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HomeMy WebLinkAboutTR-8899 Cantrell, Elizabeth From: Cantrell, Elizabeth (�/��)aa'_ AQ s�brti�ss�'`aws Sent: Friday, December 6, 2019 2:53 PM - J_/tA?� S�n C.e To: jjpatanjo@gmail.com d G6C1�S�GJ Subject: FW: Cashwell; SCTM# 1000-71-2-3 ) Z/ J:��PIek- Hi Jeff, i fC4 1 spoke to Mike Domino as to whether this application will be a full amendment (public hearing) or administrative. Mike wants this application to be a full amendment. I will process it as such upon submission of requested information. Thank you. Elizabeth From: Cantrell, Elizabeth Sent:Thursday, December 5, 2019 12:44 PM To:jjpatanjo@gmail.com Subject: Cashwell; SCTM# 1000-71-2-3 Hi Jeff, I received your application today regarding the above mentioned property. I found a couple of items that the office is requesting more information on or corrected. I am requesting these items to be completed as soon as possible due to the coming holidays our office will be processing all applications prior to the holidays. If we do not have a complete application by Tuesday, December 17th, we cannot proceed with it at our January meeting. Given that there is already a Wetland Permit in place for the structures,your application should be an amendment, not a new wetland permit application so you gave us too much money for the application fee. The fee for an as-built amendment request would be$100.00,the check submitted is for$250.00. Not sure if you want to somehow swap out the checks (check from the Cashwells) or shred old and new coming in the mail..:you let me know. As I just mentioned this will be an amendment however, I have to ask Mike Domino if it is to be an administrative amendment or a full amendment. I will get back to you on that. There are no dimensions for the as-builts/proposed on your plans other than for the pool and patio. Please update your plans to include dimensions that relate to your application. I noticed that fencing is shown enclosing the rear yard. No fencing has yet been permitted for this property. Can you please update your written project description to include the as-built fencing, please include the height, total length not necessary. There is an established 10' wide non-turf buffer along the landward edge of the bulkhead (walkway/decking part of buffer) which is not shown on your plans. Can you please update your plans to depict this buffer as it was conditioned as part of Wetland Permit#8899. Regarding the buffer, Ms. Cashwell was advised several months ago that Covenants & Restrictions about the buffer needs to be added to her deed in order to proceed with her final inspection process. To date we have not received the C&R's. Can you please remind her of this requirement. If you have any questions, don't hesitate to ask. 5&C aka eaew& Senior Clerk Typist Town of Southold Board of Trustees 631-765-1892 2 PROJECT `!� Boulhold Yacht GubO .:: '�' � a ,� LOCATION N Parish or r� v .: EXISTING RAMP/FLOAT/PLATFORM c wenczel seofoadQ f Anchor S F��T MHW & MLW ALONG FACE OF BULKHEAD . 0 640°s 10 t0 c•• Bdgdntine eooksQ s f .. 7003 wlesnoldi d .. m Koncaquare Coffee0 . i Z 76, 38 oa \ OO vRd Ext .-- ..N Boyviow Y CHAIN LINK FENCE Rd En WOOD POST & WIRE FENCE NBayWmRd oA c'N Beyt4ev Rd 2ND FLOOR BALCONY OVER DECK ry STONE PATIO a OUTDOOR SHOWER ROOF OVER PORCH PROJECT LOCATION MAP N.T.S. PROJECT COORDINATES W 41° 03' 02.17" N 72° 24' 12.67" c� F�A�'jFOSTp� . Y �o yp�SF STONE WALL / PROPERTY OWNER: PREPARED BY: GRAVEL PATIO RACHEL & JOHN CASHWELL JEFFREY PATANJO 129 STRATFORD AVE. P.O. BOX 582 \ ROOF OVER STONE PORCH GARDEN CITY, NY 11530 BOHEMIA, NY 11716 � o 2ND FLOOR CANTILEVER J31-484-9332 JPATANJO@GMAIL.COM h ONE RETAINING WALL NOTES: N64°os. _ 1. SITE PLAN PREPARED FROM SURVEY PREPARED BY: 70" PECONIC LAND SURVEYORS, P.C. �9 f _ F-1 — 4 1230 TRAVELER STREET — SOUTHOLD, NY 11971 � DATE SURVEYED: JANUARY 11, 2017 Ei - - --- .� DATE UPDATED: APRIL 2, 2019 '0 00' I: DEC 5 2019 -~ ' I e � PPR ING DOCK PERMIT PLANS SCALE: i,r=30' Board;:_:_r'. =��.__� ._� POSED PLAN, SECTION DATE: / & LOCATION MAP 11-7-19 515 HARBOR LIGHTS ROAD OUTHO F TOWN OF SOUTHOLD SUFFOLK COUNTY, NYX MAP N0. 1000-71-02-03 of FEr-t RIO-17-0009 SURVEY OF PROPERTY N a t SO UTHOLD TOWN OF SO UTHOLD SUFFOLK COUNTY, N. Y. 1000-71-02-03 SCALE- 1"=30' MAY 9, 2016 MAY 25, 2016 (WETLANDS) AUGUST 23, 2016 (B.O.H.) SEPT. 08, 2016 (B.0.H.) OCT. 25, 2016 (REWSED SITE PLAN) TEST HOLE DATA MCOQNALD GEOSCIENCE NOV 08, 2016 (REVISED SITE PLAN) 0910212016 JANUARY 11, 2017 (REVISIONS) EL 5.9 - 3 MIXED SAND AND LOAM OCTOBER 30, 2018 (FINAL) BROWN SILTY SAND SM APRIL 2, 2019 (DECK DIMS) EL 0.6 — 5.3' WATER W ORO ITN SILTY SAND SW 70' WATER IN BROWN FINE SAND SP 1101 y NOTE. WATER ENCOUNTERED 5.3'BELOW SURFACE qRe p \ �wnNo ARppI)A7)- �'C� `bo O p h � p )p0O��0 F RS gSSpC/q 7jo1 ZONE AE O AS�D/YgPQ / C EL �� A` R AV,, "'� \��'a SZ'• / 40)l¢� c. 0 /O gV,HAr -'-• ---- - ---' — --- --- �� J�yaQ °ova j0/pF p`T/ �`•�,, � �' O /yiDF � �'T,y<A"yF90 ADW h 3 Fl-OOD ZONE. ��P,�-e SONE"X"f A8 0 h ls• x .A. T3�• oy<ewkc'�t��k . \C1 �O //+io N7"Qg97�2,� oven �' 1100 ,4� �J• MM"�r °W lLOO •00' o "V)s FOC O LP7 IF EL 6.4' F Pyr LP2q��`Tq, v JQQ � •f q�RDyy����k• \V �M�T hs LP ° y Io4�e° O OV qoR� eiSB FI�.ST�Y LP chq� �,�, � J QJ u/c Ah Ns¢• TPROP ANKµE / ry OS�O�� /a< J SEPTIC LOCATION UB�c L�• Un"" „ .A. .B, ST 28.5' 47' O ro�'e <<�,�,o �y s � °Oo •\ . LM 32.5' 59' �'97FRJ (�� �FJ EL s.0*1 \,Fo le LP2 40' 55.5' �� 401 �"(/ '�' KEY RESAR C 9 = TEST HOLE S =PIPE =MONUMENT D EC 5 2019 ■ ' = WETLAND FLAG S '0,-UTTUTY POLE __ f )(Y=HYDRANT FLOOD ZONE FROM FIRM 36103CO167H ELEVA77ONS&CONTOUR LINES AR£REFERENCED FROM NAVD BB WATER SERVICE TO BE RELOCATED TO'MINIMUM FROM SEP770 SYSTEM N.YS. LIC. NO. 49618 LOT NUMBERS REFER TO APAP OF HARBOR LIGHTS ESTATES SECRON TWO"RLEO IN PECONIC SURVEYORS, P.C. THE SUFFOLK COUNTY CLERKS OFFICE ON SAY 26, 1966 AS RLE NO. 4687. _ (631) 765-5020 FAX (631) 765-1797 ANY ALTERA77ON OR ADDIRON TO THIS SURVEY 15 A NOLARON OF SEC77ON 72090E THE NEW AREA 20,000 SO.Fr.TO TIE LINE P.0. BOX 909 YORK STATE EDUCA77ON LAW. EXCEPT AS PER SEC77ON 7209-SUBDIWSTON 2.ALL or 0.459 ACRE8 TO TIE LINE 1230 TRAVELER STREET � 16-029 CER77FICA77ONS HEREON ARE VAUD FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971 gg+5fFQ�► Peter Young,Chairman H - Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., January 8, 2020 the following recommendation was made: Moved by James Abbott, seconded by Peter Young, it was RESOLVED to SUPPORT the application of JOHN & RACHEL CASHWELL to Amend Wetland Permit#8899 for the as-built revisions to previously permitted plans including the reduction of in-ground pool size from 18'X 40' down to 16'X 36', addition of 12'X 50' roof over previously permitted rear yard deck, addition of 12'X 15' roof over previously permitted side yard deck and addition of a 60'X20' bluestone patio surrounding in-ground pool. Located: 515 Harbor Lights Rd., Southold. SCTM#71-2-3 Inspected by: James Abbott, Peter Young Vote of Council: Ayes: All Motion Carried Michael J_ 'Domino, P�°�ident o`�J ��, Town Hall Annex �� John M_ Bredemeyer' �, Vice-Pres-idem 54375 Route 25 o. , Glenn Goldsm'itn N P.O. Box 1179 A Nicholas Krupski y o Southold, NY .11971 Greg Williams l , �� Telephone .(631) 765-1892 Fax (631) 765-6641 SOUTFLOLDTOWN BOARD OF TRUSTEES i r TO: SOUTHOLD TOWN BUILDING DEPARTMENT DEC 2019. RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS S CTM#: - Property Owner Name: Date Sent to Bldg. Dept: 12.q,(q The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition as described under Town Code? COMMENTS` Date nature of Reviewer QF SDr/T .Town Hall Annex: Michael J.Domino,President John M.Bredemeyer III,Vice-President �� deo 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski O ® Telephone(631)765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application* Fi ,1 Wetland Permit Application i Administrative:Permit Amendment/Transfer/ExtensionDEC 5 2019 ' Received Application: i2.5•lR I Received Fee: =Completed Application: IZ Incomplete: SEQRA Classification: Type I Type II Unlisted . Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): LWRP Consistency Assessment Form Sent: 1' 20 AC Referral Sent:: I Z•C$�(q - Date of Inspection:. ' �.8�•20 Receipt of CAC Report: Technical Review: Public Hearing Held: •!'��ZU Resolution: Owner(s)Legal Name of Property (as shown on Deed): 9 a c-h e.( Mailing Address: )a 9 5 (`R t for A ,j e .goe n Cc±-c.. . .•� Phone Number: R (7 --S 3 457.- (o L{g Suffolk County Tax Map Number: 1000- -7 / o a - 83 Property Location: g t4•c r b-r 61'q k fs - So +kti:,lde - 4.. sec Gocacas m (If necessary,provide LILCO Pole#,,distance to cross streets, and location) T AGENT(If applicable):' .. - �1 eT.�-tel PA 4,A Mailing Address: p fl• �'x 6 a`- o �/h ``-i .Phone Number: 3 (' ��• x`:33 Board of Trustees App? ation GENERAL DATA Land Area(in square feet): d �, �•' Area Zoning: S ' Previous use of property: S Intended use of property: S Covenants and Restrictions on property? Yes ✓ No If"Yes", please provide a copy. / Will this project require a Building Permit as per Town Code? Yes �/ No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. / Does this project require a variance from the Zoning Board of Appeals? Yes +/ No If"Yes", please provide copy of decision. Will this project require ny demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? Yes ✓ No Prior permits/approvals for site improvements: Agency Date sr«s *� 8 9 lam• —� 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): s-<e oL+4a "-&t Rachel Cashwell 515 Harbor Lights Drive Southold,NY 11971 SCTM No.: 1000-71-02-03 Project Description Project includes the as-built revisions to previously permitted plans including the reduction of in- ground pool size from 18'x40' down to 16'x36', addition of 12'x50' roof over previously permitted rear yard deck, addition or 12'x15' roof over previously permitted side yard deck and addition of a 60'x20' irregular bluestone patio surrounding permitted in-ground pool. All work is consistent with the Town of Southold Building Department permit. Board of Trustees Appl-'- --,,Ltion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: ell square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: 10o feet- Closest distance between nearest proposed structure and upland edge of wetlands: "0 feet Does the project involve excavation or filling? ✓ No Yes If yes, how much material will be excavated? 1A cubic yards How much material will be filled?. HI A cubic yards Depth of which material will be removed or deposited: N feet Proposed slope throughout the area of operations: it Manner in which material will be removed or deposited: Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): Short Environmental Assessment Form Part I -Project Information Instructions for Completins 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 1 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 515 Harbor Lights Road Dock Name of Action or Project: Proposed site plan revisions Project Location(describe,and attach a location map): See location map Brief Description of Proposed Action: See attached Name of Applicant or Sponsor: Telephone: 917-538-1048 Rachel&John Cashwell E-Mail: rcashwel@optonline.net Address: 129 Stratford Ave. City/PO: State: Zip Code: Garden City NY 11530 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 0✓ ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ NYSDEC/NYSDOS/USACE/Town of Southold Trustees 3.a.Total acreage of the site of the proposed action? 0.459 acres b.Total acreage to be physically disturbed? 0.004 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.459 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) [:]Industrial ❑Commercial mResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify:Name:Peconic Bay and Environs,Reason:Protect public health,water,vegetation,&scenic beauty, El F71 gency: u o County, -Date: - 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? ❑✓ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑✓ ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: F0 ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? W1 ❑ 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: m Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban m 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? ❑ W1 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO MYES ❑✓ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO ❑YES Page 2 of 3 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: W1 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: ❑✓ F1 I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor e: ilffrgy Patanjo s gen Date: # Signature: PRINT FORM Page 3 of 3 EAF Mapper Summary Report Monday,April 17, 2017 9:15 PM Disclaimer: The EAF Mapper is a screening tool intended to assist project sponsors and reviewing agencies in preparing an environmental Y, assessment form(EAF).Not all questions asked in the EAF are i answered by the EAF Mapper.Additional information on any EAF -� question can be obtained by consulting the EAF Workbooks. Although the EAF Mapper provides the most up-to-date digital data available to DEC,you may also need to contact local or other data sources in order t to obtain data not provided by the Mapper.Digital data is not a r" ~~ 17 `- �_ substitute for agency determinations rt at3 r�loritris si ` 4 1 Ou�ryj,'Ick --..t +� V k-j 1 Toraete Pucfi 1 r o5ton r I `` t' � ' '- � •M i , r:-.`� � ,= a �/ 1/ £ f,.� �, �[7�tralt • •-'� g -' i , '� ' ^v .• . •icy,� j ( +• }. ? tiny 1 4V , V s- y � c ><FNltlettcd' +'.. P, t Jrrt sf et�#jF�1EI T�3�Sd r �t �, I ;nr r+ r+ a yE y � } s titEtT East Ct s dWoGb tf mat Pittaiurr}, So�¢e _ rt;t tEI�E ' i _ t r _ a� c.qd EaQt T_.sttst+dt .9Hpr tndt3 t; Ci; 1 ,�dunUjtic D L`'`h�t= f8 S.Intpsrp • tP7s ihu+ gr thsS IPdCEtylEtdT F;ttr�Csrf,E��it J, r�JRe+�ztETl Esr.cq ikn :ihang. ,Part 1 /Question 7 [Critical Environmental lyes Areal i Part 1 /Question 7 [Critical Environmental 4Name:Peconic Bay and Environs, Reason:Protect public health,water, Area- Identify] }vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 ;Part 1 /Question 12a [National Register of INo 'Historic Places] !Part 1 /Question 12b [Archeological Sites] Yes ......,_._..._..—_............._..--._...._..___...-v._.._.e_.____...—.-.....�_.__.._�...._.-_.- _..v_-�-•.__-._.......,...-_......_.._.__..._...-...__......_..-._.�.....-_-�..._._s.__<...-e.....__._......,.—.....�-.._-...-_....._.._.�._._._.__tee...-.....�......._..,..__.{ Part 1 /Question 13a[Wetlands or Other ,Yes-Digital mapping information on local and federal wetlands and ;Regulated Waterbodies] Iwaterbodies is known to be incomplete. Refer to EAF Workbook. !Part 1 /Question 15[Threatened or JYes !Endangered Animal]_ _ _ e_ _ i art 1 /Question 16[100 Year Flood Plain] iYes ;Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form- EAF Mapper Summary Report 1 Part 2-Impact Ass ient. The lead Agency is responsible for the co tion of Part 2. Answer all of the following questions in Part 2 he information contained in Part I and other mate submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Piave my responses been reasonable considering the scale and context of the proposed action?" I No,or Moderate ' small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? El 0 J1 2. Will the proposed action result in a change in the use or intensity of use of land? EJ 1:1 1 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 F-1I establishment of Critical Environmental Area(CEA)? J i 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? El 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. Witt the proposed action impact existing: El a.public/private water supplies? ' b.public/private wastewater treatment utilities? r 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? El I Q 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 meed to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part J. 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-tern,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees _ Name of Lcad Agency Date President i Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer r�, i-f"Wr,e,-% I ..A AryAnnv Simisture of PreDarer(if different From Responsible Officer) i" Board of Trustees Application AFFIDAVIT a"- 4-r- $EING 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 BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OR ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. , Sign tura of Property Owner Signa re of Property Owner SWORN TO BEFORE ME THIS�_DAY OF .�CIT-0 �t.-hd ,20 4-ML=' j] Forb"Heaneyc Notary Public Notary Public,State Of NOWYalk No.01HE4923496 Qualified In Nassau Count' Commiseton Expires March 7.24��- Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Z.c:a �.� a S GtwC-- owners of the property identified as SCTM# 1000--7 1 — o i— v 3 in the town of New York,hereby authorizes to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. /P®roperty Owner's Signature Pro rty Owner's Signature SWORN TO BEFORE ME THIS DAY OF 20_ Notary Public Fortune Heaney Notary Public,State of NOW YO& No.O1HE4923496 C ualifted M Nassau County Commlaw Expltas Match 7.2= ZZ 2� APPLICARVAGENITMEPRESENTATWE TRANSACTIONAL.DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employecs,The nuroose of this farm is to provide inforination which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first name,.ritiddle 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 57 a shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check- the heckthe appropriate line A)through D)andlor describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); I3)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of Elie applicant;or D)the actual applicant. DESCRIPTION OP RELATIONSHIP Submitted this day o �� ' 20 /1,j Signature , Print Name At ttT L ( — Form TS 3 TRANSACTIONAL DISCLOSUPX FORM The'1 oKm of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emplovees.The purpose of this form is to provide infnrtnation whicit c to alert the town of nossible conflicts of interest and allow it to tale wlmtever action is necessary to avoid same. YOUR NAME: c.JL (Last name,first name,ipiddle 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 for 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,n�urriarc,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"o of the shares. YES NO ✓ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)tite owner of greater than 516 of the shares of the corporate stock of the applimt (when the applicant is a corporation): B)the legal orbeneficial owner of any interest in a non-corporate entity(when the applicant is nota corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this (I day of V G TV b X20 Signature Print Name -Oz.-Jh, -4, Form TS I APPLICANT/AGENT/R F,PRF,SF,N'Y'ATIVlE TRANSACTIONAL DISCLOSUPZ FORM The Town of 4outhold'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 alertUte town of possible conflicts of iwerestand allow it to take whatever action is necessary to avoid same. YOUR NAME: ®a. �y `^ (Last name,first name,4riddle initial,uniess 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 alt 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"Othee%name the activity.) Do you personally(or through your company,sponse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,njarriage,orbusiuess 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"5 of the shares. YES NO ✓ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)tie owner of greater than 5%of the shares of the corporate stock of the appliewt (when the applicant is a corporation): I3)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation), C)an officer,director,partner,or employee of the applicant:or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this (I day of ®G'-Vbep 20.L. Signature Print Name Form TS I TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to-provide information which can alert the town of possible conflicts of interest and allow it to tale whatever action is necessary to avoid same. � YOURNAME: (9 l`+Q '`ia (Last name,first n ,diddle 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 Pas even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than S`!� of e shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than S%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 Q'7 day,of Sat 20 19 Signature Print Name f w _ Form TS 1 Town of Southold ` LWRP CONSIST3ENCY ASSESSMENT FOM 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 siowcant 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 explalnW 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 F SCTM# -7- 1 ° 2 _ 03 PROJECT NAME s I S l a r b•,� L s A�t — S 9.,4 k.l tel The Application has been.submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. 0 Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital El. 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: i i" n• Location of action: 5 / S 14a r 4 o z �- .�h tc 2d Site acreage: °- Lt C Present land use: f2e,S Present zoning classification: jLe,S 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: a L� 5° C4 e. (b) Mailing address: C>trdoeg (dS30 (c) Telephone number: Area Code( )__I_/7 — 53 8 Y c Y8 (d) Application number,if any: J)/ Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No 13" If yes,which state or federal agency? Ca 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,snakes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LMW Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No '12Not Applicable Cm tvE h-S Flo tFf-ie4 so,% Qo(cGt, Attach additional sheets if necessary Policy 2e Protect and preserve historic and archaeological resources of the Town of Southold. See L'AW Section Ifs— lies Pages 3 through 6 for evaluation criteria F1 Yes ❑ leo Not Applicable !`Vje11--itg&7 Attach additional sheets if necessary Policy 30 Enhance visual quality and protect scenic resources throughout the Town of Southold. See ILWIP Section III—Policies Pages 6 through 9 for evaluation criteria ❑ Yes ❑ No LJ Not Applicable ly�e }t'� s ►�. 'e F-�e a n Pe t tet„ Attach additional sheets if necessary NATURAL COAST POLICIES Policy 40 Minimize loss of life, structures, and natural resources from flooding and erosion. See LWT Section 111t—Policies Pages h through 16 for evaluation criteria ❑ Yes ❑ No EfNot Applicable Attach additional sheets if necessary Policy 5e Protect and improve water quality and supply in the Town of,Southold. See LVERP Section III —Policies Pages 16 through 21 for evaluations criteria ❑ Yes ❑ No Zot Applicable r, jje hus no c FFeck ®,i (sc._, Attach additional sheets if necessary Policy 6e Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See ILWRI? Section III—Policies; Pages 22 through 32 for evaluation criteria. Yes No Jot Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LW" Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No U plot Applicable Pro i«* u s a® e k-eo on Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVVSection III—Policies; Pages 34 through 38 for evaluation criteria. El Yes F1 No No [ .Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, pub➢ie lands, and public resources of the Town of Southold. See LVW Section III—Policies; Pages 38 through 46 for evaluation criteria. �/ 1:1Ye� No u Not Applicable Attach additional sheets if necessary WORDING COAST ], JCIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No �ot Applicable _-- fm_ e� e--4 ke-,.( m Attach-additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary.and Townn waters. See LWRP Section III–Policies; Pages 57 through 62 for evaluation criteria. 1:1 Yes ❑ No [E Not Applicable Pr d a ec,4 hos -A-- {"e CPR pa lcec— 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 ENot Applicable rnI as lac Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III–Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No EJ liot Applicable Co h«s eL. t c d- — cam, PREPARED l a� .i Q�2 1tErA ) =Y TITLE 4�� DATE 1 November 30, 2019 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 _E� V E P.O. Box 1179 �� �'� Southold, New York 11971 RE: 515 HARBOR LIGHTS DRIVE-SOUTHOLD, NY D EC a 5 2019 SCTM NO. 1000-71-02-03 L soul hold-iown APPLICATION FOR PERMIT Board of Trustees Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. The project includes the as-built revisions to house during construction. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very trulyours, ffrey Patanjo P.O. Box 582 Bohemia, NY 11716 DEPARTMENT OF THE ARMY •�� ��� U.S.ARMY CORPS OF.ENGINEERS,NEW YORK DISTRICT JACOB K.JAVITS FEDERAL BUILDING _ 26 FEDERAL PLAZA . NEW YORK NEW YORK 10278-0090 SEP _2-8. 2017 , -Southold Town a 'Regulatory Branch' . SEP. 2 5 2017 .. .. SUBJECT: Permit Application Number NAN-2017-005577EGR ., by John and Rachel Cashwell The New York District,U.S. Army Corps of Engineers, has received a.request for Department of-the Army authorization for the following activity: APPLICANT: John.&-Rachel Cashwell 129.Stratford Avenue Garden City, New York 11530 ACTIVITY: From the existing bulkhead construct a four-foot=wide by six-foot- long platform connecting a.30-'inch-wide by 16-foot-long ramp extending northeast,, parallel to the bulkhead, leading to. six-foot' wide by 20-foot-long float. The proposed structures.will extend approximately six linear feet from the mean low water line into Shelter Island Sound. -The purpose of this project is to provide access to navigable water. WATERWAY: Shelter Island Sound LOCATION: 515 Harbor Lights Drive, Town of Southold, Suffolk County, New York As this is minor in nature, authorization may be by Letter of Permission. -This is in accordance with current Federal Regulations governing work in navigable waters of the United States. To accomplish the coordination required, prior to the issuance of a Letter of Permission, your review of,the enclosed drawings is requested. Pursuant to Section 307 (c) of the Coastal Zone Management Act of 1972.as amended (16 U.S.C. 1465 (c)(3)(A)), the applicant has certified that the activity: complies•with and will be conducted in'a manner that is consistent with the approved state coastal zone management program. ***PLEASE USE THE ABOVE 18-CHARACTER FILE NUMBER.ON ALL CORRESPONDENCE WITH THIS OFFICE`** SUBJECT- .w' Permit Application Number NAN-2017.-00557-EGR , ` SEP1.bl 2017 by John and,Rachel Cashwell To allow for the`timely"processing of the subject�application, your comments are requested within 20.doys of-the date of this letter. If.you have any.questions, please contact Andrew Gregory, of rmy staff, at (917) 790-8522 or via e-mail at and rew:gregory c usace.army.mil. ., Sincerely, Af Ronald R. Pinzon Chief, Eastern Section Enclosures (2); 1 Dated Permit Drawings Z. Preliminary Jurisdictional Determination SEP 2 `8 2017 Southold Town Board of Trustees ***PLEASE.USE THE ABOVE 18-CHARACTER FILE NUMBER ON ALL -CORRESPONDENCE WITH THIS OFFICE*** tAsmt flu. MAN-201 -00 -s 6t. Y���'S��}4r f'Yr;�3�#i tff S�*� �'tlE`���o�`rR,4s�i•a'�'tit'{��t t7 SE's 47$� 4,k<� �-:R ! x� �'7�,t�'pr�'ref}�'�e�4al[grTn � Stlpr iq �F.}y as C� 1��`1g,-- PROJECT 2"! „, t.w.0 €at r ! c j 1 -'f k,i�° r r, sa mold Yacht Club O r' f l i &rl� a r xx F . , � $� LOCATION ` 3{!•'y.S N Pnrtsh Or 1a rFirs T t-ta`1u, y P'9v a s1SR.bo..tyle.ua ``wv,ic 3 i. C pif • .. yr{r �,`.`- Ude NbA�lwetuPd o` i n Ah.:hnr t,t t�+• �,� W—el Seaload0 r„$ ArKhor(h a Shio¢D, i3 o N n � g i, Anchor Lo ti Brigantine BookaO 4 N M Pdies Holding ' `r Corporatian� .�• m O.k C Konusgvuro coffee z 5 { ..�� N Bayo Ra En - .-:A• . H NBayvtuw RaJ a fyayViCw Rd _ cn PROJECT LOCATION MAP r'_3 N.T.S. y o co � IV rn p z V PROJECT COORDINATES W 41' 03' 02.17” N 72° 24' 12:67" FLOATING DOCK PERMIT PLANS SCALE: AS NOTED PROPERTY OWNER: PREPARED BY: RACHEL & JOHN CASHWELL JEFFREY PATANJO LOCATION .MAP DATE: 129 STRATFORD AVE. 1,06 ,HEWI17 BOULEVARD 6-17-17 GARDEN CITY, NY 11530 . CENTER MORICHES,, NY 11934 s-z1-17 631-484-9332 515 HARBOR LIGHTS ROAD 6..-26-17 JPATANJOC�OPTONLINE.NET SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, NY SHEET: - TAX MAP N0. 1000-71-02-03 1 OF 3 ;; i�S�9C�;�=:Nq�1-2o�'7- 00.55,>•��a�Z "'; : PROPERTY OWNER:. .� ' PREPARED BY: EV RACHEL & JOHN. CASHWELL E 129 STRATFORD AVE. •-106 HEWITT BOUL ARD GARDEN CITY, NY 11530 CENTER, MORICHES, NY- 1,1,934 631-484-9332 JPATANJO@OPTONLINE.NET , OOH PROPOSED 6'X20' FLOATING DOCK ls• a0 PROPOSED'30°x16' ALUMINUM RAMP - Miry, 32' 3s PROPOSED,4'x6' FIXED TIMBER PLATFORM 31" 3s MHW & MLW ALONG FACE OF BULKHEAD 0 64��5•7o F�oF�iNc EXISTING VINYL BULKHEAD p / 32" 1p00o• PROPOSED ELEC. & WATER SERVICES TO DOCK , COORDINATES C7 PROJECT OORDI TES 41. 03' 02.17" 3s° REPRESENTS .WATER DEPTH IN INCHES0' N 72' 24? 12 67»` BELOW MEAN LOW WATER rn FL CK PERMIT OATING. DO BERM .PLANS :_ SCALE:, - NOTES' a c � co 1'. .SITE PLAN PREPARED FROM SURVEY ,PREPARED BY: a PECONIC LAND SURVEYORS, _P.c. PROPOSED PLAN. °ATE �' p 4-17-17 1230 .TRAVELER STREET SOUTHOLD, NY '11971 6-21 17 DATE SURVEYED: JANUARY 11, 2017 515"FIARBOR LIGHTS ROAD 6-26-17 O SOUTHOLD, , SUFFOLK COUNTY' NY OLD SHEET: TAX MAP NO. 1000=71-02-03 2 OF 3 .' s�c� FI ;.NRN-20\l-QOCjS,'�lyR PROPERTY OWNER: PREPARED BY: :,. RACHEL & JOHN CASHWELL' JEFFREY PATANJO " - 129 STRATFORD AVE. 106 HEW117 .BOULEVARD GARDEN CITY, .NY 11530 CENTER, MORICHES,. NY.11`93.4 =. 631-484-9332 - JPATANJO@OPTONLINE.NET. PROPOSED 4X4 CCA POSTS PROPOSED 2X2 TREX RAILS AT 4':0.C. SPACING PROPOSED TRIX DECKING SURFACE "n 3/4' GALVANIZED HARDWARE PRbPOStD'2XlO'CCA ' STRINGERS PROPOSED.3X6 CCA APPROOMATE M.R.W.EL 211 PROPOSED 3'X16' ALUMINUM RAMP PROPOSED 6'X20' FLOATING DOCK ±:::f APPRORIMATE 4LW EL O.Of ,". , . •i i\i\i\\�\ice\i�� _ 7 TYPICAL SECTION PROJECT° COORDINATES - N.T.S. W 41 03'_ 02.17" rn: 24' 1 67'- N 72° 2. o ' .. FLOATING DOCK PERMIT PLANS: StALE _ N o AS,NOTED V DATE: TYPICAL. SECTION 4-17-1.7 W 6-21-17 '515 HARBOR LIGHTS-ROAD 6-2s-17 SOUTHOLD, TOWN OK SOUTHOLD " SUFFOLK COUNTY,_ NY SHEET: TAX.'MAP 'NO. 1000-71-02-03 3 OF 3 Appendix 2 PRELIMINARY JURISDICTIONAL DETERMINATION (PJD) FORM- BACKGROUND ORM BACKGROUND INFORMATION "- REPORT.COMPLETION DATE FOR PJD:, 10-JULY 2017 B ;NAME AND ADDRESS'OF PERSON REQUESTING PJD:, Rachel Cashwell;les Stratford Avenue,Garden City;NY 11530• C. DISTRICT OFFICE, FILE NAME, AND NUMBER: New York;.Cashwell, Rachel and John; NAN-2017-00557=EGR D. PROJECT LOCATION(S)AND BACKGROUND INFORMATION: '(USE.THE TABLE BELOW TO DOCUMENT MULTIPLE AQUATIC,RESOURCES AND/OR ; AQUATIC RESOURCES AT:DIFFERENT SITES) State: New York- .County/oarish/borough:.Suffolk County City: South'old Center coordinates.of site (lat/long in:degree decimal format): Lat.,: 41.05065' : Long.: -72.40356 Universal Transverse Mercator:` Name.of nearest waterbody: Shelter. Island Sound E. REVIEW PERFORMED FOR SITE EVALUATION (CHECK ALL THAT APPLY): ■❑ Office (Desk) Determination. Date:.10-JULY-2017 ❑ Field Determination. Date(s): . TABLE OF AQUATIC RESOURCES IN.REVIEW AREA WHICH ',MAY BE"SUBJECT70 REGULATORY JURISDICTION. Site Latitude 'Longitude .. _" .'Estimated amount .Type of aquatic . Geographic authority number. (decimal (decimal of aquatic resource resource( .e.-,wetland to which'the:aquatic degrees) -degrees) in review area vs.non=wetland • resource"may be"' (acreage and linear' waters) , 'subject( .e.,,.Section feet, if applicable) 404 or Section 10/404).. A 41 .05065 X72.40356 40 linear feet non-wetland waters 10/404 nn IF- 11 fg " - Sautiiold Tw.,•n Rorrd of 1n1stsrs 1) The Corps of Engineers believes that there:may be jurisdictional aquatic resources in, the review area, and the requestor of this PJD;is hereby advised of his or her-option to request and obtain an approved JD(AJD) forthat,review area based on an; .informed decision after having discussed the various types of JDs and their_ characteristics and circumstances when they may be appropriate. 2) In any circumstance where,a:permit..applicant obtains•an individual permit, or a Nationwide,General Permit(NWP)or other general permit.verification requiring,'°pre- construction.notification (PC.N), or requests verification for anon-reporting NWP-or -other general permit,"and the permit applicant has not:requested an AJD for the _ activity,.the permit applicant is hereby made aware'that: (1).the permit applicant has elected to seek a.permit.authorization based on a-PJD,which does not make•.an official determination of jurisdictional aquatic resources; (2),.the applicant has the option to;request an AJD before accepting the terms and conditions,of the permit authorization,and that''basing`a permit'authorization on an AJD could possibly'result ... in less compensatory mitigation,being required or different special.conditions; (3)the applicant has the right to request an,individual.permit rather than accepting the terms,` and conditions of the NWP or other general permit authorization; (4)-the.applicant can accept a permit authorization and thereby"agree to comply with'all the terms and'. conditions of that permit;including whatever mitigation; requirements the Corps has determined to be necessary; (5) undertaking any,activity in.reliance upon the-subject. permit authorization without requesting�a, AJD constitutes the applicant's acceptance of the use of the PJD; (6) accepting'a permit authorization (e.g., signing-a proffered individual permit) or,undertaking any activity in reliance on any form of Corps permit authorization based on a PJD m constitutes agreement that all aquatic resources-in the review area affected in any way by that'activity will,be treated'as jurisdictional, and waives any challenge to such:jurisdiction in any administrative or judicial compliance or enforcement action, or in any.administrative appeal or in any Federal court; and,(7) whether-the app licant`elects,to•use-either an AJD`or a PJD,,the JD will be processed as,,soon,as practicable. Further, an AJD, a proffered individual permit-(and all terms. and conditions contained therein), or individual permit denial can-be administratively appealed pursuant to 33 C.F.R.Part 331.:If, during an,administrative appeal, it,` becomes appropriate to make.a.n official determination,whethe'r geographic jurisdiction existsover aquatic resources in•-the review,area, or to provide an official delineation ofjurisdictional.aquatie resources in the�review area, the Corps will '. ,,.Provide an,AJD to,accomplish.that result,-as soon as is practicable: This PJD finds that there "may be"waters of the'U.S. and/or that there"maybe"navigable waters of the U.S. on the subject review area;.and identifies all aquatic features in the review ` area that could.be-affected•by the proposed activity, based on the following information: V E - . 1 SEP :2 8. .2017 Southold Town Board-of Tr 4 a SUPPORTING DATA. Data reviewed for PJD (check all that apply) Checked items should be included in subject file. Appropriately reference sources below where indicated for all checked items: ❑O Maps, plans, plots or plat submitted by or on behalf of the PJD requestor: Map:Jeffrey Patanio 17-APR-2017, revised 21-JUN-2017, 26-JUN-2017 ❑ Data sheets prepared/submitted by or on behalf of the PJD requestor. ❑ Office concurs with data sheets/delineation report. ❑ Office does not concur with data sheets/delineation report. Rationale: EJ Data sheets prepared by the Corps: ❑ Corps navigable waters' study: ❑ U.S. Geological Survey Hydrologic Atlas: ❑ USGS NHD data. ❑ USGS 8 and 12 digit HUC maps. ❑ U.S. Geological Survey map(s). Cite scale &quad name: ❑ Natural Resources Conservation Service Soil Survey. Citation: ❑ National wetlands inventory map(s). Cite name: ❑ 'State/local wetland inventory map(s): ❑ FEMA/FIRM maps: ❑ 100-year Floodplain Elevation is: .(National Geodetic Vertical Datum.of 1929) Photographs: ❑ Aerial (Name & Date): or a Other(Name & Date): Existing structures and conditions, undated ❑ Previous determination(s). File no. and date of response.letter: ❑® Other information (please specify): Environmental Questionnaire,. FCAF IMPORTANT NOTE: The information recorded on this form has not necessarily been verified by the Corps and should not be relied_ upon for later jurisdictional ' determinations. GREGORY.ANDREW.WAw..a RREN.1536905754 Signature and date of Signature and date of Regulatory staff memberD e requesting PJD completing PJD Q IRED, unless obtaining Ith, s• ature is impracticable)' SEP 28 2017 Sosthold f0'fV11 - 1 Districts may establish timeframes or re oar'of T e • ms. If the requestor does not respond within the established time frame,the district may presume concurrence and no additional follow up is necessary prior to finalizing an,action. John M. Bredemeyer III,Prey nt O��Of SU(/jy0 a _N' 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 Telephone(631) 765-1892 Charles J.Sanders 'O Fax(631) 765-6641 'rouff N,� BOARD OF TOWN TRUSTEES --December 14!2016— TOWN OF SOUTHOLD Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 RE: RACHEL CASHWELL 515 HARBOR LIGHTS DRIVE, SOUTHOLD SCTM# 1000-71-2-3 Dear Mr. Patanjo: The;'Board`of Town Trustees took the following action during its regular meeting t Old on Wednesday, December 14, 2016 regarding the above matter: t WHEREAS, Jeffrey Patanjo on behalf of RACHEL CASHWELL applied to the Southold Town Trustees for an Amendment to Wetland Permit#8899 under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town_of Southold, application dated November 17, 2016, and, WHEREAS, said application was referred'to the'Sduthold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policies 1 and 4 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the installation of drywells for the pool to be installed along side of dwelling; 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 for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, BE IT FURTHER RESOLVED, that the Board of Trustees APPROVE the Amendment to Wetland Permit #8899 to relocate the proposed dwelling further seaward with an attached 868sq.ft. seaward side deck in lieu of a 912sq.ft. deck; for a proposed 18'x40' pool to be installed 50' landward of the bulkhead in lieu of 73.3'; and to install an outdoor shower against the dwelling; with the condition that the Town Engineers be fully involved in the pool construction; that drywells for the pool be installed along the side of the dwelling; and to establish and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and as depicted on the survey prepared by Peconic Surveyors, P.C., last dated January 11, 2017, and stamped approved on January 13, 2017. 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 f E _ - kd - ISI Ai 0.4 -47 - I '3 12/ 06 11 : 06 1 _ Rachel Cashwell 515 Harbor Lights Drive,Southold SCTM#: 1000-71-2-3 / / - 12/6/16 t '; fm Ai 12/ r l ♦�11►_f�}A lid}1.sAI} ♦+4`.}11.711", y _ _ s+i i s+i i`+•s tie`.,`~�~A��`i`��rfil,�`� `''i�`i`�rf`�y`` ^ti 6/2016 07 CUFF0t Y John M. Bredemeyer III, President 'o�� �'o�`; Town Hall Annex Michael J. Domino, Vice-President `'� y� = 54375 Route 25 ` �Y Glenn Goldsmith o '' ,; z P.O. Box 1179 A. Nicholas Krupski ® ori Southold, NY 11971 Charles J Sanders 07 �a;, Telephone (631) 765-1892 ==-v 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 V Pre-construction, hay bale line , 1St day of construction Y2 constructed Project complete, compliance inspection DU "OF Sd%-'UTHOI.."D. TO WVT N TRUSTEES 11 i `iib SOUTHOLD, NEW YORK PERMIT NO. 8899 DATE: OCTOBER 19, 2016 ISSUED TO: RACHEL CASHWELL PROPERTY ADDRESS: 515 HARBOR LIGHTS DRIVE, SOUTHOLD SCTM# 1000-71-2-3 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 October 19, 2016 and in consideration of application fee in the sum of$250.00 paid by Rachel Cashwell and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling(4,160sq.ft.total floor area)with a 165sq.ft.front porch,a 912sq.ft. attached seaward deck; install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff,install Kt storm drains for the driveway, and all in accordance to Chapter 236 of the Town Code Stormwater Management; install a 201x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction; with the condition to install a drywell for the pool; and to establish and perpetually maintain a 10' wide non-turf buffer landward of the bulkhead; and as depicted on the survey of Peconic Surveyors,P.C.,last dated November 7,2016, and stamped approved on November 18,2016. 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 as of this date. ov"t pa C'2 I r;A TERMS AND CONDITIONS The Permittee Rachel Cashwell residing at 515 Harbor Lights Drive Southold New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will,at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if,in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. �rZifS0Ur John M.Bredemeyer III,President Town Hall Annex, Michael J.Domino,Vice-President l0 54375 Route 25 Glenn Goldsmith P.O.Box 117 South9 Southold,New York 11971 CAI A.Nicholas Krupski � ® yp� Telephone(631) 765-1892 Charles J.Sanders l Fax(631) 765-61 1 641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 19, 2016 Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 ,I RE: RACHEL CASHWELL 515 HARBOR LIGHTS DRIVE, SOUTHOLD SCTM# 1000-71-2-3 Dear Mr. Patanjo: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 19, 2016 regarding the above matter: WHEREAS, Jeffrey Patanjo on behalf of RACHEL CASHWELL, 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 15, 2016, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards,, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on 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 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 RACHEL CASHWELL to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling (4,160sq.ft. total floor area)with a 165sq.ft. front porch, a 912sq.ft. attached seaward deck; install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff, install storm drains for the driveway, and all in accordance to Chapter 236 of the Town Code-Stormwater Management; install a 20'x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction; with the condition to install a drywell for the pool; and to establish and perpetually maintain a 10' wide non-turf buffer landward of the bulkhead; and as depicted on the survey of Peconic Surveyors, P.C., last dated November 7, 2016, and stamped approved on November 18, 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: $100.00 Very truly yours, John M. Bredemeyer III President, Board of Trustees JMB/dd I I SURVEY OF PROPERTY a t SOUTHOLD SEPTIC SYSTEM DETAIL NOT To SCALE TOWN OF SOUTHOLD F.F. EL. 11.9' SUFFOLK COUNTY N. Y. EL 9.5' f1NISHEL GRADE ' l.E. uu-ul .,�I-"' III 24' 1, MIN.MAXASONARY CH _ fjj I ll III lu III III 7,O' IN. i III SII I,11-1 ' 1' min 1". MASONARY CHIMNEY ,•MIN. 1000-71-02-03 12 2'MAX SCALE: 1'_ ' I.E. 40 1/4" PER FOOT 5'S� s 18" I.E. ® ® ® ®� MINIMUM PI TCH 5-0118" PER FOOT LE ® ® ®N 1 2' MINIMUM PITCH 49 ® CO L I MAY 9, 2016 MINA DIA. PIPE MIN.4' DIA. PIPE min. 3' SAND COLLAR 12' min. (BCLUSTERSa 1 3' SAND COLLAR 8.0 MAY 25, 2016 (WETLANDS) 1500 GAL PRECAST - -- 6 A UGUS T 23, 2016 (B.0.H.) GROUND --I- ---- --�-----GROUND YAGGA INO SEPTIC TANK 3'UOUID DEPTH WATER I I WATER EL 0.6' 01-11-2a�, SEPT. 08, 2016 (B.O.H.) \I OCT. 25, 2016 (REVISED SITE PLAN) 1�REMOVE MATERIAL 8'0 TO I I SAND (SP) & BACKFlLL WITH NOV. 08, 2016 (REVISED SITE PLAN) SAND (SM) SAND I JANUARY 11, 2017 (REVISIONS) I (sP) I PROPOSED SEPTIC SYSTEM (5 BEDROOMS) [1] 1,500 GALLON PRECAST SEP77C TANK 1010 3' LIQUID DEPTH [8] 8 FT. DIA.x 2 FT. DEEP PRECAST CONCRETE LEACHING RINGS BACKFI'' W17H 3' SAND COLLAR, 2' ABOVE GROUND WATER 40 pRppF�Q j� �V A6 �3s S6¢, 01k, 704, A& ,�T �S�SSOc ZONE AE . Q- EL 6 feet 1 oFc� 00' �nN�ti4,49k 4'& C� �- *�gr(oSR ��p"p 'oo � o AQ, yq ¢, ?O C13- vV 1�P QiS�j 40QgiNA7�� kv �v� SHS 'nC :' O ° _ _ ry Fl oOD_ZONE, �Qc'eCi RAIN RUNOFF CONTAINMENT Q J0vFa�c , , w 10 X PROPOSED NEW HOUSE Q� � nA►'s � �. p,Q�;o• �8 HOUSE = 2000 sq. ft. �� q 1 °SGS 2000 x 1 x 0.17 = 340 cu.ft. 340/42.2 = 8 VF DRI VEWA Y = 900 sq.ft 900 x 0.8 x 0.17 = 122 cu.ft. ¢Op 120/42.2 = 3 VF Q Op• `� pQOp PROVIDE (3) DRYWELLS 80 x 4' DEEP °SEo �N 701f— OR 0•/OR EQUAL ¢syr �\ a !b -Xv� Lot Covereage• � �( ;n C``i_(FA` -.R`/�.��P fie. Vv <5 N 20,000 sq ft x 20% = 4000 sq ft max TEST HOLE DATA MCDONALD GEOSCIENCE J� `Q 09/02/20164 -4k Swimming Pool 720 sf �O 110A, �gnAV�Mq Rear Deck 868 sf EL. 5.9 MIXED SAND AND LOAM �p�19 vn��� R �qc Front Deck 165 sf -- 3' �/� „jam.y' �ry'° �,se• ¢�� yq� House 2000 sf 00 BROWN Si-. Y SAND SM (A� QG ��/N , Op ' �\ � q�. Total Building Area 3753 sq ft WATER IN BROWN SILTY SAND SM �A `ti FFJ O'4 �' -- ZD 0.-A PROPOSED LOT COVERAGE WATER IN BROWN FlNE SAND SP ' ' 3753/20000 = 19% no VA }i;~ .1 13.0' NOTE. WATER ENCOUNTERED 5.3' BELOW SURFACE �lP°,P! I L017 APPROVED BY .= MONUMENT BOARD OF 1 RUSTEES ��.0C TOWN OF SOUTHOLD Y``` FLOOD ZONE FROM FIRM 36103C0167H ELEVA 77ONS & CONTOUR LINES ARE REFERENCED FROM NA VD 88 DATE �A-�vv�-K Zc t7 LOT NUMBERS REFER TO "MAP OF HARBOR LIGHTS ESTATES SECTION TWO" �- l3 WATER SERVICE TO BE RELOCA 7FD 10' MIN/MUM FROM SEP77C SYSTEM F7LED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON JULY 26, 1966 AS FILE NO. 4681. NO. 49618 ANY AL7FRA77ON OR ADDI77ON TO ..,IS SURVEY IS A WOLA77ON PECONIC SURVEYORS, .C. OF SEC77ON 7209OF THE NEW YORK STA 7E EDUCA77ON LAW. 6.31 765-5020 FAX 631 765-1797 EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICARONS AREA 20,000 SO. FT. TOM LINE < > ( ) HEREON ARE VALID FOR THIS MAP AND COPIES ]HEREOF ONLY lF Or 0.459 ACRES TO TIE LINE P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 16-0�9 WHOSE SIGNA7URE APPEARS HEREON. SOUTHOLD, N. Y. 11971 SURVEY OF PROPERTY a t SO UTHOLD SEPTIC SYSTEM DETAIL TOWN OF SO UTHOLD NOT TO SCALE F.F. EL 11.9' FINISHED GRADE SUFFOLK COUNTY, N. Y. EL 9.5' EL 6.5 GE. ,,IMF )fly pf 24 1,MIN. ASONARY CH_I�II�=III III — ( JI III II w II I q ly q 7 0' 6 MIN III a III 1' min.I i' MASONARY CHIMNEY 1000—/1-0,2—OJ LE. "`7 2"M^` SCALE.• 1'=40' 1 4" PER FOOT 5.5' .s 18" LE. ® ® ® ®r 5.0 I/8" PER FOO r ® ® ®N 2 MINIMUM PITCH MINIMUM PITCH LE ® ® a _ ;�' MAY 9, 2016 MIN.4" DIA. PIPE MIN.4' DIA. PIPE 4'9 (8) 8.0 POOL (� 4 3• SAND COLLAR 2" min. CLUSTERS I 3• SAND COLLAR MAY 25, 2016 (WETLANDS) min. 1500 GAL PRECAST I 6 AUGUST 23, 2016 (B.O.H.) , GROUND --I—�------- —+----GROUND YAGGARINO SEPTIC TANK J'UOU/D DEPTH WATER I I WATER EL. 0.6' 09-OS-2016 SEPT. 08, 2016 (B.O.H.) OCT. 25, 2016 (REVISED SITE PLAN) Nl"REMOVE MATERIAL 8'0 To NOV. 08, 2016 (REVISED SITE PLAN) I SAND (SP) & BACKFILL WITH 8,0 �— —_� SAND (SM) SAND I I (SP) I PROPOSED SEPTIC SYSTEM (5 BEDROOMS) [l] 1,500 ,ALLON PRECAST SEPTIC TANK 10'0 3' LIQUID DEPTH NOVN1 ] 2016 [81 8 FT. DIA.x 2 FT DEEP PRECAST CONCRETE LEACHING RINGS RpiOFR .L BACKFILL WITH 3' SAND COLLAR, 2' ABOVE GROUND WATER Souiha'.d Lown O� /pF FRS a Tnistees 00/ E ZONE f e , OFc�.pp, cA.O nb L' ,,Qi qT yq ¢, �Ojs��� v l� Cf �9(E. C O TO sc ° A �pF a o• ry FI o0o ZONE RF RAIN RUNOFF CONTAINMENT Q� O J0vroefN� " ---- X. pTe�¢8, � PROPOSED NEW HOUSEnclvs p�?O, R �lo�� HOUSE = 2000 .sq ft. �� �x°�sr �� n qir �O 2000 x 1 x 0.17 = 340 cu.ft. x o ,o���s 340 42.2 = 8 VF v s(v ° ,' DRI VEWA Y = 900 sq.ft Q� 3�ST �N EZ o FJ R 900 x 0.8 x 0.17 = 122 cu.ft. 120/42.2 = 3 VF �Q' °°• jDpop° � PROVIDE (3) DRYWELLS 80 x 4' DEEP SFo 7014-1 11 •5 OR EQUAL �S�Ct ,gCF $ °�Sr'� ° o ?9• I �C� �� ' t c Lot Covereage; .j -0 o � 20,000 sq ft x 20% = 4000 sq ft max TEST HOLE DATA ,y' �' Qs9'y (Fo / 94 McDONALD GEOSCIENCE ' N 9, �F h� / y� , oQ�, o Swimming Pool 720 sf 0910212016 s¢os�p� `meq `� ,' �e " ��gnpg�O Mq�R/ Rear Deck 868 sf EL. 5.9 MIXED SAND AND LOAM �AUe . - &711 ` Rq, q4 Front Deck 165 sf 3' �/° �q ,y� ry -70, �s�• ¢��T N�yB House 2000 sf BROWN SILTY SAND SM �,�� o � R,ti �',� o �� Total Building Area 3753 sq ft EL. 0.6 -- 5.3' O� �A��?•fT'�N,'I'C WATER IN BROWN SILTY SAND SMRJ �/ �'°F m�•�A PROPOSED LOT COVERAGE WATER 1N BROWN FINE SAND SPFNT 3753/20000_ - 19% 1�4c% NO 7F. WATER ENCOUNTERED 5.3' BELOW SURFACE ■= OF MONUMENT nth 7z" ti FLOOD ZONE FROM FIRM 36103C0167H ELEVATIONS & CONTOUR LINES ARE REFERENCED FROM NAVD 88 " '`P LOT NUMBERS REFER TO "MAP OF HARBOR LIGHTS ESTATES SECTION TWO - - f WATER SERVICE TO BE RELOCATED f0' MINIMUM FROM SEPTIC SYSTEM FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON JULY 26, 1966 AS FILE NO. 4681. E ' At Y. UC. NO. 49618 ANY AL7FRA710N OR ADDITION TO THIS SURVEY IS A V10LA77ON PECONIC-SORVEYORS, P.C. OF SECTION 7209OF THE NEW YORK STATE EDUCATION LAW. AREA - 20 000 S0. F7. TOM LINE (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SEC710N 7209—SUBDIVISION 2. ALL CERTIFICATIONS + P.O. BOX 909 HEREON ARE VALID FOR THIS MAF ND COPIES THEREOF ONLY IF Or 0.459 ACRES TOME LINE 1230 TRAVELER STREET SAID MAP OR COPIES BEAR 774E IMPRESSED SEAL OF THE SURVEYOR 16-02n WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 1197f SURVEY OF PROPERTY a t SO UTHOLD SEPTIC SYSTEM DETAIL TOWN OF ,SO UTHOLD NOT 1D SCALE F.F. E7.. 11.9' RNISHED GRADE SUFFOLK COUNTY, MY EL. 9.5' 14 EL 6.5 /.E. II uq 11-" pl 24' 1, MIN ASONARY CHWN I E SII III 7p' 6 UlN. I II MSNARM YI5'I 0-71-02-03 12" zz SCALE. 1'=40' 1 4" PER FOOT 5.5' 6 Is" I.E. ® ® ®®M 5.0 1/8" PER FOOT ® ®®a 12 MINIMUM PITCH MINIMUM PITCH LE MIN.4" DIA. PIPE MIN.4' DIA. PIPE ® ®E MAY 9, 2016 4 j ^4^ 3' SAND COLLAR 2'I min. () 8.0 POOL 11 3' SAND COLLAR MAY 25, 2016 (WETLANDS) i.n,4 GAL PRECAST GROUND ——i=�I` ——————— 6—t————GROUND YAGGARINO AUGUST 23, 2016 (B.0.H.) SEP77C TANK 3'UOUID DEPTH WA TER I ( WATER EL 0.6' 09-os-2At L- _ SEPT. 08, 2016 (B.0.H.) I NOV. 07, 2016 (REVISIONS) REMOVE MATERIAL 8'0 TO I 8,� ( SAND (SP) do BACKFlLL WTH __ SAND (SM) I SAND I I (SP) I PROPOSED SEPTIC SYSTEM (5 BEDRO11 DID OMS) 1 1,500 GALLON PRECAST SEP71C TANK 10'0 3' LIQUID DEPTH R��cy �v ] TS AR �� NOV 1 7 2016 [8] ,6 FT. D/A.x 2 FT. DEEP PRECAST CONCRETE LEACHING RINGS BACKFILL WITH 3' SAND COLLAR, 2' ABOVE GROUND WATER O 40 S OpFRjY S16+ 39 SOS, O�/i._ $ffU:ilv;el 70'a 00 7p F F,QS, t Tru �O x`00 00l s �SSO V� C?,.rykgQD n0N G70 ��s` /NC LOT COVERAGE �0i C3/, z Or �Araos +r HOUSE & DECKS = 2806 sq.ft. ��oNo e,, OSF qO O �6��'4V gt F.vo POOL - 800 sq.ft. C7 �qp < s fee O 3606 /20000 = 1890 `O Q' oQRcyO s• �I j meq' 00' PO S FnNG �/N'�� , �a ZOi� �EUNL-\f ry Opp ZONE o°ys r°enc S ° jO,pAoo F ±r --� _ -L7f -----. RAIN RUNOFF CONTAINMENT Q J0 �FQ9c p s �Ol sr8 PROPOSED NEW HOUSE Q� `Q ''it's �o , / ;off /•l/' ,E�A° O HOUSE = 2000 sq. ft. A� 0,;`t� / O TOe�G �'eF 2000 x 1 x 0.17 = 340 cu.ft. 340/42.2 = 8 VF v DRIVEWAY = 900 sq.ft OQ- 900 x 0.8 x 0.17 = 122 cu.ft. �� ¢OO kd 120/42.2 = 3 VF Q 00' PROVIDE (3) DRYWELLS 80 x 4' DEEP y 'IV ?P r sT✓�o_ Fo y�, J ° OR EQUAL c 4 � Q. A1s OA- �C i TEST HOLE DATA ' �►� �F�Qs9, ,�c McDONALD GEOSCIENCE M F / 09/02/2016 �OA�s�r / �� y� /,`�� ' �c �,m EL. 5.9 MIXED SAND AND LOAM �pUe 4�,,+4 -- ' ��� -.j 3 ryA ase 4� A O D BY BROWN TY SAND SM �A Q �YR Y am'� X7000 off\ +�. RD TR ST S EL. 0.6 -- 5.3' � <<�Nc N 0 N SO OLD �Y F,p *4 WATER �Q WATER /N BROWN SILTY SAND SM ;�) WATER /N BROWN FINE SAND SP , 13.0' y 4" c'9i►r�. NOTE.• WATER ENCOUNTERED 5.3' BELOW SURFACE ■= MONUMENT �. ��OF tvEbY� FLOOD ZONE FROM FIRM 36103C0167H •� V �` 3; , t� ELEVATIONS & CONTOUR LINES ARE REFERENCED FROM NA VD 88 L 0 T NUMBERS REFER TO "MAP OF HARBOR LIGHTS ESTATES SECTION TWO" WATER SERVICE TO BE RELOCATED 10' MINIMUM FROM SEPTIC SYSTEM FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON JULY 26, 1966 AS FILE NO. 4681. N.Y.S. LIC. NO. 49618 ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION �M ECON/C SURVEYORS, P.C. OF SECTION 7209OF THE NEW YORK STATE' EDUCATION LAW. AREA - 20 000 SO. FT. TOM LINE (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CER71F7CARONS + P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF Or 0.459 ACRES TOME LINE 1230 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR TRAVELER STREET 16-0,29 WHOSE SIGNATURE APPEARS HEREON. SOUTNOLD, N. Y. 11971 SURVEY OF PROPERTY a t SOUTHOLD SEPTIC SYSTEM DETAIL TOWN OF SOUTHOLD NOT TO SCALE F.F. EL 11.9' RNISHED GRADE SUFFOLK COUNTY, N. Y. EL. 9.5' EL 6.5 ,E. L qui i Ik M III 24" 11 MIN. ASgMRY CH N I I I 111 a =11E I I 1 7.0' 6%l1N. II ull 1 mm. MASONARY CHIMNEY 1000-71-02-03 . 12. . i III �111 x 1'MIN. l.E. 2'MAX 1 4" PER FOOT 5.5' 6" 18" LE ® ® ® ®lz SCALE: 1'=40' MINIMUM PITCH 5-0118' PER FOOT J.E ® ®®E 12' MINIMUM PITCH ® ®� MAY 9, 2016 MIN.4" DIA. PIPE MIN.4' DIA. PIPE 4.9 4" (8) 8'0 POOL MAY 25, 2016 (WETLANDS) min. � 3' SAND COLLAR 2" min. CLUSTERS I 3' SAND COLLAR , _ -- 6"—� YAGGAR�NO AUGUST 23, 2016 (B.0.H.) �;n/0 GAL PRECAST GROUND ——I— ———— '�'———"-GROUND _ _ SEPTIC TANK 3'LIQUID DEPTH WATER I I WATER EL 0.6 ' SEPT. 08, 2016 (B.O.H.) LI J NOV. 07, 2016 (REVISIONS) REMOVE MATERIAL 8'/ TO I I SAND (SP) &BACKRLL WITH 8,, SAND (SM) SANDI I (SP) I PROPOSED SEPTIC SYSTEM11 qRe R C D e: (5 BEDROOMS) - [1] 1,500 GALLON PRECAST SEPTIC TANK 10'0 3' LIQUID DEP77-1 NOV 1 7 2016 1 [8] 8 FT. D/A.x 2 FT. DEEP PRECAST CONCRETE LEACHING RINGS 1%O' �l BACKFILL WITH 3' SAND COLLAR, 2' ABOVE GROUND WATER Stb+ •`�9 6StOs0%li„_ � $0:+:�ii?u 1GT'idl..�_._! p0 70'. F,QS ry r t Trust!ps QO ryp0 / a qr gss0%9 V vti is "qRo nON �oF�y .4'eQt,n° /tic LOT COVERAGE SOT RFao ��? �'�r �vos HOUSE & DECKS = 2806 sq.ft. Ai ftv o J�� / FZ0sF ?O s��'�q,�v�, , POOL = 800 sq. . O �O ,�v �?�r"%*, yo 3606 /20000 = 189e Q - v�v0 Q' �snyT' qo�Rj��yq,,o,�b pZON�•T,o- F(ZU�N �F ONE, 40 RAIN RUNOFF CONTAINMENT ` / TO pR 8 PROPOSED NEW HOUSE Q� Avs - o .° , Fks ' t"ow°4Fn HOUSE = 2000 sq. ft. A� 2000 x 1 x 0.17 = 340 cu.ft. O� x�x " ;M 2000 s 340/42.2 = 8 VF DRI VEWA Y = 900 sq.ft 900 x 0.8 x 0.17 = 122 cu.ft. ¢00 120/42.2 = 3 VF �P 00. PROVIDE (3) DRYWELLS 80 x 4' DEEP OnD y z �P , sT'✓�o ' y� OR EQUAL �T �GF �� t rr Z\ ` TEST HOLE DATA ' �► ,c Qs9;�'c�. - io,'� McDONALD GEOSCIENCE F eAPPROVED BY 09/02/2016 % q 4, BOARD OF TRUSTEES MIXED SAND AND LOAM 44%EL 5.9 '°� ` TOWN OF SOUTHOLD �.�' X70 BROWN SILTY SAND SM �AUe /N �� X 00, DATE 6vlo j( . 19 ZO1� EL 0.6 -- 5.3' ' 'F lac �Nc S�FF �Q 42 WA7FR IN BROWN SILTY SAND SM c�iQJ J '`� ? kipF't'C m�. - lly WATER IN BROWN FINE SAND SP �4 �T 13 0, �cgNT NOTE. WATER t'NCOUN7ERE0 5.3' BELOW SURFACE OF N4Ep;, ■= MONUMENT FLOOD ZONE FROM FIRM J610JC0167H ELEVA77ONS & CONTOUR LINES ARE REFERENCED FROM NAVD 88 LOT NUMBERS REFER TO "MAP OF HARBOR LIGHTS ESTATES SECTION TWO , - W47ER SERVICE TO BE RELOCA7E"0 10' MINIMUM FROM SEP77C SYSTEM FILED IN THE SUFFOLK COUNTY CLERK'S OF77CE ON JULY 26, 1966 AS FILE NO. 4681. �h'D_ N. Y.S. LIC. NO. 49618 ANY ALTERATION OR ADD17ION TO 7H/S SURVEY IS A VIOLATION PECONIC SURVEYORS, P.C. OF SEC77ON 7209OF THE NEW YORK STATE EDUCATION LAW. AREA - 20,000 S0. FT. TOM LINE (631) 765-5020 FAX (631) 765-1797 EXCEPT AS PER SEC77ON 7209-SUBDIVISION 2. ALL CER77FICA77ONS P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES 7HEREOF ONLY IF OC 0.459 ACRES TO TIE LINE SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 16-029 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971 John M. Bredeme er III Presi,a f �Ol y S K� Town Hall Annex Michael J. Domino, Vice-Presia-ani � �� �Gy� 5 -- 54375 Route 25 Glenn Goldsmith y = P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders yo� Telephone (631) 765-1892 xu ire` Fax(631),765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: ` 2,0�� Completed in field by: _?It, Jeffrey Patanjo on'behalf of RACHEL CASHWELL requests an Amendment to Wetland Permit #8899 to relocate the proposed dwelling further seaward with an attached 868sq.ft. seaward side deck in lieu of a 912sq.ft. deck; for a proposed' 18'x40' pool to be installed 50' landward of the bulkhead in lieu of 73.3'; and to install an outdoor shower against the dwelling. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 CH. 275-3'- SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: -Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment 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: 4-1 1V - ia /J. Br �90 Present were: 1edemeyer � D . ominoIne, C. Sanders Other off- , 4v _ 1 John M. Bredemeyer III, Presic ��S�fFO(�-CO Town Hall Annex Michael J. Domino, Vice-Presiueni �� Gym, 54375 Route 25 Glenn Goldsmith o ` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders d, dao 'Telephone (631) 765-1892 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of RACHEL CASHWELL requests an Amendment to Wetland Permit #8899 to relocate the proposed dwelling further seaward with an attached 868sq.ft. seaward side deck in lieu of a 912sq.ft. deck; for a proposed 18'x40' pool to be installed 50' landward of the bulkhead in lieu of 73.3'; and to install an outdoor shower against the dwelling. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 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 5 Page 2 of 2 -_ SUFFOL4- John M Bredemeyer III, President ?'o�� �o� Town Hall Annex Michael J\ Domino, Vice-President `'oma y ��t 54375 Route 25 Glenn Goldsmith r P\O\ Box 1179 A. Nicholas Krupski r:y o ;' Southold, NY 11971 Charles J. Sanders � Q� , ���. ' Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ®s3sA TO: RSC ��C(EI��LL VQ Please be advised that your application dated 6741W �'S has been reviewed by this Board at the regular meeting of CCDM 1% "(� and your application has been approved pending the completion of the following items checked off below. VRevised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) V 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: �t 2 Q G 303 TOTAL FEES DUE- $ BY- John M. Bredemeyer III, President Board of Trustees _ SURVEY OF PROPERTY rF t, , e a t SO UTHOLD SEPTIC SYSTEM DETAIL TOWN OF SO UTHOLD F.F. EL 11.9' NOT 7i7 SCALE ri 5 201 SUFFOLK COUNTY, N. Y. f7NlSHED GRADE I EL. 9.5' EL 6.5 _— JEm—m 1111=" III 24'[121; MINLUL1-j 111 . ASONARY CH/ N__J _ IIIA, I II III T u III III So 'Irl i inw„ ` = = 1 m n.P P+ard nr Tr r ry t� NJ. I �.IIII 111 1 MASONARY CHIMNEY —._._. _:�.: ::_.___ _. 1000—/1-02-0 II Illi- = 1' MIN. 12 2'MAX LE. 114- PER FOOT 5.5' s 18" I.E. I ® ® ®®a SCALE.' 1 =40 5.01/8" PER FOOT ® ® ®N 12' MINIMUM PITCH MINIMUM PITCH I E ® ® 1 MAY 9, 2016 4,. I M1N.4" DIA. PIPE MIN.4" DIA. PIPE 4 9 (8) 8'0 POOL MAY 25 2016 (WETLANDS) mm. 3' SAND COLLAR�2' min. CLUSTERS 1 3' SAND COLLAR I, 1500 GAL PRECAST GROUND ——I—�I`——————— 6 —+————GROUND Yaccarino AUGUST 23, 2016 (B.0.H.) SEP77C TANK 3' UOUID DEPTH WATER I I WATER EL. 0.6' 09-08-2016 SEPT. 08, 2016 (B.0.H.) I I I\REMOVE MATERIAL 8'0 TO SAND (SP) do BACKFlLL WITH SAND (SM) SAND I PROPOSED SEPTIC SYSTEM (5 BEDROOMS) y�'Q6pR [1] 1,500 GALLON PRECAST SEPTIC TANK 10'0 3' LIQUID DEPTH [8] 8 FT. DIA.x 2 FT. DEEP PRECAST CONCRETE LEACHING RINGS BACKFILL WITH 3' SAND COLLAR, 2' ABOVE GROUND WATER V 407' A6 qT 9SS00, pN/ 4- 40 r OFO,�\0 C /NC ey slincO�'� LOT COVERAGE Ci loT ��gYy'�'os HOUSE & DECKS = 2806 sq.ft. O qNo� ��� Qg F� EF e t 00 ?O s q�Gt-yF40 POOL = 800 sq.ft. , s 3606 / 20000 = 1890 0 \v�y�Q F�isn op ^oOF� c10 00 S Nc ipF *4v <1 \F _ ryFL00D ZONE Q(uQ` 0�i cOySSw Sys o ppAOO �`� \� .5_ __—tR1F---- 40 RAIN RUNOFF CONTAINMENTO J /41 _ o a A B PROPOSED NEW HOUSE Q `. , F/ o a oF�n Q gnAVs � o / �T HOUSE = 2000 sq. k. �� 2000 x 1 x 0.17 = 340 cu.ft. x\x o 340/422 = 8 VF v r<v `9�\' p o�oysFvo (s, DRIVEWAY = 900 sq.ft OQ- 900 x a8 x 0.17 = 122 cu.ft. 120/422 = 3 VF �P 00' pROp N PROVIDE (3) DRYWELLS 80 x 4' DEEP ti � OR EQUAL 4k p .4,, 2P m0--,We OIL- Itis C,NF, ` �CA !• FA,` O,v�v t^, � 'UORp1, �S,B. 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Box 1179 A Nicholas Krupski o �t Southold, NY 11971 Charles J Sanders p� t7 Telephone (631) 765-1892 ��l Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �ll , Completed in field by: M Jeffrey Patanjo on behalf of RACHEL CASHWELL requests a Wetland Permit to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling (4,160sq.ft. total floor area) with a 165sq.ft. front porch, a 912sq.ft. attached seaward deck; install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff, install storm drains for the driveway, and all in accordance to Chapter`236 of the Town Code-Stormwater Management; install a 20'x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71- 2-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 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: r _ Z41— Present'were: J. Bredemeyer M. Domino G. Goldsmith /_N. Krupski /C. Sanders Other Page 1 of 2 John M. Bredemeyer III, Pr ��gUFFO(o Town Hall Annex Michael J. Domino, Vice-Present 20 G 54375 Route 25 Glenn Goldsmith P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Charles J. Sanders �y�j�l �aoG�4 Telephone(631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Jeffrey Patanjo on behalf of RACHEL CASHWELL requests a Wetland Permit to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling (4,160sq.ft., total floor area) with a 165sq.ft. front porch, a 912sq.ft. attached seaward deck; install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff, install storm drains for the driveway, and all in accordance to Chapter 236 of the Town Code-Stormwater Management; install a 20'x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71- 2-3 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 measurableincrease 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 r Iy� 1 1 / ♦ '� 3. `. �..: ^h� 4 �� �t1:;"j ' 1;1`91 �✓1 ��� q �'�, J I �. f�� 1 •x 't,. E -T'�1! c fltik 1> ' �{�, k,4�.1f� '�Y.�{ (� f.U� �f ,� r .�, �R iM � .)'•/ � '� `�J' �'" :� � � 1 1 F' � � � / / I'/ .1F�F� ��` `r♦ ~,. ♦_ •/;1, .� 'Y�. ��_ , I �-�1 w arl�i`���Y � 1.. ..�-•�_y�L'l5d 4�+//L1 t {(• ' t ��. j I 7,` �.1 � :y� � - _ ..•jar �' 7r .� y �eA " '",{�i'r "!�.,f. : , � / �1/' f r _{ - " ! � I� _ �.�. .. r• r -•. . 1. � �P� �.\ r i V� xrR,1,y I /I yyi S� • tl1 Rachel Cashwell 515 Harbor Lights Drive,Southold rr►:, 111 - r L _ 10/11/16 r •A / 1 r jr 1,4 i`�F 01 O Y�, ` � c ''�� •y / a sly;•,� .' a.„, - � . J.. i�• ���' ,u�,l! III Iillilll illllli • • ' J m +I I xnzm a11A. a 18 p Z7 C A _ x?9;� WSERTA sC.VF.1isS SOUTHOLD BAY �$Lp.43 r N 6AYL z.7Hq �i 8 T 6 9 10 11^ 12 f3 f Ra c 161 �� rf \ Myr 15 162e 2AA(q— y _� n. .a u � rs uR%a � ♦ w ry w� e`n �i m5 35 t 3M1 1l s 32 ]1 �_ 29 _ IB a 2l + o w ® 1.(IAr.1 m 4 r)e wg W11i1 ula � (s91 O p¢ w 8 - e 1 � xn 3 14 15 F � d SEEM o E�� u� (21) ®� O _6pi__ n°iY°� NOTICEaroW, COUNTY OF SUFFOLK © E 1b as SOUTNOLD SECTION ND " Real Property Tax Seance Agency Y � _ �� CounlyLemetsrNY11961 �1 071 p,y,J ...+MP ® A .+ wan sicsouccawrvlu rva�s 71 I 4Se..9 .`. -.Y'.".r..�......t.:+?_,..a-n.+ s•-,> •rrw,,•-� a--wo-.�, w�....._.. T...:..y.. .. ,^,-,»-. y _ 10a0 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.) vs Southold, NY 11971 ® �� Telephone: 631765-1938 ® Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM D E To: John Bredemeyer, President DEC - 8 2016 Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Southold Town Roard of Trustee Date: December 8, 2016 Re: LWRP Coastal Consistency Review for RACHEL CASHWELL SCTM# 1000-71-2-3 Jeffrey Patanjo on behalf of RACHEL CASHWELL requests an Amendment to Wetland Permit #8899 to relocate the proposed dwelling further seaward with an attached 868sq.ft. seaward side deck in lieu of a 912sq.ft. deck; for a proposed 18'x40' pool to be installed 50' landward of the bulkhead in lieu of 73.3'; and to install an outdoor shower against the dwelling. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 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 INCONSISTENT with the below listed Policy Standards and therefore is INCONSISTENT with LWRP provided: 1. The setback of the proposed residence and pool does not comply with Policy 1. They project further seaward than the adjacent residences. 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. The policy is intended to foster a development pattern that provides for beneficial use of the environmental, historical, and cultural coastal resources of the Town of Southold while maintaining and building on its traditional economic base. The primary components of the desired development pattern are: ...enhancing stable residential areas, and preserving agriculture, open space and environmentally sensitive coastal resources. Development that does not reinforce the traditional land use pattern,of the Town of Southold would result in a loss of the community and landscape character of Southold. It is recommended that the residential structure be set back to maintain the existing setbacks of adjacent structures (Figure 1). 4.s LI '� m _ x, Figure 1. Residential setback line (red line). The pool and de-watering well do not comply with Policy 4 Minimize loss of life, structures, and natural resources from flooding and erosion. The partial areas of the pool and the pool dewatering well occur within a FEMA AE EL 6' flood zone. A policy directive is that development and redevelopment in hazard areas needs to be managed to reduce exposure to coastal hazards. It is recommended that the pool and dewatering well be moved to outside of the FEMA AE EL 6' flood zone to further policy 4.1. Minimize losses of human life and structures from flooding and erosion hazards. Note that the depth to groundwater is 5.3 feet from grade (9//2/16 test hole data). How will the applicant address the groundwater levels and the construction of the pool? What are the dimensions of the drywells? Would the pool and drywells encounter groundwater at the proposed locations? Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. j ��9g�yfFOtkca Peter Young,ChairmanH Town Hall,53095 Main Rd. Lauren Standish,Secretary - P.O.Box 1179 Southold,NY 11971 ��/�l �` Telephone(631)765-1889 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: Moved by Peter Meeker, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of RACHELL CASHWELL to Amend Wetland Permit#8899 for the new location of the proposed house and pool. Located: 515 Harbor Lights Dr., Southold. SCTM#71-2-3 Inspected by: Peter Meeker The CAC Supports the application with the Condition of a 10' non-turf buffer. Vote of Council: Ayes: All Motion Carried Cantrell, Elizabeth From: Jeff Patanjo <jpatanjo@optonline.net> Sent: Tuesday, November 22, 2016 12:27 PM To: Cantrell, Elizabeth Subject: RE:differences in plan vs. description for Cahswell The 18x40 is correct and there is an outdoor shower on West side of house. I didn't notice the change when I got revises plans. if you can change the description it would be great Thanks so much Sent via the Samsung Galaxy SCS 6,an AT&T 4G LTE smartphone -------- Original message -------- From: "Cantrell,Elizabeth" <elizabethc@town.southold.n�us> Date: 11/22/16 11 140 AM (GMT-05:00) To: "Jeffrey Patanjo (jpatanjo@optonline.net)" <jpatanjonoptonline.net> Subject: differences in plan vs. description for Cahswell Jeff, Please verify immediately if this is to make it onto December's meeting. I see the revised survey depicts an 18'x40' pool, not a 20'x40' as your description states...do you want to change the plans or description. If plans, then it must be tabled to January as today is the final day to make changes. I see a proposed o,tdoor shower on survey, is this correct? It needs to be part of the project description C'i�ClL"GLpl �tfYlp�£�W Senior Clerk Typist Town of Southol Board of Trustees 631-765-1892 i John M.Bredemeyer III,President so Town Hall Annex Michael J.Domino,Vice-President �® �® 54375 Main Road P.O.Box 1179 James F. King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G Telephone(631) 765-1892 Charles J. Sanders,Trustee COUf Fax(631) 765-6641 A BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD To: Southold Town Building Department Re: Verification of Building Department Permit Requirements SCTM#: 7/ J Property Owner Name: 1 Q0_CA ej a5�cwj/ Date Sent to Bldg. Dept.: Z/ �2016 '^ t�14`n2� PST n�;ca on The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: ,YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: igna ure-'of Reviewer Date November 12, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 D Southold, New York 11971 NOV t 7 zoos RE: 515 HARBOR LIGHTS DRIVE-SOUTHOLD, NY SCTM No. 1000-71-02-03 Southold Town AMENDED PLAN SUBMISSION Apard of Truste Dear Trustees: We hereby submit one (1) original and three (3) copies of the revised based on a new location of the proposed house and pool. We hereby request an amendment to the original permit due to the revised location of the proposed residence and pool. Also included is an updated LWRP form and a check in the amount of$50 as requested to obtain a revised permit for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Ver truly yours, effrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 V) \ I Rachel Cashwell 515 Harbor Lights Drive Southold, NY 11971 SCTM No.: 1000-71-02-03 Project Description Project includes demolition of existing 2 story residence and associated deck and sanitary system. Construct proposed 4,160 SF (total floor area) 2 story frame residence with 165 SF front porch, 868 SF rear deck and proposed sanitary system in accordance with SCDHS standards. Also included is a proposed 20' x 40' in-ground swimming pool in the rear property. All roof and driveway runoff to be directed to on-site storm drains and pool backwash directed to dedicated drywell. A 10' non-turf buffer will be placed along the existing bulkhead.A proposed silt fence with hay bales to be placed around the construction site for the duration of the project. Wayember a 2016 Town of Southold-Trustees Town Hall Annex Building 54375 Rte. 25 P.C. Box 1179 D E C E IV E Southold, New York 11971 RE: 615 HARBOR LIGHTS DRIVE-SOUTHOLD, NY DEC - 8 2016 SCTM No. 1000-71-02-03 /AFFIDAVITS Southold Town pard Tu e s Dear Trustees: Attached please find affidavits of mailing and posting for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, J ey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: JV5-W zz�d_s-� ._� �►y _�-oDv_i_� 7. 014 2120 GOOD 5437 889-5 ___ __' 7014 2120 0000 5437 8888 7014 2120 0000 54. 37 8871 7014 2120 DODO 5437 8864 STATE OF NEW%RK -- - - -- -- - COUNTY OF SUFFOLK — ---- SoLA„�J a_�y 7014 2120 0000 5437 8857 residing at to a 8)wd. �'i3 , being duly sworn, deposes and says that on the C60 20/0, 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 at(�Cn�Cr 40"CIV,3 , that said Noti s were mailed each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to efore me this Day of bfV-1 201(,o 1 Notary Public Lo6ann Pataylo Notary Public State of liew York Qualified in Suffolk County No.04P508107120 !S Commission Exit 'U T11 ti • _ CERTIFIEDstal Service MAIL@ RECEIPT till •. mes tid Mail Only MEt�r m j LnPose - 0934 Ii 14 O Certified Fee $t:(4�I• i 04 (Endorse e rn n Req 1 edj l °�}ja'e $ 1 fl 1 O i Restrfctpd Delivery Fee p (Endorsement Regwred) rLj _I r-1 Total Postage&Fees Sent To t ror PO Box No. Cite, -]1��1'.-----ty �---C--- --- -N\j 1, Postal ServiCeT� TI Postal Servic ke CERTIFIED , m RECEIPT CERTIFIED r� O ■ ■ �- Domestic Mail OnlyDomestic q I ail Only CO eo 71 N Postgtj@ -1192k j Postage $, f I93J Certified Fee $l:1. CIO t7 I Certified Fee $ft°!t[i4i 0 e� $ Q Return Receipt Fee .� Postm� ! C3 ,+ O (Endorsement Required) $�l,�0 (� Herm �j C3 Retum Receipt Fee $�1°=11 y NPostrn C3 _ ® LnC( O (Endorsement Required) ® Here vik Restricted Delivery Fee p r3 (Endorsement Required) ° ® Q-1 Q Restricted Delivery Fee � Cary f V $i_l° J� 2 �� 0 jEndorsement Req drPri) Total Postage&Fees 1 i f 1J Tali 2 f1J $3°/ ,•� j Total Postage& Qps & l t Sent To ,V fnj ent To _rS 179 la C3 Street&iipt/Vo., - N or PO Box No. ( n ` i C3 Spee Apt No. -------- = '� or PO Box No. I City State,Z/P+4 C� 1Y _ -- ` r` - X015 -- _ - (IA CityState,Zl15P- • • Postal Servic6T' 1:0 CERTIFIED MAIL@ RECEIPT. CERTIFIED MAIL@,RECEIPT Domestic MaY Only CD r' Domestic Mail On c iLn iY soLP04l MY 'til ', so t ,g Po j6 Q. 0934 ' "n ! Posu3�i Certified Fee 14° i ! Ln Certified Fee Retum Receipt Fee -9r g ark D l� ��� vd\ R®os t sem�,� M (Endorsement Required) $i•1•(l)�l`"e O Return Receipt Fee ' j rieft— � Here ��`t a, O ! p (Endorsement Required) / Restricted Delivery Fee p • *01/ (Endorsement Required) I Restricted Delivery Fee ru i° G O�(► 3 (Endorsetnent Required) r—1 Total Postage&Fees $ e 1 i�• A n I I7J $��• � ��� �` n� � ""' y r9 Total Postage&Fees $ ( y A Sent To ru ®�� � Sent To a ---- ------ - '- V Y�Y" � fir. O Street&Apt.No., --'-'�----"---"� � � -__-�- or PO Box No. � -'Da 9 � p Street&x 1110--------------------------- ---- , --------------- L ----- SS..11 1 or PO Box No. [�;��, Crty State,Zlf'+4 N --------------------�-i37�,�.((�� \I-_ ` 1 (1vy ' 1 I State, IP+4 ---------------------- City, --- il J �— i :00 John M. BredemeY er III President �pS�FFO(off, Town Hall Annex o � Michael J. Domino, Vice-President rj� ti1E 54375 Route 25 Glenn Goldsmith 4 y P.O. Box 1179 A. Nicholas Krupski �y �� Southold, NY 11971 Charles J. Sanders 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 RACHEL CASHWELL 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 residing at/dba 1Wypw (,t 6)Vd. l9`54 being duly sworn, depose and say: That on the 7 day of , 2011 , I personally posted the property known as by placing the Board of Tru' es 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: J_L !L gnature) Sworn to before me his day of`g7iZ_:0 Notary Public Loriann��P��a�etan o Not�au Ifi m rk Sutioyk County No:04PA6150861 Gommisslon Expires 08107120 5 NUTILt: Ulm Ht: A K- ING 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: RACHEL CASHWELL SUBJECT OF PUBLIC HEARING : For an Amendment to Wetland Permit #8899 to relocate the proposed dwelling further seaward with an attached 868sq.ft. seaward side deck in lieu of a 912sq.ft. deck; for a proposed 18'x40' pool to be installed 50' landward of the bulkhead in lieu of 73.3'; and to install an outdoor shower against the dwelling. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 TIME & DATE OF PUBLIC HEARING : Wednesday, December 14, 2016 — at or about 5 :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 r 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 dreaLwluch'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•exulained in-detail, listing both supnorfina and non- suaportine facts. If an action cannot be certified as consistent with the LWAP 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,thfi gR�en'u�al local libraries and the Town Clerk's office. -----� B. DESCRIPTION OF SITE AND PROPOSED ACTION NOV 1 7 2016 SCTM# 71 - 0:3 Southoid Tom ® 1-10+s OIL - S®u- 616 Bar tTr "ee PROJECT NAME � � ��+r b�� ' The Application has been submitted to(check appropriate response): �/ Town Board 1:1 Planning Board El Building Dept. Z' Board of Trustees I-1 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: :S.e.e 6, -t'-ra c dteJQ XtSc (, t Location of action: 6I S' f-)a r bor 4/f b-kj At Site acreage: 'P �59 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: 04e�4 e l Ck S (b) Mailing address: I A9 5-rret-t-•4 r Q Ave- (9a rW« 01 Il 53P (c) Telephone number:Area Code( ) 9) 7- (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ZNoR If yes,which state or federal agency? °l S®V C-- 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. 2Yes ❑ No ❑ Not Applicable P6pos.-A Prnl,-rA -enk&nces GmM/Kuev�.,, GM�r�L?'e/ ZJ.-, Qrloms�6eN� d. .yew rfssd,caee G®ns`s he-4+ ..Olt* -'*& ✓lGtgh�ao/be __rea_�`adCeS saavC�e�••l w Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No L 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, ZYes ❑ No ❑ Not Applicable �t..� res,d"eg mill loe. eh.ord&caF- Aesbe,r6oa pwb et-t";s - — 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 I ❑ Yes ❑ No [- Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Polidies Pages 16 through 21 for evaluation criteria Eg"Yes ❑ No 0 Not Applicable ®ur rt r:y G s? vr-f'i e►+s &j 66.le s Awry. S t c.+ Fence &-M 6e �•St. //ecQ -E'o 15,,rroe & em-h a Sree-- Ad( tLvv►®Gf �0y.4 PA +Ae rQroldGf &.111 bis dtreered1 ^Ca GQ,rdw^S Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages,22 through 32 for evaluation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes [:]No Not Applicable 4 Attach additional sheets if necessary t Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes F] No I J Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ Ye�j No 9 Not Applicable Attach additional sheets if necessary � 1 WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III•—Policies;Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [�Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ElYes ElNo 2 Not Applicable ' Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ElYes 1:1No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No RNot Applicable PREPARED BY J' e 'TITLE -A 9en�° DATE 9 /2 -/6 November 12, 2016 Town of Southold Trustees Town Hall Annex Building D E C E Q V E 54375 Rte. 25 P.O. Box 1179 NOV 1 7 2016 Southold, New York 11971 RE: 515 HARBOR LIGHTS DRIVE-SOUTHOLD, NY South aid"fawn SCTM NO. 1000-71-02-03 Board ofTrustees REVISED PLANS AND CHECK Dear Trustees: We hereby submit one (1) original and three (3) copies of the revised plans per the public hearing and a check in the amount of$100 as requested to obtain the permit.for the above referenced project. Plans have been revised to include the 10 wide non-turf buffer along with a drywell for the pool backwash. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, Peffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 OFFICE LOCATION: ®�®f MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 `fir Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 a Telephone: 631 765-1938 ® Fax: 631 765-3136 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 RACHEL CASHWELL SCTM# 1000-71-2-3 Jeffrey Patanjo on behalf of RACHEL CASHWELL requests a Wetland Permit to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling (4,160sq.ft. total floor area) with a 165sq.ft. front porch, a 912sq.ft. attached seaward deck;-install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff, install storm drains for the driveway, and all in accordance to Chapter 236 of the Town Code-Stormwater Management; install a 20'x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 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. Verify the installation of a pool de-watering well to further Policies 5 and 6. 2. Require a vegetated, non-turf buffer to further Policy 6. 3. Encourage the installation of a alternative sanitary treatment system to further Polices 5 and 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. Q%15FFOJ�.�dG Peter Young,Chairman ti Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 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 John Stein, it was RESOLVED to SUPPORT the application of RACHELL CASHWELL for the demolition of the existing two-story residence and associated deck and sanitary system. Construct proposed 4,160 sf. two-story frame dwelling with 165 sf. front porch, 912 sf. rear deck and proposed sanitary system in accordance with SCDHS standards. Also included is a proposed 20'X 40' in-ground swimming pool in the rear property. All roof and driveway run-off to be directed to on-site storm drains. A proposed silt fence with hay bales to be placed around the construction site for the duration of the project. Located: 515 Harbor Lights Dr., Southold. SCTM#71-2-3 Inspected by: Peter Young The CAC Supports the application, however, the pool and proposed development were not staked. Vote of Council: Ayes: All Motion Carried `Y �� S0�T John M. Bredemeyer EEE, Presid' Town Hall Annex�/ Michael J. Domino, vice-President � Ol0 54375 Main Road P.O. Box 1179 Jaynes F. King,Trustee Southold, New York 11971-0959 Dave Bergen,Trustee G Telephone(631)765-1892 Charles J. Sanders, Trustee 'Q ® ly��UNT`i,�� - Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ��p 1 4 2016 To- Southold-Town Building Department Re- Verification of Building Department Permit Requirements nLDYNGDEPT. P,,_ -)p SOUTHOLD SCTMff: Z� Property Owner Name: ' Date Sent to Bldg. Dept.: L7.lvb The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: AsCLQ-J dtvoAlm 0� an --- --- --------------------- --- - - - -- - - -- ---- ---------- -- --- - �� 140 Signature or Reviewer Date 1 John M.Bredemeyer III,President ,'��; ='��--�-_��g; Town Hall Annex Michael J.Domino,Vice-President Q 54375 Main Road P.O.Box 1179 James F.King,Trustee ' ' Southold,New York 11971-0959 Dave Bergen,Trustee -- � Telephone(631)765-1892 Charles J.Sanders,Trustee �1 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Off[ce Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit _Amendment/Transf--i/Extension Received Application: 7115-440 _ Received Fee:$ ? - Completed Application 11�/ t E `, E7 D Incomplete ! SEQRA Classific ti Type[ Type 11VSEP 15 2016 Coordination:(date sent) �� -7�!(m FLWRP Consistency Assyy��sment Form $ _.CAC Referral Sent: `1�?�$�/ Southold Town Date of Inspection: I D I t I Bo d of TrusteesA _Receipt of CAC Report: _Lead Agency Determination: _Technical Review: d/ Public Hearing Held: 10� D Resolution: Name of Applicant lG c h e 1 A C&C,4w a 11 Mailing Address 1 a 4 5-t-r4+riorg Ave- 67a$JeA C44CI . b 115 ,3 o Phone Number:( )ql1- 53 10 4 6 Suffolk County Tax Map Number: 1000- X11 " ® 2-- ®� Property Location: 5,15' 4)A e b.-r kd-S ��-• ���`���1� Der'eC+ yr w,n,4 ,*mt .'er Anise (provide LILCO Pole#, distance to cross streets,and location) AGENT: �J e 4�.'-,e IP4+41 f e -- (If applicable) Address: 106 j/eWjfit- 131,VA, reri -p4horicheS A 1 I qY1 Phone• • 3!• 5/100 9-TS ��— I � Board of Trustees Application GENERAL DATA Land Area(in square feet): O v v e o Area Zoning: 2c S Previous use of property: fL e S Intended use of property: Res. Covenants and Restrictions on property?' Yes ✓ No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. / Does this project require a variance from the Zoning Board of Appeals? Yes ✓ No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes No F Does the structure(s)on property have a valid Certificate of Occupancy? + Yes No Prior permits/approvals for site improvements: Agency Date lowv% or f SGvtto I te &I et #3 001 1 b- 11-11 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): . S-ee A4,achek d-esx o p-h ay . Rachel Cashwell 515 Harbor Lights Drive Southold, NY 11971 SCTM No.: 1000-71-02-03 Project Description Project includes demolition of existing 2 story residence and associated deck and sanitary system. Construct proposed 4,160 SF (total floor area) 2 story frame residence with 165 SF front porch, 912 SF rear deck and proposed sanitary system in accordance with SCDHS standards. Also included is a proposed 20' x 40' in-ground swimming pool in the rear property. All roof and driveway runoff to be directed to on-site storm drains. A proposed silt fence with hay bales to be placed around the construction site for the duration of the project. vh; Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: SC•G Area of wetlands on lot: square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: /3/ feet Closest distance between nearest proposed structure and upland edge of wetlands: 131 feet Does the project involve excavation or filling? No Yes a If yes,how much material will be excavated? 257-- cubic yards How much material will be filled? S_ cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: / S Manner in which material will be removed or deposited:, J%S r!51-L.-e,9 -t®- ,-v Qrk.11 F001-I fiS a✓teQ. draj.'att SvoSfc�++S 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): 7'titfc Witt 4e: 40' P1eJ4+d&Ae e�Frc-E �•, wts^E�l4�d�s ®.0 —1'�tQ4 (, w�•t'c,R.s s�..t -l-a a1( w�/L!L vplancQ a 6�c,�tc�6� r� Short Environmental Assessment Form Part I -Project Information 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 1 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: L n 6,15- #4'C '-'4 Project Location(describe,and attach a location map): N®t-$ b SOde r F Ell.r 4-4- G +J D,2 d ,lee+1 ac pro is -FrmoK W+nAJ'e,,.,,Mer 02. Brief Description of Proposed Action: sire v tt$6% a'leeSZ/rl• "Sretene a Aus ge $aa:tat27 S�S't��a- err 32/l..e-C .�•e. 'J 0V1r5Vrvc-r 2D1 !" `!'` tr1-g(v�nc2 r��.+yMir►�ny imat • 44 -Ca 16L LgrnrQwrc/d1 vh 'C.Ae�srj"fi .ii-ii Ef� 66jej e4ri& S'-0- (^carr Name of Applicant or Sponsor. Telephone: 917 - S 9 6 ~ I o y S fL Ac 6c t Cft%�W C l( E-Mail. FGeo"&v cls & o(;4'm4W-r-Ne+ Address: 1a of Str-t-!'1orA AVC - City/PO: State, Zip Code• Cvardeyt 04-l; /v`( ! lS"3v 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: N`ISOEc.�Town uF Sm04kdt2 vi- Sa tkolu2 Aldo Ocp4-1 Sx-QH•S. i5T9- 3.a. Total acreage of the site of the proposed action? s. q sq acres b. Total acreage to be physically disturbed? ®. 3q J acres c. Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 'p'y S 9 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban []Rural(non-agriculture) ❑Industrial ❑Commercial EfResidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 3 5. Is the proposed action, Yl NO YES N/A a.A permitted use under the zoning regulations? ® R b. Consistent with the adopted comprehensive plan? 1:1 Rr El 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:Name:Peconic Bay and Environs,Reason-Protect public health,water,vegetation,&scenic beauty, Agency:suttolk county, a e: - - 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? 0 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: ® 0 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: El 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment- e•45'rrL­+ Rr 11 4411+195, I^, 4e0,.-d1& CC _w( 5.6•b d-1. $. JZ*J Vire-nce+'� 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? 21 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? El IZI— b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? El If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres- 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ® 21 16 Is the project site located in the 100 year flood plain? NO YES 17. Will the proposed action create storm water discharge,either from point or non-pomt sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? [ NO ®YES b.Will storm water discharges be directed to established conveyance systems runoff and sto drains)? If Yes,briefly describe: (❑NO aYES All rygv F F 4.v by of i acepe a -4✓0 ®.1—Sitt S+,mt drou i s 4.s Page 2 of 3 f 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 LJ 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: ❑ 20.Has the site of the proposed action or an adjoming property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe. 0 I AFFIRM THAT TIME INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO DES OF MY ]KNOWLEDGE Applicant/sponsor name: A C-ti e l l a t e l Date: Signature: PRINT FORM Page 3 of 3 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: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing 6r NO YES completed)for hazardous waste? If Yes,describe: F] R I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning11regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? D 3. Will the proposed action impair the character or quality of the existing community? E 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, Imo" 1:1architectural or aesthetic resources? u 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Efr ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 r 1 1 No,or Moderate small to large impact impact may may occur occur 10 Will the proposed action result in an increase in the potential for erosion, flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? El 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 box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. F1Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead A ency Date vV � President Print or TypeNa of Responsible Officer in ad Agency Title of Responsible Officer Signa re o Responsibl O icer in Cead Ag cy Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 r-- EAF Mapper Surrlirri--! Report - Sunday, September 11, 2016 8:26 PM Disclaimer: The EAF Mapper Is a screening tool Intended to assist project sponsors and reviewing agencies in preparing an environmental t, ''} assessment form(EAF).Not all questions asked In the EAF are ,i 1',3300'1'60'-23040 answered by the EAF Mapper.Additional information on any EAF question can be obtained by consulting the EAF Workbooks. Although • '�-��� =�_�__,; .„ •, :, `+.'; � the EAF Mapper provides the most up-to-date digital data available to `� + `1'3304104;-`0000 DEC,you may also need to contact local or other data sources in order to obtain data not provided by the Mapper.Digital data is not a 7100-100-1000'11 substitute for agency determinations. 7,1 1,00;2007740,0 71100-100-1-7000 7x100-2 0 7100-200'100 3 ;1401' 7100-200-60 71 0-200-3000 I r 7I0,Q-200!,905�0TI00 4_;0= 404 t ;zmE ]r 7'1 00=16-18000 r -o--r r I + 7104-20OT160008 100'100-2000] ) fir 'tL `r,•t§'� - 1 �1 '71i�OL240-2004 l r 71+Q0-200-17 '0 ` " r�F, , , i ,,7'1.00-200,-80 007-106-200-100007 ikt 7u`d�.�r I C� $10-0--i"06-4666, }I• . r` > � f + Toronto 1 r ` 1 "I0�24Q>'1200� + J860!}=500-9000 �r t _,e La�awic r 7'100-200-900.4 l 7`100-200-13 r f, 5x7900' '6-1'006, t-- w_ r t Q0 ,3000.100-200021' {� Rccheslar_ , Hull ao,n t X10 7100-200-I'1002�, 1 1 _ j f � ' :_( r v`fc,r, Alhat�,r• 940 300 u000 =--- 71 d0 2 00-'1�U00 iii o a Bares 4tf ''70_4-100-S000y�7'100-200=1'4400"- ��, 1 X000 500 2001 °3t]efral�, y'•' p �'`•. .;c, n _ II , �;% 7900-40035000 7900r4{1d 00'1 7 �. riS�icf .'tlev+ `eeil. {; , •�r,4',.'r -;:;� — r -� !r 7904- ,0--�o4oav r 7900-1-00401 z 26000 -_7t0 4r1,Qg2000 r er �u _Esr'i ERE �L rrfi Ile 1 � 7 0.0--1134 tt 7o h� r � 5• r. �+r.Y f 7940- 0 X7940-100 7t�00 Inyk p, in r` it '��pdf� ,t 1E5i0 ii:c Pitt burro,'' Smtarr: E. 11000 y 7900--14o i -� 7 J u1E Es-C a•(H fig; n r n Cdumtiuo ; 1: DeL ``� I$B� ���0 4 1<c' I$f«8,Interma 900-100-170251 T` �Q0.�440-33,j fi ile �y�y's I ���v� ltr tt�a f� s� y P, r r },v � �S rn emLn P cs NRCAN;• 340 A00-150007900--140-1204 �,7900;tf1�3� t�iLlny 420 " rP rrfr 000 ^^" r P �y 4 ci. psi�ETiJa?Z ser }' rcirrna6 J ;.;; J n,t=AETI,Esri;Chins,, Part 1 /Question 7 [Critical Environmental !Yes Area] Part 1 /Question 7[Critical Environmental Name:Peconic Bay and Environs, Reason:Protect public health,water, Area- Identify] ;vegetation, &scenic beauty,Agency:Suffolk County, Date:7-12-88 Part 1 /Question 12a [National Register of �No Historic_Places] Part 1 /Question 12b [Archeological Sites] Yes Part 1 /Question 13a [Wetlands or Other Yes- Digital mapping information on local and federal wetlands and Regulated Waterbodies] ,waterbodies is known to be incomplete. Refer to EAF Workbook. Part 1 /Question 15 [Threatened or 'Yes Endangered Animal] Part 1 /Question 16[100 Year Flood Plain] -Yes Part 1 /Question 20 [Remediation Site] No Short Environmental Assessment Form - EAF Mapper Summary Report 1 r� aogUl Town of Southold y Erosion, Sedimentation A Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#- THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Ol Ixf loop -71 D7. p STORM WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN T r c e3`c(lon or Toe— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORKASSESSMENT Yes No a. What is the Total Area of the Project Parcels? WIII this Project Retain All Storm-Water Run-Off (Include Tota)Area of all Parcels located within „ the Scope of Work for Proposed Construction) 490000 IP s Generated by a Two(2)Inch Rainfall on Site? (S. ./Acres) (This Item will include all run-off created by site b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all vEJ and/or Ground Disturbance for the proposed l'Joe�D o•3 Site Improvements and the permanent creation of construction activity? y impervious surfaces.) (S.F:/Acres) ' Q Does the Site Pian and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCREMON (Provide AddldenalPages asNeeded) Drainage Structures indicating Size&Location?This Item shall include all Proposed Grade Changes and SGGg."�-� VU g,Ghe� f � C t7e4-I®^ Slopes Controlling Surface Water Flow. 3 Does the Site Pian and/or Survey describe the erosion and sediment control practices that will be used to control site erosion and storm water discharges. This item must be maintained throughout the Entire Construction Period, 4 Will this Project Require any Land Filling,Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards — 1 of Material within any Parcel? �j WIII this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand �_ x (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities Involving soll Beach? disturbances of one(1)or more acres; including disturbances of less than one acre that 7 WIII there be Site preparation on Existing Grade Slopes are part of a larger common plan that will ultimately disturb one or more acres of land; which Exceed Fifteen preparation feet of Vertical Rise to Including Construction activities Involving soil disturbances of less than one(1)acre where One Hundred Fifteen of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges. (SWPPP's Shall meet the Minimum Requirements of the SPOES General Permit 8 Will Driveways,Parking Areas or other Impervious for Storm Water Discharges from Construction activity-Permit No.612-0.10-001.)- Surfaces be Sloped to Direct Storm-Water Run-Off 1.The SWPPP shall be prepared prior to the submittal of the Not.The N01 shell be Into and/or In the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shell 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 will be used and/or Removal of Vegetation and/or the Construction of any 00000,a constructed to reduce the pollutants In storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item Will NOT Include the Installation of Driveway Aprons.) Identify potential sources of pollution which may reasonably be expected to effect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice In a Box and the construction site disturbance Is between 5,00D S.F.&1 Acre In area, component shall be prepared by a qualified Design Professional Licensed In New York a Storm-Water,Grading,Drainage&Eroslon Control Plan Is Required by the Town of that Is knowledgeable In the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. (NOTE: A Check Mark(4)and/or Answer for each Question is Required for a Complel(I Application) STA7T OF NEW YORK, COUNTY OF...........................................SS I That I :eG 6A C"s ht,,&A I ................. being duly sworn,deposes and says that he/she is the applicant for Permit, (Name of Individual signing Docdment) Andthat he/she is the ...........................................�.t...ah. l�t�.ei ...................................................................................................................... (Owner,Contractor,Agent,Corporate Officer,etc.) Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work mid to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn too before me this; I ............I.5......... �....qday of ....... . ..... ,201.I(1 Notary Public: ....`.v�{!�'!c........... ... ................. .�.........J/ ........ ........ ..... ................................ (Signature of Applicant) t FORM - 06/10 Lotiann Patoniio� Notary.Public Ste clpflNew York Qualified in Sufk County No:01H.150861 Cornatission Expires 08107120 ' J October 9, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 515 HARBOR LIGHTS DRIVE-SOUTHOLD, NY SCTM No. 1000-71-02-03 AFFIDAVITS Dear Trustees: Attached please find affidavits of mailing and posting for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, c(e"' Je ey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 rv, i PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 161rbDr L Pa _PV Wk ice] Sboftid g 1 7015 1730 0000 0894 5640 --j 7015 1730 0000 0894 5275 7015 1730 0000 084 5282 IIS , PD 8D� gX17 5DtJq,-io1Cf //9971 { 7015 1730 0000 0894 5299 j bDLI I26 W ZUd 5.4. x$- C NY N� 100 f STATE OF NEW YORK 7015 1730 0000 0894 5305 COUNTY OF SUFFOLK residing at_fOLP l kLyl bb f31 kA being duly sworn, deposes and says that on the day of®( (j , 20-tLa, 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 oll of the Town of outhold; that said Notices were mailed at the United States Post Office at UMt&r MO-qCWS, that said No ' were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. 1 Sworn to 1Xfore me this Day of Notary Public pZILOM sm., 3 uoiss 3 Loriann Patant Notary PubNc Sta a few York �unoo !pe�!I�.D Qualfied in S �k County )POA used uu d Commission Exores�0a/071� I /r I A Er �• Ir rU Ln SOPTHOLri37 1i.1 :F1 LR711 i^: p-• Certf Lj Jy3a l TieED$3W8, l $ des 1 . 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Ln I I ru Ln . Ln , SOUTHOi.Pr 4y 11,971 r f tff:I 1,977p r p^ Certified Mad Fee 1:13 $,:1.3171 fig,;, . E CertifledMadVee A $�.,?,�1 I,19,:r4 o $ 14 0 $ So 110 ,14 Extra Services&Fees(check box,add fee at Is, Extra Services&Fees(check box,add(ee ayt.�lorq(r�te) • Q ❑Return Receipt(hardcopy) $ Y.a 1.'t-1 e.9 V ❑Return Receipt(hardcopy) $ 71JT5.1 w O O Return Receipt(electronic) $ �I,ILII I �r P � � � r-3 ❑Return Receipt(electronic) $ rx�. Certified Mail Restricted Delivery $ '�° e (y� n� Certified Mail Restricted Delivery $ $ 1_of1 �j He 0 El Adult Signature Required $ 0 ❑Adult Signature Required $ d t��i �� ❑Adult Signature Restricted Delivery$ -•'' E]Adult Signature Restricted Delivery$ /� ) - ,, O Postage ® _i, (� M Postage M $ $C1.47 ! m $ $0.47 ® i Total Postage and F ed 77 wB. 17/21 i � Total Postage and Ft,!. I /201' 4� $ '■ �� '� $ ,.77 LO Sent To `� jam', Y1 rq Ln -------------- R.- sll1�Y_r.° 4 Street and Apt Nd,o P x IV. '� Street and A t IVo., B o ObOr !i City,-9ate,ZIP+4® -------- -- ----- CState,ZIP+4®------- --------------------------------------------------- 1�7 old fU 1R71 :11 1 I I 111•1• BI - 1 11 111••• 1 ) John M. Bredemeyer 111, President co 'z yf Town Hall Annex Michael J. Domino, Vice-President 54375 Route 25 Glenn Goldsmiths ,? P.O. Box 1179 A. Nicholas Krupski o� Y Southold, NY 11971 Charles J. Sanders `' ��� ���; 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 RACHEL CASHWELL 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 (j a �, residing at/dba (o10 flfw 0t, t ly-d . min Gf 11'rA being duly sworn, depose and say: That on the I day of ®G���r , 201(p, I personally posted the property known as 515 Mvbo- I 1/u+S 12 n vC,- by placing the Board of Trustees offs al 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: (si re) Sworn to before me this q day of A-LW1 20 1(P iwam� Xatqc) Notary Public Lonan Patantto Notary-Public State oftw York Qualified in Suffolk County No:01PA6150861 Commission Expires 08/07/20 NUTILt: Uim 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: RACHEL CASHWELL SUBJECT OF PUBLIC HEARING : For a Wetland Permit to demolish the existing two-story dwelling with associated deck and abandon existing sanitary system; construct a two-story dwelling (4,160sq.ft. total floor area) with a 165sq.ft. front porch, a 912sq.ft. attached seaward deck; install a new sanitary system landward of dwelling; install gutters to leaders to drywells on the dwelling to contain roof runoff, install storm drains for the driveway, and all in accordance to Chapter 236 of the Town Code- Stormwater Management; install a 20'x40' in-ground swimming pool on the seaward side of dwelling; and install silt fencing with staked hay bales around the construction site prior to and during construction. Located: 515 Harbor Lights Drive, Southold. SCTM# 1000-71-2-3 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 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, JahA 0"thweil -M- residing at 1 V ST'r! (print name of owner of property) (mailing address) .41 l ayGyp Cit t lS3o do hereby authorize (Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. ( ` ner's signature) i APPLICA-NT/AGF,NT/REPRESENTATWEI TRANSACTIONAL DISCLOSURE' FORM The Tolvn of SovtlaOld's Code of Ethics firohihits conflictg of interest on the part of CmYrt Ott Iceg and Cn7pI0Vr�Cs 'tllo pUriTeSe Of mesas form is to provide informnrinn%�hich can atert the town ofMssible conflicts of t iriterc ad allow it to Ia c whatever chop is necana to avoid same. YOUR NAME: (Last name,first name,.rpiddie initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicatetheother 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 _r Other (If"Other",name the activity.) Do you personally(or through your co€np.my.spouse,siblinS"parent,or child)have a relationship with any officer or employee of the'rown of%outhold'? '-Relationship"includes by blood,ntarrin gc,or business interest."Business interest"means a business, including a paruiership,to which the lolwn off icer oreinployec has even a partial olxnership of(Or employment by)a corporation in which the town officer or employee owns more trim 5%of the shares, YES NO 1 APPLICANT/AC,TENI'/KEP t 'SF,NI'ATIN``E TRANSACTIO-NAL DISCLOSURE FORM Tho Town nf5aut i d's Goch of t th c5 nhitaitN cnnllic s of in;crest on lase ,art ctif;nv:n ofTia•r,<it"d cmplo�c .'/lie �usc oC viz f„ c�t_itt —,t provitic inror:natin�>>vliici�cyn<ilrr, t t�c to-m cif nssiblc_L ,tllicI of inJfYCsi:Nttl 311oce it In t3kc vf(tntc�rcr actionis mm ary to avoid same. —�--� YOUR NAMIM — a-r` n (bast name, list name,>aiddle initial, nless you asp applying inthe 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 Vartance __ -_ 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 per4onally4or through your company,spowx%sibling.porcal,or child)have a relationshipwith any officer or employee of the'l'own of Southold? "Relationship"includes by blood,marriage,or business interest"Business interese,means a business, including a partnership,in which the town officer or employee:ha;:cvcri a partial olvnersitip of(or employment by)a corporation in which the to«v officer or employee owns more than S°/G/of the shares. YES NO _Y_ 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/agcnUmpresentative)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$%of tine sitars of the corporate stock of tine applictutt ("Viten the applirntnt,is acorporation); jd)Ilia legal orbengficial oNyner of any interest in a non-corpora(e entity(when 010 applicant is not a corporation); ___C)an officer,director,partner,or employee:of the applicant;or ____D)the actual applicant DESCRIPTION OF RELATIONS14IP Submitted this S day Signature Print Name Form TS 1 Board of Trustees Applicatiun County of Suffolk State of New York 9a 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 roperty Owner SWORN TO BEFORE ME THIS DAY OF ,20 ALO Notary Public Lpa4an' Notary-Public ��}}e of�16w York Qualifietta gu W County No:01P 6150861 Commission Ex0ines 08/07/20 $ From: Jeffrey Patanjo tpatanlo@optonhne net �' ✓" " Subject: tir, Date: September 12,2016 at 9:02 PM N' To: Rachel Cashwell rcashwelCoptonline.net Board of "suehia®a Aaplieat:ion Ceauuy o SaMik s'Sta a of New yiITk ;,', e, 11 . BEHhGDULY SWORN DEPOSES,M-AFFIRMS THAT HEi5HI:IS TPE APPL.TC kNT F OR TrTFs A130'% DES CP42ED PER-MTT(S) D THAT ALL S TAT EL'vf PK S Ca\'TAINF-U ITFRFVIN ARE TRLrB TD'IV—R B13ST C!F HMHER R.KNUtW'.I.,IvD(it AND BELIE:N,D THAT A L.L.WORK W)LL BE DONE IN THE MAN-TTFP,SL'T FORTH IN MI5 APPUCATT0 XN AND AS-,N-LA Y BE APPROVED BY THE SOUTH0l..7'I'C IX K BOARD OF TRUSTEES. TI-M;1PPLTC:t'.NT AGRT3T4,S'F0H0T.D T-tEETO`�NOF-ROCfHOL-I)ANf3'fHETC'r�N-,4 TRUSTEES H.kUI RSS AND FKBE FRM4 ANY AM?NLLL DAIN AGES?0\7C3 CT.AMIS ARISING UNDER OR BY VIRTUE OF SAID PFRMTT(Sh IF GRANTED- IN CO1mNL.1 TI G-PHIS APP LTC;ATION;I HLREII�,' A.UTHORIME THE TRUS`T'EES+,'iliM ?1C+Eti'T{S)OR REI'}T E SENT�'1'lb'L,S(Sj,TO ENTER O-N'TO MY PROPERTY W INSPECT TT TL PREMISES L+1C"ON.1T.-NIC TON N,*Ml RE'r`I W OF THIS PPLICA710N, i S'-u tore of PruPertp Otrxtec SWORN TO BEFORE)ME THIS � � DAY OF wpA- Notary Public Pu OM Psta.n' Yolk Not County 0:el SAG10--61 0�1 Co.,,,;;6 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Qac he 1 s hwc it residing at /a q S7"rf.+4rA Ave. (print owner of property) (mailing address) Caa rcr, Cj /V y ! 153 D do hereby authorize _(Agent) to apply for permit(s)from the Southold Board of Town Trustees on my behalf. F (Owner's signature) " APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code ofEthics prohibits conflicts ofinterest on the part of town officers and employees.The purpose, this farm is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is t necessary to avoid same. YOUR NAME: a$4 ,c I I . R 4 C.k c k (Last name,fust name,ipiddle 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 Of"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,rrlarriage,or business interest""Business interest"means b business, including a partnership,in which the town officer or employee has even a partial ownership-or(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO ! E If you answered"YES",complete the balance of this form and date and sign where indicated. i Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legator 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/1*3 L f S�'A 20 �b Signature _/L Print Name ja the I e4 s hovel I Form TS 1 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 jwhich includes'all o£Southold to- A . 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. Thies, each answer must'be-explained inAetail, listing both suunafing.and non- suagorting 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# '71 - 0 2 - 0:3 PROJECTNAME 5/5- t/arbc,L Lt1J4+S 02 — Sou4tialiR The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. El' Board of Trustees LJ 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: 5c.e 0, -r-Ta e keS 4csc rip-ho,� Location of action: 5/5' 1�e r bor li jtb-fes P2 - 50,4401A Site acreage: ®• 59 Present land use: Re S�c��ifia.(� Present zoning classification: RIC 61dv i-0,:;"C- 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: e4c 4e we l/ I (b) Mailing address: 7d 9 5-'ra-t-4 r& Ave• (94 rad l °k.AJy i �1S3D (c) Telephone number:Area Code( ). 17) 7- (d) 9) 7•(d) Application number,if any: l - or approval b a state or federal agency? Will the action be directly undertaken,require funding, pp y ag y Yes [�I/No❑ 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. Yes ❑ No ❑ Not Applicable P�•pDst� Pr•l`GF e»�►vnCtS Go�nirtl,.nv�., GI-iata�L�"�/ �y Qtiav�ceNy a .yca.a s ('c St�t nC e L�►Sci t'��'E' r•+tt� -�'tiB,. r7ct yh yo�I000d ag�, in ca.lC-CS �a-a,�G F c�,•� .BSc of -t'�G L�c�Qcr b� iyloy�n� - Ac- ,re S«1 cheep GloselL -i--& -t-kc Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No L 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 Nt.✓ ,resp "ee- will h.c a t,s-te0¢ -It- L surr,04,49 d+P, hoi,acr u•1 j Ch, r.�e•fc t. ,a.F A.& r#04 PrsA.erlt,�s Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP n Section III—Policies Pages 8 through 16 for evaluation criteria _ Yes,❑ No 2 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Poliddiies Pages 16 through 21 for evaluation criteria ol u Yes ❑ No D Not Applicable Dv rt rtiy Goa ST vc�•I wJ hkY b.Kles A,.A St c+ Fewec w r lI 6e /nStw drew 4-o Surlen�t odtd'rrt wwrLlC. Sren All A-nPY 400-s A4iplc-170.4 -A + LQ ,erol eG•1 wlll kA-- djreerecO -Vb eei-Se's 5-'er-VL eQfa.OKS 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. r ' Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes NoNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies;Pages 34 through 38 for evaluatiop criteria. ❑Yes ❑ No lJ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through,46 for evaluation criteria. ❑ YeF—] No U Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES t Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No 2 Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III=Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY TITLE DATE 9'/2 /A I September 15, 2016 Town of Southold Trustees Town Hall Annex Building 54375 Rte. 25 P.O. Box 1179 Southold, New York 11971 RE: 515 HARBOR LIGHTS DRIVE-SOUTHOLD, NY SCT'M No. 1000-71-02-03 APPLICATION FOR PERMIT Dear Trustees: We hereby submit one (1) original and three (3) copies of the proposed plans, application and check for permit approval for the above referenced project. If you should have any questions or require anything further, please do not hesitate to call me at 631-484-9332. Very truly yours, ) _c4q��� Jeffrey Patanjo 106 Hewitt Blvd. Center Moriches, NY 11934 ECUVE 1� SEP 14 2016 Southold Town E �Brd of Trustees