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TR-8933
I o��OF SoUjyOl Town Hall Annex Michael J.Domino,President John M.Bredemeyer III,Vice-President ~ 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �pQ Telephone(631) 765-1892 Greg Williamsl�COM � Fax(631) 765-6641 e BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 19, 2018 Sam Fitzgerald Architect, PC 15 E. Putnam Avenue, #234 Greenwich, CT 06830 RE: ELIZABETH-W. FURSE 2412 PENINSULA ROAD, FISHERS ISLAND SCTM#: 1000-10-3-5 Dear Mr. Fitzgerald: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 19, 2018 RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8933 for the as-built 5' wide by 14.9' long deck extension in lieu of the previously proposed 175sq.ft. extension; and for the as-built removal and replacement of the existing set of stairs off deck to ground with associated middle landing in lieu of the proposed removal of the existing stairs and construction of new further landward along deck extension; and as depicted on the site plan prepared by Sam Fitzgerald Architect, PC, dated July 2, 2018, and stamped approved on September 19, 2018. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. incerely, Michael J. Domino President, Board of Trustees MJD/dd Af A$ Wz 00 Vo 0 z t 111 In V— N N II it I w I JUL 2 6 2018 N 3s'�+� r �• I Southo!d Town z 20'-0' Board o`TruLtees w RIGT OF AY LCL N r ► i I I 35'-0' APPROVED-BY I - BOARD OF 1 Rus TEES y J I TOWN OF SOUTHOLD � o l 2 I Q I DATE' T o O I &4 «s i EXISTING EXISTING HOUSE DECK I `' j z I L I EXISTING DECt �—___ LU W EXISTINGSTAIRS e I CL TO REMAIN I I OPEN DECK ADDITION ADDITION I I I EL. 17.68 I I q 50, _ I ONE-STORY FRAME ADDITION I 3. 183 WITH LOWER LEVEL BELOW I I ELISABETH W. FURSE _J LOT #37 & 38 -- PENINSULA ROAD FISHERS ISLAND, NEW YORK I I 0 "_ SECTION 10, BLOCK 03, LOT 5 I „ E 10,050 SF. 0 I 12g WLL u. Q � a SITE PLAN N - o SCALE: 1/16" = 1'-0" W °° � � a cy) �� W Z 10 r I 1►;�! ! V o N I I, t J U L 2 6 2018 z g I I w o pW a Seuthold Town N Cl Board of Trustees W o Q I � g wEn — — W �_ ------ --i I � 04 LL N 20'-0" WEST oy j IGHT OF WAY (GREAT) �V _ I '359-09' o� HARBOR � o I I I o I EXISTING DECK EXISTING I Q /,c HOUSEoc EXISTING DECK I PROPOSED J STAIRS DOWN I j �tr TO GRADE r3• FROM DECK LINE OF EXISTING PROPOSED DECK TO BEOPEN I Ui ADDITION DECK PROPOSED - I REMOVED Fj ADDITION ELISABETH W. FURSE o ONEADDISTORYFRAME �s:3. � ITION WITH LOT #37 & 38 -- PENINSULA ROAD J BASEMENT BELOW FlSHERS ISLAND, NEW YORK SECTION - 10, BLOCK 03, LOT 5 E 10,050 SF. LLQ SITE PLAN lco co SCALE: 1/16° = 1'-0° Nco i; SAM Fr[ZGERALD AkCHITECTM 15 E.PUn MAVO&W,",GREM",Cr 0680 P.860.287.38081 P 631.788.71921 MffV fapc ret 25 July 2018 Diane DiSalvo ! ' (� Town of Southold Board of Trustees Town Hall Annex Building 54375 Route 25 '' JUL 2 6 2018 P.O. Box 1179 ^_ Southold, NY 11971 -- RE: Furse & Fisher Residences Fishers Island, NY Dear Diane, I would like to submit two amendments to Trustees permits. These are the following: 1a-3-S Furse Residence-2412 Peninsula Road: the original permit included rebuilding stairs down from an open deck, and building a new 8' deep deck extension. We decided in the course of construction not to rebuild the existing stairs and to keep them, and to make the deck 5' deep instead of 8'. This action reduces the level of disturbance on the seaward side of the house. Fisher Residence -3300 Clay Point Road: the original permit called for removing a deck built along an open porch on the seaward side of the house, and building a new 20' x 40' swimming pool. In the course of construction it was decided to remove the deck but extend the existing porch slightly, and to construct a much smaller pool, 12' x 40'. The setbacks from the top of bank, wetlands, and high water remain the same as what was originally approved. Please feel free to contact me if you have any questions, and please let me know about next steps. Sincerely, SAM FITZGERALD ARCHITECT, PC Michael J. Domino, Presid' �Q Com: Town Hall Annex John M. Bredemeyer 111, Vice-Presiaent y�Q 54375 Route 25 Glenn Goldsmith ro z P.O. Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: / Completed in field by: �� Sam Fitzgerald, Architect on behalf of ELIZABETH W. FURSE requests an Administrative Amendment to Wetland Permit #8933 for the as-built 5' wide by 14.9' long deck extension in lieu of the previously proposed 175sq.ft. extension; and for the as-built removal and replacement of the existing set of stairs off deck to ground with associated middle landing in lieu of the proposed removal of the existing stairs and construction of new further landward along deck extension. Located: 2412 Peninsula Road, Fishers Island. SCTM# 1000-10-3-5 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 1'00 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/comment /standards: Gln- � - d I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer '_�M. Domino G. Goldsmith N. Krupski G. Williams Other Michael J.Domino,President ��0f SO!/j�o Town Hall Annex John M.Bredemeyer III,Vice-President ,`O l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski • Q Telephone (631) 765-1892 Greg WilliamsyCOU O Fax(631) 765-6641 � NTY,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: v /� �Ch. 275 Ch. 111 -INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction �'/ constructed ly" Project complete, compliance inspection. •`�INSPECTED BY: COMMENTS: CERTIFICATE OF COMPLIANCE: John M.Bredemeyer III,President �*rjf SD(/jiy® Town Hall Annex Michael J.Domino,Vice-President '`� l0 54375 Route 25 P.O.Box 11 Glenn Goldsmith J 5 Southold,New York 11971 A.Nicholas Krupski d Telephone(631) 765-1892 Charles i.Sanders Di 'rP�'TYpm ` �� Fax(631) 765-6641 C®U ,� SOARD 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 —---------- BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 8933 DATE: DECEMBER 14, 2016 ISSUED TO: ELIZABETH W. FURSE PROPERTY ADDRESS: 2412 PENINSULA ROAD, FISHERS ISLAND SCTM# 1000-10-3-5 k, AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on December 14, 2016, and in consideration of application fee in the sum of$250.00 paid by Elizabeth W. Furse and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits . , the following: R Wetland Permit to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two- 1 ti story dwelling; on seaward side of new addition,construct a 175sq.ft.open deck extension with stairs to natural grade to be connected to existing 121021 seaward deck;with the condition that the proposed rain garden meets the requirements of Chapter 236 of the Town Code,Storm lr ti Water Management; and as depicted on the site plan prepared by CME Associates < Engineering,Land Surveying&Architecture,PLLC,dated October 12,2016,and stamped approved on December 14,2016. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board s of this date. 1;4S%aF F ;Cow 7Q-75�7 W-W .......... TERMS AND CONDITIONS The Permittee Elizabeth W. Furse, residing at 2412 Peninsula Road,Fishers Island,New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. ' 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized,or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required,upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 10. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title,or interest in real or personal property held or vested in a person not a party to the permit. i John M.Bredemeyer III,President O��®F S0 2-,®l Town Hall Annex Michael J.Domino,Vice-President ® 54375 Route 25 Aff P.O.Box 1179 Glenn Goldsmith W Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Charles J.Sanders Oyu Fax(631) 765-6641- _ oUllf�, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 14, 2016 Samuel W. Fitzgerald, AIA P.O. Box 447 Fishers Island, NY 06390 RE: ELIZABETH W. FURSE '2412'PENINSULA ROAD, FISHERS ISLAND SCTM# 1000-10-3-5 Dear Mr`. Fitzgerald: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 14, 2016 regarding the above matter. WHEREAS, Samuel W: Fitzgerald, AIA on behalf of ELIZABETH W. FURSE, 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 October 26, 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 December 14, 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, 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 ELIZABETH W. FURSE to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two- story dwelling; on seaward side of new addition, construct a 175sq.ft. open deck extension with stairs to natural grade to be connected to existing 12'x32' seaward deck; with the condition that the proposed rain garden meets the requirements of Chapter 236 of the Town Code, Storm Water Management; and as depicted on the site plan prepared by CME Associates Engineering, Land Surveying &Architecture, PLLC, dated October 12, 2016, and stamped approved on December 14, 2016. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, 16 John M. Bredemeyer III President, Board of Trustees JMB/dd k J John M.Bredemeyer III,President zf SU!/j�o Town Hall Annex Michael J.Domino,Vice-President '`� l® 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski ® Q Telephone(631) 765-1892 Charles J.Sanders Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 0 TO: u� �s `I® SA-M r-cTZC46_kA-LD Please be advised that your application datedOCT- Z(O1 zoao has been reviewed by this Board at the regular meeting of %C-, (4,-' Z®l(y and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) Y2 Constructed ($50.00) X 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: IZA TOTAL FEES DUE: $ BY: John M. Bredemeyer III, President Board of Trustees COASTAL EROSION HAZARD UNE PER MAP REF. #2 I DIST I MAP REFERENCES �0 f� 1. SURVEY MAP PREPARED FOR ELIZABETH W. FURSE, _ LOTS #37 &38 -- PENINSULA, FISHERS ISLAND, NEW YORK °i Qj T o I N/F BRADFORD & N o IGH WATER MEAN EL. 2.80 SCALE 1' = 20', CHANDLER, PALMER & KING NORWICH, E CONNECTICUT, JANUARY 15, 1999 � y.., o U a, ELIZABETH BURNHAM v Y � i I SINGLE FAMILY I I 2. COASTAL EROSION HAZARD AREA MAP, TOWN OF SOUTHOLD _ 0 .5 v .6 a r' RESIDENCE- MUNICIPAL I SUFFOLK COUNTY, NEW YORK, SCALE 1"=200' (APPROX.) W t o a' WATER-ON SITE SEPTIC I SHEET 47-FI OF 49, 8/29/88 c i _ _ 0) c ( SYSTEM 44-5 W Q 0 �, E / -PIca P \ \ I NOTES 111 w / (NOTFUND) 101'± I SITE Q o t 9 S 1. THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE V U _j o INDICATED .HEREON. ANY EXTENSION OF THE USE BEYOND THE _ a, N PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR Q 44-6 O °�, cc: M �• � � / �/ � I EXCEEDS THE SCOPE OF THE ENGAGEMENT. � d E B � rn STEPS / \ i v LU 00 2. IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY Q ��'., �,� M / / \ \ PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED W (� M C I,.1A I �`t LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY. °a-'s 3. ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND as-tacq V / \ 'OH J I SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL caUSEARE THE PRODUCT OF THE LAND SURVEYOR. / • I �,• � �-' � I ^ � / / � �, ; I 4. SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX Qui "-17 MAP 1000, SECTION 10, BLOCK 03, LOT 5. iT \ / \ �10' I - Z as-is , ��'j \ l l o. TREE I 5. DEEDED AREA 10,500 SF. / y / / J T CONC / .f/ I Q I II 6. SITE IS LOCATED IN ZONING DISTRICT R-40. STOCKPILE �� 7. PERCENT OF LOT COVERAGE-PROPOSED 16.9 as-is �_2 ' /� / I S�EpSI / / / AREA VACANT LAND �- / /Z, / J L 1 I 7. VERTICAL DATUM IS NAVD 1988 LOCATION MAP SCALE 1 =400 ( z STAGING I Z I I CONCRETE WASH l v� / BASEMENT AREA OUT AREA (SEE DETAIL) FF EL. 9.11 13" J I rlq 1 1 BIRCH G WR SERVICE I 1� I I EXISTING W I w w I PROVIDE TEMPORARY $ _ I CONSTRUCTION ENTRANCE Qo 5 K - - I AT EXISTING PARKING AREA `< ' r. STING EXISTING r / �s ' ^v •1 r" I / RESIDENCE QQy I I El r DECK FF EL. 17.68 � i,. / I-) 4'G%per KNOCKOUT INLET AND :? -35' / sro OUTLET OPENINGS / - 17 -)I // ABANDON EXISTING SEPTIC tiF r�I�I�U EXISTING I a GRAVEL PARKING -0 SYSTEM AND PROVIDE NEW rRIBS INSIDE R X F 1 � :� �� I Z I SYSTEM PER SCDHS REQUIREMENTS FgeR f 1 7.68 I z 1000 GAL. SEPTIC TANK & 2 _ c I I LEACHING POOLS CONSTRUCTION ENTRANCE + - + / 2 7 'C•\ , I S \ )3, 35.3 NOT TO SCALE N SEPT N L I SEPTIC / / h \ \ 8' DIA =i I EXPANSION - AREA LiJ GO >° N PFi�POSED`IADDITION � ^0 I 4- / FF=17 8 ) I I V) z IOU 46 ,� F� S / ,� / I / CAST r/ Y O I a / / D I LIMITS OF SITE CONCRETE COVERS op r 4kY D A LL \ m DISTURBANCE - / VV , I / I 2300f S.F. V- o. �n /� / PLAN o o w p L �..� I o z / I -1��'• 1 �' �SF o i/ ( \ - 1, I COVER LOCKING CASTING g o / a- w o _ \ moo, 14�83 / \ / I IF ROP ET TO GRADE LL1 Q _ Q R Yeo / I ~ a_ V) IS USED FINISHED GRADE U) LdHIGH WATER g (n W o I \ CHIMNEY (FO ND) I „ - \ / 1 I SILT FENCE 4 x 4 12.6/12.6 GA. WIR MESH m 7- - O VACANT LAND - z w I I 36 f 1 I 6 x 6 .6 6 GA WIRE MESH J� WOVEN WIRE FENCE (MIN. 14 X 20 / LV = BUILDING LINE\ 20' GAUGE W/ MAX. 6" MESH Q min. 20 6" Q o- cn 9j 8�• (TYP.) _ / I SPACING) min. N O 10 MAX. CENTER 361 MIN. LENGTH FENCE INLET _/�•• �� _j • TO POSTS DRIVEN MIN. 16" 3" VENT Q 3" VENT OUTLET INTO GROUND 0 9 BENCHMARK: CP ROD8637 I r11 � I I CENTER � W CV �- LIQUID LEVEL EL=9.62 PROVIDE 60 SF RAIN APPROX OMITS OF FLOOD ZONE VE '� _ ' L GARDEN IN EXISTING ELEV. 19 PER FIRM 36103CO019H I p �1� 4" OUTLET ryl _ CONTINUOUS HOT MAP REVISED SEPTEMBER 25TH 2009 I BAFFLE COASTAL EROSION HAZARD UNE PER MAP REF. #2 LAWN AREA FOR NEW I LIMITS OF I _� ASPHALT SEAL LINED WITH ROOF DRAINAGE- PROVIDE CLEARING `O I 4" SCHEDULE #40 c 1/8' PVC 4" PVC DRAIN W/STONE PROVIDE SILT �` INLET BAFFLE 60• GAS SPLASH PAD-PLANT �,�,� HEIGHT OF ,. ► DEFLECTOR a N/F SUSAN GAIL FENCE- MAINTAIN ( FILTER = 16" MIN. AS DIRECTED BY OWNER `'�`-��;��;\�;�,�;�, , .• SCHONGAR TRUST DURING CONSTRUCTION °� ��,, EMBED FILTER 1 0 SINGLE FAMILY I �,� CCLON A MIN.GROUND OF 4 5 -8 RESIDENCE- MUNICIPAL °� CROSS SECTION m WATER-ON SITE SEPTIC SYSTEM PERSPECTIVE VIEW 1000 GALLON DRAINAGE CALCULATIONS (ADDITIION TO MAIN RESIDENCE) ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° m ° ° ° woGA WIRE FENCE (MIN. 14 I 2 COMPARTMENT Z 0_ ° ° � 1/2 GAUGE W/ MAX. 6" MESH 0 N ROOF AREA = 375 SF SPACING) WITH FILTER CLOTH z w REQUIRED = 375 SFX 1.0 X 2/12 = 63 CF ° SEPTIC TANK o 36" MIN. FENCE POST o NOT TO SCALE 63/ 1.5 = 42 SF FLOW GROUNDRBED ` PROVIDE 6' X 10' RAIN GARDEN 1.5± FT. DEEP Ld ° COMPACTED SOIL \j\ Ld uj EMBED FILTER CLOTH TYPICAL PLANTING AND SEEDING FOR RAIN GARDEN AREAS: � 4' 3:1 3:1 ° \� a ° 4, ° A MIN. OF 6" IN GROUND 0 1.SEED HIX - NEW ENGLAND COASTAL SALT TOLERANT GRASS MIX, o MAX MAX o a" APPROVED BY NEW ENGLAND WETLAND PLANTS, INC. O 4 2.MEDIUM SHRUB - BAYBERRY, MYRICA (MORELLA) PENSYLVANICA o a SECTION MEW BOARD OF TRUSTEES z 3.MEDIUM SHRUB - SWEET PEPP'ERBUSH CLETHRA ALNIFOLIA TOWN OF SOUTHOLD 4.LOW GROUNDCOVER - BEARBERRY ARCTOSTAPHYLOS UVA-URSI CONSIRUC110N SPECIFICAl10NS ° 5.MEDIUM GROUNDCOVER - SWEET FERN COMPTONIA PEREGRINA o 0 ° 1. WOVEN WIRE FENCE TO BE FASTENED SECURELY TO FENCE POSTS WITH WIRE DATE r '�' / a PLAN ° ° TIES OR STAPLES, POSTS SHALL BE STEEL EITHER "T" OR "U" TYPE OR r ~ PLAN PLAN HARDWOOD. Q _j 0_ rJ 2. FILTER CLOTH TO BE FASTENED SECURELY TO WOVEN WIRE FENCE WITH TIES p SPACED EVERY 24" AT TOP AND MID SECTION, FENCE SHALL BE WOVEN WIRE, L GEND 6" MAXIMUM MESH OPENING. 5'-0" �y PROPERTY LINE `0 v C C° `0 4, 1 3. WHEN TWO SECTIONS OF FILTER CLOTH ADJOIN EACH OTHER THEY SHALL BE _ _ o = m = 0 0 OVER-LAPPED BY SIX INCHES AND FOLDED, FILTER CLOTH SHALL BE EITHER ABUTTERS LINE m N Or N cc N N V MIN. PROVDE STRAW BALES BACKED FILTER X, MIRAFI 100X, STABILNKA T140N, OR APPROVED EQUIVALENT. EDGE OF GRAVEL ------------------- O w WITH SILT FENCE(TVP) O � J El []0 ED ❑ 3• 31 4. PREFABRICATED UNITS SHALL BE GEOFAB, ENVIROFENCE, OR APPROVED EXISTING CONTOUR --- 12 --- z Ld z o `` ❑❑ o 0 0 ❑� j EQUIVALENT. w z Y O❑ O O O ❑❑ UNE PIT WITH 10 MIL o o 2 Q w 0 w El 11 O O � ❑❑ N PLASTIC SLEETING, KEY If-4 � 5. MAINTENANCE SHALL BE PERFORMED AS NEEDED AND MATERIAL REMOVED WHEN O' O LLJ � = 0 J Li Li O O (] LI 11 ENDS INTO GRADE 0- m 0 O v O i � "BULGES" DEVELOP IN THE SILT FENCE, I El 0DATE: 10/12/2016 ❑❑ E:J�Q � ❑❑ � SECTION fl o a o�o o �0 CONCRETE WASHOUT PIT - ! 0 o a o o ❑❑ NOT TO SCALE { � SCALE: 1 " = 10' OCTG QUALITY CONTROL CERTIFICATION I 1.O DIMENSIONS SHOWN ARE FOR TYPICAL RESIDENTIAL OC2 6 216 ��~ ' PROJECT: # 2016816 F�6'-6 CONSTRUCTION, LARGER PROJECTS OR PROJECTS REQUIRING GROUP REVIEWED DATE PUMPS MUST BE SIZED ACCORDINGLY (7 GALLONS/TRUCK, ff 50 GALLONS/PUMP, PLUS MIN. V FREEBOARD). + I PROJECT MANAGER SG!iEi'DI�Ti?Yfl (, VED FROM SURVEY LEACHING POOL DETAIL 2 PITANDPROPERTURE ILY DISPOSAL AND EDIOF WHEN THE PITDS MUST BE O REACHES BOd((i-� TfIJ`a-' ------ -.-."a'� 1O 5 Q 10 ENVIRONMENTAL NOT TO SCALE 75% OF ITS CAPACITY. SHEETiiia CIVIL 3. INSPECT PIT PRIOR TO EACH USE TO ENSURE CONTAINMENT GRAPHIC SCALE IN FEET 1 O F 1 OF WASH WATER. " STRUCTURAL ARCHITECTURAL i IM I W Z g I V ° I Z g I I LU LnL � W Q =Ln o wo CD T WZ LU N 20'-0.. LL l IGHT OF�AY_ WEST (GREAT) 35 v I ,-0" CO HARBOR 'oc EXISTING C) Q 3.51�� DECK EXISTING / HOUSEcr oo� EXISTING DECK F 51,3, PROPOSED STAIRS DOWN f h FRO SEK ^ '3 I Q LINE OF EXISTINGct PROPOSED DECK TO BE r n OPEN DECK PROPOSED S I REMOVED (J ADDITION ADDITION ELISABETH W. F U R S E ONE-STORY FRAME 183, ADDITION WITH J LOT #37 & 38 -- PENINSULA ROAD BASEMENT BELOW o „ FISHERS ISLAND, NEW YORK I o ci SECTION 10, BLOCK 03, LOT 5 pj 10,050 SF. +/— — _ -E- E VE Lj OCT 2 6 2016 'x' a°° SITE PLAN Southold Town SCALE: 1/16" = 1'-0" i Board of Trustees _J u ti -- V z p N I Zg z I W N I QLnM I � N W � N W u- l0 W I EXISTING EXISTING BASEMENT FIRST FLOOR LL I I �0 EXIST'G - DECK - ----- --------- I ° I LO 0 0 0 DN --, n ---------------- -- CLOSET I II ❑ I I NEW j BASEMENT o 0 NEW DECK NEW STAIRS DOWN EXTENSION TO NATURAL GRADE NEW BATH UP I EXISTING BEDROOM CONSTRUCTION I Lo ----- TO REMAIN — �, 18.3' �, 8.0' �, 18.3' PROPOSED CONSTRUCTION Q to J =� E ECE � VE Do PROPOSED BASEMENT PLAN �l, OCT 2 6 2016 PROPOSED FIRST FLOOR PLAN SCALE: 1/8" = 1'-0" SCALE: 1/8" = 1'-0" u° outhold Town a Board of Trustees 1 �^ N Li d �a - I — C? . - — . VW >-Zo 1rO 0 -- - - --- - - z w - - - - = z g -1H---------- - 0 W L Ln ---- of W N W U- ti - ---- -------- ------- rn ® W _i PROPOSED ONE-STORY FRAME ADDITION - — — --- — U— i I � — L — PROPOSED ADDITION EXISTING HOUSE �____ EAST (STREET SIDE) ELEVATION SCALE: 1/8" = 1'-0" SOUTH ELEVATION SCALE: 1/8" = 1'-0" - - - - - -- H - ------------ H EXISTING - ------- _ CONSTRUCTION , TO REMAIN PROPOSED - � -- CONSTRUCTION mm m 1 r�i g M STAIRS NOT SHOWN OCT 2 6 2016 FOR CLARITY EXISTING HOUSE PROPOSED ADDITION LL og Southold Town rS M WEST (WATER SIDE) ELEVATION SCALE: 1/8" = 1'-0" John M. Bredemeyer III, Presii �'' S�FF��k �+ Town Hall Annex Michael J Domino, Vice-PresyUUr,i� hso�0~ CpGy 54375 Route 25 Glenn Goldsmith $ P.O. Box 1179 A. Nicholas Krupski o ® Southold, NY 11971 Charles J. Sanders 4,- p fi Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 6 l� Completed in field by: Samuel W. Fitzgerald, AIA on behalf of ELIZABETH W. FURSE requests a Wetland Permit to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two-story dwelling; on seaward side of new addition, construct a 175sq.ft. open deck extension with stairs to natural grade to be connected to existing 12'x32' seaward deck. Located: 2412 Peninsula Road, Fishers Island. SCTM# 1000-10-3-5 CH. 2.75-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet !, 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111, SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment 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 I eview/consultant/application completeness/comments/standards: j 67 r de A (2 pe 61 ""j V w Present were: J. Bredemeyer elm. Domino G. Goldsmith /N. Krupski C. Sanders Other k Page'1 of 2 John M. Bredemeyer III, Presid �pSvFF �R�o . Town Hall Annex Michael J. Domino, Vice-Presideno Gym 54375 Route 25 Glenn Goldsmith o `; P.O. Box 1179 A. Nicholas Krupski Southold, NY 11971 Charles J. Sanders y ® o�� , Telephone (631) 765-1892 11 - Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Samuel W. Fitzgerald, AIA on behalf of ELIZABETH W. FURSE requests a Wetland Permit to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two-story dwelling; on seaward side of new addition, construct a 175sq.ft. open deck extension with stairs to natural grade to be connected to existing 12'x32' seaward deck. Located: 2412 Peninsula Road, Fishers Island. ,SCTM# 1000-10-3-5 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 # g rv,;y ' ,� . '��+i _ t k. � ♦. v, '-`SFr $ - i,�� 1 • a x Proposed One-Story Addition with Deck A '"` •. ` r ' Or • or N th IN x .:•may, . /¢F k # 3 1 *' 4 ' t ff Y , {{ • j ki # # � �v+J t •/ i .,� ;.. + - of +F ,. . s. fix s t, y' r � - n APPLICATION FOR TRUSTEES PERMIT kit,5 Proposed one-story frame addition and new extension «. of existing deck . 2412 Peninsula Road, Fishers Island, NY County Tax Map 1000 -- Section 10 -- Block 3 -- Lot 45 �� .. t a wJ� p• 4 � L c1q Vo w . y , Z g Y N t ii LU aJV N tt TWOV'�t.a , x W Z. r r, t� ah : c . CN LL C't AW t 4 a 1 a + R/• r �t k f �� -� � ��. �' � �' � 1'2!'x• 60 'fi w w ,+ {{ 2412 Peninsula Roadwill wI. Am 44 r 1l" / # a. a r' a ,.. � r..: �"�►'.� ���,`` ." ..,��� .fit r �,:. a� a • T s y f �• _ 'tom E { o- c_ �a a �.. °�' "t,.*�` ,krrt`' .� " r t ?�y, J► �rM�r .♦ �'� O *� f ...iL. 11 « a .. Dc � . , _ c x WS u , r .,. _ .. - f W M .max f a� y M » N a • vI EXISTING SITE PHOTOS I I Lu z>- 10 I Vo 0 Zs I I I WN pW a Lo _ _ PHOTO wo 6 I I Wz cn Z PHOTO I I Lu LLN PHOTO WEST 5 ) �rR� OPHOTO 2 6 2016__j GREATHARBOR SOULbold Town PHOTO Beard of Trus4 PHOTO EXISTING 2 DECK Q PHOTO EXISTING O 8 HOUSE J I PROPOSED STAIRS DOWN PHOTO PHOTO TO GRADE 3 FROM DECK PROPOSED OPEN DECK PROPOSED ADDITION ADDITION I SEE CORRESPONDING I c PHOTOS PAGES 5-8 - Lu W- D EG ECS WMA OCT 26 2016 SITE PLAN oar_d fTrusln V' co Board o{Trusfqes _J N SCALE: 1/16" = 1'-0" tj L a f 1 • w�iii� f+�ei` -'° f' �• #' .�-�•_�'1��* }=8+±.tI •< �, ,, r .ti.Y � '1 w - r . A r •t � ��v5 ter, - .0-' Y�. .� � a• 1C ': h;� > _ fJ., ,y, rrti- ll � 1'� +.•' �. �- •'".X + ,�L.sNrs�.ae.. `�+.,r�. = g�+.•��,•y—��' �.� ..*���. •'Y`,tel.T Y�• n ��{ i. •• �. ;t 7 y'1� ..i..'� w'L� r- a'-. +� y �� R ..',� i,?C .,.� z. .rP4..�lwye � R __.. - �y. .�/.�l;!' - a.�°Ili .•� �.,* ��,,:�;. 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F >-• :�P..t .X;,� a"i'� �� .. �_ � - '� � � t� a r - r' iin .. .•...K �i• _ aal�' ;x �•>� OPM IWO 07. , Y . r • a �i t*i¢ .�..' a Nt 7 �.y`f '' •a. P ,yam � v► Afo...' ,i'v • "Is .100 e bM� ! f . ".. _•�.,. •.. ',ems �..-,..'. -'.:v:. - ., r . N1 i" omfi�_ 'r:,, n••nw:f:a:irr.`-z".-.°xa=•°,:, n4aAw.....'+'. ggw?rewr4�trl,tr:WtsGnmt�.� ..y�`x,£" :swr_:ti.:Le» s..^sa :SAr ^ od �> .t,-^�.r, - '*'r^. '•;,,•�.py�. -::,�g:�?�� rs1„ y-�.:' ..*!9�. "' ,.�:'.�;ra: :?'?$,',�,,.�`°,"-' R".,.3:'»-'.. ..' ,,. �; � � X -_ ®F S0 OFFICE LOCATION: MAILING®�® MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 ® �� Telephone: 631 765-1938 O Fax: 631765-3136 c®UNT`I,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: John Bredemeyer, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: December 8, 2016 Re: LWRP Coastal Consistency Review for ELIZABETH W. FURSE SCTM# 1000-10-3-5 Samuel W. Fitzgerald, AIA on behalf of ELIZABETH W. FURSE requests a Wetland Permit to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two-story dwelling; on seaward side of new addition, construct a 175sq.ft. open deck extension with stairsto natural grade to be connected to existing 12'x32' seaward deck. Located: 2412 Peninsula Road, Fishers Island. SCTM# 1000-10-3-5 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 the LWRP provided that: 1. The Board establishes a non-turf vegetated buffer landward of the wetlands. Require that the buffer be shown on a survey. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman Q Town Hall,53095 Main Rd. ca Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 y' Fax(631)765-6641 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 7, 2016 the following recommendation was made: ELIZABETH W. FURSE for a one-story frame addition to existing two-story frame residence with low-height basement, accessed from the exterior of the house only, to be used for storage. Proposed open deck extension with new stairs down from deck to natural grade. Located: 2412 Peninsula Rd., Fishers Island. SCTM#10-3-5 The CAC did not make an inspection, therefore no recommendation was made. John M. Bredemeyer 111, Presid---, Oy aU(/Tyo ✓" - Town Hall Annex Michael J. Domino, Vice-Presidia j �� 1p 54375 Main Road P O. Box 1179 James F. King,Trustee `78` Southold, New York 11971-0959 Dave Bergen,Trustee G Charles J.Sanders, Trustee 'Q Yo Telephone(631)765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ® l� V I.� D To: Southold-Town Building Department Nov ® 3 20% Re: Verification of Building Department Permit Requirements BMDING DEFT- SCTM#: TOWN Off'SOUTHOL 9 FJRS� Property Owner Owner Name: Date Sent to Bldg. Dept_: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from / the Zoning Board of Appeals? �0 Will an part of this application be considered as Demolition y p pp t as described under Town Code? COMMENTS: JAI fy �g Signature of Reviewer Date 4 1 , Cantrell, Elizabeth From: Sam Fitzgerald <sam@sfapc.net> Sent: Friday, November 18, 2016 12:57 PM To: Cantrell, Elizabeth Subject: Furse Residence, Fishers Island Hi Elizabeth, The existing house measures 24' x 27'.The existing deck measures 12' x 32'. Let me know if you need anything else and I can get it to you very quickly. Regards, Sam From:Cantrell, Elizabeth<elizabethc@town.southold.ny.us> Sent:Wednesday,August 12, 2015 2:34 PM To:Sam Fitzgerald Subject: RE: 3300 Claypoint Road, Fishers Island Hello Sam, Good question, I didn't think of that. Unfortunately, I have to request that you please separate the two proposed projects onto two separate plans. Elizabeth From: Sam Fitzgerald [mailto:Sam@sfapc.net] Sent: Wednesday, August 12, 2015 1:42 PM To: Cantrell, Elizabeth Subject: 3300 Claypoint Road, Fishers Island Hi Elizabeth, I was in yesterday re: a property with a newly proposed revetment and swimming pool. We're following your advice to make them two separate applications. Quick question: can we submit the same survey for each application showing both the revetment and swimming pool? Our plan would be to date the two applications a day apart, and put notes on the survey saying something like, "Trustees application dated such-and-such includes only the revetment," and "Trustees application dated such-and-such includes only the swimming pool." Is this okay, or would you like two separate surveys, one only showing the revetment and one only showing the pool?Thanks for the help! Regards, Sam Sam Fitzgerald Architect, PC 15 E. Putnam Avenue, #234 Greenwich, CT 06830 1 J Box 447, The Gloaming Fishers Island, NY 06390 860.287.3808 samcd)sfapc.net 2 y Town Hall Annex • James F.King,President SOF S�Ujy . Bob Ghosio,Jr.,Vice-President ,�0� OHO 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer �0 Telephone(631)765-1892 Michael J.Domino ��C N Fax(631)765.6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only �astal Erosion Permit Application etland Permit Application Administrative Permit / Amendment/Transfer/Extension V Received Application: 1012 011& - ` r Received Fee:$ ZS1)kVD E (CrE U V E Completed Application- 1l, ' Incomplete s _SEQRA Classification: OCT 2 6 2016 Type I Type II Unlisted ' i Coordination:(date sent) 12�2�lCO �LW Consistency Assessment Form —. Southold Town CAC Referral Sent: I t Z 'O 19W of Tru eft Date of Inspection: 1 Z• Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: ,1 Resolution: Name of Applicant Elizabeth W. Furse. Mailing Address 2 Burnwood Drive, Bloomfield, CT 06002 Phone Number:( ) 860-216-1745 Suffolk County Tax Map Number: 1000- 10 -- 3 -- 5 Property Location: 2412 Peninsula Road, Fishers Island, NY (provide LILCO Pole#,distance to cross streets,and location) AGENT: Samuel W. Fitzgerald, AIA (If applicable) Address: 1420 The Gloaming, P.O. Box 447, Fishers Island, NY 06390 Phone: 860-287-3808 � 1 j Board of Trustees Applice Du GENERAL DATA Land Area(in square feet): 10,500 sq. ft. +/- Area Zoning: R-40 Previous use of property: Single Family Residential Intended use of property: Same Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this-project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: Agency Date Building Dept. - Permit#4596 10/22/1969 - Construct new residence (C of O no. 12765) Building Dept. - Permit#23345-Z 4/5/1996 - Basement Repair (C of O no. z-24579) No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a.governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary): Proposed one-story frame addition (360 sq. ft.)to existing two-story frame residence. The addition will have a low-height basement, accessed from the exterior of the house only, to be used for storage of kayaks, bikes, etc. Proposed open deck extension with new stairs down from deck to natural grade,(both totaling 175 sq. ft.). - 2 - - aoard of Trustees Appl.icatln—n r WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: The house will remain as a single family dwelling. We are proposing to add a bedroom to the first floor of the existing house for the benefit of a senior resident. Area of wetlands on lot: 415 sq. ft. square feet Percent coverage of lot: 3.95 % Closest distance between nearest existing structure and upland edge of wetlands: 37.5' +/- feet Closest distance between nearest proposed structure and upland edge of wetlands: 51.3' +/- feet Does the project involve excavation or filling? No X Yes If yes,how much material will be excavated? 53 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 4.5' feet Proposed slope throughout the area of operations: 25% Manner in which material will be removed or deposited: Excavation debris will be removed by a small excavating machine, deposited into dumpsters and carted away. All construction and excavation machinery will remain landward of the existing house. 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): There will be no effect on the tidal wetlands.The property is located in West Harbor, an inlet off of Long Island Sound. All proposed construction will be at least 50' landward of the limits of the tidal wetlands, and at least 20' landward of the Coastal Erosion Hazard Line. Further, there will be a silt fence barrier installed as indicated on the attached site plan prepared by CME Engineering. - 3 - 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-Project information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 Information Name of Action or Project: Elizabeth W. Furse Residence Project Location(describe,and attach a location map): SCTM 1000 Section 10, Block 3, Lot 5 2412 Peninsula Road, Fishers Island, NY 06390 BriefDescription of Proposed Action: Proposed one-story frame addition to existing two-story frame residence. The addition will have a low-height basement used for storage of kayaks, bikes, etc. Proposed open deck extension with new stairs from deck down to grade. Name of Applicant or Sponsor: Telephone: 860-287-3808 Samuel W. Fitzgerald, agent E-Mail: sam@sfapc.net Address: 1420 The Gloaming, Box 447 City/PO: State: Zip Code: Fishers Island NY 06390 1.Does the proposed action only involve the Iegislative adoption of 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 g6vernmentai Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ Building department 3.a.Total acreage of the site df the proposed action? + - acres b.Total acreage to be physically disturbed? 01 acres c.Total acreage-(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? •24 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial []Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic []Other(specify): ❑Parkland Page 1 of 4 - 4 - 5. 1s the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ® ❑ b.Consistent with the adopted comprehensive plan? F] FK ❑ 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: Fishers Island 8, a.Will the proposed action result in a substantial increase in traffic above present levels? NO 1 YES ® ❑ b.Are public transportation service(s)available at or near the site of the proposed action? Q ❑ 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 publiclprivate water supply? NO YES If No,describe method for providing potable water: ❑ a 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment:- rVi VId 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 arcbeological sensitive area? o ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: UN 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: KI Shoreline 0 Forest ❑Agriculturallgrasslands ❑Early mid-successional ❑ Wetland 0 Urban 0 Suburban 15.Does the site of the proposed action contain any specie's of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X ❑ 16.Is the project site located in the 100 year flood plain? NO YES TX -1- 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. ®NQ ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ®YES -R-5-5T—run-off Will a directed to downspouts and into a new dry well on the property Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: a ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: a ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsore: �` ,t"dQ��" Date: SignaturermflWfl HIMA 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 toaarge impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning1:1regulations? 2. Will the proposed action result iri a change in the use or intensity of use of land? [3 ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on tbd environmental characteristics that caused the rj( E]establishment of a Critical Environmental Area(CEA)? t1JJ 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action-cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 1—! 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 - 6 - 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 ® E] problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. F]J Check this box if you have determined,based on the information and analysis above,and any supporting documentation, Luthat the proposed action may result in one or more potentially large or significant adverse impacts and an l=vironmntal impact statement is required. thisebox 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 i pacts.1 Town of Southold-Board of Trustees 1 Name of Lea�gency J Da e o h y_ President Print or Type a of k6s nsil5le OfG in ead ency Title of Responsible Officer Si re of Res r le Officer in Lead gency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 - 7 - John M. Bredeme er 111, President �� Town Hall Annex Y �o �'r, Michael J. Domino, Vice-President 54375 Route 25 Glenn Goldsmith ,? P.O. Box 1179 A. Nicholas Krupski �y �� Southold, NY 11971 Charles J. Sanders �o� 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 ELIZABETH W. FURSE 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, /�L d - ,residing at/dba M Q k'4 A, C� being duly sworn, depose and say: That on the dq day of IV p v, , 201!p, I personally posted the property known as GQ'i PIC," n 5"1 y 620 C_a r'-'4,r -f'slc' -r�' -/y 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, December 14,2016. Dated: /a/`v l i (signature) $worn to before me this 004"Sl;ii OA day of 20/9 "� W � C - oe� Notar ublic • . JASON W.DRENA NotaryPublic-stateofNewYork No.01DR6350454 ;Si, ��Iia���������e•'' Qualified in suffolk County My Commission Expires November7,2029 , � 11 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: V-Vi-�:ISS $�tZt\JN�1M II1. A Q- 3 --4.A R O. &y- TS-3 -T1 14 t,fllyl�, N`j 06390 StJSAO GAIL S&i4o064-�Q_ TP—UST- Q-3- �. �1 4 c�og CCC i ►JA- CpT `+oV-T- ►- YPZS , :FL 3 3 c3 08 E-LB6-P--"F RtiD bOI.IS $U A o—� — 3 .'1 �k Ea l CLEti LP JE` S/qLi=- M 06 tj20 STATE OF NEW YORK COUNTY OF SUFFOLK WG L I Q'tPA 6-0M 605- 9HHo esiding at 4 '1 i xoo S-1 ZI d +loov w s Fek-l-', 21 W-99 A , being duly sworn,deposes and says that on the — 2-91* day of WO V-t M �;i , 20 4C, deponent mailed a-true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office I S C8JUh , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this Day of ov 20�� Notary Public JASON W.DRENA 'A Notary Public-State of NewYork {jl a �a " kAt c No.01DR6350454 I, -.�OKasa�a�;�'`. Qualified in Suffolk County `•••••• My Commission Expires November 7,2020 \�Zef �h' COV ��►� /?11111/lldl�� r TMTM Postal ServicePostal ■TIFIED © ■ ■ CERTIFIED , . ■ I• Only •• • 1O 117 !MGM-k4liffil."'Offl, T-1 O OF [3 C 5 A L U C ,..0 Certified M ee� � � � � � J] Certified M I Fee ROY, sp $ IR $ 3 Extra Services&Fe (check box,add fe a '9 Extra Services&Fees(cheekbox,addReturn Receipt(hardoop» $ �� ❑Return Receipt(haidcoP» $❑Return Receipt(electronic) $ A6 a -i C3 ❑Return Receipt(elecWnic) $� CertHled Marl Restricted Delivery $ 29t'ler� - , ❑Certified Mail Restricted Delivery $Adult Signature Required $ 1Z C ❑Adult Signature Required $O ❑Adult SignatureRestrictedDelivery$ ❑Adult Signature ReaNcted DeMery$ D Postage (J O Postage O 6 i $ 1 1] $ g r3 Total Postage and Total Postage and Fee $ 16 I $ I u7 Sent To Ln Se t To 9 ISI �.�t.��ra^'t �i• o �jf � ----------------------------------- �iieetand t r Pb Box No. oPO Boz IYo.o �� ------------------------- -- ---- -S3 I------- ---- -- ----- - -- - - -a— I loq0� - ------ --- -- ------ :. $tat City,-State,ZIP+4s is e-e- I S LAW 06 agca r1.5 PSN 7530-012000-904ruct - ■ , TM stal Service CERTIFI 1oRECET Z ED MAIL IP0 Domestic For dblixfdry informa-tion,Visit our website at WWVv.uSPS.q0M'e`.S ' -1.1 Certified Mail Fee R 5 Q0. r FISHERS ISLAND P.O. ro $ �� �S- 1 ORIENTAL AVE Extra Services&Fees(ch ox,add as ro' j -9 FISHERS ISLAND, NY 06390-4998 ❑Return Receipt(hardoopy) $ USPS 3528550390 p ❑Return Receipt(electronic) $ J��Stn1 Q 1-800'215"i��in ®, ❑Certified Mall Restricted Delivery $ ` Hera ` q 040256101 O EI Adult Signature Required $ ❑Adult Signature Restricted Delivery$ 1i a Postage 63S 0 Y Mercitint ID. 4445023716068 �- $ Term ID 01 o Total Postage and Fees Qu �� 0 Clerk ID 000003Ln $ rr=l Sent To L SC�------- —�Y115 (y OG as �LSAM C. ------- - S a 1 G r- Stre t and"3.Wrd,orPc7 sox No. as_�te"zTP+d®�---�- �L 3 3�0�---------------------- AMEX PS Form 3800,April 2(�.15 PSN •, ,,, off TU(AL: $2588 I - /f Postal Service'm 11!29116 1111.09 © ■ 0 C Inv #. 000001 Appr Code. 89039 = Domestic 1 nly Receipt #: 00000001 Norm -M , all Sales Final on Stamps and Postagy' .0 Certified Mail F a e. I O (} R S Refunds for Guaranteed Services Only. C L S e F D 2y p CUSTOMER COPY ! a Extra Serviceg&FOUS heckbox,add �J ❑Return Receipt(hardcopy) $�— —J ��' ❑Return Receipt(electronic) $ Order Starces at USPS corlsholl or call 1.880-8110 G o2d Go to � D ❑certified Mall Restricted Delivery $ � ` o n USPS comlcliclinship to print shipoinp Adult Signature Required $ libels nith posla¢e For other Inco tall . ❑Adult Signature Restricted Delivery$ Postage' f-W"a K USPS `! = $ g 6 -90 t' r3 Total Postage_Slid F s $ Lr) an To oLerf - ori S - -tLL -- e r andA-t.Aro.,or P�sox o. ------------------- - -- ----- -- - - ------------------- C:1 Slate,zrP*a� "----------- Jr r0. vrd C.1 NUTILL Uim Ht: AKING 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: ELIZABETH W. PURSE SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a proposed one story 360sq.ft. addition onto existing 24'x27' two-story dwelling; on seaward side of new addition, construct a 175sq.ft. open deck extension with stairs to natural grade to be connected to existing 12'x32' seaward deck. Located: 2412 Peninsula Road, Fishers Island. SCTM# 1000-10- 3-5 TIME & DATE OF PUBLIC HEARING : Wednesday, December 14, 2016 — at or about S:OOP. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Board of Trustees Application County of iic �Iew Ldqk StateofNevv-� CoAndc6Gto Elizabeth W. Furse 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. Signature of Property Owner SWORN TO BEFORE ME THIS1�14 DAY OF ®G oBe ,20_/S w otary Public ,,,,;�•, W Drena tdOTARY PUBLIC > Stale of Connedcat t,4� Qrpmission Expires 313717 l It' 1 Board of Trustees Application 1 AUTHORIZATION (where the applicant is not the owner) ; Elizabeth W. Furse residing at 2 Burnwood Drive (print owner of property) (mailing address) Bloomfield, CT 06002 do hereby authorize (Agent) Samuel W. Fitzgerald, AIA to apply for permit(s)from the Southold Board of Town Trustees on my behalf. 0 (Owner's signature) _ t } APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE,FARM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emnloyees The Ramose of ic forth is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action_tsthis necessary to avoid same. YOURNAME: Elizabeth W. Furse (Last name,fust name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building , Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) - Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"•means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or desc4be 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 applicont (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 thi��day of c," 200.k Signature h ,.�� X f Print Name L W_ t=✓+R-S C Form TS 1 66 APPLICANT/AGENT%REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM !he Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The nuroose of this form is to RL(vide information which can alert the town of possible conflicts of interest and adlow it to take whatever action is necessary to avoid same. YOURNAME. Samuel W. Fitzgerald ; (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ Variance Trustee Change ofZone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship-with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest.`Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title br position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal orbeneficial 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 thi d )f 204(o Signature Print Name Form TS 1 - 11a - Town of Southold . Erosion, Sedimentation A Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.TALP. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM WATER,GRADING,DRAINAGE AND EROSION CONTROL PIAN section oc —I.o CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 1 will this Project Retain Al Storm-Water Run-Off (Include Total Area of all Parcels located within .24 +/- Generated by a Two(2°)Inch Rainfall on Site? the Scope of Work for Proposed Construction) (S.F. ) (This Item will include all run-off created by site X brea ❑ . What is the Total Aof Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 01 +/- Site Improvements and the permanent creation of construction activity? impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDE BR1iEF'PROJECT DESCRiP'!;'!ON llrewee Aams.W Pae-+ffi d) Drainage Structures Indicating Size&Location?This X ❑ item shall include all Proposed Grade Changes and Proposed one-story frame addition (360 S.F.) Slopes Controlling Surface Water Flow. to existingtwo-story frame residence. The 3 Does the Site Plan and/or Survey describe the eroslon X a ry and sediment control practices that will be used to addition will have a low-height basement used control site erosion and storm water discharges. This for storage of kayaks, bikes, etc. Proposed item must be maintained throughout the Entire Construction Period. open deck extension with new stairs (totaling 4 Will this Project Require any rand Filling,Grading or 175 S.F.) from deck down to grade. Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards _ X of Material within any Parcel? 5 Will this Application Require land Disturbing Activities Encompassing an Area in Excess of Five Thousand X (5,000 S.F.)Square Feet of Ground Surface? El 6 Is there a Natural Water Course Running through the Site? Is this Projectwithin the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Welland or Submission of a StNPPP Is mquked for all Construction activities involving so➢ Beach? disturbances of one(1)or more acres;Including disturbances of less than one acre that 7 Will there be Site preparation on Ex1iting Grade Slopes are part of a larger common plan thatwN ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to X Including Construction activities Involving soli disturbances of less then one(1)acre where One Hundred(1001)of Horizontal Distance? —the DEC has determined that a SPDES permit Is required for storm waterdischarges. (SWPPP s Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Perking Areas or Other Impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10401.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X 1.The SWPPP shall be prepared prior to the submittal of the Not.The NOI shalt be into andfor in the direction of a Town right4--way? submitted to the Department prior to the commencement of construction activity. 2.The SlNPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, required post construction storm water management practices that wilt be used ardor Removal of vegetation and/or the Constnicdon of any Q X constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance vab the terns and conditions of this permit.In addition,the SWPPP shall Area?(N,utero will NOTrnchrdethe hoW.eon of Ddveway Aprons) identify potential sources of pollution which may reasonably be expected to e8ect the quality of storm water ftseharges. NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark 3.Ail SWPPPs that require the post-construction storm water management pnutttce in a Box and the cons ruaton stte disturbance ft betyweh 5.00 8F.&•r Awe to erne, component shall be prepared by a qualified Design Professional Licensed in New York a storm-water,Grading,Drainage&Erosion Control Plan is Required by the Town of that Is knowledgeable in the principles and practices of Storm $eu0'old and Must be submitted for Review Prior to Issuance of Any Building Permit. (ROTE: At;tcedcMark(�►)endlorAnswertoreadrQuesUonlsRequiredfaro0ortpleteApplkallorti STATE OF NEW YORY, COUNTY OF...........................................SS »..�........�.��...f..��..........being drily sworn,deposes and says that he/she is the applicant for Permit; (Name of rndvidual signing Document) Andthat he/she is the .................................... .. .. .. .............................................................. (Owner,tamifiaslar,IA4ent,Ocipaaate Officer,etc) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in.this.application are t me to the best of-his knowledge and belief,and that the work will be performed in the manner set forth in the,application filed herewith. Sworn to before me this; .......... ...........day of....C).C�'C)1 ......... Notary Public ...... �!._...�..... ........... ......-Ce ........ FlI fIXFOPAs ........... . ........ .. . ... .......................... (Slgnatuo of A rent) FORM -06I40STATEOF-CC&INECTICUT My Commission Expires Jan. 31, 2017 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a.determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 10 _ - 3 _ 5 Owner: Elizabeth W. Furse PROJECT NAME Addition to Furse Residence The Application has been submitted to(check appropriate response): Town Board El Planning Board❑ Building Dept. � Board of Trustees .X❑ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Proposed one-story frame addition with low-height basement below. Proposed deck extension and new stairs down to grade. - 12 - 'Location of action: 2412 Peninsula Road Fishers Island, NY 06390 Site acreage: 24 acres (10,500 sq. ft.) Present land use: Single family residential Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Samuel W. Fitzgerald, architect (b) Mailing address: Sam Fitzgerald Architect, PC 1420 The Gloaming, P.O. Box 447, Fishers Island, NY 06390 (c) Telephone number:Area.Code( ) 860-287-3808 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes D No I 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. RYes E] No n Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt The addition is in keeping with the density of the neighborhood -- it is a one story addition on a street with all two-story houses -- and the addition fits in architecturally with the character of the neighborh000d. On the water side, none of the proposed work will encroach any closer to the coastal wetlands than the existing house. The proposed construction conforms to all Town of Southold requirements for setbacks, coverage, building height, etc. -- all suggesting that the proposed work falls within Southold's preferred pattern of development. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria F] Yes 11 No [fvD Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt - 13 - The existing house is of a contemporary coastal shingle style that is common for the neighborhood. The proposed addition will match the existing architectural style of the house. 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 F] Yes [] No a Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt The view of the property from the water will not be diminish by the proposed construction. It is a one-story addition that will be lower in height than the existing house. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria 11 Yes 11 No Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt All proposed activity will be well above the Coastal Erosion Hazard line, and will not encroach any closer to the coastal wetlands than the existing house. The area of coastal wetlands will be protected with a silt fence during all construction activity. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III a --Policies Pages 16 through 21 for evaluation criteria Yes 1:1 No Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt The natural grade will not be modified in any way, so natural drainage courses will remained undisturbed. The owner is committed to being chemical-free in her lawn care. 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. ❑ M See LWRP Section 268-3(F)-minor LWRP actions are exempt 14- 'Yes No Not. dicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section Ili — Policies Pages 32 through 34 for evaluation criteria. F] Yes []No E Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ElYes ❑ No � Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt PUBLIC COAST POLICIJES 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 evaluatian criteria. 11 YXI No[:-f�J Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt Attach additional sheets if necessary - 15 - •WORIKING COAST POLII'�_.. . Policy 10. Protect SouthoId's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies;Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No Q Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria. ❑Yes No 0 Not Applicable see LWRP Section 268-3(F)-minor LWRP actions are exempt 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. ElYes F] No 0 Not Applicable See LWRP Section 268-3(F)-minor LWRP actions are exempt .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. QYes ❑ No 0 Not Applicable see LWRP section 268-3(F)-minor LWRP actions are exempt PREPARED BY TITLE DATE D 2( - 16 -