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HomeMy WebLinkAboutTR-8885A Glenn Goldsmith,President __``,�®F S®�/�� Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President hOV� ®�® P.O. Box 1179 Eric Sepenoski l l Southold,New York 11971 Liz Gillooly ear Telephone(631) 765-1892 Elizabeth Peeples � �� Fax(631) 765-6641 C®Uf1�,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 15, 2024 Rick Campos, R.A. 706 Union Boulevard West Islip, NY 11795 RE: ROBERT & PATRICIA DELSIGNORE 956 LAKE DRIVE, SOUTHOLD SCTM#: 1000-59-5-16 Dear Mr. Campos: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, August 14, 2024: RESOLVED, that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit #8885A for the existing exterior deck which is smaller in square footage with shortened outward footprint dimensions; and as depicted on the site plan prepared by Ricardo E. Campos, R.A., received on July 30, 2024, and stamped approved on August 14, 2024. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerel , Glenn Goldsmith, President Board of Trustees 9 O RICARDO E. CAMPOS, R.A. ARCHITECTURAL ARTS & DESIGN 706 UNION BLVD WEST ISLIP, NY_ 11795 PHONE (631) 576 7761 0 - 99 1 9 �O LONG ISLAND (� SOUND S e-44 g� `l F h 955 o ' 0z29 v X 9 LOCATION MAP DRAWN BY: CHECKED BY: LAND N/F JOHN MULDER RESIDENCE — PUBLIC WATER E EI� V E .t \ JUL 3 0 2024 Southold Town Board of Trustees IT IS A VIOLATION OF THE LAW FOR ANY PERSON UNLESS ACTING UNDER EXISTING DRI WAY THE DIRECTION OF A LICENSED J > ARCHITECT, TO ALTER THESE DRAWINGS AND/OR ACCOMPANYING SPECIFICATIONS. 00 APPROVED BY 010 0- WHERE SUCH� ARE MADE, BOARD OF TRUSTEES HE COGNIZANTLLICENSO 0 ED NS ARCHITECT /�O S MUST SIGN, SEAL, DATE AND DESCRIBE � TOWN OF SOUTHOLD THE IFIC REVISION S.ON THE DRAWING AND/OR �\ r�' �C) 0/ DAI (See Appropiate Sections of NYS Education Law) F 00 �� �0 7- 00 � o to �\ o EX 1 STORYDWELLING �-S, dip #955 �/S F.FL=17.53 0 ,i �o � <<\ `V O ' LAND N/F JUNE BURGESS & AMY CUTILLO RESIDENCE — PUBLIC WATER o- O O� c, F,-o / Q� EX PINE TREE "D OQ� • J T�PSJ / \i_ <6" DIA TO REMAIN C' S 1 �� / \/ (7 TOTAL) 41 _ • J `b/ EX PINE TREE I EXISTING 573 SF EX 'X6' BHED 0 <6" DIA TO BE REMOVED � 6 \ COMPDE DECKING� B'� j REMOVED (7 TOTAL) #2 Revised Deck footprint plan 7-02-24 #1 Revised as per DEC comments j r I • �` REMOVE EX T�' •ROSE BUSH (2) ��'� REV_ NO. DESCRIPTION 2-20-17DATE � — LOWER LEVEL PATIO: R E v I s I o N s NE- / CONCRETE PAVERS'SET bN / i I S PS "BOXED'f AREA SAND BED �EXIST'G L ND / MOVE E CLEARING.28'L,14'R &\ 11'R. PROJECT: VVEEGETAT N / APPROVED BY NIS�DEC 1 �J �� / FINAL INSPECTION / LGGD LINE LI OF CLEA IWSTURBANCE GROUND_ / 6,s PROPOSED NEW DECK @ Residence of A Cr� SURVEY INFO PROVIDED BY MICHAEL �, Np�O` / / / /�t` 9,� \0 Robert 8c Patricia WICKS, LAND SURVEYING oj ,� \ Delsignore 200 BELL VIEW AVE. •� � q� / - / / ��,O �� ` CENTER MORICHES, NY. 11934 - NOTE: NO PRY WELLS 0�;� Located at G / REQUIRED. EXISTING / �O / 955 Lake Drive SLOPE KNOT ALTERED. / Pr\� NOTE: Southold, NY. Z OWNER AGREES TO PLANT NATIVE TOLERANT SHRUBS, (I.E. 3 GAL STOCK x 6) IN WETLAND AREA SEC 59 BLK 05 LOT 016 �Q AS PERMITTED BY TOWN BOARD .�. OF TRUSTEES & DEC. l , f DRAWING: tx DRAWING PREPARED BY" SITE PLAN �,Q RICARDO E. CAMPOS, R.A. OWNERS: n' ROBERT & PATRICIA DELSIGNORE / V O PROJECT/PROPERTY LOCATION: O� v� 955 LAKE DRIVE, SOUTHOLD, NY PROPOSED SITE PLAN " / Q P� SCTM; 1000-59-5-16 SCALE: 1 10' P� PROJECT NO.: DATE: DRAWING NO.: " = � � '�,� � � J v w CS01622 7-18-16 S _ I' THK LIMESTONE PAVER ;Mr 1" THK SAND SETTING BED 5" THK RECYCLED CRUSHED CONCRETE BASE LAYER EX 1 STORY lz ==- COMPACTED SUBGRADE RICARDO E. CAMPOS, R.A. ARCHITECTURAL ARTS & DESIGN FRAME 1 706 UNION BLVD WEST ISLIP, NY. 11795 TYPICAL PAVER DETAIL PHONE (631) 576 7761 DWELLING SECTION VIEW F.FL=17.53' O 2X10 BAND BD `" 2x10 BAND BOARD 00 BOLTED TO EX. FND. o 8"H _J ;a 4'-0" O.C. ALONG PERIMTER TYPICAL CLSD RISER � CL (TYPICAL) p 12 W TREADS VISION: ADD DETAIL #1 ;� - ,:-r ",�'`'r`>' 2_x1_0 HDR _ O — - - � — w� C ANCHORED TO c� FTGS ;� 12 DIA PC FTGS 022 � �,. PROP 573 SF � v o 0 3'-6" BELOW FIN of DECK F FL f— 0 = GRADE (TYPICAL) 0 OW (n I I XT EXTERIOR WALL 1 x6 hand rest, continuous 2 x ZOI, ELEV 17.4' (V OI N CONSTRUCTION: 4 horizontal support T&B, 2x2 J 00 x I Vert railing w/ 3 1/2" spacing Q_ N © N I O= between, 3' H total (Vinyl DRAWN BY: CHECKED BY: W N U contruction) �w Q 2'-8»DP O --� _ _ 2X10 HDR - - � — _ I 3 —7 DP o — — C ANCHORED—FTGS �- d- Hurricane clips X First Floor JST (Typ) 1 x 8 fascia bds N '1 2x8 JOISTS aroI.lnd perimeter of �� I -CGS deck 4 W HANDRAIL w/ 2x2 — — — — —L Dbl 2x10 Girder POSTS SPCD 4" APART, �- 4x4 Post anchor FIN GRADE `- CL �G� �y 36" ABOVE FINISHED DECK Q' EX Concrete IT IS A VIOLATION OF THE LAW FOR C�? 6' MAX LENGTHS foundation 4M4 Post o/ ANY PERSON UNLESS ACTING UNDER 8 dia x 3 dp p/c ftg THE DIRECTION OF A LICENSED typical ARCHITECT, TO ALTER THESE DRAWINGS 8'— 0 Q — O AND/OR ACCOMPANYING SPECIFICATIONS. 7 — 0" - 20, `- 0" 6'— 0" U WHERE SUCH ALTERATIONS ARE MADE, I THE COGNIZANT LICENSED ARCHITECT I 1 » MUST SIGN, SEAL, DATE AND DESCRIBE 33 - 0 THE REVISIONS ON THE DRAWING AND/OR SPECIFICATIONS. SECA A : TYPICAL STRUCTURAL SECTION T H R U DECK (See Appropiate Sections of NYS Education Law) SCALE: 1 /4" = 1 '-0" PROPOSED DECK PLAN GENERAL NOTES: 1 /4" = 1 '— 0" 17 GRADING AROUND NEW CONSTRUCTION SHALL SLOPE AWAY FROM THE HOUSE AND BLEND 1. CONTRACTOR SHALL CHECK AND VERIFY ALL CONDITIONS OF THE SITE PRIOR TO STARTING OF WORK AND SHALL FAMILIARISE HIMSELF WITH THE INTENT OF THESE PLANS AND MAKE INTO EXISTING GRADE IN THE CASE OF RENOVATIONS OR ADDITIONS. WORK AGREE WITH SAME. 18 ALL FOOTINGS SHALL BEAR ON UNDISTURBED SOIL WITH A MINIMUM SOIL PRESSURE OF 2 TONS ® 2• THE CONTRACTOR OR OWNER SHALL OBTAIN A BUILDING PERMIT FROM THE GOVERNING PER SQ. FT. AND SHALL HAVE A MINIMUM COVER OF 36". CONTRACTOR OR OWNER SHALL METAL RAIL BRACKET SECURED W/ MUNICIPALITY PRIOR TO STARTING WORK. VERIFY AND REPORT ANY DISCREPENCIES TO THE ARCHITECT. 3-#10X1%" SCREWS TO TOP RAIL, 7'-7-Y4 MAX (FOR IN-LINE) 19 GENERAL CONTRACTOR TO PROVIDE A 1 HR. FIRE RATING ON VALL WALLS AND CEILINGS 2-#10X1%" SCREWS TO POST 7'-6" MAX (FOR 45') 3. CONTRACTOR SHALL OBTAIN ALL REQUIRED APPROVALS, CERTIFICATE OF OCCUPANCY, BETWEEN GARAGE AND ADJACENT ROOMS. 44" 7'-2%" MAX (FOR STAIRS) 44" INSPECTION APPROVALS, ETC. FOR WORK PERFORMED FROM AGENCIES HAVING JURISDICATION THEREOF. 20 ALL WOOD SILL PLATES SITTING ON THE FOUNDATION SHALL BE PRESSURE TREATED MINIMUM NOTES FOR STAIR CONDITION: T 0.40 cco. IN ADDITION PROVIDE SILL INSULATION BETWEEN FOUNDATION AND WOOD PLATES. 4"x4" WOOD POST 5 TOP RAIL 2 REV DECK DWG 2 6 24 USE SUPPLIED ACUTE ANGLE BRACKET 4• ALL WORK SHALL CONFORM TO THE RESIDENTIAL CODE OF NEW YORK STATE and 1 SECTION: PAVERS 5 17' TT--,- --^-- --T--^--^--TT-T--^-- - --^--�-�--^- BUILDING CODE AND ALL RULES AND REGULATIONS OF THE MUNICIPALITY HAVING AT TOP OF STAIR RUN WITH 21 LUMBER SHALL BE MINIMUM, HEM-FIR #2 OR BETTER Fb= 1,150 PSI, E= 1,400,000 PSI. HIGHER 2-#10X1%" SCREWS TO RAIL, AND JURISDICATON. STRESS LUMBER MAY BE SUBSTITUTED FOR HEM-FIR. REV. NO. DESCRIPTION DATE 4Ya"X4Ya" POST COVER �4' PICKET INSERTED 2-#tOX1%" SCREWS TO POST. 5. IF IN THE COURSE OF CONSTRUCTION A CONDITION EXISTS WHICH DISAGREES WITH THAT AS INTO TOP RAIL 22 MINIMUM BEARING FOR ALL JOISTS, BEAMS, HEADERS AND RAFTERS SHALL BE 4". PROVIDE R E V I S I 0 N S USE SUPPLIED OBTUSE ANGLE BRACKET INDICATED OF THESE PLANS, THE CONTRACTOR SHALL IMMEDIATELY NOTIFY THE (LATERAL SUPPRORT) BLOCKING/BRIDGING ® 8'-0" O.C. MAX.. BEARING WALLS SHALL BE AT BOTTOM OF STAIR RUN WITH ARCHITECT. SHOULD HE FAIL TO FOLLOW THIS PROCEDURE, AND CONTINUE WITH THE BLOCKED @ 48" O.C.. DOUBLE JOISTS AND/ OR RAFTERS AROUND ALL OPENINGS. DOUBLE 1Ya" SQUARE HOLLOW 2-#10X1" SCREWS TO RAIL, AND WORK THE CONTRATOR SHALL ASSUME ALL RESPONSIBILITY AND LIABILITY ARISING THERE JOISTS UNDER ALL PARTITIONS PARALELL TO SAME. PROJECT: CO-EXTRUDED 2-#10X15/8" SCREWS TO POST. FROM. PVC BALUSTER 23 MINIMUM HEADER SIZE SHALL BE (2) 2x6 UNLESS NOTED OTHERWISE. PROVIDE (3) 2X4 POSTS 0 i 6• ALL NEW MATERIALS AND INSTALLATIONS SHALL BE IN ACCORDANCE WITH THE ALL HEADERS UNLESS NOTED OTHERWISE. N M MANUFACTURERS LATEST PRINTED SPECIFICATIONS AND CODE REQUIREMENTS. PICKET INSERTED 7. THE ARCHITECT ASSUMES NO RESPONSIBILITY FOR CONSTRUCTION MEANS, METHODS, 24 ALL RAFTERS SHALL BE ANCHORED TO FRAME WALLS WITH "HURRICANE CLIPS". METAL RAIL BRACKET INTO BOTTOM RAIL TECHNIQUES SEQUENCES OR PROCEDURES, OR FOR THE SAFETY PRECAUTIONS AND SECURED W/ PROGRAMS IN CONNECTION WIT HTHE WORK. THERE ARE NO WARRANTIES NOR ANY DESIGN LOADS(PER SO. FT.) 3-#10X1%" SCREWS � DEAD DEFLECTION LIMIT PROPOSED NEW DECK Ca? TO BOTTOM RAIL, -�-�- BOTTOM RAIL MERCHANTIBILITY OF FITNESS FOR A SPECIFIC USE EXPRESSED OR IMPLIED IN THE USE OF LIVING AREAS 40# 10# Y360 THESE SLEEPING ROOMS 30# 10# L60 2-#10X1 SCREWS _ _ 2022.01.27 ATTIC �NONSTORAGE) 10# 5# L/240 TO POST --•-----�-----------�-�---- -�----�-�---�-------�- ----�-�- PLANS. Residence of 8. THE ARCHITECTURAL SERVICES ON THIS PROJECT ARE TERMINATED WITH THE PREPARATION ATTIC STORAGE) 20# 10# L/240 ALTHOUGH THE TEST ROOF (W/O FIN. CLG.) 30# 7# L 240 REPORT PERIOD HAS OF THESE DRAWINGS (UNLESS OTHER ARRANGEMENTS ARE MADE) CONFORMING WITH 1 Robert & Patricia ANCHORAGE 1/3 1/3 1/3 a EXPIRED,WE ASSUME THE BUILDING CODE REQUIREMENTS AND THESE DRAWINGS WHETHER INDICATED OR ROOF (WITH FIN. CLG.) 30# 15# L 180 AS REQUIRED � THERE ARE NO CHANGES D e I s i nor e NATIONAL BUILDING CODE 1Ya" SQUARE EXPANDED CELLULAR 2019 ALBERTA 25 TO THE ASSEMBLY. NOT, SHALL NOT RELIEVE THE CONTRACTOR OF THE RESPONSIBILITY OF CONFORMING TO ALL g SNOW LOADS HAVE BEEN ADJUSTED, WHERE APPLICABLE TO REFLECT THE SLIDE-OFF FACTOR PVC FOOT BLOCK SECURED W/J GOVERNING CODES. THIS CONTRACT DOES NOT INCLUDE (UNLESS ARRANGED AS A FUNCTION OF ROOF PITCH. Located at NATIONAL BUILDING CODE — 2019 ALBERTA EDITION REQUIREMENTS 1—#10X3" SCREW TO BOTTOM RAIL EDITION REQUIREMENTS INTERTEK1ARCHITECTURAL TESTING OTHERWISE) SITE OBSERVATION, SUPERVISION OR PART 9 — RESIDENTIAL USE (FROM COMPLIANCE REFERENCE INSPECTION BY THE ARCHITECT. 26 ALL DRYWALL SHALL BE PRIMED AND PAINTED (2 FINISHED COATS). 955 Lake Drive 9- 9.8.8.3 Height of Guards Table 9.8.8.2 Specified Loads for Guards) (Test Series No. & Condition) Except as provided in Sentences (2) to (4), all guards shall be not Tess than 107oMM (aft 6 in) high. 9• DRAWINGS AND SPECIFICATIONS AS INSTRUMENTS OF SERVICE ARE AND SHALL REMAIN THE 27 ALL FINISHES (INTERIOR & EXTERIOR) AND COLORES ARE THE RESPONSIBILITY OF THE OWNER Southold, NY. Horizontal Load Applied Inward or Outward PROPERTY OF THE ARCHITECT WHETHER THE PROJECT FOR WHICH THEY ARE MADE IS AND SHALL BE SELECTED BY SAME. at any Point at the Minimum Required Test Series No.1 (In-Line Condition) EXECUTED OR NOT. THEY ARE NOT TO BE USED ON ANY OTHER PROJECT OR (2) All guards within dwelling units shall be not less than 900 mm (2 ft 11 in) high. EXTENTIONS TO THIS PROJECT EXCEPT BY AGGREMENT IN WRITING AND WITH APPROPRIATE 28 INSTALL AS PER OWNER DIRECTION ANY AND ALL INTERCOM, TELEPHONE, AND/OR T.V. WIRING SEC 59 BLK 05 LOT 016 Height of the Guard: Test Series No.2 (45' Condition) COMPENSATION TO THE ARCHITECT OF RECORD. 0.75 kN/m (52 lb/ft) or concentrated load Test Series No.3 (Stair Condition) IN WALL PRIOR TO INSTALLATION OF WALLBOARD. ALL TEMPERATURE CONTROL WIRING SHALL (3) Exterior guards serving not more than one dwelling unit shall be not less than 900 mm (2 ft 11in) high where the of 1.0 kN (224 lb) applied at any point 10• DONOT SCALE DRAWINGS. WRITTEN DIMENSIONS SUPERCEDE SCALED DIMENSIONS. RUN CONCEALED IN WALLS, FLOORS AND/OR CEILINGS. VERIFY OUTLET, SWITCH AND LIGHTING walking surface served by the guard is not more than 1800 mm (5 ft 11 in) above the finished ground level. LOCATIONS WITH OWNER PRIOR TO INSTALLATION. Horizontal Load Applied Outward on Elements Within the Guard, Including Solid Panels and 11. EXISTING CONDITIONS INDICATED WERE FROM FIELD MEASUREMENTS. (4) Guards for flights of steps, except in required exit stairs, shall be not less than 900 mm (2 ft 11 in) high. Test Series No.1 (In—Line Condition) DRAWING: Balusters: Test Series No.2 (45' Condition) 12•ALL DIMENSIONS AND LOCATIONS INDICATED ON THE DRAWINGS SHALL BE CONSIDERED Concentrated load of 0.5 kN (112 lb) CORRECT. IT SHALL BE UNDERSTOOD THAT THEY ARE SUBJECT TO MODIFICATIONS AS MAY BE (5) The height of guards for flights of steps shall be measured vertically from the top of the guard to a line drawn Test Series No.3 (Stair Condition)applied over an area of 100mm by 100mm NECESSARY DUE UNFORSEEN CIRCUMSTANCES. DECK PLAN through the tread nosing served by the guard. at any point on the element or elements so DECK SECTION 13.ELEVATIONS AND SECTIONS ARE FOR INFORMATION PURPOSES ONLY AND THE CONTRACTOR IS 9.8.8.5. Openings In Guards as to produce the most critical effect TO REFER TO ALL PLANS FOR CONSTRUCTION INFORMATION. QQ,�, (1) Except as provided in Sentence (2) and (3), openings through guards shall be of a size that will prevent the C.X. Evenly Distributed Vertical Load Applied at Test Series No.1 (In—Line Condition) G E N NOTES the Top of the Guard: Test Series Not (45' Condition) 14. ALL METAL JOIST HANGERS AND OTHER METAL CONNECTORS IF USED AND REQUIRED SHALL BE passage of a spherical object having o diameter of 100 mm (4 in). 1.5 kN/m (103 lb/ft) "TECO CONNECTORS" OR EQUAL. THE CONNECTORS SHALL BE CAPABLE OF HANDLING LOADS Test Series No.3 (Stair Conditwn) AT CONNECTION POINTS. INSTALLATION SHALL BE IN STRICT CONFORMANCE WITH Refer to TimberTech Installation Guide for additional installation information. Radiance Rail Express System MANUFACTURES SPECIFICATIONS AND RECOMMANDATIONS. This document is valid for one year from issue date. It may be renewable on an annual basis. Our ABC compliance calculations compared data " 15• ALL CONCRETE SHALL BE PLAIN, UNREINFORCED (UNLESS INDICATED OTHERWISE), obtained from: Architectural Testing Reports: Architectural Testing Reports No.A9084.01-119-19 dated OCT.07-2011. 3�4 —1 —� CONTROLLED STONE CONCRETE HAVING A MINIMUM COMPRESSIVE STRENGHT OF 2500 PSI ® PROJECT NO.: DATE: DRAWING NO.: 28 DAYS. 16. PROVIDE 1/2" DIAMETER X 15" LONG ANCHOR BOLTS WITH 3" PROJECTION AND TREAD, V-0" CS01622 7-18-16 FROM CORNERS AND 6'-0" O.C. MAX.. S - 2 Glenn Goldsmith,President �0 COGy Town Hall Annex A.Nicholas Krupski,Vice President 4 < 54375 Route 25 Eric Sepenoski ,x P.O.Box 1179 Liz Gillooly P, Southold,NY 11971 Elizabeth Peeples �l A Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Au ys� 20 Z4 Completed in field by: Eli ua C+'n pet mkt Rick Campos on behalf of ROBERT & PATRICIA DELSIGNORE requests an Administrative Amendment to Administrative Permit#8885A for the existing exterior deck which is smaller in square footage with shortened outward footprint dimensions. Located: 955 Lake Drive, Southold. SCTM# 1000-59-5-16 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: pkio W 6trVL mucd la yAwAyrl of oYigt cA nw)Posed aVtd +kurcfif e ah c0A eMMfZjZ I eg+_ Present Were: G. Goldsmith N. Krupski E. Sepenoski L. Gillooly ✓ E. Peeples CAMPOS STUDIOS Rick Campos, R.A. 706 Union Blvd,West Islip, NY. 631576 7761 Date:July 9, 2024 To: Southold Building Department Town Hall Annex Building 54375 Route 25 Southold, New York 11971 Attn: Elizabeth Re:Administrative amendment to Application#8885A for Installation of Deck&patio for Robert&Patricia Delsignore 955 Lake Drive, Southold, NY. 11975 To whom it may concern, Enclosed is the paperwork (2 revised sets of Site plan, architectural floor plans and $200 fee) required for the renewal of my client's building permit. The project in question (building a new exterior deck) was revised from the original plans submitted to the town but is smaller in its square footage total and was shortened in its outward footprint dimensions than the original submission. Thank you for your expeditious attention to this matter. If you have any questions for me please do not hesitate to call my office. Sincerely �c Rick Campos, R.A., Rep:Delsignore residence D � tVE JUL 30 2024 Southold Town BoetdofTnutees t , Hobson, Thomas From: Hobson,Thomas Sent: Monday,July 15, 2024 8:49 AM To: 'rec42@aol.com' Subject: Administrative Amendment to Permit#8885A Mr. Campos, Elizabeth and I reviewed the plans and description that was dropped off on Friday and have a few questions. A few additional items might need to be added to the description for the Administrative Amendment. The plans you submitted show a proposed concrete patio. Was this built or will it be built? If so, it should be included in the Amendment. The plan also indicates that an existing shed is to be removed. This should also be included in the description for the Amendment if it is to happen. Last,there are stone steps on the new plan that differ from the plans submitted for the original permit. They would need to be included as well. Please feel free to email a revised description. There is no need to drop off a hard copy. Thomas Hobson Administrative Assistant Town of Southold Board of Trustees Phone: (631)765-1892 Fax: (631)765-6641 1 CAMPOS STUDIOS Rick Campos, R.A. 706 Union Blvd.,West Islip, NY. 631576 7761 Date:July 9,2024 To: Southold Building Department Town Hall Annex Building 54375 Route 25 Southold, New York 11971 Attn: Elizabeth Re:Administrative amendment to Application#8885A for Installation of Deck&patio for Robert&Patricia Delsignore 955 Lake Drive, Southold, NY. 11975 To whom it may concern, Enclosed is the paperwork (2 revised sets of Site plan, architectural floor plans and $200 fee) required for the renewal of my clients building permit. The project in question(building a new exterior deck) was revised from the original plans submitted to the town but is smaller in its square footage total and was shortened in its outward footprint dimensions than the original submission. Thank you for your expeditious attention to this matter. If you have any questions for me please do not hesitate to call my office. Sincerely Rick Campos, R.A., Rep:Delsignore residence 7JUL EiVE Ibb 12 M SO ER Town � � o / RICARDO E. CAMPOS, R.A. / ARCHITECTURAL ARTS & DESIGN 706 UNION BLVD WEST ISLIP, NY. 11795 \ PHONE (631) 576 7761 ((0 n 1 �0 -- lb � 'V !�( / LONG ISLAND p� SOUND ��. C,`? Q 2 � sue, •..,,� 955 DRAWN BY: CHECKED BY: O LAND N/F JOHN MULDER LOCATION MAP RESIDENCE — PUBLIC WATER IT IS A VIOLATION OF THE LAW FOR \ \ ANY PERSON UNLESS ACTING UNDER \ EXISTING DRI WAY THE DIRECTION OF A LICENSED , TO ALTER 1111X'y l�s, AND/ORCACCOMPANYINGHESE SPECIFICATIONS. J WHERE SUCH ARE0• �OO, THE COGNIZANTLTERATIONS LCENSED ARCHIME T 0 MUST SIGN, SEAL, DATE AND DESCRIBE THE REVISIONS ON THE DRAWING AND/OR / \ rv� 0� 1I0 SPECIFICATIONS. \ , J� 0 O"l/0 (See Appropiate Sections of NYS Education Law) 0& 'S EX 1 STORY FRAME DWELLING \ #955 \ F.FL=17.53' ,��1 �J, 0 �G LAND N/F JUNE BURGESS & AMY CUTILLO \ / 6 RESIDENCE PUBLIC WATER \ '0' G�pS� ,Z.o� EX PINE TREE 0 S � Q Ix Q L®J � TE <6 DIA TO REMAIN 5 / (7 TOTAL) t k f d D i PROPOS�D�3 SF L® EX 4'X6' S�D EX PINE TREE r — \ 6'• �3TTE DECKING ,�a'�. O r TO BE R OVED <6 DIA TO BE REMOVED L®J COMP0 #2 Revised plan \ / (7 TOTAL) — 7 02-24 \ I #1 Revised as per DEC comments �„� O T J / \ REMOVE EX 7.7 2-20-17 / ROSE BUSH (2) REV. NO. DESCRIPTION DATE„ ST NE / /\ \ B0XED/AREA PS PROPOSED PATIO MOVE E CRETE PAVERS SET \ / \ PROJECT: \ EVE�GETAT N ON AND BED I J / / / G --� EX STI LAND CLEARING. D LINE L OF CLEA ING GROUND �a N STURBANCE ® ® J / ss• / D E C E I V E ., PROPOSED NEW D �ro DECK JUL 2 2P24 Residence of / / ��/ �� / Dc/ G`Z` / Southold Town SURVEY INFO PROVIDED BY MICHAEL PN� / /. �Q� / \� Bmrdofhus" Robert & Patricia WICKS, LAND SURVEYING °� G Delsignore 200 BELL VIEW AVE. OF, Q\0 CENTER MORICHES, NY. 11934 / NOTE: NO RY WELLS / � Located at G / REQUIRED. EXISTING / OGF. \ SCOPE—I�NOT ALTERED./ � � 955 Lake Drive � QUO / NOTE: Southold, NY. OWNER AGREES TO PLANT NATIVE TOLERANT SHRUBS, (I.E. 3 GAL STOCK x 6) IN WETLAND AREA SEC 59 BLK 05 LOT 016 AS PERMITTED BY TOWN BOARD OF TRUSTEES & DEC. DRAWING: tx ►`QJ,Z,G DRAWING PREPARED BY" SITE PLAN RICARDO E. CAMPOS, R.A. OWNERS: ROBERT & PATRICIA DELSIGNORE PROJECT/PROPERTY LOCATION: \ / ✓ O v 955 LAKE DRIVE, SOUTHOLD, NY PROPOSED SITE PLAN / / Q P� SCTM; 1000-59-5-16 SCALE: 1 10' PROJECT NO.: DATE: DRAWING NO.: " = � 1, Q' �� s' C j C�i� �/ CS01622 7-18-16 S - 1 1" THK LIMESTONE PAVER 1" THK SAND SETTING BED 5" THK RECYCLED CRUSHED CONCRETE BASE LAYER COMPACTED SUBGRADE RICARDO E. CAMPOS, R.A. EX 1 STORY — — — — ARCHITECTURAL ARTS & DESIGN FRAME 706 UNION BLVD WEST ISLIP, NY. 11795 TYPICAL PA VER DETAIL PHONE (631) 576 7761 DWELLING SECTION ME F.FL= 17. 53' 0 2X10 BAND BD —; -�• ,, 00 BOLOT DAND TO EOARND. �����f,, �. �`� `�• 8 H —� L4'-O" O.C. ALONGCLSD RISER � CL ERIMTER (TYPICAL) 12"W TREADS ISION: ADD DETAIL #1 - - -� - - 2x10 HDR - _ �_ _ - 0 �'" ANCHORED TO I r! t c� of FTGS �� .c_ P OP 573 SF � 12 DIA PC FTGS ��~� (�22�3'� �,�<.�• R M 0 a o 3 6 BELOW FIN O 0 �' ' �'� Ir DECK F FL F- o = GRADE (TYPICAL) 0 LL1 Cn I I EXT EXTERIOR WALL 1 x6 hand rest, continuous 2 x Z I— ' D " O 0 - CONSTRUCTION: 4 horizontal su ort T&B, 2x2 O LLJ ELEV 17. 4 N , I LLJ N pp J > 00 x O� d Vert railing w/ 3 1/2 spacing Qry N © N I O= between, 3' H total (Vinyl DRAWN BY: CHECKED BY: V) LL1 N (> contruction) 1.- z 2'-8"DP 0 3,-7"DP o - - "L _ _ Q 2X10 HDR _ _ _ _ ^ 00 C- ANCHORED-FTGS `- First Floor Hurricane clips N I- JST ( yP) _ 1 x 8 fascia bds ,@A O0 '1 '1 2x8 JOISTS ar4nd perimeter of O�F�G� 4" W HANDRAIL w 2x2 - - - - Dbl 2x10 Girder deck POSTS SPCD 4" APART �- 4x4 Post anchor � FIN GRADE `- CL 36" ABOVE FINISHED DECK P © 6' MAX LENGTHS EX Concrete 4x4 IT o IT IS A VIOLATION OF THE LAW FOR foundation .� �/ ANY PERSON UNLESS ACTING UNDER 8 dia x 3 dp p/c ftg THE DIRECTION OF A LICENSED typical ARCHITECT, TO ALTER THESE DRAWINGS Q — O Q — O AND/OR ACCOMPANYING SPECIFICATIONS. 7 — 0 2 0 — 0 6 — 0 C� C, WHERE SUCH ALTERATIONS ARE MADE, THE COGNIZANT LICENSED ARCHITECT > » MUST SIGN, SEAL, DATE AND DESCRIBE 0 3 3 - 0 THE REVISIONS ON THE DRAWING AND/OR SPECIFICATIONS. SEC A A : TYPICAL STRUCTURAL SECTION T H R U DECK (See Appropiate Sections of NYS Education Law) SCALE: 1 /4" = 1 '- 0" PROPOSED DECK PLAN GENERAL NOTES: 1 /4" = 1 '— O" 17 GRADING AROUND NEW CONSTRUCTION SHALL SLOPE AWAY FROM THE HOUSE AND BLEND 1. CONTRACTOR SHALL CHECK AND VERIFY ALL CONDITIONS OF THE SITE PRIOR TO STARTING OF WORK AND SHALL FAMILIARISE HIMSELF WITH THE INTENT OF THESE PLANS AND MAKE INTO EXISTING GRADE IN THE CASE OF RENOVATIONS OR ADDITIONS. WORK AGREE WITH SAME. 18 ALL FOOTINGS SHALL BEAR ON UNDISTURBED SOIL WITH A MINIMUM SOIL PRESSURE OF 2 TONS 2• THE CONTRACTOR OR OWNER SHALL OBTAIN A BUILDING PERMIT FROM THE GOVERNING PER SQ. FT. AND SHALL HAVE A MINIMUM COVER OF 36". CONTRACTOR OR OWNER SHALL METAL RAIL BRACKET SECURED W/ MUNCIPALITY PRIOR TO STARTING WORK. VERIFY AND REPORT ANY DISCREPENCIES TO THE ARCHITECT. 3— 10X1%" SCREWS TO TOP RAIL, 7'-73'4" MAX (FOR IN—LINE) 19 GENERAL CONTRACTOR TO PROVIDE A 1 HR. FIRE RATING ON VALL WALLS AND CEILINGS 2— 1OX1%" SCREWS TO POST 7'-6" MAX (FOR 45') 3. CONTRACTOR SHALL OBTAIN ALL REQUIRED APPROVALS, CERTIFICATE OF OCCUPANCY, BETWEEN GARAGE AND ADJACENT ROOMS. 4Ya" 7'-2%" MAX (FOR STAIRS) 4Ya" INSPECTION APPROVALS, ETC. FOR WORK PERFORMED FROM AGENCIES HAVING JURISDICATION THEREOF. 20 ALL WOOD SILL PLATES SITTING ON THE FOUNDATION SHALL BE PRESSURE TREATED MINIMUM 4"X4" WOOD POST 5" NOTES FOR STAIR CONDITION:If TOP RAIL 4. ALL WORK SHALL CONFORM TO THE RESIDENTIAL CODE OF NEW YORK STATE and T 0.40 cca. IN ADDITION PROVIDE SILL INSULATION BETWEEN FOUNDATION AND WOOD PLATES. #2 REV DECK DWG 2 6/24 USE SUPPLIED ACUTE ANGLE BRACKET BUILDING CODE AND ALL RULES AND REGULATIONS OF THE MUNICIPALITY HAVING #1 SECTION: PAVERS 5/17 AT TOP OF STAIR RUN WITH 21 LUMBER SHALL BE MINIMUM, HEM—FIR #2 OR BETTER Fb= 1,150 PSI, E= 1,400,000 PSI. HIGHER 4Ya°X4Ya" POST COVER 3/a" 2— 10X1%" SCREWS TO RAIL, AND JURISDICATON. STRESS LUMBER MAY BE SUBSTITUTED FOR HEM—FIR. REV. NO. DESCRIPTION DATE PICKET INSERTED 2— 10X1 " SCREWS TO POST. 5. IF IN THE COURSE OF CONSTRUCTION A CONDITION EXISTS WHICH DISAGREES WITH THAT AS INTO TOP RAIL 22 MINIMUM BEARING FOR ALL JOISTS, BEAMS, HEADERS AND RAFTERS SHALL BE 4". PROVIDE R E V I S I 0 N S USE SUPPLIED OBTUSE ANGLE BRACKET INDICATED OF THESE PLANS, THE CONTRACTOR SHALL IMMEDIATELY NOTIFY THE (LATERAL SUPPRORT) BLOCKING/BRIDGING ® 8'-0" O.C. MAX.. BEARING WALLS SHALL BE AT BOTTOM OF STAIR RUN WITH ARCHITECT. SHOULD HE FAIL TO FOLLOW THIS PROCEDURE, AND CONTINUE WITH THE BLOCKED ® 48" O.C.. DOUBLE JOISTS AND/ OR RAFTERS AROUND ALL OPENINGS. DOUBLE 1Ya" SQUARE HOLLOW 2—#1OX1" SCREWS TO RAIL, AND WORK THE CONTRATOR SHALL ASSUME ALL RESPONSIBILITY AND LIABILITY ARISING THERE JOISTS UNDER ALL PARTITIONS PARALELL TO SAME. CPROJECT. CO—EXTRUDED 2—#10X1%" SCREWS TO POST. FROM. O PVC BALUSTER 23 MINIMUM HEADER SIZE SHALL BE (2) 2x6 UNLESS NOTED OTHERWISE. PROVIDE (3) 2X4 POSTS 6• ALL NEW MATERIALS AND INSTALLATIONS SHALL BE IN ACCORDANCE WITH THE ALL HEADERS UNLESS NOTED OTHERWISE. N M MANUFACTURERS LATEST PRINTED SPECIFICATIONS AND CODE REQUIREMENTS. PICKET INSERTED 24 ALL RAFTERS SHALL BE ANCHORED TO FRAME WALLS WITH "HURRICANE CLIPS". INTO BOTTOM RAIL 7. THE ARCHITECT ASSUMES NO RESPONSIBILITY FOR CONSTRUCTION MEANS, METHODS, METAL RAIL BRACKET TECHNIQUES SEQUENCES OR PROCEDURES OR FOR THE SAFETY PRECAUTIONS AND SECURED W/ DESIGN LOADS(PER SO. FT.) PROGRAMS IN CONNECTION WIT HTHE WORK. THERE ARE NO WARRANTIES NOR ANY LIVE DEAD DEFLECTION LIMIT PROPOSED NEW DECK @ 3-#10X1 T SCREWS BOTTOM RAIL MERCHANTIBILITY OF FITNESS FOR A SPECIFIC USE EXPRESSED OR IMPLIED IN THE USE OF LIVING AREAS 40# 10# L 360 TO BOTTOM FAIL, 2-#10X1%" SCREWS 2022.01.27 THESE SLEEPING ROOMS 30# 10# L/,60 Residence of TO POST — — -- -- — -- — — — -- -- — — -- — -- — — — PLANS. ATTIC NON STORAGE) 10# 5# L/240 8. THE ARCHITECTURAL SERVICES ON THIS PROJECT ARE TERMINATED WITH THE PREPARATION ATTIC STORAGE) 20# 10# L/240 ALTHOUGH THE TEST ROOF W/O FIN. CLG.) 30# 7# L 240 REPORT PERIOD HAS OF THESE DRAWINGS (UNLESS OTHER ARRANGEMENTS ARE MADE) CONFORMING WITH f Robert & Patricia ANCHORAGE 1 3 1 3 1 3 ROOF WITH FIN. CLG.) 30# 15# L 180 / / / �. '� EXPIRED,WE ASSUME THE BUILDING CODE REQUIREMENTS, AND THESE DRAWINGS WHETHER INDICATED OR Del signore AS REQUIRED THERE ARE NO CHANGES NOT SHALL NOT RELIEVE THE CONTRACTOR OF THE RESPONSIBILITY OF CONFORMING TO ALL 25 SNOW LOADS HAVE BEEN ADJUSTED, WHERE APPLICABLE TO REFLECT THE SLIDE—OFF FACTOR 1Ya" SQUARE EXPANDED CELLULAR NATIONAL BUILDING CODE 2019 ALBERTA TO THE ASSEMBLY. PVC FOOT BLOCK SECURED W/ GOVERNING CODES. THIS CONTRACT DOES NOT INCLUDE (UNLESS ARRANGED AS A FUNCTION OF ROOF PITCH. NATIONAL BUILDING CODE — 2019 ALBERTA EDITION REQUIREMENTS PVC SCREW TO BOTTOM RAIL EDITION REQUIREMENTS JNTERTEK/ARCHITECTURAL TESTING OTHERWISE) SITE OBSERVATION, SUPERVISION OR Located at PART 9 — RESIDENTIAL USE (FROM COMPLIANCE REFERENCE INSPECTION BY THE ARCHITECT. 26 ALL DRYWALL SHALL BE PRIMED AND PAINTED (2 FINISHED COATS). 955 Lake Drive 9.8.8.3 Height of Guards Table 9.8.8.2 Specified Loads for Guards) (Test Series No. & Condition) Southold, NY. 1) Except as provided in Sentences (2) to (4), all guards shall be not less than 1070MM (aft 6 in) high. 9. DRAWINGS AND SPECIFICATIONS AS INSTRUMENTS OF SERVICE ARE AND SHALL REMAIN THE 27 ALL FINISHES (INTERIOR & EXTERIOR) AND COLORES ARE THE RESPONSIBILITY OF THE OWNER Horizontal Load Applied Inward or Outward PROPERTY OF THE ARCHITECT WHETHER THE PROJECT FOR WHICH THEY ARE MADE IS AND SHALL BE SELECTED BY SAME. at any Point at the Minimum Required Test Series No.1 (In—Line Condition) EXECUTED OR NOT. THEY ARE NOT TO BE USED ON ANY OTHER PROJECT OR (2) All guards within dwelling units shall be not less than 900 mm (2 ft 11in) high. EXTENTIONS TO THIS PROJECT EXCEPT BY AGGREMENT IN WRITING AND WITH APPROPRIATE 28 INSTALL AS PER OWNER DIRECTION ANY AND ALL INTERCOM, TELEPHONE, AND/OR T.V. WIRING SEC 59 BLK 05 LOT 016 Height of the Guard: Test Series No.2 (45' Condition) COMPENSATION TO THE ARCHITECT OF RECORD. (3) Exterior guards serving not more than one dwelling unit shall be not less than 900 mm (2 ft 11in) high where the 0.75 kN/m (52 lb/ft) or concentrated load Test Series No.3 (Stair Condition) RUN CONCEALED IN WALL PRIOR I INSTALLATION OF WALLBOARD. ALL TEMPERATURE CONTROL WIRING SHALL f 1.0 kN (224 lb) applied at any point 10• DONOT SCALE DRAWINGS. WRITTEN DIMENSIONS SUPERCEDE SCALED DIMENSIONS. N WALLS, FLOORS AND/OR CEILINGS. VERIFY OUTLET, SWITCH AND LIGHTING o walking surface served by the guard is not more than 1800 mm (5 ft 11 in) above the finished ground level. LOCATIONS WITH OWNER PRIOR TO INSTALLATION. Horizontal Load Applied Outward on Elements Within the Guard, Including Solid Panels and 11. EXISTING CONDITIONS INDICATED WERE FROM FIELD MEASUREMENTS. DRAWING: (4) Guards for flights of steps, except in required exit stairs, shall be not less than 900 mm (2 ft 11 in) high. Test Series No.1 (In—Line Condition) Balusters: Test Series No.2 (45' Condition) 12•ALL DIMENSIONS AND LOCATIONS INDICATED ON THE DRAWINGS SHALL BE CONSIDERED (5) The height of guards for flights of steps shall be measured vertically from the top of the guard to a line drawn Concentrated load of 0.5 kN (112 lb) Test Series No.3 (Stair Condition) CORRECT. IT SHALL BE UNDERSTOOD THAT THEY ARE SUBJECT TO MODIFICATIONS AS MAY BE through the tread nosing served by the guard. applied over an area of 100mm by 100mm NECESSARY DUE UNFORSEEN CIRCUMSTANCES. DECK PLAN at any point on the element or elements so 13.ELEVATIONS AND SECTIONS ARE FOR INFORMATION PURPOSES ONLY AND THE CONTRACTOR IS 9.8.8.5. Openings In Guards DECK SECTION as to produce the most critical effect TO REFER TO ALL PLANS FOR CONSTRUCTION INFORMATION. 1 Except as provided in Sentence 2 and (3), openings throw h guards shall be of a size that will prevent the Evenly Distributed Vertical Load Applied at Test Series No.1 (In—Line Condition) CX G E N NOTES ( ) p p ( ) ( ) 9 9 p the Top of the Guard: passage of a spherical object having a diameter of 100 mm (4 in). Test Series No.2 (45' Condition) 14. ALL METAL JOIST HANGERS AND OTHER METAL CONNECTORS IF USED AND REQUIRED SHALL BE 1.5 kN/m (103 lb/ft) Test Series No.3 (Stair Condition) TECO CONNECTORS OR EQUAL. THE CONNECTORS SHALL BE CAPABLE OF HANDLING LOADS AT CONNECTION POINTS. INSTALLATION SHALL BE IN STRICT CONFORMANCE WITH Refer to TimberTech Installation Guide for additional installation information. Radiance Rail Express System MANUFACTURES SPECIFICATIONS AND RECOMMANDATIONS. This document is valid for one year from issue date. It may be renewable on an annual basis. Our ABC compliance calculations compared data 3/4„-1 ,-0„ 15. ALL CONCRETE SHALL BE PLAIN, UNREINFORCED (UNLESS INDICATED OTHERWISE), obtained from: Architectural Testing Reports: Architectural Testing Reports No.A9084.01-119-19 dated OCT.07-2011. CONTROLLED STONE CONCRETE HAVING A MINIMUM COMPRESSIVE STRENGHT OF 2500 PSI ® 7PROJECT DATE: DRAWING NO.: 28 DAYS. 16. PROVIDE 1/2" DIAMETER X 15" LONG ANCHOR BOLTS WITH 3" PROJECTION AND TREAD, V-0" 7-18-16 S _FROM CORNERS AND 6'-0" O.C. MAX.. ij bt :•x � x_l. � ¢'!t4 1 1 ..s�:t�� f/ �fY. - 1+�� �!�!�\����9.f� t+ jw MF At ct litIL -1 `' 'a .fir{ i!'` yam•' '' John M. Bredemeyer I. resident }o��` �o� 4 Town Hall Annex Michael J. Domino, Vice-President "� � Y� �� 54375 Route 25 Glenn Goldsmith o ,� ? P.O" Box 1179 A. Nicholas Krupski �•o ® Southold, NY 11971 � � � -. Charles J. Sanders ~==r��1 ,xc �� _" 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 .Ist day of construction Y7 constructed Project complete, compliance inspection John M.Bredemeyer III, President ��0� soupz'O Town Hall Annex Michael J.Domino,Vice-President �O l® 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G ® O - Telephone(631) 765-1892 Charles J.Sanders O Fax(631) 765-6641 ly�4UNT`1,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8885A Date of Receipt of Application: August 31, 2016 Applicant: Robert Delsignore SCTM#: 1000-59-5-16 Project Location: 955 Lake Drive, Southold Date of Resolution/Issuance: October 19, 2016 Date of Expiration: October 19, 2018 Reviewed by: Michael J. Domino, Trustee Project Description: To construct a 22'6"x41' deck with two sets of steps to grade attached to dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Ricardo E. Campos, R.A., dated July 18, 2016, and stamped approved on October 19, 2016. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. John M. Bredemeyer, III President Board of Trustees { i O RICARDO E. CAMP05, R.A. / ARCHITECTURAL ARTS 4 DESIGN / '706 UNION BLVD WEST (SLIP, NY. II-7a5 PHONE (651) 516 "7761 / \ o\"? o � / Y DRAWN BY: CHECKED BY: \ \ IT IS A VIOLATION OF THE LAW FOR ANY PERSON UNLESS ACTING UNDER THE OF A \ \ ARCHITECT,TION TTOALTER TIHESEEDRAWINGS \ EXISTING DRI Y AND/OR ACCOMPANYING SPECIFICATIONS. \D`� SZ WHERE THE COGNCZANTLLCREN ED ARCHITIOAREMET / oMUST SIGN, SEAL, DATE AND DESCRIBE � O s THE SPECIFVISION S.ON THE DRAWING AND/OR 5 7 (See Appropiate Sections of NYS Education Law) \?� EX 1STORY ME DWELLING F.FLI?.53' \0 \� \ = \x/ / �'" ® 0/CORX� EX PINE TREE F- —I \ .� <6" DIA 0 TOTAL) L J REMOVE EX ROSE BUSH (2) Dry F. EX1X6' SHED PROPOS / E REMOVED / 6 � / � #2 Resubmitted to Bldg Dept.4-14-16 41' L X 22'-6"-(rrtaxj D k / 6' / W OD DECK l L®� / Drywell calcs, piping size, pool dist., / eogrid Info,veg screening,dry well detail 8"H STONE \ 3-7-16 ( #1 Submitted to Bldg Dept. STEPS / 40 REV. N0. DESCRIPTION DATE / �s,, � � J R E V I S 1 0 N S J 10 NONE / • LKWAY \ / ! PROJECT: nB \ OXED AREA �'EMCAVE EX STONE P TIO Residence 0f tK / / \ Robert 4 Patricia / / \� Delslgnore / Co/ O / \ • Located at / /ro a55 Lake Drive Southolscl, NY. APPROVED BY SEG 5cf BLK 05 LOT 016 �° / / .� / BOARD OF TRUSTEES TOWN OF SOUTIC3 vv/ °�1 E GTO IQ� ."2OI DRAWING: 51TE PLAN PROPOSED SITE PLAN \ ,. V FE \ AUG 31 2016 SGLE: I = 2O� / o \\ PROJECT NO.: DATE: DRAWING NO.: outhold Town rc10{Trust re 0501622 "1-18-I6 S - 1 EX I STORY FRAMF_ 1:;)/�ELRICARDO E. CAMP05, R.A. *�' I � ARCHITECTURAL ART5 4 DESIGN 706 UNION BLVD WEST 15LIP, NY. II'ig5 I PHONE (631) 576 "f'161 2X10 BAND BD perimeter of house 2X I O BAND BD O I 7 Ix6 TIMBER TECH Coll DECKING O � _ (2) 2X10 ` � — — �I ® I EXT EXTERIOR Ixb hand rest, continuous 2 x 4 R < N 4X4 P05T5 ANCHORED - WALL horizontal support T45, 2x2 „ „ - CONSTRUCTION: vert railing w/ 5 1/2" spacing _ TO 12 DIA FG FTGS 3'-6 between, 5' H total Nin i I1 y DRAWN BY: CHECKED BY: LU X BELOW FIN GRADE _ contruction) 7 w I N (T`I'P I GAL) I NQ I I Hurricane clips First Floor J5T (Typ I x 8 fascia bds --� 2x8 JOISTS 11 orc}und perimeter J ` Dbl 2x10 Gird of deck 2X10 BAND BOARD _ 4x4 Post anchor FIN 6RADE 4" N HANDRAIL W1 2X2 I I EX Concrete IT IS A VIOLATION OF THE LAW FOR BOLTED TO EXISTING POSTS SPGR 4" APART, 4x4 Post o/ FOUNDATION 4 -O O.G. I 36" ABOVE FIN 15HED I I _�� foundation 8" dia x 5' dp p/c ftg TED RECTION OF ANY PERSON UNLESS A LICENSED UNDER ALONG PERIMTER DECK 6' MAX LENGTHS I II I II typical ANDARC/OR CACCOMPANYINGTO ALTER HSPECIDFI�CATIONS. (T)'PI GAL) WHERE SUCH ALTERATIONS ARE MADE, Iu THE COGNIZANT LICENSED ARCHITECT 111 MUST SIGN, SEAL, DATE AND DESCRIBE THE REVISIONS ON THE DRAWING AND/OR SPECIFICATIONS. (See Appropiate Sections of NYS Education Law) 0- SES AA : T"' I CAL 57RU�TURAL SEDT 10N THRU Z�E�K � I�� II SCALE: 1/4" = I '-0" 00, FROFOSED 1:;)ECX FLAN GENERAL NOTES: 1/4" = 1 '-0" I. CONTRACTOR SHALL CHECK AND VERIFY ALL CONDITIONS OF THE 51TE PRIOR TO STARTING OF 17 GRADING AROUND NEW CONSTRUCTION SHALL SLOPE AWAY FROM THE HOUSE AND BLEND WORK AND SHALL FAMILIARISE HIMSELF WITH THE INTENT OF THESE PLANS AND MAKE INTO EXISTING GRADE IN THE CASE OF RENOVATIONS OR ADDITIONS. WORK AGREE WITH SAME. 18 ALL FOOTINGS SHALL BEAR ON UND15TURBED 501L WITH A MINIMUM SOIL PRE55URE OF 2 TONS 2• THE CONTRACTOR OR OWNER SHALL OBTAIN A BUILDING PERMIT FROM THE GOVERNING PER 50. FT. AND SHALL HAVE A MINIMUM COVER OF 56". CONTRACTOR OR OWNER SHALL MUNGIPALITY PRIOR TO STARTING WORK. VERIFY AND REPORT ANY D15CREPENCIE5 TO THE ARCHITECT. Ig GENERAL CONTRACTOR TO PROVIDE A I HR. FIRE RATING ON VALL WALLS AND CEILINGS 3. CONTRACTOR SHALL OBTAIN ALL REQUIRED APPROVALS, CERTIFICATE OF OCCUPANCY, INSPECTION APPROVALS, ETC. FOR WORK PERFORMED FROM AGENCIES HAVING BETWEEN GARAGE AND ADJACENT ROOMS. JUR15DICATION THEREOF. 20 ALL WOOD BILL PLATES SITTING ON THE FOUNDATION SHALL BE PRESSURE TREATED MINIMUM 4• ALL WORK SHALL CONFORM TO THE RESIDENTIAL CODE OF NEW YORK STATE and T 0.40 cca. IN ADDITION PROVIDE SILL INSULATION BETWEEN FOUNDATION AND WOOD PLATES. BUILDING CODE AND ALL RULES AND REGULATIONS OF THE MUNICIPALITY HAVING 21 LUMBER SHALL BE MINIMUM, HEM-FIR #2 OR BETTER Fb= 1,150 PSI, E= 1,400,000 PSI. HIGHER JURI5DICATON. 5TRE55 LUMBER MAY BE SUBSTITUTED FOR HEM-FIR. REV. NO. DESCRIPTION DATE 5• IF IN THE COURSE OF CONSTRUCTION A CONDITION EXISTS WHICH D15AGREE5 WITH THAT AS 22 MINIMUM BEARING FOR ALL JOISTS, BEAM5, HEADERS AND RAFTERS SHALL BE 4". PROVIDE R E V I S 1 0 N S INDICATED OF THESE PLANS, THE CONTRACTOR SHALL IMMEDIATELY NOTIFY THE (LATERAL SUPPRORT) BLOCKING/BRIDGING 0 &-O" O.G. MAX.. BEARING WALL5 SHALL BE ARCHITECT. SHOULD HE FAIL TO FOLLOW THIS PROCEDURE, AND CONTINUE WITH THE BLOCKED a 48" O.G.. DOUBLE JOISTS AND/OR RAFTERS AROUND ALL OPENINGS. DOUBLE WORK THE GONTRATOR SHALL A55UME ALL RE5PON515ILITY AND LIABILITY ARISING THERE JOISTS UNDER ALL PARTITIONS PARALELL TO SAME. FROM. PROJECT: 6• ALL NEW MATERIALS AND INSTALLATIONS SHALL BE IN ACCORDANCE WITH THE 25 MINIMUM HEADER SIZE SHALL BE (2) 2x6 UNLESS NOTED OTHERWISE. PROVIDE (3) 2X4 P05TS MANUFACTURERS LATEST PRINTED 5PECIFICATION5 AND CODE REQUIREMENTS. ALL HEADERS UNLESS NOTED OTHERWISE. 7. THE ARCHITECT ASSUMES NO RESPONSIBILITY FOR CONSTRUCTION MEANS, METHODS, 24 ALL RAFTERS SHALL BE ANCHORED TO FRAME WALLS WITH "HURRICANE CLIPS". TECHNIQUES, 5EQUENGE5 OR PROCEDURES, OR FOR THE SAFETY PRECAUTIONS AND DESIGN LOAMER 50. FT) PROGRAMS IN CONNECTION WIT HTHE WORK. THERE ARE NO WARRANTIES NOR ANY LLVIE DEAD DEFLECTION LIMIT MERCHANTIBILITY OF FITNE55 FOR A SPECIFIC USE EXPRESSED OR IMPLIED IN THE USE OF LIVING AREAS 40# 10# L/560 PROPOSED NEW DECK C�? THESE SLEEPING ROOMS 30# 10# L/560 Residence of PLANS. ATTIC, (NON STORAGE) 10# 5# L/240 8. THE ARCHITECTURAL SERVICES ON THIS PROJECT ARE TERMINATED WITH THE PREPARATION ATTIC (STORAGE) 20# 10# L/240 OF THESE DRAWINGS (UNLESS OTHER ARRANGEMENTS ARE MADE) CONFORMING WITH ROOF (W/O FIN. GLC.) 30# 7# L/240 THE BUILDING CODE REQUIREMENT5, AND THESE DRAWINGS WHETHER INDICATED OR ROOF (WITH FIN. GLC) 50# 15# L/180 Robert $ Patricia NOT, SHALL NOT RELIEVE THE CONTRACTOR OF THE RESPONSIBILITY OF CONFORMING TO ALL 25 SNOW LOADS HAVE BEEN ADJUSTED, WHERE APPLICABLE TO REFLECT THE SLIDE-OFF FACTOR Delsignore GOVERNING CODES. TH15 CONTRACT DOES NOT INCLUDE (UNLESS ARRANGED AS A FUNCTION OF ROOF PITCH. OTHERWISE) 51TE 055ERVATION, SUPERVISION OR Located at INSPECTION BY THE ARCHITECT. 26 ALL DRYWALL SHALL BE PRIMED AND PAINTED (2 FINISHED GOATS). 955 Lake Drive g. DRAWINGS AND 5PIECIFICATION5 AS INSTRUMENTS OF SERVICE ARE AND SHALL REMAIN THE 27 ALL FINISHES (INTERIOR 4 EXTERIOR) AND COLORES ARE THE RESPONSIBILITY OF THE OWNER Southolsd, NY. PROPERTY OF THE ARCHITECT WHETHER THE PROJECT FOR WHICH THEY ARE MADE 15 AND SHALL BE SELECTED BY SAME. EXECUTED OR NOT_ THEY ARE NOT TO BE USED ON ANY OTHER PROJECT OR EXTENTIONS TO THIS PROJECT EXCEPT BY AGGREMENT IN WRITING AND WITH APPROPRIATE 28 INSTALL AS PER OWNER DIRECTION ANY AND ALL INTERCOM, TELEPHONE, AND/OR T.V. WIRING SEG rj�f BLK OE LOT 016 COMPENSATION TO, THE ARCHITECT OF RECORD. IN WALL PRIOR TO IN5TALLATION OF WALLBOARD. ALL TEMPERATURE CONTROL WIRING SHALL RUN CONGEALED IN WALLS, FLOORS AND/OR CEILINGS. VERIFY OUTLET, SWITCH AND LIGHTING 10. DONOT SCALE DRAWINGS. WRITTEN DIMENSIONS 5UPERCEDE 5CALED DIMENSIONS. LOCATIONS WITH OWNER PRIOR TO INSTALLATION. 11. EXISTING CONDITIOiN5 INDICATED WERE FROM FIELD MEASUREMENTS. + DRAWING: 12. ALL DIMENSIONS AND LOCATIONS INDICATED ON THE DRAWINGS SHALL BE CONSIDERED CORRECT. IT SHALL BE UNDERSTOOD THAT THEY ARE SUBJECT TO MODIFICATIONS AS MAY BE NECESSARY DUE UNlFOR5EEN CIRCUMSTANCES. DECK PLAN 15. ELEVATIONS AND 5>ECTION5 ARE FOR INFORMATION PURPOSES ONLY AND THE CONTRACTOR 15 TO REFER TO ALL ]PLANS FOR CONSTRUCTION INFORMATION. DECK SECTION 14. ALL METAL JOIST HANGERS AND OTHER METAL CONNECTORS IF USED AND REQUIRED SHALL BE 4 6EN NOTE5 "TECO CONNECTOi V OR EQUAL. THE CONNECTORS SHALL BE CAPABLE OF HANDLING LOADS AT CONNECTION POINTS. INSTALLATION SHALL BE IN STRICT CONFORMANCE WITH MANUFACTURES 5P'EGIFIGATION5 AND RECOMMANDATION5. 15• ALL CONCRETE SHIALL BE PLAIN, UNREINFORCED (UNLESS INDICATED OTHERWISE), CONTROLLED STONE CONCRETE HAVING A MINIMUM COMPRESSIVE 5TREN6HT OF 2500 P51 ® PROJECT NO.: DATE: DRAWING NO.: 28 DAYS. 16. PROVIDE 1/2" DIAMETER X 15" LONG ANCHOR BOLTS WITH 5" PROJECTION AND TREAD, 1'-0" G501622 "7-IS-Ib S - 2 FROM CORNERS AND 6'-0" O.G. MAX.. LPO �j PCP R �(L (60 850 56 t11 i Q ell \ m 95 92, o. �, •cn P. Yo o, 0" �i �P! ✓ `7" --r— a 'L.7 i� G+ � rra 6 �� 619 SURVEY OFPROPERTY z SITUATE SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. s SURVEYED DEC. 6, 2012 ADDED TOPO: MAY 6, 2015 i NOTES- 1. PROPERTY KNOWN AS TAX MAP# 1000-059-05-016 COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED 2. LOT AREA= 20163.7SQ FT. (0 463 ACRE(S)) OR EMBOSSED SEAL SHALL NOT RECONSIDERED TO BE A VALID COPY u 3 THIS SURVEY WAS PREPARED USING A TRIMBLE 5 S3 ROBOTIC TOTAL STATION 4. PROPERTY CORNER MONUMENTS WERE NOT SET AS PART OF THIS SURVEY. 5. ELEVATIONS REFER TO NAVD88 DATUM. i 3 pE CEVC STANDARD NOTES. _ I CO GRI 2DI MICHAEL k ICKS o—SUINE NG 1 UNAUMORI EDALTERARON OR ADDIDN TO THIS SURVEY MGP DEARING A J. LICENSED LAND SURVEYORS SELL IS A NOLATION OF SECDON)209 MICHAEL K WICAZ PLS. #50390 E SU 0 I.Y BION R OF NEW YORK SLATE EDUCATION LAW AUG ® q /No�q O ONLY BOUNDARY SURVEY MMS WITH ME SURVEYORS EMBOSSED SGl .Aw®U�V9! tl6 L ,hf y ARE GENUINE O TRUE AND CORRECT COPIES OF THE SURVEYORS ORIGINAL MICHAEL K. W Icxs WORK AND OPINION 3 k GERRHICATON9 ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP WGA PREPARED IN ACCORNS mTH THE CURRENT EYDNK G CODE OF LAND SURVEYING PRACi10E FOR LPN.SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCV.PON ER ONS FOR WHO LAND SURVEYORSINC NE P IS PREPARED,R m U&N TO PERSONS FOR WHOM THE BOUNDARY SURCI MAP T PPFPAREO, 2 LENDING IISTRRONA USTEOO OONTHE THS eau NDANY SUfiVE1 NAP TME outhold Town 200 BELLE VIEW AVENUE, E 5TH CERTIBCATONS HEREIN N E NOT TRANSFERABLE CENTER MORICHES. NEW YORK 11934 fi THE LACFRON OF UNDERGROUND IMPROVEMENTS OR ENCRWCHMENiS ME VOICE- 631.874.0156 — FAX. 631.909 3845 m NOT ALWAYS KNOWN AND OFTEN MUST BE ESOMATE. IF ANY UNDERGROUND a NNPRGv MtMENTTR NTS OR EENNG�R° HHreERrs�NOT COVERED SY RS SURVY RECORDS OF RICHARD C DRAKE 7 THE OFFSET(OR DIMENSIONS)SHOWN HEAEGN FROM THE STRUCTURES TO SCALE- SURVEYED BY. DRAWN BY. SHEET: THE PROPEN Y U—ME FOR A SP—C PU THEREFORE - ARE NOT HNTENOEO TO CUIDE THE ERECTOR OFFENCESflETUM C WPllS POOLS,PA M PUNTNG ARFPS ADDRDNS TO BwmINGS AND ANY OMER 1 M W &A. A.C. 1 OF 1 - IYPE OF COXSHNUCUON John M. Bredemeyer III, Presid, pSaFF04 i Town Hall Annex Michael J. Domino, Vice-Presiaeni ,` �o� ��y 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A. Nicholas Krupski o ® Southold, NY 11971 Charles J. Sanders 4,, Telephone (631) 765-1892 Fax (631) 765-6641 - -urzrsz*r.�'i BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: � /Z_ Completed in field by: Rick Campos, R.A. on behalf of ROBERT DELSIGNORE requests an Administrative Permit to construct a 22'6"x41' deck with two sets of steps to grade attached to dwelling. Located: 955 Lake Drive, Southold. SCTM# 1000-59-5-16 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. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 John M. Bredemeyer III, Presid i o�oS1lFFOlt/( Town Hall Annex Michael J. Domino, Vice President 54375 Route 25 Glenn GoldsmithN � P.O. Box 1179 A. Nicholas Krupskia ^� Southold, NY 11971 Charles J. Sanders y�j® o�� , Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Rick Campos, R.A.,on behalf of ROBERT DELSIGNORE requests an Administrative Permit to construct a 22'6"x41' deck with two sets of steps to grade attached to dwelling. Located: 955 Lake Drive, Southold. SCTM# 1000-59-5-16 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=* Al, 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 DiSalvo, Diane From: Rick Campos <rec42@aol.com> Sent: Tuesday, September 13, 2016 10:09 AM To: DiSalvo, Diane Subject: Re: Delsignore - 955 Lake Road, Southold Attachments: RC Transact form jpg Hi Diane... Sorry I confused it with a different form... Here's a copy(Applicant/Agent/Rep/Trans-actual Disclosure form) in the meantime... I'll mail the original to you today. PS. You can throw the building permit application away... I'll fill out a new one later.. Thanks for your help, -Rick R. Campos, R.A 631 5767761 -----Original Message----- From: DiSalvo, Diane <diane.disalvo@town.southold.ny.us> To: 'rec42@aol.com' <rec42@aol.com> Sent: Mon, Sep 12, 2016 3:36 pm Subject: Delsignore-955 Lake Road, Southold Mr. Campos: Receipt is acknowledged of the original affidavits and site plan. You neglected to send me your original Applicant/Agent/Representative Transactional Disclosure Form. Thank You. Dewe D% salvo Southold Toti,,•n Trustees Town Hall Annex/First Floor 54375 Route 25 P.O. Box 1179 Southold,NY 11971-0959 (631) 765-1892 Fax: (631) 765-66'11 i TOWN OF SOUTHOLD BOARD OF TRUSTEES ATTN: DIANE DATE:SEPTEMBER 6,2016 RE; DELSIGNORE RESIDENCE;PROPOSED DECK @ 955 LAKE ROAD,SOUTHOLD AS PER YOUR REQUEST, ENCLOSED ARE(1)COPY OF SITE PLAN, PLUS ORIGINAL DOCUMENTS WITH ORIGINAL SIGNATURES TO REPLACE THOSE"COPIED"VERSIONS PREVIOUSLY ISSED TO YOUR DEPARTMENT FOR THIS APPLICATION.SHOULD YOU HAVE ANY FURTHER REQUESTS OR QUESTIONS PLEASE DO NOT HESITATE TO CALL ME @ 631576 7761. THANK YOU FOR YOUR ASSISTANCE WITH THIS MATTER, RICK CAMPOS, R.A. IT IS MY UNDERSTANDING THAT IS APPLICATION WILL BE HEARD BY THE BOARD ON OCTOBER 19T" C E V SEP 1 2 2016 f r e Southold Town I t BaardQf Trustees _,_j r �, f � �'�,- . ." �, r �> . • � � ,,� t i � , � ��: � �` ,� r � + �: h ,'� � � � / ��;: - - - 4 .. i; ,fir ... t �¢ -` .'MIF A'+�..� � a,, ; �: v � ,. -- .. ^''#.. ..� a. .. , � ,_ �, ,. ` ,. �. .- N r y , t rK-.w d r dj k t A MiE s n � l rq; OFA r Ll s '. • r��. t k i . vv ZV I 4r yy 1• y. Ht' y� "�Y �• •_ 6� �. .. ���» ...� .-. •4•'elm � �p[ r r ' . i•b M r ` Y �1,.. _f '�,.'� 4� arm%.d '� �"'°1r� µ'+�'"• m _ 4 • y r _ ' a 'd ��1 I••,.ic fir`' _ f d � r p , 1 1 •yi��7 ���` r .fps' 4��•- � a _ e,�•" +3F #,� ,y� �>R. I, �*� e.. °e. ,,,f. '4'Y .Z v a-. 6 Y' -}4l" � M :1,. 4 'r Fs, w J L4 ar�aY°���� •.�°0.'�Y .f • re 11MkY i. �j'k SEE SEC NO ONE -z-— 2 V3 V �M 41, I Nw-, INA tD 4 25 FOR P�NO TOM OF SOUTHOW SEE SEC NO GRE4T POND lZa 17A U6 dt� 311.1.1 cou—OF su FDU( 63 s 9A(.) 6� 1.8 63 5 2�1. 4 62 61 2 Im 16A(.) 3�5 7 RA(c) 1 OA(C)� lk 7- FOR PCL NO SN't) IZIA SEES C NO W-1-1 –Z MATCH z ONE ONE W,,,TcH SEESEC NO m SEE SEC NO M N NO K NOTICE COUNTY OF SUFFOLK souTHoLD E rty Tax Service Agency y Real=e 059 ---------- 77 � t OFFICE LOCATION: �rq S® yO MAILING ADDRESS: Town Hall Annex �® l® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) cn_ Southold,NY 11971 ® �®� Telephone: 631 765-1938 ® Fax: 631765-3136 lycon UNl`1,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: October 11, 2016 Re: -LWRP Coastal Consistency Review for ROBERT DELSIGNORE SCTM# 1000-59-5-16 Campos, R.A. on behalf of ROBERT DELSIGNORE requests an Administrative Permit to construct a 22'6"x41' deck with two sets of steps to grade attached to dwelling. Located: 955 Lake Drive, Southold. SCTM# 1000-59-5-16 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 action is CONSISTENT with the below listed Policy Standards and therefore is CONSISTENT with LWRP provided: 1. A vegetated, non-turf buffer including the existing vegetation on site is established landward of the wetland line to further Policy 6. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. l" rte,, OT John M. E3redemeyer t[l, Presi� + �i3f SO Town Hall Annex �f O� �l 54375 Main Road Michael J. Domino, Vice-President O P.O Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen, Trustee G � Telephone(631) 765-1892 Charles J. Sanders, Trustee 'Q i0 lyCOUMN, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To- Southold-Town Building Department Q [PEF OVIE Re: Verification of Building Department Permit Requirements SEP 12 2416 SCTM#: Property Owner Name: ' Re st"®A 'TOWN or Svc iHOLD Date Sent to Bldg. Dept.: q. l' l 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 /he Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: ignature of Reviewer Date I r a John M.Bredemeyei;III,President ,� ', Town Hall Annex Michael J.Domino,Vice-President .r. 154375 Main Road P.O.Box 1179 James F.King, Trustee Southold,New York 11971-0959 Dave Bergen,Trustee Charles J.Sanders,Trustee �`�' �1, �t1 Telephone(631)765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application —_/Wetland Permit Application V Administrative Permit _ /Z Amendinent/Transfer/Extensibn r Received Application:- 9 fld� p C E G V E _Received Fee: $ 18®,,00 Completed Application:-_Cie 12t11� A Incomplete: _ AUG 3 1 2016 _SEQRA Classificari Type I Type II Unlisted Southold Town �Coordination:(date sent): 7 Ito Consistency Assessment Form: ®' tom._BQar�1 of Trusts _CAC Referral Sent: Date of Inspection: _Receipt of CAC Report: _Lead Agency Determination: Technical Review: _ Public Hearing Held: f O+ Q a l Resolution: Name-of Applicant:, TZ08EXT Df_-L.,516 1402S Mailing Address: �?�� „� /�� '0ce/V'o 55'ejan/y Phone Number: Suffolk County Tax Map Number: 1000- ej �- e? —. C) Property q�55' Property Location: ®L rt _ s s e Tie, leo'VW-a YS A dg-o (provide LILCO Pole#, distance to cross streets, and location) AGENT: _ to 107Tl4e AO j" A (If applicable) Address: f�� t,�z'�L�i'� ��i� d� Phone: 6 ` 7 2 41 Board of Trus-taea ApP GENERAL DATA Land_Ar_ea_(in_square.feeO:. , /,67 5-A Area Zoning: Ile— Previous use of property: 1ntendeduse-of property: oq=A2 Covenants and Restrictions on property? Yes i/ No If"Yes",please provide a copy. Ayes Will this-project require a Building Permit as per Town Code? No If"Yes";�be advised this application will be reviewed-by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? - --Yes No Does the structure(s)on property have a valid Certificate of Occupancy? L/Yes No Prior permits/approvals for site improvements: Agency Date __V1 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? ✓ No Yes If yes, provide explanation: , Project Description(use attachments if necessary):_. �/� Board of Trustees Applic_-_-.on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: d�,lS Lr�� G✓�r�1' rn.- s� - ���i� Area of wetlands on lot: J� 760 square feet Percent coverage of lot:_ % Closest distance between nearest existing structure and upland edge of wetlands: ST feet Closest distance between nearest proposed structure and upland edge of wetlands: . _ �;�; feet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? L�lf - cubic yards How much material will be filled? WIA cubic yards Depth-of which.naaterial will be-removed-or-deposited:. �✓ fee . Proposed slope throughout the area of operations: 15)el �✓$ �� �� Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): /V Board of TruSt�ees APPlicL--OU A.FMAVIT 12e)-,60,or-.- 97-9/- :57f 4 Niro BEING DULY SWORN DEPOSES AND AFFIRMS THAT /SITE IS THE A?PEICA`NT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT AEI..,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 t -BOARD OFTRUS`�'EES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRAN'T'ED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO EN'T'ER ONTO My PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATIONS INtCLUDUNG A FINAL..,INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDI'T'ION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. ^' 1=Pro Ocvnur - SWORN TO BEFORE ME THIS DAY OF Aff _ ,20-/&— Not y PubPAJOSS KATHERiN NOTAROUBIJC STATE OF NEWYORK SUFFOLK COUNTY LIC.#01JO6252937 COMM.EXP.DECEMBER 19, Board of Trustees Application AUTHORIZATION (where the applicantis not the owner) residing at `t 13 a& 1,dr& (print name of owner 4 property) (mailing address) v:7)% do hereby authorize ea, bm,005 r<'T` - r (Agent) to apply for permit(s)from the Southold Board o Town Trustees on my behalf. (Owner's signature Board of Trustees Application AFFIDAVIT BEING DULY SWORN DEPOSES AND AFF PHAT HE%SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL ; EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property weer SWORN TO BEFORE ME THIS P DAY OF /�U trv-f7 ,20 l DONALD A. KURZ Notary Public,State of New York, Notary Public No.4765116 Qualified in Nassau County Commission Expires March 30,20 APPLICANT/AGENT/REPRESJENTATWE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics Pro ']7ie purpose hibils con ll icts of interest on the Part of town officers rind cmplo�s. rpose of this form is to provide in rormation which can alert the town of nossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NikivlE: _ Aga GSi14/11t P—'' (Last name,first name,ipiddle initial,unless you are applying rn 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 peisoiittlly,(or_tlirough your company,spouse,sibling,parent,-or child)have a relationship with any officer or employee of the'Town of Southold? "Relationship"includes by blood,nlarriage,or business interest."Business interest"•means abusiness, including a partnership.in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the�iown titTicer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant(agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent;or child is(check all that apply): A)the owner ofgreater than-5%of the shares of the corporate'stock of the applicont (when die applicant is a corporation); 13)die legal or beneficial owner of any interest in a non-corporate entity(Whets the applicant is nota corporation); C)an officer,director,partner,oremployee of die applicant;-or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted thi •Z-) day of CI ' vt 209�C Signatureis - Print Name Form TS l P`? e APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL DISCLOSURE,FORM The Town of So6thoI&s Cadeof Ethics nrohibi'ts conflicts of inteie�t on the part of town ofriicers'and emigovecs.:The purpose of this f6rm'i4 to nmvidc infarination which can'alert tlie-town of possible confhets or-interest and allow rt to take whatever_ttctton is necessaa to avoid same. 7 YOUR NAME: _ P„yl -j (Last name,first name,ipiddie initial;,/unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) ; NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _- Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring = Exemption from plat or official map Planning Other (If"Other",name the activity.) — Do you personally(or through your company,spouse,sibling,parent,or child)have a,relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business itlterest."-Business interest"means a business, including a partnership,in which the town officer or employee has even a partial,ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold / Title or position of that person lens Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): i 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); an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted is day of �" "*"7 201 Signature tw,� r Print Name i4�� Form TS 1 DONALD A.KURZ Notary Public,State of New York_ No.4765116 Qualified in Nassau County Cominissio,n Expires March 30�20s'W APPLICANT/AGENT/REPRESENTATIVE TRANSACTI®NAL DISCLOSURE FORM, The T c `of S uthold'S oile`of fithies bi conflicts of interest on the• art of own.o ice s and em to eet The u ose of lo t_h>s form is to oxide infarinatian which ban alert the town c f ible conflicts of interesi and allow,it•to ke whatever a i n-is necessary to avoid same. -YOUR NAME: (Last name,first name,-Widdle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indieate,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 pirsonatly{os through your company,spouse,,sibli ig,parent,-or•ehild)have a relationship with any officer or employee of the Town of Southold?-"Relationship"�iiieludes by blood;marriage,or business interest."Business interest means a-business, including,a partnership,iri�vhich=tlic town'oftice'r pr=employee has cyen a-partial ownership of(or employment by)a corporation in which the town o�ccr'ar employee,owns.more Wan e5010 of the shares. YES NO `s If you answered"YES", mplete 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 pe on - - - Describe the relationship b een yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)thro h D)and/or describe in the space provided. The town officer or employe or his or her spouse,sibling,parent,or child is(check all-that apply): A)the owner ofgreate 'than 5%ofthe shares'0f the corporate stock of the applicant (viten the applicant t:i corporation); B)the legal or�benefici olynei of any interest in a'cion-caipbrafe entity(whertthe applicant is nota co oration); C)an officer;diirector;<p rtiier;ofcmployee Of the applicant;ar D)the actual applicant. DESCRIPTION OF RELATION HIP Submitted this �d of St 2001 Signature Print Name Form TS 1 of Trustees Appiica- !" AFFIDAVff ;&F Gl�e g2,rqt-/77 pct _ BEING DULY SWORN DEPOSES AND AFFIRMS THAT�7S13E I9 TIIE APPLICANT FOR THE ABOVE DESCItIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OFTRUS'T'EEsHARMLESS'AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH-THIS-APPLICATION, INCLUDING-A FINAL INSPECTION. IFURTHEI7 AUTHORIZE'THE BOARD-OF' TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature 77o �� SWORMTO BEFORE ME THIS _ _ �, DAY OF 20_z� t _ �� - lza �N MINY(�I��A F�E3f�fy PO4 = gf@f@ of Now York 901l'E:o ifs �4T, lk cult '%iotbxy Pub iso 61-7:20' Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses -become part of`the application for approval or funding,are su`6ject to public review,and maybe subject to further ver"ificafion. Complete Part 1 based on information currently available. If additional research or investigation would bye needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a location map): gr.5� J_ 04-1 -Brief`Description of Proposed'Action: .moi ®�i77� Name of Applicant or Sponsor: ' Telephone: s 6r' ®-A/_.S'/ 49Ald R...6 E-Mail: Address: �y City/PO: State: Zip Code: 11f 7/ 1.Does the proposed action only involve flie legislative-adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES .,If Y-es,>list.agency.(s).name and_-permit_or.approval: 710AIIJ 64-.m-, 043e 77 Al YS 3.a.Total acreage of the site-of the proposed action? r J acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. /' [:]Urban E3 Rural(non-agriculture) ❑Industrial [:]Commercial &<Csidential(suburban) E3 Forest ❑Agriculture [:1 Aquatic ❑Other(specify); ❑Parkland Page 1 of 4 5. Is the proposed action, _ NO YES _N/A- -a.n permitted-use underthezoning regulations? -❑ 't—I b.Consistent with the adopted comprehensive plan? EZ-❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? Z _Lnn d , c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO ' -YES If the proposed action will exceed requirements,describe design features and technologies: F nf 10. Will the proposed action connect to an existing public/private water supply? NO _ YES If No,describe method for providing potable water:, 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: I Zi 12. _a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Viaces?` b.Is the proposed action located in an archeological sensitive area? F—P-1101 El 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain "NO I YES wetlands or other waterbodies regulated by a federal,state or local agency? F] b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Ide � the typical ha at types that occur on,or are likely to be found on the project site. Check all that apply; L2'Shoreline [(Forest ❑Agricultural/grasslands [:]Early mid-successional ER Wetland ❑Urban ❑Suburban 15.Does the site of the.pro_posed action contain any species of an imal,or associated habitats,listed ::NO " YES_ by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO ' YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO_ . YES If Yes, a.Will storm water discharges flow to adjacentproperties? []NO FIYES -- L] b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Page 2 of 4 18.'Does the proposed action include construction or other activities that result"in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size; 19.Has the site of the proposed action or an adjoining property been the location of an active or closed 'NO -YES solid waste management facility? 1i Yes-,des'cribe:- f 20.Has the site of the proposed action or an adjoining property been the subject ofremediation(ongoing or-- 'NO YES completed)for hazardous waste? If Yes,describe:; _ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsormame: ��� �, �7 r��S ` �_��, Date: A la _ Signature: -_-- Part 2-Impact Assessment. The Lead-Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" — - No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use'plan or zoning regulations? -2. Wi1.l.the.<pr9p4asedaction--result i",_,aange.in-the-usesor.intensity ofuse_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 a establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affecttx�istinginfrastructure4orlmass`iransir hiking or-waikway? . 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: LJ 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, El 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 smaiT to Targe impact impact may may occur occur -10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage (—t problems? it.tlVjH,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 aparticular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering'its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box ifyou have determined,based on the information and analysis above,and any supporting documentation, ' that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date- President atePresident Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer t Signature of Responsible Officer in Lead Agency Signature of Preparer(if different fi•om Responsible Officer) __- . PRINT Page 4 of 4 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated. as to its significant beneficial and adverse,eBects,00n the-coastal area(wltich.includes all of Southold.Town)'. 1* 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. Thews, each-Answer must be.chained in,detail, listing both,s=orting 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# 014 PROJECT NAME-_ 004 516 Wei A p heat*m -bm.b-eewsubmuted.to.�icheck_appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Lam' 1. Category of Town of Southold agency action(check appropriate°response): (a) Action undertaken directly by"Town agency(e.g. capital ❑` -construction,planning activity,agency regulation,land transaction) El (b) Financial assistance(e.g. grant,loan,subsidy) U (c) Permit,approval,license,certification: Nature and extent of action: � f ' P Location of action:____ 115 _� .y__ 01: Site acreage:_ !-T/67 Present land use: g Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: {a)-Vann of-applicants (b) Mailing address:. {c)-Telephone-Number:Ax-ea-Code (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes.1J NoO If yes,which state or federal agency?= 6 C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes No F] Not Applicable Attach additional sheets if necessary Folicy- 2: -Protect and preserrve historic and archaeological -resources of the Town of-Southold7. See LWRP Section III—=Not es 3 through 6 for evaluation criteria F1 Yes'R Nolicable 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 0 No,� loot 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 S 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, —Polieies Pages 16 through 21 for evaluation criteria 0 YesF] No Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the'quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 -through-3.2-for-evaluationcriteria. ,� ElFJ ,Yes No Not -Applicable FE S!e Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies 'Pages 32"through 34"for evaluation criteria. ❑ Yes [—] No Not Applicable Attach additional sheets if necessary -P-oliey--8r Minimize environmental-degradation-in, Town, of Southold- frown- solid-waste-and-hazardous- substances and waZ=e Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes ❑ No 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. ❑. `�,0. .lam ,Not A'pPlicable Attach additional sheets if necessary VVORIUNG COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LVVRP Section III—Policies; Pages 47 through 56 for evaluation criteria. Yes Q No,T�Kat 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 LVVRP Section III—Policies; Pages 57 through 62 for evaluation criteria. es,�= lo2ot A Fly- 0 Attach additional sheets if necessary - Policy 12. Protect agricultural lands in the Town of Southold. See LVVRP Section III— Policies; Pages 62 through 65 for evaluation criteria. "El yes `0' N�o`� Not Appiica ale Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LNMP Section III—Policies; P s 65 through 68 for evaluation criteria. ;0 Yes-.0,leo- NotApplicable- PREPARED BY-_ fG ��Aaj TITLE Cel z T DATE