbance during construction will be contained by a project limiting fence. For all of these reasons,the project will be consistent with Policies 5 and 6 of the LWRP. See attached addendum. '- Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [:] No M Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. Yes [:] No M Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold'-s- water-dependent uses and promotes iting 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 ® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PREPARED BY TITLE Coastal Mgmt.specialist DATEAugwt 16,2016 Robe errmarm Amended on 811105 r i 2P .h EN-CONSULTANTS August 16,2016 Town of Southold Board of Trustees njD E I ,J E 54375 Main Road Post Office Box 1179 Southold,New York 11971 AUG 2 2 2016 Re: Constantine&Pamela Stamidis 1325 Bayview Avenue, Southold outhold Town SCTM#1000-52-5-13 $4atd of Trustee Dear Board of Trustees: In regard to the above referenced property,enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization Forms; c) Applicant/Agent/Representative Transactional Disclosure Forms 2. Survey prepared by Nathan Taft Corwin III Land Surveyor, last dated July 26, 2016. 3. One(1)set of site photographs. 4. Application fee of$250.00. 5. Three(3)LWRP Consistency Assessment Forms including: a) Survey(as referenced above). I trust this information shall allow you to process our permit request. Should any additional information be required,please do'not hesitate to contact our office. SiZe RHerrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631283.6136 www.enconsultants.com environmental consulting