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TR-8946
Michael J.Domino,President �QF S0!/rTown Hall Annex John M.Bredemeyer III,Vice-President ,`O� Ol0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith [ Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1548C Date: January 2,2019 THIS CERTIFIES that the construction of a two-story, single-family 2 276sq.ft(footprint) dwelling with attached garage, 600sq ft of covered and screened-in seaward side porches; 139sa.ft. covered entry porch; 684sq ft seaward side on-grade terrace; 183sq ft on-grade terrace on side of dwelling;renovate the existing 107sq ft shed,• as-built 4'x8' (32 sq ft)outdoor shower connected to an existing dDmell• and for the as-built 4'4"x14' (61 sq ft)basement stair access in lieu of the proposed Bilco stairs; remove existing and install a new sanitary system landward of dwelling; install gutters to leaders to drywells to contain roof runoff install doMell for proposed driveway' install underground electric and water lines,• install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead,• and a line of silt fencing is to be installed prior to and during construction; At 3575 Wells Road,Peconic; Suffolk County Tax Map#86-2-10 Conforms to the application for a Trustees Permit heretofore filed in this office Dated December 14,2016, pursuant to which Trustees Wetland Permit#8946 Dated January 18,2017,was issued and Amended on January 2,2019 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a two-story, single-family 2 276sq.ft(footprint) dwelling with attached garage 600sq ft of covered and screened-in seaward side porches-, 139sa.ft. covered entry porch; 684sq ft seaward side on-grade terrace; 183sq ft on-grade terrace on side of dwelling;renovate the existingl07sa ft shed,• as-built 4'x8' (32 sq ft)outdoor shower connected to an existing drywell• and for the as-built 4'4"x14' (61 sq ft)basement-stair access in lieu of the proposed Bilco stairs;remove existing and install a new sanitM system landward of dwelling; install gutters to leaders to dDmells to contain roof runoff install dryffell for proposed driveway' install underground electric and water lines,• install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead,• and a line of silt fencing is to be installed prior to'and during construction. The certificate is issued to ROBERT SERLING owner of the aforesaid property. Authorized*Signature ' 4 Michael J.Domino,President �� sojyO Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G � O Telephone(631) 765-1892 Greg Williams O Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: I L 1�G11 <k� � . ?.D --' Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/ constructed Project complete, compliance inspection. r , INSPECTED BY: 5 COMMENTS: , �- CC,155 ct- of X00/' .� 42 -5 P1 1 � CERTIFICATE OF COMPLIANCE: :l " Michael J.Domino,PresidentOQF SOU� l Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G • Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 COUNT`1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 2, 2019 Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 Attn: Nancy Steelman, R.A. RE: ROBERT SERLING 3575 WELLS ROAD, PECONIC SCTM#: 1000-86-2-10 Dear Ms. Steelman: The following action was taken by the Southold Town Board of Trustees at their Organizational Meeting held on Wednesday, January 2, 2019: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#8946 for the as-built 4'x8' (32 sq. ft.) outdoor shower connected to an existing drywell; and for the as-built 4'4"x14' (61 sq. ft.) basement stair access in lieu of the proposed Bilco stairs; and as depicted on the site plan prepared by Samuels & Steelman Architects received on December 19, 2018, and stamped approved on January 2, 2019. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, Michael J. omino President, Board of Trustees MJD/dd REVISIONS YiIRE FENCE K/ WELLS ROAD SITE DATA AjDec. 19, 2108 OUTDOOR SHOWER FILTER CLOTH TEMPORARY ER051 ON EDGE OF (PUBLIC WATER IN STREET) DRAINAGE CALCULATIONS SCTM # 1000-86-02-10 & BASEMENT STAIR CONTROL MEASURES P4 VEMEN T AREA OF RESIDENCE (DW-A) AS-BUILT SURFACE PROP05ED SILT FENCE PROPERTY: 3575 Wells Road FILTER CLOTH MIN. VRAINA6E DR'T' NELL AREA x RAINFALL x RUNOFF FACTOR FLOA DURINI57 CONSTRUCTION ON-A) 5,545 5F x (2/12 FTJ x 1.0 = 5cll CU. FT. Peconic, NY 11958 6" BELOIN (SRADE SEE DETAIL UTIL17Y USE: (4) & DIAMETER x 4' HI&H POOL POLE OWNER: Robert Serling N, (4) & X 4' STORM DRAIN RIN6 = 615.6 CU. FT. 104 Roxen Road PUBL 10 PROVIDED > REOUIRED Rockville Center, NY 11570 INATER ------- 615.6 CU. FT. 5CII CU. FT. >1 METER R=256.60' AREA OF DRIVEWAY (DW-B) SITE: 16,419 SQ. FT. 0.376 AC. TEMPORARY STORM WATER PERMANENT STORM (1-7 (n DR�( YiELL AREA x RAINFALL x RUNOFF FACTOR AREA RUNOFF CONTROL MEASURE ViATER RUNOFF CONTROL ZONING: R-40 MEA5URE NEN DRYOELL (DA-15) 1,268 SF X (2/12 FT.) X 0.1 14a CU. FT. USE: (1) & DIAMETER x 4' HI&H POOL SION 11 SEDIME.NT CONTRO.LDETAILS U L=79.54' YV MTL 6RATE TYPICAL (1) 5' X 4' 5TORM DRAIN RIN& = 165A CU. FT. ALLOWABLE PROVIDED REGUIRED LOT SEE DETAIL EXP LP 165A CU. FT. > 145 CU. FT. COVERAGE: 20% OR 3,283 SF LP I( rzxf= I Exp ' Vol\ ACTUAL NEN UNDERC7ROUNP LOT "7.a COVERAGE: 19% OR 3,122 SF PROP05ED NEN SEPTIC SYSTEM .1) V : LP LF ELECTRIC, UTILITIES LINE D LP FOR A 5 BEDROOM RE5IDENC.,E Uj FLOOD: X - (1) 1200 &AL SEPTIC, TANK (ST) ZONE z 10 FT VIA x 2 FT LD TEST PERMEABLE STONE &RAVEL pitch_ - (5) VDIA x 2' Hl(9H IL HOLE DRIVENAY - NON ROA SURVEYOR: Peconic Surveyors DN P.O. Box 909 C LI-- (5RAVEL MATERIAL LEACHIN6 POOL (LP) A Southold, NY 11971 - FUTURE LOCATION FOR Lic. No. #49618 (5) VDIA x 2' HI&H ST DATED: February 11, 2014 LEACHIN67FOOL (EXP) �'A NOTES: + ELEVATIONS 4 CONTOURS ARE REFERENCED TO NAVD '66 FLOOD ZONE FROM FIRM MAP NUMBER 5610500162H ...................................... .. ..... ............ PROP05ED NEV4 NATER LINE FROM .................... . ... 20 Y�ETLAND FLASS EX15TIN& HOUSE DEMOL15HED - NA17ER MAIN AT ROAD TO &ARA&E pob, '�& 8% � AM, .............................................. ............ ................. .................................................... ............... ......... ......... ..................... Ulm LUCA] I MAr ..............I....... ... .... ....... ............:--w-.................... :..�.�.".",....."....",�....+.,�..................... .................................................................................................................. ........................................ ...... ....... ....... ..... -...........- -............................................................... .........I....................... ....................................... ........ .............................. ................... ........ ... ........ ............................................................ .................-......... ...................... .................... .................................... .......... .......................................... ........ ............. EX15TIN6 SANITARY SYSTEM PUMPED OUT ... . .................... .................... ......................................... ,.......... ............................................ .......................................................................... .......................................... .................. .... ......... ....... .................................. ......................... ............. ........................... ................................................................................................................................................................................ .............. ......... ........... ........................... . .......... �x.,.'..-, '*.. ....... . -.. tl*-'-"`0!i`11'-'1!� Dyq AND REMOVED ........ ..... .............. ............................... A ............ .............................. ............................. ........ ....... .............. . ....................... ........ ........ ......................................................... ...... ............. 1000-86-02-11 ........... .......................... ........................... .._. ........%%............. ............. ....... ....... ...................................... .............. ............ ..................... ..................................... ....... .......................... LAND N/F OF Ila .......... ..% 1> ..................................... ........... ................................................ ....... .... EIN BASEMENT ACCESS STAIR ........... ... .... ........................... ............................. ........ ............ ... ............ ................. ........ ....................... ..................11........... ................................ ................................................................. ........... ......................... 13 ELIZABETH & ROBERT SCHUPLER Aw� .... ....... ........................... ............ ...........I— ................ .............. .............I .... .. ....... RESIDENCE WITH -7 ............... .............. 101 ......... PUBLIC WATER & SANITARY SYSTEM ............. z 2. ................ .. ........... I . ........... ............. 3635 Wells Rd, Peconic, NY 11958 .. .............. .......... ....................... .............. ........ . ....... . . ...... ... ........................................................................................................ ............... ......................... .......... SIT w SEL I T I ENCE r_X ST ............. ......................................... .................... rt ff , . ........... co ......... Al EkN OUTDOOR 5HOOER .............. .............. ..........I............ ........ ........... dia ............. TIED TO DRYNELL ........... ........ ........... ..................... ................ ............... ........... .................... ............... ....................... 4 ... . ....... ........... ......... ......... 1000-86-02-9 . .... ....... ........ .......... .......... ......... .........- LAND N/F OF .......... JOSEPH M. & ALBERT C. SCHUPLER Z02= TEST HOLE NO SCALE .... . . .... ......... ... RESIDENCE WITH X BY McDONALD GEOSCIENCE PUBLIC WATER & SANITARY SYSTEM cmone_— - / 0/1' 11 ad z- E /X/ SOUTHOLD, NEWYORK 11971 TEMPORARY EROSION CONTROL Opp�BEB 1 3475 Wells Rd, Peconic, NY 11958 MEASURES PROP05ED SILT FENCE _R ON co <. /< TEST HOLE DATA 10 24-16) ELEV +7.8' DURIN6 CONSTRUCTION SEE DETAIL L LOA L N A 3.0 FT. MIXED SAND AND LOAM Uj t' �< z w BROWN AND PALE BROWN NE TO MEDIUM SAND SPII 0 '9 8.6 FT. F1 C4 V M W. . cl (.5 CO EX15TIN67 DECK PERMANENT STORM kNATER RUNOFF 0 rn MOVED CONTROL MEASURE NEkN DRYYiELL WATER IN PALE BROWN Cn cf)- X 0 TYPICAL SEE DETAIL 17 FT. FINE TO MEDIUM SAND SP E K) qs. p TIO X 8.6 FT BELOW SURFACE - WATER ENCOUNTERED, ELEV -.08 REMOVED U) ........... 'ONTROL rn z RE&RADIN& 0 TEMPORARY EROSION C APPROVED BY MEASURES PROPOSED SILT FENCE -7� AS 5HONN -7 BOARD OF 'I RUSTEES DURIN67CONSTRUCTION SEE DETAIL 0 .=............. k-,S ............ TOWN OF SOUTHOLD ........................ _>. .............. rn CS *41 .......................: _i Q A ZONE -x Qn rn ..................... M DAT _TNVAf_I[ 212-01q X E ......... ................ ............. . EXISTINC-67 rn LOOD 5 EDGE OF -71 < ZONE—LlNff- rn SILT FENCE rn M L13L�_ If I/c, -A > M Z ZONE TOP OF EXISTINS WETLANDS A E (E L ro) �O -0 — --z— < rn M CAST IRON FRAME AND COVER 11.4 EX15TINC7 5HED TO M 0) M TO 6RAOE (AS REGUIlREP) �ROJErO: BE RENO VATED 1612 TRAFFIC SLAB (SEE DRAWN BY: PLANS FOR LOCATIONS) UT < CO M CHECKED BY: tQ NON TURF BUFFER 0 NS TOP OF BU KHEAD 3.9' DATE: Dec. 13, 2016 S27*50"22"W WOOD BULKHEAD 129.04' [B 23 CE E� FZI Eg EEI E�3 H 46" HI&H x 4a" DIA SCALE: PRAINA&E 13A51N If = W - 011 C: M (TIE LINE ALONG BULKHEAD) S63 min [B 123 CE E31 E3 EK E�3 E�] E�] 1 10 5UILPINC7 �NALL FF EL 11.0 FT _RZ &RA1;)E LINE ELE\/ATION 5.0 FT. > MEAN HIGH WATER ALONG BULKHEAD [B DE E31 E�l 12�1 E� E�3 E�J R SHEET TITLE: 0 > F;Q 12�1 EK E33 H > LINE r=LE\/ATIoN 5.0 FT. M BACKPILL 6P,APr MIN. > 0 23 29 F;l 12�9 FK E33 E 2' MAX. 0 ?-\ MATERIAL TO SITE 0 CREEK 29 EE� 12E� E� BE CLEAN SAND T7 RICHMOND EX15TIN6 DOOK, CE 129 E?I E?l H Ei� E� H ED AND (SRAVEL 1/4"/FT. TOP OF POOL RAMP AND PLAN 5EPT 10 LEACHIN6 6.45 FT. PLOATIN& DOOK z (ITz 6ROLbp_yi619&_ TANI< IE. 40.5, POOL BOT OF POOL 2.45 FT. le. +6.1151 50T OF--'P- 6ROUND kNATER > PERMANENT STORM WATER SHEET NO: F-Lr=\/ -0.5 FT if -a RUNOFF CONTROL MEASURE TANK, +1.3' _j -)STORM DRAINAGE RING TYPICAL DEC 19 2018 A3 H NO SCALE w"* 101 14.5' Ir "p (7::Z, I SCALE: 1 10'-0" 51=11=TIC, TANI< Vil MONOLITIC, BASE SEPTIC PROFILE 0 0 > (N.T.S.) n --j Uj /7-7 TRUSTEES Amendment , i S A M U E L S & S T E E L M A N December 19, 2018 Board of Trustees Town of Southold E G. EPO Box 1179 k� 1 Southold, NY 11971-0959 ;' DEC 19 RE: SERLING RESIDENCES° ""�'�`'"' 3575 Wells Road, Peconic, NY 11958 SCTM# 1000-86-02-10 Wetlands Permit#8946 Dear Board of Trustees: We are requesting an AMENDMENT to the WETLANDS PERMIT for the above referenced project for an as-built outdoor shower and basement stair. We have attached 4 revised Site Plans and a check for $50. The as-built outdoor shower is 32 SF (4'x8") and is connected to an existing dry well. The concrete basement stair is in lieu of the Bilco" stair which was originally permitted. The stair area is 61 SF (4'-4"x 14'). Please get back to us with any questions or concerns. Sincerely, Samuels nd Steelman Architects ancy to an, R. . Enclosur ARCHITECTS 25235 MAIN ROAD CUTCHOGUE,NEW YORK 11935 (631)734-6405 FAX(631)734-6407 ��OF SU/yj Town Hall Annex John M.Bredemeyer III,President /y� l Michael J.Domino,Vice-President �� 0 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 ,Charles J.Sanders Fax(631) 765-6641 Iy10ou ,N 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 a Pre-construction hay bale line/silt boom/silt curtain 1St day of construction Y2 constructed Project complete, compliance inspection ''i2i�..l,ir:. _ .,".•��•� S�.' :iii,°i'r«,.- �'•i'i �r ,:r'yit�•ii' - ,PP rr'°'� "= - :,P Ore,• -� py: - �i ij=.' `� •�� c,°. ..,`�i y,.7 �., �� iSr,.�„_T_.•„��fi rrry �„��, •.,,y rr�...'. ``\� \ ,y✓y='&r�.nc:w'y+ss`yf�_•t �iyr.�.ruy.a`r,;tyL':;,� �"c '�, Lv- \ /-�"„ ;LL,_,_ � - 'r'%` :'= :-rte-:� _ ''•s,•� - •"p,,.r� •"rte � �=:�, � - _ �;�'�,, �,l`�:•}:rri�.Unli:'�'.t•sc�4n.'\'^.5457 hrcrn N^;Wx•9r"d7e'2'';^,•4�rs}ralaePa+ru4Cuexrt2:lv4•,3!r,TrG7Lot;L�,n,7�.rumY.•o*�9S•all°b''T•A(^l^'>'ai^'a}�"�,"'r'x7.•'tW,rcrnvn2AL IC•lC�'�::nrSY.t}t•'n.XOR-C^''Y.th•{q,lAr•V•'v.'11?Xn•:td''''AnYQ.°�.r"iIr4•u R:'..�+...n•',,�'J�',' BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK � � DATE: JANUARY 18, 2017 PERMIT NOi . 8946 ISSUED TO: ROBERT SERLING :�- •[, i-11,Y Ir•Ij• 5 ' r-£ PROPERTY ADDRESS: 3575 `YELLS ROAD, PECONIC SCTM# 1000-86-2-10 �. AUTHORIZATION f= Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in >�• 0. '= accordance with the Resolution of the Board of Tnistees adopted at the meeting held on January 18,2017, and r < . P g in consideration of application fee in the sum of$250.00 paid by Robert Serling and subject to the Terms and a r Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the . <. following: a " y Wetland Permit to construct a two-story,single-family 2,276sq.ft(footprint) dwelling with t J attached garage, 600sq.ft.of covered and screened-in seaward side porches; 139sq.ft. covered • t, entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft.on-grade terrace on side of a r�. _ al'ra,•rr dwelling; renovate the existing 107s •f. shed; remove existing and install a new sanitary system ' landward of dwelling; install gutters to leaders to dr ells to contain roof runoff; install , drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10'wide non-turf buffer along the landward edge of the bulkhead; and . . P P Y � t= f a line of silt fencing is to be installed prior to and during construction; and as depicted on the site plan prepared by Samuels& Steelman Architects,dated December 13,2016, and stamped approved on January 18,2017. ,, IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, r '•' and these presents to be subscribed by a majority of the said Board as of this date. J ' I pFFOZ� cm� Cha rle J. Sander �. _ jF` ��%��UU.e11"bi.Jau'+'iseaiva'LSFiNti.:i;aa+�ux�f(iwRS:u�;u�l"u"n.6ial .W\`3R,£SL`71eie1d�YKL'T1��AisAz:'�ffi�.cwsa<4,9de;adi5lniXS.-yi.7Cs£v'w)tiSS4T�a5fii�9i-ieiw.,3'#U'=iiwfaT:7�rx.^,n1as.:Sw+NAL'xuiASrA"aji:'aSit�,F?2dtisi:7Y.'.6Yf aYQ ixieiCuit)ii -`� - {� _�lLi n �.r.vc+,.. = '�.?I, °•`H'•--.� '`,��J ,+.'�'� ,a��S�.,+ -. val. � »,�� -� � J' �-� a -: ZS..',. .,•,/ �•"- �.Er .,ras -./ ... 'T,:.. .y�..,a.:.� �, ?. ;.Fr �:`•.yam 'y` �- `SSS •r, `A`�R"£iy��Y ....... ' . . -"�k�CC�I*�CR'.^^AoJa,�`s+"'`-" \`��;A*••`' •tt��i i.:`�f - . �t��i•l,� :ti3�'i'�i'" •t'�iijy�•,i�ri� -- .ttt:��.41Z:L:. +,t `t:ira�••:ie:�'.• _ ...�����.r"��:.t -att���F•VEL fa;k . TERMS AND CONDI'T'IONS The Pennittee Robert Serling residing at 3575 Wells Road Peconic,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 Pen-nit 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 pennitted 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. Michael J. Domino, President oma e42 _f Town Hall Annex John M. Bredemeyer, III, Vice-President y` 54375 Route 25 Charles J. Sanders H P.O. Box 1179 Glenn Goldsmith �y ® �� Southold, NY 11971 A. Nicholas Krupski '��� , dao Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD January 18, 2017 Nancy'Steelman Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: ROBERT SERLING 3575 WELLS ROAD, PECONIC SCTM# 1000-86-2-10 Dear Ms. Steelman: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, January 18, 2017, regarding the above matter: WHEREAS, Samuels & Steelman Architects, on behalf of ROBERT SERLING 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 December 14, 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 January 18, 2017, 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 f 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 ROBERT SERLING to construct a two-story, single-family 2,276sq.ft (footprint) dwelling with attached garage, 600sq.ft. of covered and screened-in seaward side porches; 139sq.ft. covered entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft. on-grade terrace on side of dwelling; renovate the existing 107sq.ft. shed; remove existing and install a new sanitary system landward of dwelling; install gutters to leaders to drywells to contain roof runoff; install drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and a line of silt fencing is to be installed prior to and during construction; and as depicted on the site plan prepared by Samuels & Steelman Architects, dated December 13, 2016, and stamped approved on January 18, 2017. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, c7lu��/ Michael J. Domino, President, Board of Trustees MJD/dd John M.Bredemeyer III,President �*rjf SO 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 51i ® Q Telephone(631) 765-1892 Charles J. SandersyCDUNT`(, O Fax(631) 765-6641 � �� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Ido �,euff(r c O SA- GGL5� Sy s/ A�-�-crau5 TO: Please be advised that your application dated Per I ((0 has been reviewed by this Board at the regular meeting of 4V IIK 200 and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project ;Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) Y2 Constructed ($50.00) 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: TOTAL FEES DUE: $ /lao`6V BY: John M. Bredemeyer III, President Board of Trustees RE FENCE Y41 WELLS ROAD SITE DATA' /pFN11LTEP, CLOTH TEMPORARY ER05ION EDGE OF PA (PUBLIC WATER IN STREET) DRAINAGE CALCULATIONS SCTM # 1000-86-02-10 CONTROL MEA5URE5 VEMENT AREA OF RESIDENCE (DW-A) SURFACE l=ROP05ED SILT FIENCE PROPERTY: 3575 Wells Road DRAINArvE DRYkNELL AREA x RAINFALL x RUNOFFFACTOR FILTER CLOTH MIN. -FLOP4 DUPINS 00NS71;ZUCTI0N (rM-A) 5,545 5F x (2/1:2 FTJ x 1.0 = Sel I CU. FT. Peconic, NY 11958 6" BELOYi 67RADE SEE DETAIL UTILITY USE: (4) b' DIAMETER x 4' HIC7H POOL OWNER: Robert Serling POLE (4) 8' X 4' 5TORM DRAIN RIN6 = 6-15.6 CU. FT. 104 Roxen Road PUBL I C PROVIDED RECUIRJED YiATER 75.6 CU. FT. > 5011 CU. FT. Rockville Center, NY 11570 TEMPORARY STORM WATER PERMANENT STORM t-lETER R=256.60' - AREA OF DRIVEWAY (DW-B) SITE: 16,419 SQ. FT. = 0.376 AC. -0 DRY YNIELL AREA x RAINFALL x RUNOFF FACTOR AREA RUNOFF CONTROL MEASURE V4ATER RUNOFF CONTROL (DN-5) 1,265 5F x (2/12 FT.) x 0.-1 = 148 CU. FT. ZONING: R-40 WION 8, SEDIMENT CONTROL DETAILS MEASURE NEN DRYNELL S Q) +a.2 L=79.54' USE: (I) a, PIAMETER x 4' HIC7H POOL N ?E YV MTL &RATE TYPICAL 4: (1) 8' X 4' 5TORM DRAIN RIN& = 166A CU. FT. ALLOWABLE SEE DETAIL C) PROVIDED REQUIRED LOT Exp LP 165A CU. FT. > 145 CU. FT. COVERAGE: 20% OR 3,283 SF Lf= () EXP ACTUAL -R(SROUND rl? NEV4 UNDE LOT COVERAGE: 19% OR 3,122 SF PROPOSED NEA SEPTIC SYSTEM D .0 LF LP ELECTRIC, UTILITIES LINE - )�� -V LIP FOR A 3 BEDROOM RESIDENCE 5 1 FLOOD: X Uj - (1) 1200 &AL SEPTIC TANK (ST) toh z ZONE TEST PERMEABLE STONE &RAVEL 10 FT DIA x 2 FT LD pitch SURVEYOR: Peconic Surveyors - (5) VDIA x 2' 1416H a, tL V) RA HOLE DRIVEAA-,( - NON RCA P.O. Box 909 LEACHIN& POOL (LP) _vEL-- EL +-7b &RAVEL MATERIAL A Southold, NY 11971 - FUTURE LOCATION FOR It Lic. No. #49618 (5) 5' DIA x 2' HIC7H 0 .2 DATED: February 11, 2014 SID 5T LEACHINC-7 POOL (EXP) �= I-, RD k / — NOTES: ..... ............. .. .......... ......... .... .. ...................................................................................................... ..... ................ 'k... ............................................................................................ ELEVATIONS 4 CONTOURS ARE REFERENCED To NAVD 158 ..... ........................... .......... ....................................................... z......... ............ FLOOD ZONE FROM FIRM MAP NUMBER 36103CO162H ... ................. ............................ ........................... PROP05ED NEY4 YiATER LINE FROM ............. .................. .............. :20 .............. ......... ............ .............. NETLAND FLAC75 ................................................... ........... ....................-...................... ........ EX15TIN6 HOUSE kNATER MAIN AT ROAD TO &ARA67E DEMOL15HF-D ....... ..... M A Lj'j ..................... ................ ....... .......... A ro 'n .............................. .. .................................... t ................. Ulm =................. ................................................................ zz,........... 0 ............ ..................................................... ................................ .......... ............... .......................................... ...................... . .............:..Z..Z..Z.-.-Z...-.Z......-.-. .--..Z......... .............-------- .6 f . .......................................... ............... ........................................................ ........................... .... ..................................................... ................................. EXISTIN& SANITARY SYSTEM PUMPED OUT ......................... .................. ................. .................... ................ ........ ..... .......... ............... ........... ......... .. ........ .................................... �d-................,.................................. ................... .......... . .... ........... CD .................. .............. ............ ........... ............. ........................................................z........................... .............................................................................--........... ....................................................................................................................................................................................................... ............... DN .. ..... .......... AND REMOVED ........ ..................z ............ 0 ....... .......... ...... .......... . ........... ............. ......... .................................. ............................. A ..................................................................................... ........................................................................................................................ ......................................... ............................ .............................. .. ......... ......... ............ ........................... .............................................. 1000-86-02-11 ................. ................... ......... ...................... ....................................................................................................................... ..... t> ............................................................... .......................................................... .. .... ....... ............ ... ........ .... .. ......... L 'V� ... ......... .................... .z........-...........,................. ....................................................................................................... ..... ...... .......................... .......... . ............................. ... ........... ......... ............... ---............................ .................. ...... LAND N/F OF 15'i "*'*"**..........*............."*"* ........................................ NEN BA5EMENT ACOF-55 DOOR .............. .......... ...................................................... ......... .................................................... .. . ................ . ..... .. ............=- . ....... ..... .................. ....................... .... ..... ....................... ....... ......... .................................................................................I.... . .......................... ................ .................................................... . ..... ............ .......... ... ......... ....... .......... .. ........................... ........................................ .......... .......... ........ ... .... ......... ... MEN ...... .................. N.S.2 ffifflom 14 �016 .............................................. ....................... ......... ELIZABETH & ROBERT SCHUPLER I C �'N -F.... ..... .......... .................................. ....... ............... ............... ... . ...... . ......... ............. ............... DEC ......... ........... ............. ..... .......... . .............. . ................. .. .... ................................................. ....................-........... ............ . ........................................................... .................... ....................................... ........- . .............................................................................................. ................................ ............ ............................... ......... . ....... ................................ .......................... ......... . ... . ................. ............... .. .......... .... .............. ... ............................................... ...............-.1-1.... ............ .............. ................................................... ............... ........ ......................1-.... ............... ........... lot RESIDENCE WITH �17 .............. .. ...... ..... .............................. .......... ..... ........................... ..................... .. . ............................................ z PUBLIC WATER & SANITARY SYSTEM Soulhold 3635 Wells Rd, Peconic, NY 11958 k6' ............. .............................. ... .... .................. ............................................... ......... qrar� T%1, ............. .............. ................ ........... . . ........ .. ...... -Q —A ............................ ........... ........ ........... ................ .......... ..... ......................................................... .......................................... ......... ....... .................................................. .... ................................................... ..................... -T1316"OK, .................................................. ................................. ................................................... .... ....... LU ..................... ......................................... ...... ...................................... .......................................... ........................................... SI LU EX15TIN& SPLIT RAIL FENCE ............ .............................. ............. CL ... ......... Sodom.... ........................ ..... .................. ............. ..................... .-...... ....... . ......... ..... ........................... ................... ............ ............................ ...................-- ... I�"" .......... .......... ............. .......... ..... �ww 1000-86-02-9 .......... .......... .......... ............................ ............. ................ ...................... ............................................ ........ ..............�... ........ .. ... .............. ....... .... ............ ........ ... . .......... ................. LAND N/F OF ..... ....... ....... .. ................. .......... + ............ ........... ............. . .............................. JOSEPH M. & ALBERT C. SCHUPLER ...................... ................ .............. ....................... ........................... TEST HOLE NO SCALE ......... .............. ............ ........................................ ............. U +-7.2 RESIDENCE WITH PUBLIC WATER & SANITARY SYSTEM BY McDONALD GEOSCIENCE SOUTHOLD, NEW YORK 11971 06 z- XX TEMPORARY ER05ION CONTROL �/0 3475 Wells Rd, Peconic, NY 11958 MEASURES PROPOSED SILT FENCE C' C TEST HOLE DATA 10-24-16) ELEV +7.8 DURIN6 CONSTRUCTION SEE DETAIL < c' j n L A 3.0 FT. MIXED SAND AND LOAM 1 Y X LU -j z 0 W. BROWN AND PALE BROWN LU W. W) O 'i 0 0 8.6 FT FINE TO MEDIUM SAND SPI 04 EXISTIN69 -CO PERMANENT STORM kNATER RUNOFF DECK 17TI X MOVED CONTROL MEASURE NEN DRYNELL WATER IN PALE BROWN TYPICAL SEE DETAIL 0 ., 17 FT. FINE TO MEDIUM SAND E K3 8.6 FT BELOW SURFACE - WATER PATIO X ENCOUNTERED, ELEV -.08' REMOVED TEMPORARY EROSION CONTROL rn z RECvRADIN6 MEASURES PROPOSED SILT FENCE .......... .... ....................... '77 AS SHONN 0 or- NEW),0 .............. DURIN& CONSTRUCTION SEE DETAIL ... ............ ................ �.= ,.. ST ............ 4- -'XI............... ............. ZONE' ........................ rn ...,.................. X 03 ............. ......................... .7' EX15TINC-7 rn IM 2L00p < U) U zol EDGE OF rn SILT FENCE �EL—IN E— TOP OF EXISTIN& 0 WETLANDS > M Z ZONE AE (EL 0 -0 — --z— 0 SR.ADE E < ril 0 M CAST IRON FRAME AND COVER EX15TINC-7 SHF-12 TO rill rn PROJ T NO: E3E RENO VATED TO &RAVE (AS REQUIRED) 1612 TRAFFIC SLAB (SEE WN BY: PLANS FOR LOCATIONS) < UT Cr3 rn CHECKED BY: NON TURF E3UFFER b % - TOP OF BUI�KHEAD 3.9' 1 U DATE: NS De c. 13, 2016 CU ;;0 S27*50'22"W WOODBULKHEAD 129.04' DB CE 123 Ei� E�3 Eg EK H 45" HI&H x 45" VIA SCALE: C: M (TIE LINE ALONG BULKHEAD) sQ,5' min IS DE CE H H E�3 E� S H DRAINA&E BASIN lug = 10, - 0 TV BUILDIN6 kNALL FF EL 11.0 FT T- :z 2S CH SHEET TITLE: &RADE LINE ELEVATION 5.0 FT. > MEAN HIGH WATER ALONG BULKHEAD 0 6RADE LINE ELEVATION 5D FT. 13 CE CE S DiEg EE3 ED EK H 115ACKFILL > MIN 0 MATERIAL To . 0 S ED EKI ED BE CLEANSAND 2' MAX. T1 RICHMOND CREEK EX15TINC-7 DOCX, 2 CE AND ORAVEL SITE 1/411/r-T. TOP OF POOL -,U 1% 9 PLAN ro.45 FT- RAMP AND r�- z /A 5EPTIO LEACHINC-7 FLOATIN6 DOCf< (I &ROLUE PA—AM&— VIE. +-1.0' TANK IE. +(0.511 POOL BOT OF POOL IE. +(0.5' .2.45 FT. APPROVED BY IE. +6.15' BOT 01=---*"- &ROUND NATER > PERMANENT STORM WATER BOARD OF TRUSTEES SHEET NO: —E—LE\/--O.b FT RUNOFF CONTROL MEASURE `YP ��M DRAINAGE RING.111CAL TOWN OF SOUTHOLD TANK +13' 10 1451 P L AR% H IN DATE SCALE: 1 1 0'-Ovv rr"Zzs 5EPTIC TANK, A/ MONCLITIO 5A5E SEPTIC PROFILE 00 rK,�—j (N.T.S.) 0 > 0 --1 TRUSTEES DEC SUBMISSION 1 j RAIN RUNOFF CALCULATIONS EXISTING HOUSE -894 SQ. FT. �vp p��a �t APPROVED �� PROPOSED ADDITION -030 SQ. FT. a�L1 V Y OF PROPERTY Y TOTAL-1B84 SQ. FT. 1884X1X0.17 F TRUSTEES I PROVIDE2 DiVs- CU.F1. 2 BOMD �B 0X 41520/42.2=7.6 DE .2= 7.6 VF PEC®111A�IC EP TOWN OF SOUTHOLD 1000-86-02-10 �-,��, �CeFRT FEBRUARY 11, 201.4 cQfo 1 Q SC AUG. 28, 2014 (PROPOSED ADDITION) - t `''c JUNE 15, 2015 (REMSIONS) N Jp - � � GRAVEL �+ { G� 'Poe ,• it/ttJ Gj01 °A.I ��� j '� � i. co •2A � q �ti moo• �� -o- /`��/ s � �a �� Rq�Q . V LOT COVERAGE � }�P° EXISTING 894 SQ. FT. y �o� o I PROP. ADDITION 990 SQ-FT- TOTAL 1884 SQ- FT-AT COMPLETION OF CONSTRUCTION 1884/16419=11.5% �o J i X= STAKE AV o ��' L - g 2015 � o j A = WETLANDS FLAG JAN �' �o EDGE OF WETLANDS, AHWM & ALWM BY JMO ��Ao � ENVIRONMENTAL -- CONSULTANTS *TIDAL WETLANDS STAKED 3/16/2015 "Qo 4 e, ` � �e s• FIELD WORK WAS COMPLETED WITH B" OF SNOW scy �2�' ry , COVER. %I LKWAYS NOT SHOWN HEREIN. • CED TO N./1.V.D. 19>�6 i ELEVATIONS REFERENCED FLOOD ZONE FROM FLOOD INSURANCE RATE MAP ! MAP NUMBER 36103COl62H SEPTEMBER 25, 2009 S. LIC. NO. 49618 ANY ALTERA77ON OR ADD]77PN TO THIS SURVEY IS A WOLA77OhI I RI/EYURS P.C. OF SECTION 72090F THE NEIN YORK STATE EDUCA77ON LANE, o�',� BG � '`` ' EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERT(FICA-BONS AREA=16,419 O. p �Q '�;y�ti 8� �.ys �� -5020 FAX (631) .765-179°7 j HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF �o 4f Q- P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR �'® `�'� �� � y� � 12,30 TRAVELER STREET WHOSE SIGNATURE APPEARS HEkEON. ` SOUTHOLD, N.Y 11971 14-002 i i { 0 N "Q SURVEY OF PROPERTY A T PECONIC TO WN OF SO UTHOLD yb z9¢o.F °�F �os�py SUFFOLK COUNTY, N Y. M. 1000-86-02-10 SCALE: 1"=20' o RT c FEBRUARY 11, 2014 JUNE 15, 2015 (REVISIONS) \Sts, F GRAVEL 0 o� �o °Oc k �pc RAM,o Ar �. 0 J� 4, O~ Q' 'gyp 0J c0J V X = STAKE ♦ = WETLANDS FLAG �� �` ��, IY � �� EDGE OF WETLANDS, AHWM & ALWM BY NO F`j� _ I� ENVIRONMENTAL CONSULTANTS 1, i *TIDAL WETLANDS STAKED 3/16/2015 apo �' li! 1 4 2016 1 DEC I FIELD WORK WAS COMPLETED WITH 8" OF SNOW 1>1s� 162 ti ' 41/1 9Southold Town t COVER. WALKWAYS NOT SHOWN HEREIN. 'S(i �� h O i -BoaCci4f Trustees _l ELEVATIONS REFERENCED TO N.A.V.D. 1988 FLOOD ZONE FROM FLOOD INSURANCE RATE MAP MAP NUMBER 36103CO162H SEPTEMBER 25, 2009 ANY ALTERATION OR ADDITION TO 774/S SURVEY IS A VIOLATION N. YS. LIC. NO. 49618 OF SEC77ON 72090F THE NEW YORK STATE EDUCA77ON LAW. <„° ao a PECONIC SURVEYORS, P.C. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77FICA77ONS AREA=16,419 SO. FT. �� „ '�ti y� a° qys (631) 765-5020 FAX (631) 765-1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF q° y yFgO°A, P.0. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR TO TIE LINE 1230 TRAVELER STREET WHOSE SIGNA 77JRE APPEARS HEREON. 14— 0 02 SOUTHOLD, ,N. Y. 11971 John M. Bredemeyer III, Pre., `Lt QS�FFO(K�' Town Hall Annex Michael J Domino, Vice-Presiaentyo� �Gy 54375 Route 25 Glenn Goldsmith o P.O. Box 1179 A Nicholas Krupski o Southold, NY 11971 Charles J. Sanders 1 y�jol � ? Telepho e (631) 92 Fax765 6-18 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:/�0� Completed in field by: Samuels & Steelman Architects on behalf of ROBERT SERLING requests a Wetland Permit to construct a two-story, single-family, 2,276sq.ft (footprint) dwelling with attached garage, 600sq.ft. of covered and screened-in seaward side porches; 139sq.ft. covered entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft. on-grade terrace on side of dwelling; renovate the existing 107sq.ft. shed; remove existing and install a new sanitary system landward of dwelling; install gutters.to leaders to drywellsIo contain roof runoff; install drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and a line of silt fencing is to be installed prior to and during construction. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 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 A. Septic Tank: 75 feet- 5. Swimming Pool and related structures: 5,0 feet '6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100'feet 2. Driveway: 100 feet 3. Sanitary leaching pool,(cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card' Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders Other Page 1 of 2 I / t ` John M. Bredemeyer III,'Pre: t UFFO(irCo Town Hall Annex Michael J Domino, Vice-Presicrent .�° Gym, 54375 Route 25 Glenn Goldsmith o .' " '` P O Box 1179 A Nicholas Krupski Southold, NY 11971 Charles J. Sanders Telephone (631) 765-1892 Fax (631) 765-6641 , BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Samuels & Steelman Architects on behalf of ROBERT SERLING requests a Wetland, Permit to construct a two-story, single-family,2,276sq.ft (footprint) dwelling with attached garage, 600sq.ft. of covered and screened-in seaward side porches; 139sq.ft. covered entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft. on-grade terrace on side of dwelling; renovate the existing 107sq.ft. shed; remove existing and install a new sanitary system landward of dwelling; install gutters to leaders to drywells,to contain roof runoff;-install drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and a line of silt fencing is'to be installed prior to and during construction. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 Ch. 275-12 - STANDARDS FOR ISSUANCE OF PERMIT MET=X or Comment=* A. Adversely affect the wetlands of-the Town: B. Cause damage from erosion, turbidity or siltation: C. Cause saltwater intrusion in the fresh water recourses of the Town: D. Adversely affect fish, shellfish or other beneficial-marine organisms, aquatic wildlife & vegetation or the natural habitat thereof: E. Increase the danger of flood and storm-tide damage: F. Adversely affect navigation tidal waters or the tidal flow of the tidal waters of the Town: G. Change the course of any channel or the natural movement or flow of any waters: H. Weaken or undermine the lateral support of other lands in the vicinity: I. Otherwise adversely affect the health, safety and general welfare of the people of the Town: J. Adversely affect the aesthetic value of the wetland and adjacent areas: Ch. 111-9 - ISSUANCE OF PERMIT MET=X or Comment A. Is reasonable and necessary, considering reasonable alternatives to the proposed activity and the extent to which the proposed activity requires a shoreline location: B. Is not likely to cause a measurable increase in erosion at the proposed site and at other locations: C. Prevents, if possible, or minimizes adverse effects on natural protective features and their functions and protective values, existing erosion protection structures and natural resources: D. :525% Expansion/Calculation _Work Session Notes Application Complete SEQRA Classification Confirmed Coordinated Review Y/N Pos%Neg Declaration CAC: LWRP: Additional information"on comments/to be discussed/Public Hearing: Date: Completed By: Present: J. Bredemeyer M. Domino G. Goldsmith N. Krupski C. Sanders E. Cantrell D. Di Salvo Other Page 2 of 2 h ' In 4A- �q►..�_a ! ms`s `"•� ���'�J�► I F WAN it _ R-- y w+�'2 int VIEW DURING FIRE SERLING RESIDENCE - 3575 WELLS ROAD, • 1000-86-2-10 :.• sy��• �( n,'(�I `rte° '..et'... 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY,11971 a� Telephone: 631 765-1938 ® Fax: 631765-3136 COU LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: January 13, 2017 Re: LWRP Coastal Consistency Review for ROBERT SERLING SCTM# 1000-86-2-10 Samuels & Steelman Architects on behalf of ROBERT SERLING requests a Wetland Permit to construct a two-story, single-family 2,276sq.ft (footprint) dwelling with attached garage, 600sq.ft. of covered and screened-in seaward side porches; 139sq.ft. covered entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft. on-grade terrace on side of dwelling; renovate the existing 107sq.ft. shed; remove existing and install a new sanitary system landward of dwelling; install gutters to leaders to drywells to contain roof runoff; install drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and a line of silt fencing is to be installed prior to and during construction. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the below listed Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. 1 �L4g�,ffOt,,f�d Peter Young,Chairman y '� Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 Southold,NY 11971 JKI 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., January 11, 2017 the following recommendation was made: Moved by Peter Meeker, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of ROBERT SERLING to construct a two-story, single-family dwelling with attached garage; basement and covered porches, permeable terraces and renovations to an existing shed. New sanitary system, new drywells for roof and driveway run-off, relocated underground waterline, new permeable gravel driveway, removal of existing sanitary system, installation of 10' non-turf buffer at bulkhead, and installation of temporary silt fencing during construction. Located: 3575 Wells Rd., Peconic. SCTM#86-2-10 Inspected by: Keith McCamy, John Stein, Peter Meeker Vote of Council: Ayes: All Motion Carried Jotin M liredemeyer III, President ��J"' /yv town ball Annex l Michael J. Domino, Vice-P 54375 Main Road,rte, � P O. Box 1179 James F. King,Trustee Southold, New York 11971-0959 Dave Bergen, Trustee G Charles J_Sanders, Trustee Telephone(631)765-1892 I,YG, Fax(631) 765-6641 )BOARD OF N TRUS OWN OF OUTHOLDTES D [E(g:[E0%q[2 To- Southold-Tow_ n Building Department D DEC 1.5 2016 Re- Verification of Building Department Permit Requirements I BUILDIN(;DEPT. SCTMff: 6(0s�`l 0 TOWN OF SOUTHOLD ` RdfT- See_LtW, — Property Owner Name: ` Date Sent to Bldg. Dept.: The Office of the Board of Trustees is forwarding the above referenced appficatioa 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: Signature or eviewer Date - i I John M.Bredemeyer III,President Town Hall Annex Michael J.Domino,Vice-President ®ld 54375 Main Road gq P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee G e 'rte ��O Telephone(631)765-1892 Charles J.Sanders,Trustee `i�c®U N Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOO Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit / —Amendment/Transfer/ x ension V d Received F=09<6'00 ^ 'VIP, P f _Completed Application12, iF- Incomplete ! !_ SEQRA Classification: Type I Type II Unlisted DEC 1 4 2016 Coordination:(date sent) �LWRP Consistency Assessme t Form ICAC Referral Sent- 12.ZZ { Southold Town V!!!�Date of Inspection CD IBarc}of Trust��s _Receipt of CAC Report- -Lead Agency Determination: Technical Review Public Hearing Held ��7 —Resolution- •a , Name of Applicant Robert Serling Mailing Address 104 Roxen Road, Rockville Centre, NY 11570 Phone NumberV 9 766-5660 Suffolk County Tax Map Number: 1000- 86 - 2 - 10 Property Location- 3575 Wells Road,Peconic NY 11958, 3,525.54 feet south of Main Road (provide LILCO Pole#, distance to cross streets, and location) AGENT' Nancy Steelman, Samuels and Steelman Architects (If applicable) Address. 25235 Main Road, Cutchogue NY 11935 Phone: 631 7346405 2 Hoard of Trustees Application GENERAL DATA Land Area(in square feet): 16,419 sf Area Zoning: R-40 Previous use of property: Residence -Single Family Intended use of property: Residence -Single Family Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s)on property have a valid Certificate of Occupancy? Yes X No Prior permits/approvals for site improvements: Agency Date DEC: Title Wetland Approved 8/10/1015 Trustees Z2-:5 A No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary): See Attached Serling Residence 3575 Wells Road Peconic NY 11958 SCTM# 1000-82-10 Project Description: Building Project: Construction of a new two story, 3 bedroom Single Family Residence with attached Garage, Basement and Covered Porches, permeable Terraces and renovations to an existing shed. The building areas are as follows: Residence: 2,276 sf(footprint) Porches/Screen Porch: 600 sf Covered Entry Porch: 139 sf Terraces on grade: 867 sf Existing Shed: 107 sf Site Improvements: New Sanitary System for 3 bedroom house New Drywells for roof and driveway runoff Relocated underground waterline New underground electric line New permeable (non RCA) gravel driveway Removal of existing sanitary system 10' Non Turf buffer at bulkhead Temporary Silt fencing during construction i Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: Construction of single family residence, sanitary system and drywells (see attached description) Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 % Closest distance between nearest existing structure and,upland edge of wetlands 6' - 10" feet Closest distance between nearest proposed structure and upland edge of wetlands: 56' feet Does the project involve excavation or filling? No X Yes If yes,how much material will be excavated? 290 cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: 4' to 5' feet Proposed slope throughout the area of operations: 2.6% _ Manner in which material will be removed or deposited: Backhoe 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): None r\ � 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information, The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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: SERLING RESIDENCE Project Location(describe,and attach a location map): 3575 Wells Road,Peconic NY 11958 Brief Description of Proposed Action: Construct new residence and sanitary system. Name of Applicant or Sponsor:- Telephone: 516 766-5660 Robert Serling E-Mail: rseris@hotmail.com Address: 104 Roxen Road,,NY 11570 City/PO: State: Zip Code: Rockville Centre NY 11570 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 �, F]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: Southold Town Building Permit,New York State DEC,Suffolk County Dept of Health ❑ I 3.a.Total acreage of the site of the proposed action? 0 316 acres b.Total acreage to be physically disturbed? 0.209 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.376 acres 4. Check all land uses that occur on,adjoining and near the proposed action., ❑Urban ®Rural(non-agriculture) [:]Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ X❑ ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ D 7. is the site of the proposed action located in,or does it adjoin,a state Iisted Critical Environmental Area? NO YES If Yes,identify; Fx ❑ ' 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? X❑ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies; ❑ D 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: 1—t ❑ 11.Will the proposed action connect to existing wastewater utilities? NO 1 YES If No,describe method for providing wastewater treatment; new Sanitary system o ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑ I ❑ b.Is the proposed action located in an archeological sensitive area? FM 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? ❑ a b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? 0 F-1If 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 El Early mid-successional ® Wetland El Urban [2Suburban 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? ❑ ❑ 16.Is the project site located in the 100 year flood plain? NO YES X 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? n NO ❑YES ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: [:]NO YES —gh hafilR Page 2 d4 I 8. 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: Q ❑ 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: 7 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: I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons e: N nc teel an Date: /z/q A G Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? E 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impairthe character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 \` J 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? Ef It. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should, in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this 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 nvironmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, ���—��W// that the proposed action will not result in any significant adverse environmTtaI Impacts. Town of Southold-Board of Trustees Y4 '11 Name of Lead gency C Date �G President Print or Type me of Resp ible Of icer in Lead Agency Title of Responsible Officer Sign a of Responsefacer in Lead ency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 7,-�'CX e-J) STATE OF NEW YORK COUNTY OF SUFFOLK L r' residing at Z S Z,3 S— ��i N lzad C& Ll e- being duly sworn, deposes and says that on the /0 ay ofj�A1gj- r 20_`� deponent mailed a true copy of the Notice set forth in the Board of Trustee's 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 (,/,/ T 0 9 y-c that said Notices were m 'led to each of said persons by CERTdFIEID P&ULIRKTURN RECEIPT. rh Sworn to before me this /0 Day of �91VV,920 / '1 LAUREN M MCKISSICK NOTARY PUBLIC-STATE OF NEW YORK No.01 MC6342308 Qualified in Suffolk CoUnty Notary Public My Commission Expires May 233 2020 1 � ROBERT SERLING SCTM# 1000-86-02-10 Hearing: January 18, 2017, 5:30 p.m. ADJACENT PROPERTY OWNERS 3440 Wells Rd 86.-1-13 Weissert William F Weissert Angela 23 Seaton St Massapequa, NY 11758 3475 Wells Rd 86.-2-9 Schupler Joseph M Schupler Alberta C 7 Diamond Ct Huntington, NY 11743 3635 Wells Rd 86.-2-11 Schupler Robert Schupler Elizabeth 3635 Wells Rd Peconic, NY 11958 John M. Bredemeyer III, , ,)sident �0�0 �o'`, Town Hall Annex Michael J. Domino, Vice-President 4 0� `��� 54375 Route 25 Glenn Goldsmith N c P.O. Box 1179 A. Nicholas Krupski y �� 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 ROBERT SERLING COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, N A Ijc-q S i e e_1 in ,9 r ) ,residing at/dba SSM u els +S+ee.I M w Arc�ll fe QTS. sa 3 s M'4/,&) ko'q-d , C,r/7 CA vq pie, ,�Jy being duly sworn, depose and say: That on the to day of Sgr,)u4n1 , 201'7 , I personally posted the property known as 3S- iJc. is 90Acl �e G�n�) C. , Ny by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday,January 18,2017. Dated: (si nature) Sworn to before me this 1 g day of j,-4 e. 20 LAUREN M MCKISSICK NOTARY PUBLIC-STATE OF NEW YORK No.01 MC6342308 bloc Qualified in Suffolk County My Commission Expires May 23,2020 ,i 1 ■ CE c O m ■ . , "'� I. - - ! 23 i CQ Ln M L '72 72z I rM Certified Mad Fee a In $ $3.3101,; 0935 :- i . 03 Extra Services&Fees(check box,add ❑❑ teto) Return Receipt(hardcopy) . : $' �r„4r=�=='Postm a'�rkr Return Receipt(electronic) i $ $0.00 :r � I a E]Certified Mail Restricted Delivery- $ C Here 0 ❑Adult Signature Required $ ❑Adult Signature Restricted Delivery$, O Postage 1,r a #1.36 Er Total Postage and Fees. ).�1�10'L2[►1 T $ 7. ' Sent To William F. and An ela Weissert__-_____ ; O $tiee[andApENo:,oiB"'511 ton Street N ecdl - ary,state,Z(P+4� Massapequa, NY 11758 ■ mService CERTIFIEDNAIV, RECEIPT M I• i 0 ni I Ln .-ItY,4,1174x3 A ` • - LnP Ec 1 g „p jee r ateJ- -p EXetrtraifiSedBNlVIiCaelis F&eeCertified Mad Fee $Ln $3.30- 0935 Fee$s 3(ch.a3ck0$ t box,add tdee4 In, f Lry5 Ln Extra Service s&Fees(check box,add ' ,( b •; ` tJ.0 - ❑Return Receipt(hardcopy) $ ❑ pt(hardcopy) Retu Return Recei -+ � J '. .• ,� -❑Return Receipt(electronic) -•r$ $jJ�OQ lP.atnark��~ El Return Receipt(electronic) $ /12 Postma ks ❑CertHled Mail Restricted Delivery $ tk_,• �') �-IBfO n=' E3 Certified Mall Restricted Delivery '$ ( I Here CO E - 'G■�JO/ - ❑Adult Signature Required $ 1��Cd C] ❑Adult SlgnaturQ Regwred' $ 0= , i. ❑Adult Signatt�ee)iestricted Delivery$ S ❑Adult Signature Restricted Delivery$ C] Postage r" a} r� C] Postagerq 36 fT Total Postage and Fees Cr Total Postage Fain--f- -- - - 1 J I O — $ r I .� ,t centro Sent To Joseph M. and Alberta C. Schupler o ert an 1za et cup er- O Street andApt:No.,or P 3&• --------- --- ----------- - --------------------------------- W�I�S Roa -------------------- 0 ------------ .� StreetandAptNo.,'y'FF���(�n 011rt r` r- ---- cfry;'siare;zia+d®~- EfJniE, N -11-95$-------------------------- City,State,ZIP+4 tIuritirigton, iNY---IIT43------------------------- NUTILt: Uim Ht: AKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNERM OF RECORD: ROBERT SERLING SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a two-story, single- family 2,276sq.ft (footprint) dwelling with attached garage, 600sq.ft. of covered and screened-in seaward side porches; 139sq.ft. covered entry porch; 684sq.ft. seaward side on-grade terrace; 183sq.ft. on-grade terrace on side of dwelling; renovate the existing 107sq.ft. shed; remove existing and install a new sanitary system landward of dwelling; install gutters to leaders to drywells to contain roof runoff; install drywell for proposed driveway; install underground electric and water lines; install and perpetually maintain a 10' wide non-turf buffer along the landward edge of the bulkhead; and a line of silt fencing is to be installed prior to and during construction. Located: 3575 Wells Road, Peconic. SCTM# 1000-86-2-10 TIME & DATE OF PUBLIC HEARING : Wednesday, January 18, 2017 — 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 County of Suffolk State of New York ROBERT SERLING 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. gnature o ro erty Owner SWORN TO BEFORE ME THIS DAY OF 1eCfg&�20- LAUREN M MCKISSICK NOTARY PUBLIC-STATE OF NEW YORK _ No.01 MC6342308 Qualified in Suffolk County Notary Public My Commission Expires May 23,2020 Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Robert Serling residing at_ 104 Roxen Road (print owner of property) (mailing address) Rockville Centre,NY 11570 do hereby authorize (Agent) Nancy Steelman to apply for permit(s)from the Southold Board of Town Trustees on my behalf. 6 ( wner's signa e) i APPLICANT/AGENT/REPRESENTATWE TRANSACTIONAL DISCLOSUR7E FORM The Town of Southold's Code of Ethics prohibits con nicts of interest on the part 6f town officers and employees.The Uumoose of this form is to provide information which can alert the town of nossible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Nancy Steelman (Last name,first name,ip ddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (if"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent,,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest'means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. !' YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant ' (when the applicant is a corporation); B)the legal or,beneficial owner of any interest in a non-corporate entity(when the + applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted tit+ 97", d L2e- 200 S ignatur Print Nam anc tee man Form TS I APPLICANT/AGENTMEPRESEl'4TATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part nftown officers and emnlovees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is neccs ary to avoid same. Robert Serlin YOUR NAME: g (Last name,first name,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 X Change of Zone Coastal Erosion Approval of plat Mooring f Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse,sibling,parent;or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. ` YES NO X If you answered"YES",complete the balance of this form and date and sign where'indicated. Name of person employed by the Town of Southold Title or position of that person E 1 Describe the relationship between yourself(the applicantlageattrepresentative)and the town officer or employee.Either check i the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP i I Submitted this�ou4lday of I�e-U�bc'' 20'0 L Signature &Ro PrintName ert Serli Form TS 1 I 1 tr�stit �r Town `of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION.OF A 01 I�1 - 1 000 86 02 10 STORMnWATER,GRADING;-DRAINAGE AND EROSION CONTROL PLAN ' s cwt o o1Tc t— CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW.YORK." SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#'/ WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? 16,419 sf 1 Will this Project Retain All Storm-Water Run-Off (Include Total Area of all Parcels located within 0.376 ac Generated by a Two(2")Inch Rainfall on Site? the Scope of Work for Proposed Construction) (This item will include all run-off created by site X b. What is the Tota(Area of Land Clearing (S.F./qref clearing and/or construction activities as well as all — and/or Ground Disturbance for the proposed 30.20 Site Improvements and the permanent creation of construction activity? 0.20 acres. Impervious surfaces.) (S.F./Acres) 2 Does the site Plan and/or Survey Show All Proposed PROVIDE BRIEF PROJECT DESCRIPTION (Provide AddldW onal Pages as Needed) Structures Drainage Sctures Indicating Size 8 Location?This X - - Item shall include all Proposed Grade Changes and El Construct new residence and sanitary Slopes Controlling Surface Water Flow. 3 Does the Site Plan and/or Survey describe the erosion System. and sediment control practices that will be used to X 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 X Existing Grade Involving more'than 200 Cubic Yards of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand X (5,000 S.F.)Square Feet of Ground Surface? Li 6 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction a X Genera! DEC SWPPP Reguiremonts: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities Involving soil Beach? disturbances of one(1)or more acres; Including disturbances of lose than one acre that 7 Will 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(15)feet of Vertical Rise to X , Including Construction activities involving soil disturbances of less than one(1)acre where f One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit Is required for stone water discharges. El (SWPPP's Shall meet tiro Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious !' forStorm Water Discharges from Construction activity.Permit No.GP-040-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ID X 1, 1.The SWPPP shall be prepared prior to the submittal of the Not.The Not shall be into and/or in the direction of a Town right-of-way? - submitted to the Department prior to the commencement of construction activity. (_ 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Projapt Require the Placement of Material, l required,post-constructlon storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any X s 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 Me Installation of Driveway Aprons.) El1 Identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice In a Box and the construction alto disturbance Is between 5,000 S.F.&I Acre In area, component shall be prepared by a qualified Design Professional Licensed In New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management Southold and Must be Submitted for Review Prior to Issuance of Any Building PermlL , (NOTE: A Chedc Mark(j)and/or Answer for each Question Is Required for a Complete Applicagon) STATE OF NEW YORK, COUNTY OF....Suffolk ...................SS That I, ..... Nancy Steelman ........being duly sworn,deposes and says that he/she is the applicant for Permit, - -(Name of individual signing Document) "" "' Andthat he/she is the ..Agent............. .... ... ... ' .. ... ... ............................................... ......... (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 and to make and file this application;that all statements contained in this application are true to the best of his luiowledge and belief;and that the work will be performed in the manner set forth in the application filed herewith. Sworn to before me this ....................................3......day of. U...... ..... .20 Notary P ................. •l:�ilJflEN .f." .. _ ........_ ... �1 If�1�7�71L/n�• •„: ••� gnature of if I) Ike FORM - 06/10 YOR No.o1 MC6342308 Qualified in Suffolk County - My Commission-Expires May 23, 2020 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 sigc ificant beneficial-and adyerse:effects Mon.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,a lained in,detail;listins'both,suanortift and non-. supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net),the Board of Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 86 02 10 PROJECT NAME Robert Serling The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept.' ❑ Board of Trustees X _ 1. Category of Town of Southold agency action(check appropriate'response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: ❑' Nature and extent of action: Construct new residence,sanitary system, and drywells. Location of action: 3575 Wells Road,Peconic NY 11957 Site acreage: 16,419 sf= 0.376 ac Present land use: RESIDENTIAL Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Robert Serling (b) Mailing address: 104 Roxen Road, Rockville Centre, NY 11570 (c) Telephone number: Area Code(5)16 766-5660 (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No❑ If yes,which state or federal agency? New York State DEC 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 ❑X Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LVW Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ❑ Not Applicable There are no historic or archeological structures on property. 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 0 Yes ❑ No ❑ Not Applicable Building structure is in keeping in style and scale of neighboring structures. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No FX1 Not Applicable Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ No X Not Applicable F] Yes 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 not applicable Yes No Not Applicable No development will take place in the"protected"or"natural indiginous environment". 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. X� Yes n No[:] Not Applicable The development will not add pollutants into the air. Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVM Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes 0, No 0 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. F] Ye�] No 0 Not Applicable No public land involved. Littoral access unimpeded. Attach additional sheets if necessary 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 0 Not Applicable There are no public or commercial activities or uses on site. Historically this property and _ neighboring properties are residential in use and will remain residential. 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. 0 Yes ❑ No ❑ Not Applicable This project will protect and preserve the living marine resources by maintaining all rainwater discharge on site. 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 0 Not Applicable There are no agricultural lands on site. 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. El Yes ❑ No ❑ Not Applicable The construction will be using equipment approved by the Federal government for energy usage.The project will meet Federal standards for conserving energy "energy Star Program". PREPARED BY Nancy Steelman TITLE Architect DATE /Z�9 S A M U E L S & December 9, 2016 S T E E L M A N Board of Town Trustees Town of Southold s !]p r P.O. Box 1179 Southold, NY 11971-0959 RE: Serling Residence D EC 14 2016 3575 Wells Road Peconic, NY 11958 Southold Town TAX MAP # 1000-86-2-10 of Trus,+ees Dear Board of Trustees, We are requesting a WETLANDS PERMIT for the above reference property. For your review we are submitting the following documents (original and three(3) copies): 1. Completed application with project description 2. Short Environmental Assessment Form 3. Storm Water Assessment Form 4. Authorization Form 5. Agent Authorization Form 6. Agent & Owner Transactional Disclosure Forms 7. LWRP 8. Survey of property in current state 9. Previously Trustees approved Survey 10. Project Site Plan 11. Photographs 12. Application Fee - check for$250 Please note that a Trustees' Wetlands Permit was issue on March 23, 2015 for construction of additions to an existing residence. This project was under construction during the spring and summer of 2016. On August 10, the existing house, and addition was hit by lighting and was totally destroyed. Since that date the remaining charred structure and foundation has been removed. A new house and deck and related improvements are being proposed as part of this new application. Please call us with any questions or concerns. Sincerely, SAMU S & STEE N ARCHITECTS ARCHITECTS ancy Ste Iman, 25235 MAIN ROAD CUTCHOGUE,NEW YORK 11935 Principal rchitect (631)734-6405 FAX(631)734-6407