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HomeMy WebLinkAboutTR-8901 7 Michael J.Domino, PresidentOF SUrTown Hall Annex ol John M. Bredemeyer III,Vice-President 54375 Route 25P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 C4UNT`(,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1612C Date: August 30,2019 THIS CERTIFIES that the existing 2,154.1sq ft dwelling-, construct a 4'x20.2' first floor addition; existing 42'xl2 3' deck to be reconstructed and proposed to be extended 26.5'x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell• remove 8'x16' shed in side yard and for the existing 4.3'x8.2' "doll house" shed to remain; with the condition to establish and perpetually maintain a 10' wide non-turf buffer located along the landward edge of tidal wetlands; At 1130 Glenn Road, Southold Suffolk County Tax Map#1000-78-2-29 Conforms to the application for a Trustees Permit heretofore filed in this office dated September 16, 2016 pursuant to which Trustees Wetland Permit#8901 Dated October 19, 2016,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the existing 2 154 lsq ft dwelling; construct a 4'x20 2' first floor addition, existing 42'x12 3' deck to be reconstructed and proposed to be extended 26.5'x8' south side& 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new dawell• remove 8'xl6' shed in side yard and for the existing 4.3'x8.2' "doll house" shed to remain; with the condition to establish andyemetually maintain a 10' wide non-turf buffer located along the landward edge of tidal wetlands. The certificate is issued to Reuben&Margery David owners of the aforesaid property. Authorized Signature � F SQ Michael J. Domini, esident ��� yO Town all Annex O l 54375 Route 25 John M.Bredemeyer Ili,Vice-President '` O P.O. 13�ox 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Q 'Telephone( 31) 765-1892 Greg WilliamsO Fax(6311 765-6641 COUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD /t T DATE OF INSPECTION: $ � d Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction constructed �( Project complete, compliance inspection. INSPECTED BY: � pl� COMMENTS: CERTIFICATE OF COMPLIANCE: t Michael J.Domino,President �0f SUUTy� Town Hall Annex John M.Bredemeyer III,Vice-President ~� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith y Southold,New York 11971 A.Nicholas Krupski COQ Telephone(631) 765-1892 Greg Williams ly`Oum Fax(631) 765-6641 BOARD OF TOWN TRUSTEES _ TOWN OF SOUTHOLD October 17, 2018 Margery & Reuben David 1130 Glenn Road Southold, NY 11971 RE: 1130 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-29 Dear Mr. and Mrs. David: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 17, 2018: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#8901, as issued on October 19, 2016. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. Domino President, Board of Trustees MJD:dd John M.Bredemeyer III, President AN\\rj� S�(/jiyo Town Hall Annex Michael J.Domino,Vice-President ,`O l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 G A.Nicholas Krupski . Telephone(631) 765-1892 Charles J.Sanders O 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/silt boom/silt curtain 1 st day of construction constructed Project complete, compliance inspection rj( ,3=•ia CC#: C17-15314 't r 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 04/13/2017 under Liber D00012908 and Page 482 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 04/13/2017 SUFFOLK COUNT�Y� CLERK JUDITH A.PASCALE SEAL a[fl Number of pages This document will be public record.Please remove all Social Security Numbers prior to recording. Deed/Mortgage instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 M FEES - Mortgage Amt. Page/Filing Fee 1,Basic Tax Handling 20. 00 2. Additional Tax SubTotal TP-584 Spec./Assit. Notation or t' _ EA-5217(County) SubTotal Spec./Add. TOT MTG.TAX EA-5217(State) Dual Town Dual County R.P.T S.A. �C � '0 Held forAppointment Comm-of Ed. 5. 00 TransferTax ° 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 family dwelling only. Sub Total Y-E-5 orNO Other Grand Tota{ - (� If NO;see appropriate tax clause on page# of this instrument. �e3r-i9 1Jivi 3374590 1000 07800 0200 029000 3.000 5 Community Preservation Fund Real Prop P T S f (� Consideration Amount$ Tax Servi R LPA A Agency CPF Tax Due $ Verificat 93 APR 17 Improved Satisfactions/Discharc Mro erw Owners Mailing Address 6 � R RrT49' Vacant Land PATRICIA C. MOORE ESQ. 51020 MAIN ROAD TD SOUTHOLD NY 11971 TD TD Mail to:Judith A.Pascale,Suffolk County Clerk Title Company Information 310 Center l704e� , Riverhead, NY 11901 Co Name www.suffoikcountyny.gov/clerk Title# - 8 Suffolk County Recording & Endorsement Page This page forms part of the attached DECLARATION OF COVENANTS made by: (SPECIFY TYPE OF INSTRUMENT) REUBEN DAVID R MARGERY RIFKIN DAVID _ The premises herein is situated in b SUFFOLK COUNT'd,NEW YORK TO In the TOWN of SOUTHOLD TOWN OF SOUTHOLD in the VILLAGE u „ or HAMLET of SOUTHOLD BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. lover) G I I 1 Il lilll llil 1111!llf II 11111 Illll Illi!Illfl 111!11111 1111 1111111 1111111111 IIlI IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 04/13/2017 Number of Pages: 4 At: 01:15 :18 PM Receipt Number : 17-0062469 LIBER: D00012908 PAGE : 482 District: Section: Block: Lot: 1000 078.00 02 . 00 029.000 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 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 $5. 00 NO RPT $200 .00 NO Fees Paid $265.00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County DECLARATION OF COVENANTS CD THIS DECLARATION made this S ' day of March, 2017, by REUBEN DAVID and MARGERY RIFKIN DAVID, residing at 1 Ryder Court, Dix Hills, New York, hereinafter referred to as "DECLARANT(S)": WITNESSETH : WHEREAS, DECLARANT(S) is/are the owner(s) of certain real property located at 1130 Glenn Road, Southold, Town of Southold, County of Suffolk, State of New York, dscribad in the Suffolk County Tax Map as District 1000, Section 78, Block 2, Lot 29 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 a 10'wide Non-Turf buffer along the landward edge of the tidal wetlands; follows:NOW, THEREFORE, the DECLARANT(S) do/does hereby covenant and agree as 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and subsequently maintained a 10'wide Non-Turf buffer along the landward edge of the tidal wetlands as defined by Chapter 275 of the Town Code and as depicted on the site plan prepared by Geoffrey Freeman Architects, last dated January 29, 2014 and stamped approved on February 19, 2014; and as also depicted on the revised site plan prepared by MCH Design Services, dated November 27, 20-16 and stamped approved on December 2,2016, 2) These covenants shall run with the land and shall be binding on the DECL ANT(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 duly executed this instrument this day of March, 2017 Redden David r . Margery Rifkin David STATE OF NEW YORK ss: COUNTY OF SUFFOLK On thea day of March, in the year 2017, before me the undersigned, a Notary Public in and for said State, personally appeared REUBEN DAVID and MARGERY RIFKIN DAVID, 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/shelthey 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. �otary Publ� BETSY A.PERKINS Notary Public,State of New'pip' No.01 PE6130636 Ousliiled,in Suffnik Co" Commisstun piras July 15 2 t SCHEDULE A DESCRIPTION OF PREMISES PACE 1 OF 1 ALL THAT CERTAIN plot,piece or parcel of land,with the buildings and improvements th6iwn crested,situate,lying and being at Southold,Town of Southold,County of Suffolk and State of New York;known and designated as Lot No_13 on a certain map entitled'Map of West Creek Estates, property of Ernest E.and Harold W.Wilsberg,situate at Southold,Suffolk County,New York"made by Otto W.Van Tuyl from surveys completed January 28, 1963,and filed in the Suffolk County Clerk's Office on August 19, 1963 as Map No.3848 and bounded and described according to said map as follows: Beginning at apoint on the southeasterly side of Glenn Road distant 1,084.10 feet easterly and northeasterly along the southerly and southeasterly sides of Glenn Road,as the same curves,from the corner formed by the intersection of the southerly side of Glenn Road with the easterly side of Main Bayview Road,said point of beginning being the intersection of the division line between lots 12 and 13 on the aforesaid map with the southeasterly side of Glenn Road; RUNNING THENCE North 41 degrees 40 minutes 00 seconds east along the southeasterly side of Glenn Road a distance of 100 feet to a point on the southeasterly side of Glenn Road,said point being the intersection of the division line between lots 13 and 14 on the aforesaid map with southeasterly side of Glenn Road; THENCE South 16 degrees I5 minutes 40 seconds east along the division line between Lots 13 and 14 on the aforesaid map a distance-of 264.04 to a point; THENCE South 14 degrees 48 minutes 40 seconds west a distance of 89.89(File Map)90.01 feet (survey)to a paint; THENCE South 78 degrees 05 minutes 40 seconds west a distance of 79.88 feet to a point; THENCE North 7 degrees 55 minutes 00 seconds west and along the division line between Lots 1,2 and 13 on the aforesaid map a distance of 284.99 feet to a point on the southeasterly side of Glenn Road,said point being the intersection of the division line between lots 12 and 13 on the aforesaid map wi3h.the southeasterly.side of Glenn Road,the point or place of BEGINNING. �r�,ol Michael J.Domino,President o��fjF SOTown Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith CP_ Southold,New York 11971 A.Nicholas Krupski COQ Telephone(631) 765-1892 Greg Williams Cou ,��' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES _ TOWN OF SOUTHOLD October 17, 2018 Margery & Reuben David 1130 Glenn Road Southold, NY 11971 RE: 1130 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-29 Dear Mr. and Mrs. David: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 17, 2018: RESOLVED that the Southold Town Board of Trustees grants a One-Year Extension to Wetland Permit#8901, as issued on October 19, 2016. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, o Michael J. Domino President, Board of Trustees MJD:dd l John M. Bredemeyer III, Presidentrg SUUry� Town Hall Annex Michael J.Domino,Vice-President '`� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Charles J.Sanders �� 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/silt boom/silt curtain 1 st day of construction Y2 constructed Project complete, compliance inspection Al gft BOARD OFSOUTIJOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8901 DATE: OCTOBER 19,2016 ISSUED TO: REUBEN & MARGERY DAVID PROPERTY ADDRESS: 1130 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-29 AUTHORIZATION i. Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in and accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 19, 2016, C a in consideration of application fee in the sum of$250.00 paid by Reuben&Margery David and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wettand Permit for the existing 2,154.1 sq.ft. dwelling; construct a 41x20.2first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5'x8l south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.61x10.51 screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for i': i3 the existing 4.3'x8.2' "doll house" shed to remain; with the condition to establish and perpetually maintain a 10' wide non-turf buffer located along the landward edge of tidal wetlands; and as depicted on the revised site plan prepared by MCH Design Services, dated November 27, 2016, and stamped approved on December 2, 2016. fF IN WITNESS WHEREOF,the said Board of Trustees hereby cats Corporate Seal to be affixed, at i /cases sits and these presents to be subscribed by a majority of the said B a, of e. I TERMS AND CONDITIONS The Pennittee Reuben&Margery David, residing at 1130 Glenn Road, 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 T:-ustees 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 au'LLLorization 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 Pen-nit 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 *oE SOUjyO Town Hall Annex Michael J.Domino,Vice-President h0 lQ 54375 Route 25 P.O.Box 1179 Glenn Goldsmith j Southold,New York 11971 A.Nicholas Krupski G Q � � Telephone(631) 765-1892 Charles J.SandersO Fax(631) 765-6641 �ycOUNT`l,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 19, 2016 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: REUBEN & MARGERY DAVID 1130 GLENN ROAD, SOUTHOLD SCTM# 1000-78-2-29 Dear Mrs. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 19, 2016 regarding the above matter: WHEREAS, Patricia C. Moore, Esq., on behalf of REUBEN & MARGERY DAVID 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 September 16, 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 October 19, 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 i 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 REUBEN & MARGERY DAVID for the existing 2,154.1 sq.ft. dwelling; construct a 4'x20.2' first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5'x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for the existing 4.3'x8.2' "doll house" shed to remain; with the condition to establish and perpetually maintain a 10' wide non-turf buffer located along the landward edge of tidal wetlands; and as depicted on the revised site plan prepared by MCH Design Services, dated November 27, 2016, and stamped approved on December 2, 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, John M. Bredemeyer III President, Board of Trustees JMB/dd SITE DATA: SCTM # 1000-13-50-171 �� M C H DESCRIPRON: SQ.ff.AREA: LOT[OVERAGE f(CAVAIE ML .� Desiservice s www mchdeslonservices.com PROPmY 30705.6 SQ Fl. ]o 09 phone. (631)296-2250 PROPERIYYE MS. 75049 SQ Fl 17A01IS - _ email BUDDABIE PROPmIY 23200)SQR 53 AM michael@mchdeslgnservices cam ESOMIED AM Of MOO SQ R . OIDUND 00 MEE: Q10"CUSL 21759 SQ Fl 94% - — _ z - 13M 0E0i 4822 SQ FL 11% MMPDM S&O SQ.R 01% - p EC EI uVRE �- mmN6 fN®k 2569 SQ R Ll x NOVR""111111118 8745Q R o4% IV3 2016 w r , ^ Q PROPOS®DRY AXff1 t♦: 2198 SQ R 09% 4W YD 2W YD ' Z P� Southold Ta1ron ww 0 W SENJPOSED DIYdEU 1-Td. - 5 W YD 3a]YD Q t 2 zi 2 IOSAL 32782 SQ ES 141% 901 YD 5E0 YD I Hpd/gT IT OF - AP OF TITE LANDWARD B I LIn1T TITAL WETLAND II A Q A a b'NON-NRF r ^ O 0 I I to v 1 rl W z t N 07 I W 284.910' O A 0 3 II II umn'810F BALE RN Y Q 1 1 91.2' :----------. oc°rrne muaiar 1 Q 1\ 1\ di 11 ¢3 a GARBAGE EXISTING ABPHALT IVEWAY r:E D 2 N WEST GREEK \\ id 1 IXIST- O \ pj (DREDGED) \ qq�-- 1 DECKp- \ \ \ ? 1 Q� Ex ISTY. EXIST. ORCH � DRAWN BY: MH \ \ ......................... �,€ 1 w .—APPROVED BY s PROF SED .- '4 a.o<arroc�ic \\ N.oxs ""n°P I ADC'iriON O G O O • " . ,. 48. °« - "t0r.•rzvOfooH min"`,w e I 40„� \ \ . .................... o. 11/27/2016 BOARD OF T RUSTEES ..... 89 \ GONGRETE��Q: - NEW /t °i .�DRT7UEIL 1\\J TOWN OF SOUT�� 99 , \ WABNG T -m ............................. ...:........... .. , LDGATIDN"....:�........ . SCALE: SEE PLAN r 1 1 IL b N&o F Ln7(WArl GALL IES) G L, 16°1514011 E 264,040' DATE D ,e �,.. Ze�(a 1 11 11 APROXIMATE LANDWARD �1O LIMIT OF TITAL WETLAND 11 1I EL ® SHEET NO: IV 2 SITE FLAN MEETS'BOUNDS BY.YOUNG'YOUNG SCALE: 1 FE _ 401_011 DATED AUG 22 19.. John M Bredemeyer III, President :?o`� cow; - Town Hall Annex Michael J. Domino, Vice-President :'ter 'z <= 54375 Route 25 Glenn Goldsmith ` o '`✓ z : P-O- Box 1179 A. Nicholas Krupski ':y o '} ;_' Southold, NY 11971 J Charles J- Sanders ���i , Telephone (631) 765-1892 ti'Jt� =- Fax (631) 765-6641 J BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 16eWtf? Clo ?Ai-k1CtA- c. meaec e8o E�(a TO: Please be advised that your application dated _S� J('e Z01(' has been reviewed by this Board at the regular meeting of f1Lj C and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) '/ Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due_ Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: 150,ov TOTAL FEES DUE: $ \ BY: John M. Bredemeyer III, President Board of Trustees SITE DATA: SUM # 1000-1-3-50-17--1- �� ® C E M C JH Desi n Services OESQIIPi* SQ.9.ARF&: LOT OM% allVAIE flLL �— www mchdesionservlces.com mmTY. 3D7056SQFL 1009 - SEP 162016 216 31)296-2250 i�envWumL Isa4.9sQrt v11YFs . mail: BUBDF8IE PSYR®h 232007 SQ FL 331010 - ichael@mchdesignservices.com SDUIhOItI TDwn BWHD 1PF10F 3m SQ FL um D68R8FNcL 900 of Trustees-- t11 FY6101GROWE: mg SQ FL 9.4% - z FY0105 DW(: 48u SQ FL 11% - FLDIDWPDn S&O SQ SL DI% - - DEIA6 SB®L 7569 SQ FL L14 W � P 91ADDmDBL 81;1 SQ FL 0.4% - W r , O F9 MI)F0i100mfdk 7193 SQ.FL 0.9% 4W YD 2W.YD. L. _ v� Q FPoPoSlO OPYYHIk I.8'dn - SW YD 3W.YD � � a < A �{ z IDI1L• 32782 SQ FL NI% 9111.YD. SW YD. 1 I I APROXIHATE LANDWARD I LIMIT OF TITAL WETLAND z 1�1 < A a EL Qui cn I I to ,pI9� N 7°54'599 W 28 ^1 �--1 0 Ori I I 1 4 970 ® A 0 3 I 1 LIMUSIOV C(FARRiNG CQ �. O 1 I 91.3 w:14r BdLEB) : a 6Tae nwdcvar _ .-..wAw.. 1 1 1 D3 "?43�- N EX. Q GARAGE � EXISTING ASPHALT IY9UAY WEST GREEK \\\ ? 1 IXEICK (DREDGED) \ \ 1 DSCK •� O EX ISTY, EXIST. 0,, wouss + \ ....................... DRAWN BY: MH PROI?OSED ) O l5/4'S( aeDi f1O :uor unwim a ADLjfTION R O O 8, ' .rnrovnuccRu : :: :......................: V 9/16/2016 eONCREMi oe __DRTWELL � \ NBV r� m"•� V �L=, i — 1.ai 1.00ArwNee...::........ . ........`................... ......:.:........ SCALE: SEE PLAN 1 1 �04AYle�) S 16 1$'40° E 264.040 II 1 1 APROXIMATE LANDWARD IO 1 1 LIMIT OF TITAL WETLAND 1' 1' 2 SHEET NO: SITE FL^AN MEEfT 6 BOUNDS /L BY:YOUNG 6 YOVNG SC,4LE: 1 FF = 4OI�0" DATED.AUG 22.1993 E C E � V E C H Desion Services 1,ppw.m'hdesianservlces.com SEP 1 6 2016 (63)298-2250 -- — — — — em III: mic hael@mchdesignservices.com _ Southold Tow B r f hutees Z DOE] Doug�� I� � . Il �l , �� �, � �! ,� �, � , I I I ll 11 11 l! 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CPEN RNUNG • _ DRAWN BY: MH EX STORAGE EX STORAGE 9/10/2016 ' SCALE: I1111111111111111111111111111111111111111 SCALE: SEE PLAN BASEMENT FLAN SHEET NO: SCALE: 1/5" = 1'_011 A�3 L � �9 � M C H C C Desion Service www.mchdesinnservices com SEP 1 6 2016 (631)298-2250 w'v° email: EXPAND DECK michael@mchdesignservices.com Southold Town Board of Trustees C/1 4 z co 19'-II' STAIR O EXISTING DECK 7-Iib• A'-0•k 3'd 13/16• _r Ex w�4 o 0 EX.BEDROOM B µ _ NEW ENLARGED insW V STAIR Q 4'-0° m O W 3'_I° O EXISTING DINING ROOM EXISTING ® y J ED EXISTING DEN 100 KITCHEN W rT, SHELVES Z a A WALK-IN 0 v CLOSET O In �O � ----------------------------- E L BAf"— UNEN ovER L TOILET EX.BEDROOM 9 EXISTING GARAGE EXISTING LIVING ROOM ........................ EXISTING ENTRY DRAWN BY: MH Ex.BEDROOM 9/10/2016 SCALE: 111111111111 1 11111111111 1111111111111 SCALE: SEE PLAN FLOOR PLAN SHEET NO: SCALE: 1/8" = 11_0 1 1 John M. Bredemeyer III, Presi �FFO(,��,* {` Town Hall Annex Michael J. Domino, Vice-PresIaU&fh ��� oF_ 54375)Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski o ® Southold, NY 11971 Charles J. Sanders 'y& �p�r Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Q0_11, 2-0/ Completed infield by:-4" /&!2" Patricia C. Moore, Esq. on behalf of REUBEN & MARGERY DAVID requests a Wetland Permit for the existing 2,154.1 sq.ft. dwelling; construct a 4'x20.2' first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for the existing 4.3'x8.2' "doll house" shed to remain. Located: 1130 Glenn Road, Southold. SCTM# 1000-78-2-29 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet , 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: d 1"; k-4 r� i Present were: ✓�! m Bredeeyer _ 4. Domino _V/G. Goldsmith -v'-IN. Krupski V C. Sanders Other Page 1 of 2 John M Bredemeyer III, Pres ��gOfF01,�� Town Hall Annex Michael J. Domino, Vice-Presiaent 54375 Route 25 Glenn Goldsmith o '` P.O. Box 1179 A. Nicholas Krupskio Southold, NY 11971 Charles J. Sanders 'y?j® o�� , Telephone (631) 765-1892 Ol �� Fax (631) 765-6641 �zztrlrc.�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Patricia C. Moore, Esq. on behalf of REUBEN & MARGERY DAVID requests a Wetland Permit for the existing 2,154.1 sq.ft. dwelling; construct a 4'x20.2' first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5'x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for the existing 4.3'x8.2' "doll house" shed to remain. Located: 1130 Glenn Road, Southold. SCTM# 1000-78-2-29 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 2 111 • y AW a/i •l i t 3 a � �. � r f t,. �4 r - — ... •�}]!!,� y...�� rye _� ,�� �e��r ' 1-' � ,,.w lor y David / Glenn Road,Southold 1000-78-2-29 c-ti ,!. '• 10/11/16 ,, kk � r ! i K x _ + Ao Y h DAVID 113' GLENN • • , SOUTHOLD 1000-13-50-171 -- _ �� � • i a +h' 4 40 n1l 14 4• i All IP 14 Io Jw " '. -• ilk !; ti .. �iii �",...�.� • • ,�.��'� ! Y•. ,_. s-� �r- . � a _ y � "". alp + _ C • ,. .. + •, i ,�. r ,� �, +rr 1 Y .. OL r� � - r �.� �-•` '""�'P�iX'k�'Tc..._. �' ~er. lie. ++ � --.,it R Ifo4„ �Aie r s 1 i Yui' ♦. `! '`*ft NIL - � 4J 41 DAVID ll 30 GLENN ROAD SOUTHOLD t i �1 1000-13-50-171 t, WOW- • ; ' #; • '• f'' po AIL + •- '' , ` +.i. • _ ,'�•►, , 7F C moi + -4,4 .� - •� � int �. � . � � `• -� i ' ,. A. .._ �w' lot" r v dip f TV AA `f t A s 1 •� ' .. • ♦ f it` �. - rpt;. *Oar} � 'rte �`�M • .����' r :�-'t -t�%etir`•*-�� � �r• � ` � ' p . OIL- NCO i ? ,. _ '`••- � - - • � �' �.` .� `ti , ,1#, •ems' r�`i��,. .414 al A � �• ■ �' p • ( 1Alk ., .. AAW 4f pe 4d I it Ar me a '�i FF �i1 - - C o-��3i �•^ ,_* �„ S a• yj ._ :' + -'�",_ _ • t� _ J Y .f" . 'fir. *::• p. . 1 u ` L. • '° iy - �.. ` r , + ' - ',fir y. oe ' - '." Vis'f �• '! t. _� a s �'�'�' , '- '�� .. e • i.. _ j .� 6• , r1 _ i _ 4 'fib h +. I1--Wwwww - 1 � , , • s _ - Ab it J 7 {..14 - } M. 49 AL 4v JAL %10 dA DAVID 1130 GLENN ROAD SOUTH OLD SCTM: 1000-13-50-171 t 1 f r 4 � j • k Y s _+s. ''��' �r• r •,r�M 7r � i' w s s� •� ,,� RRSM�i«' xu,���. r � -.. i 1'. f •i..� �'r -' �� }Y �� a 1 � � .a �,� _..tiF kfo ye'2k ♦ -� 1 r kr _ 11 10 AN I � � DAVID 113 0 GLENN ROAD SOUTHOLDr SCTM: 1000-13-50-171 .9 { - Y -s+ -- r MAP! Atd OWN l i op— �.. '10 111 1 _ � '�''°•' � ,�''; . ,, a s i y Now h" { _ .. . .. ._ _ .•-- - _•- ; ice' , `�+die+r . Til.. w - �'• Aa- .. mob" � A . AAW email Betsy Perkins <betsy.moore765@gmail.com> nD E C E I V E .nn� Reuben a , 1 message NOV 3 0 2016 DiSalvo, Diane <diane.disalvo@town.soutFri, Nov 18, 2016 at 11:01 AM t ld. To: Betsy <betsy@mooreattys.com> Sot;thTownfT BoW T FYI —You had given me a $50.00 check for the Final Inspection fee. I still need revised plans showing a 10' wide non- turf buffer before I can issue the permit. Di,Glv,-e Di Salvo I l Southold Town Trustees Town Hall Annex/First Floor 54375 Route 25 P.O. Box 1179 Southold NY 11971-0959 (631) 765-1892 Fax: (631) 765-6641 C.• �oF so�j� OFFICE LOCATION: ®S� ®l® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) N ac ® �� Telephone: 631 765-1938 Southold, NY 11971 O Fax: 631765-3136 c®UN�`6,� 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 12, 2016 Re: LWRP Coastal Consistency Review for REUBEN & MARGERY DAVID SCTM# 1000-78-2-29 Patricia C. Moore, Esq. on behalf of REUBEN & MARGERY DAVID requests a Wetland Permit for the existing 2,154.1 sq.ft. dwelling; construct a 4'x20.2' first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5'x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for the existing 4.3'x8.2' "doll house" shed to remain. Located: 1130 Glenn Road, Southold. SCTM# 1000-78-2-29 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. Require a vegetated, non-turf buffer 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. �g�yfF0t,� Peter Young,Chairman y Town Hall,53095 Main.Rd. Lauren Standish,Secretary P.O.Box 1179 i Southold,NY 11971 Telephone(631)765-1892 Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., October -12, 2016 the following recommendation was made: Moved by Greg Williams, seconded by Jack McGreevy, it was RESOLVED to SUPPORT the application of REUBEN DAVID & MARGERY DAVID for a proposed first floor addition to the existing dwelling; existing deck to be reconstructed and proposed to be extended 26.5'X 8' south side, 12.3' north side along the rear of the existing dwelling with new 4' stairs; 42.6'X 10.5' proposed screened-in porch below existing deck; 4'X 6' outdoor shower; install a new drywell; remove 8'X 16' wood shed in side yard; and 4.3'X 8.2' "doll_house" shed to remain. Located: 1130 Glenn Rd., Southold. SCTM#78-2-29 Inspected by: Greg Williams, Peter Young The CAC Supports the application with the Condition of a 15' non-turf buffer. Vote of Council: Ayes: All Motion Carried John M Bredeme er I[[, Presu'' �Qf S�UTiy t % Town Hall Annex 3 Y 54375 Main Road Michael J- Domino, Vice-President P.O-Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen,Trustee G 19� Telephone(631) 765-1892 Charles J. Sanders, Trustee 'Q YO I,YG,oU�'�� - Fax(631) 765-6641 BOARD OF TOWN TRUSTEES CFO V i a I D TOWN OF SOUTHOLD D To: Southold-Town Building Department stp 6,11 Re: Verification of Building Department Permit Requirements c� TOWr1 0�'S®U'1'�0LD SCTM#: �o��r �� Property Owner Name: ' &UeRf, PAVO 6" Mtk" DAVID Date Sent to Bldg_ Dept.: 1 ` r 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 ill the proposed project require a Building Permit? Will the proposed project require a variance determination from 2he Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: X V I QJ DCs--�d Signature of Revie r Date John M.Bredemeyer III,President % ?Q Town Hall Annex Michael J.Domino,Vice-President 10 `'�O 54375 Main Road p, �'•� P.O.Box 1179 James F.King,Trusteecn Southold,New York 11971-0959 Dave Bergen,Trustee �`; �,' r 'h ' 4 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/Tran sf xtf nsion D E u Received Application: ► 0.V I Y Received Fee:$ 26,-M Completed Application:: Incomplete: _ _ _ I SEP 1 6 2016 _SEQRA Classification: Type I Type lI Unlisted -,�Coordination:(date sent): Southold Totiyn LWRP Consistency As sme�}t,Form. 10.7`1 b CAC Referral Sent: ll((�� Date of Inspection: 1641.1ire _Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: o Resolution: Name of Applicant: v h__ -_-)_ _. �c�- - GV✓ D�_J_lcl� Mailing Address: �d� C3—. D1 — c `s W1 I Z y –�I 5 . Phone Number: ✓tet(o -7, -79 Suffolk County Tax Map Number: 1000-_ l` IZ W–z r tl Property Location: _ // 3 0 � enf'1 6�-D ceGi , (provide LILCO Pole##,distance to cross streets, and location) AGENT: _--.- -- Ct��Y G G/Ct DD l (If applicable) Address: 6—1010 1010 Ce/l'1 (?0qC,/jj . _ 1f ./V Phone: (T 10 1 << Board of Trustees Application GENERAL DATA Land Area(in square feet): (,D -70j-, Area Zoning: Previous use of property: U,--e Intended use of property: i9r291.7owd &CQ2 s & eWi,1,zq c{eGl- Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes 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.? _ X Yes No Cy14Wq- Does the structure(s)on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date - 12 �6gz 30 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):- le, zC 1 David&Margery Reuben Project Description Existing house constructed 75' from edge of wetlands (2,154.1 sq.ft.) in 1984 Proposed existing house first floor addition 4'x 20.2' (87.4 sq.ft.) Existing Deck 42.0'x 12.3' (482.2 sq.ft.)to be reconstructed and proposed to be extended 26.5 x 8' south side/12.3'north side (219.8 sq.ft.) along the rear of the existing house with new 4' stairs; 42.6'x 10.5'proposed screened in porch below existing deck; 4'x 6' outdoor shower new drywell; remove 8 X 16 wood shed in side yard. 4.3 X 8.2 "doll house" shed to remain Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Jowared add-z- ' - `e3 Cf 5e ��G�,6 �x /a;Z,3 > S/d7'I -f-0 �N(S kW6 /C Area of wetlands on lot: o Z e6e15 Percent coverage of lot: '38 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: __ _feet Does the project involve excavation or filling? No X Yes 'AVOA YlVs 1f yes,how much material will be excavated? AVI' ' yards How much material will be filled? _ D _ _ _ cubic yards 00 0414,, Depth of which material will be removed or deposited: _ -f' t Proposed slope throughout the area of operations: 5 A2& Manner in which material will be removed or deposited:/ J A4 Statement of the effect,if any, on the wetlands and tidal waters of the town that may result by r reason of such proposed operations(use attachments if appropriate): 61 Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 1 -Project and Sponsor Informat[on Name of Action or Project Project Location(describe,and attach a location map): 1130 6-le-4 &> =W610'1 Brief Description of Proposed Action: de C/C) 27 SkwI 60 Name of Applicant or Sponsor: Telephone:c�/� _�2Yl_ 7:37T E-Mai: 'Address: City/PO: State: Zip Code: �tX �/� �� /VY //7z/6,- 6l 1.Does the proposed action only involve the legislative-adoption o-f 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 d 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 i YRS i If Yes,list agency(s)name and permit or approval: 3:a.Total acreage of the site of the proposed action? acres, b.Total acreage to be physically disturbed? _._Of _ __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 ❑Rural(non-agriculture) ❑Industrial [:]CommercialB<Csidential(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? ❑ ;❑ b.Consistent with the adopted comprehensive plan? ❑ _19 ❑ I 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑l 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? N�O'y y YES b.Are public transportation service(s)available at or near the site of the proposed action? '4�� ❑ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action?,# ❑ .❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO__ YES- If No,describe method for providing potable water:_ 11.Will the proposed action connect to existing wastewater utilities? NO YES 1 If No,describe method for providing wastewater treatment: 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b.Is the proposed action located in an archeological sensitive area? ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? El 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: S eline ❑forest ❑Agricultural/grasslands ❑Early mid-successional Eg"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? j-fes/ a 16.Is the project site located in the 100 year flood plain? NO YES o 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO _YES! If Yes, a.Will storm water discharges flow to adjacent properties? EINO QYES {❑ b.Will storm water discharges be directed to established conveyance systems(runoff and stor drains)? If Yes,briefly describe: , 0NO [TYES F7�1(fU`�ie Page 2 of 4 18.Does the proposed action include construction or other activities that result id-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 i NO YES solid waste management facility? If Yes,describe: ' 20.Has the site of the proposed action or an adjoining property been the iubjeci of remediation(ongoing--or'- 'NO' YES' completed)for hazardous waste? _ If Yes,describe: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE D Applicant/sponsorna � Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the-following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" - - - -- -- - - ---- •-- �,--No;o'r -Modci•atc small to Inrge impact impact may may occur occur_ I.; Will the proposed action create a material conflict with ab 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 I private water supplies? b.public/private wastewater treatment utilities? El 8. Will the proposed action impair the character or quality of important historic,archaeological, a architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, tu waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate! small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage + problems? i Ill. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact, including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this-'bo-x-if you have determined,based on the informafio-n and analysis above;and any supporting docuiiientafion, that the proposed action may result in one or more potentially large or significant adverse impacts and an vironmental impact statement is required. heck 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 en vironmental,'inpacts. Town of Southold-Board of Trustees rani of Lead Agency Date - - OZ President Print or Type N_ of Res i6­n icerun-lAdid Agency Title of Responsible Officer Signa Responsi ffi er rn Lead Age y Signature of Preparer(if different fi•om Responsible Officer) ! PRINT Page 4 of 4 i John M. Bredemeyer 'rii, President �y4�oSUfF04 o Town Hall Annex Michael J. Dom ino,,Vice-President 54375 Route 25 � o Glenn Goldsmiths ? P.O. Box 1179 A. Nicholas Krupski o �� Southold, NY 11971 Charles J. Sanders t'�'�0! Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of REUBEN & MARGERY DAVID 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 1 ,residing at/dba l 3D n f—d. o being duly sworn, depose and say: That on the day of , 201 , I personally ooted the property known as t 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, October 19,2016. Dated: (signature) worn to efcre me this da 20 t (O r –b--ACI otary Pub BETSY A.PERKINS Notary Public,State of New York No.01 PE6130636 Qualified in Suffolk CoMal Commission Expires July 1 BOARD OF TRUSTEES TOWN OF SOUTHOLD: NEW YORK ---------------------------------------------------------------x In the Matter of the Application of AFFIDAVIT OF DAVID MAILING Applicant's Land Identified as 1000-7-8-2-2.,e dq ---------------------------------------------------------------x COUNTY OF SUFFOLK) STATE OF NEW YORK) I, Betsy Perkins, residing at Mattituck, New York, being duly sworn, depose and say that: On the 6T" day of October 2016 1 personally mailed at the United States Post Office in Southold, New York, by CERTIFIED MAIL, RETURN RECEIPT REQUESTED, a true copy of the attached Legal Notice in prepaid envelopes addressed to the neighbors on the,attached list. Attached hereto is the white receipt post-marked by the Southold Post Office on said date. etsy Perki (Signature), Sworn to before me this /arm day of October, 2016 (Notary Public MART C. RUTKOWSKJ Public,state o N w York Notary No 4982528 oualified in fres June 3nty.- Commission Exp PLEASE list, on the back of this Affidavit or on a sheet of paper, the lot numbers next to the owner names and addresses for which notices were mailed. Thank you. i DAVID TRUSTEES MAILING LIST 1000-78-2-29 JOHN&JUDITH LYNCH 1020 GLENN ROAD SOUTHOLD NY 11971 SCTM: 1000-78-2-28 JOHN&LORENA BLOOM 503 SWEET HOLLOW ROAD MELVILLE NY 11747- SCTM: 1747SCTM: 1000-78-2-30 PETER&LYNN RICHARDSON 45 HARRISON DRIVE BERKELEY HEIGHTS NJ 07922 SCTM: 1000-78-2-6 ANIELLO &MIRIAM D'APONTE 592 7TH STREET BROOKLYN NY 11215 SCTM: 1000-78-2-5 •- � w RECEIPT 14 7901 5002 8200 oloo 15 RECEIPT RECEIPT RECEIPT FROM: 214 7901 500 8200 0097 37 214 7901 5002 8200 0097 44 214 7901 5002 8200 0097 51 oore Law Office FROM' I FROM. FROM' ?Edavid trustees oore Law Office core Law Office core Law Office ~ E david trustees E david trustees E david trustees I 0 UDITH LYrRCFi SEND TO: SEND TO: 11 SEND TO. 0 NN O/CD OHN&LO ETER&LYNN RICHARDSON NIELLO&MIRIAM D'APONTE O DtYi1197103 S 1�t RO 5 HARRISON DRIVE g2 7TH STREET E Lely ERKELEY HEIGHTS NJ 07922 j ROOKLYN NY 11215 FEES: tags m�rq,', cp n, 3 FE FE s o ass S ertified Fee �{`' L' O 0 3 30 s ,; ;.;, 4 i ost �rwF^' ® 0 o a9H �:, co etum Receipt 270 �nl"?, e ee"j" �l 3 3 3 3 ee q'N°� LL rs p r. oe O 70 Restricted et i 7 pr 2, !' et m ceipt,Q70 Co t Recent N ;, e r ash., t yrr Nj, esl icte TOTAL $6.465 j estr '��' POSTMARK OR DATE TOTAL -465 — - T o$6r4 ` L $;6. POS POSTMARK OR DATE 7('O_.DAl qS- 11�ARK O ?DA 1 - NUTILL Ulm HtAKING, 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: REUBEN & MARGERY DAVID SUBJECT OF PUBLIC HEARING : For a Wetland Permit for the existing 2,154.1sq.ft. dwelling; construct a 4'x20.2' first floor addition; existing 42'x12.3' deck to be reconstructed and proposed to be extended 26.5'x8' south side & 12.3' north side along the rear of the existing house with new 4' wide stairs to grade; construct a 42.6'x10.5' screened-in porch below deck; construct a 4'x6' outdoor shower; install a new drywell; remove 8'x16' shed in side yard, and for the existing 4.3'x8.2' "doll house" shed to remain. Located: 1130 Glenn Road, Southold. SCTM# 1000- 78-2-29 r TIME & DATE OF PUBLIC HEARING : Wednesday, October 19, 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 I Board of Trustees Appli__ don County of State of New York REUBEN DAVID AND MARGERY DAVID BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. %euben David e J - Margery Da Qd Sworn to before me this day of a _, 2016 otary Publ' BETSY A.PERKINS Notary Public,State of New York No.01PE6130636 Qualified In Suffolk Cou��....� Commission Expires July 18 , , H Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) REUBEN DAVID AND MARGERY DAVID, as owner of premises 1130 Glen -/ 3- 50--/7/ Road, Southold,NY (sctm: 1000- )residing at 1 Ryder Street, Dix Hills, NY 11746 do hereby authorize our attorney, Patricia C. Moore,to apply for permit(s) and appear before the Southold Board of Town Trustees on our behalf. f � (Owner's signature) Reuben David (owner's signature) Margery v r� ` APPLICANT TRANSACTIONAL DISCLOSURE FORM (FOR SUBMISSION BY OWNER and OWNER'S AGENT) 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: DAVID,REUBEN&MARGERY AND MOORE,PATRICIA C. (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 or company name.) NATURE OF APPLICATION:(Check all that apply.) Tax Grievance Variance Special Exception If"Other", name the activity: Change of Zone Approval of Plat Exemption from Plat or Official Map Other Trustees X 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 Complete the balance of this form and date and sign below where indicated. Name of person employed by the Town of Southold: Title or position of that person: Describe that relationship between yourself(the applicant) and the Town officer or employee. Either check the appropriate line A through D(below)and/or describe the relationship 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 Signature: �21 eu enn David Mar �a C.Moore Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS L 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 signifi�nifioant bene ioiahand adverse effect's,upon-tlie coadW:diea'(wlu'ch includes,ill,of Southold Town). 34 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. Tlius;-,'eacli-`'Ahsrver must be�exnli"d 'iri'iletiail, Iistina`b'atli•su[pnortina aid-,uon- sunAortina 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# =~—TS'p7� 7 2 s g ® 2-q PROJECT NAME . . D) e--u - The Application has been submitted to(check appropriate response): Board of Trustees in Town Board ❑ Planning Board❑ Building Dept. ❑ , I Category of Town of Southold agency action(check appropriate'response): n (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: _ lel/ .e- ,r•{ a� ,��rs - - 6W,--f `x 'o ' Location of action:_ 130- Site 3 _Site acreage:. Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: , (a) Name of applicant: C,h" (b) Mailing address:_ 01 117Y�- '6),�;-7 (c) Telephone number:Area Code 73 -7? - (d) w -7? -(d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes;0;. No�LyJ,' If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. 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. [5Yes ❑,' No ❑ Not Applicable 77w, v ro 1,9,6 L i� /}9CelGeo .����e�_� G1�.2 -P�_ Gip �ii1C�s i`�te c1 ,S /�•fy_caw___. - - --, -. — -,- - Attach ad 'Tonal sheets if nece sary 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 ❑,5 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 Sectio II—Policies Pages 8 through 16 for evaluation criteria Yes ` No ❑ Not Applicable s- W 57 IF LZ 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 throng 21 for evaluation criteria Yes ❑, 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 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWMP Section III — Policies Pages 32 through 34 forev luation criteria. F] Yes [`No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—PoIicies; Pages 34 through 38 for evaluation criteria. 0 Yes 0' No I 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 LWMP Section III;Policies; Pages 38 through 46 for evaluation criteria. Yeo No Not Applicable Attach additional sheers if necessary \1 WOREING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III•—Policies; Pages 47 through 56 for evaluation criteria. 0;Yes Q, No ffNot 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. 11 Yes 1:1 No 1 atNot 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. 0 Yes "0 No Not Applicable PREPARED BY, .__._ __ TITLE DATE. �"�I2 -AP