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1000-122.-6-29.4
rOFFICE: DESIGN AND EXPLANATORY NOTES CUTCHOGUE, NY JOB NO. 1.) EXTERIOR DOOR AND WINDOW LOCATIONS ARE TAKEN FROM THE EXTERIOR FACE, 128-053493 OF THE NAILERS AND ARE TO THE CENTER OF THE DOOR AND WINDOW UNITS, 4 2'WIDE (ZONE 2) 4,ONE 2&3) OWNER.2'WIDE VERIFY ALL DOOR, WINDOW,SKYLIGHT AND SIDELIGHT LOCATIONS WITH THE M N (Z (ZONE 2&3) (ZONE 1) o (ZONE 3) C.,..� 777M 7/77777/7777 (ZONE 2) Cv 0— a (ZONE 3) on 46 w 3 ` 6E O r �. /a' 4E 2 EDti 5 1 1 1 p w 81.6'WIDE(ZONE 4) MWFRS Z 4.2'WIDE WIDE Reference Q (ZONE 5) (ZONE 5) '- Corner 12'-0" 22'-0" 22'-6" 21'-611 12'-0" LL 00 b _ Z } -I O Z N NORTH ELEVATION � _ 1 4.2'WIDE b 4.2'WIDE Z p (ZONES 2 &3) (T (ZONES 2&3) � zz O 4.2'WIDE 4.2'WIDE O � (ZONE 2&3) 4,12 (ZONE 2 &3) 12 4 40 T#16 GABLE TRIM W t_11 O sO Clef o HI-RIB STEEL SIDING u T#21 CORNER TRIM O Li 00 II T#1 67TRANSITION TRIM Z O HI-hIB STEEL WAINSCOT n. T#167 BASE TRIM IL ..... ......... 11,11,11,11, 1 V (� LU z ® w 33.6'WIDE (ZONE 4) a. 33.6'WIDE (ZONE 4) L`. 4.2'WIDE L 4.2'WIDE 4.2' {WIDE 4.2'WIDE Q vi (ZONE 5) (ZONE 5) (ZONE S) (ZONE 5) L1 1 8 21'-0" 211-011 21'-0" 21'-0" J - ` 0 0 zQ o I 0 c�, EAT ELEVATION "N� (ZONE 2) I S _ WEST ELEVATION . (ZONE 1) _,..... . DRAWN BY. MCCALLISTER (ZONE 3) i DA TE: 10/26/2015 (ZONE 2) `M VENT-A-RIDGE CHECKED BY. WOLF y.. 5"O.G. GUTTERS DA TE. 10/29/2015 (ZONE 3) / REVISED DATE.' 10/29/2015 i REVISED DA TE: ---- REVISED DATE.' HI-RIB STEEL SIDING REVISED DATE.' ---- T#21 CORNER TRIM OF NEW Y T#167 TRANSITION TRIM ,�Q' 'p L• SGS HI-RIB STEEL WAINSCOT y • `� „' �` * O O• • T#167 BASE TRIM .......... 81.6'WIDE (ZONE 4) u 4.2 WIDE 44"WIDE APR 1 ZONE 5 [1111NE 5) ,.m __ _ . ... ....,.:.s 14'-0" 15'-0" 22'-0" 22'-6" 7'-6" 4'-0" Flann�" 'id 10 4 4 �? 0' 4 � 4 O o cr rv� 10 � � SCALE.,AS NOTED SOUTH ELEVATION Os tCALE: 2 8 SHEETNO. '` 1' 4' 16' S4 OF SU �o es oti SEWAGE DISPOSAL SYSTEM DESIGN= a� vo o' 'i 41• ALLOWABLE DENSITY: (GROUNDWATER MANAGEMENT ZONE IV.) ¢ op' TOTAL SITE AREA: 40,761 S.F. (O.g357 AC.) A\�\`�Ca O D \� �P 0. 1357 AC. x 600 G.P.D./AC. - 561.4 G.P.D. NAP\ O ��� ,' p PROJECTED FLOW- 1P O,0PCO OP .� S 17 E OFFICE SPACE �/ `� IST FLOOR - 704 S.F. ` � 0 704 S.F. �- 704 S.F. x 0.06 G.P.D./S.F. OF BLDG. AREA 42.2 G.PD. �O o a o w E STORAGE \i\' �\ PCO , 1S7 FLOOR - 3,492 S.F. ° O 2ND FLOOR - 3,492 5.F. - 6,984 S.F. ! \QD ° °� �' �,`\ �`.� '\ FRESHWATER WETLANDS AS 0 Co,984 S.F. x 0.04 G.P.D./S.F. OF BLDG. AREA - 279.4 G.PD. � Q� (p ` / \7 \% I DELINEATED BY EN-CONSULTANTS NOV. 10,2015 TOTAL - 321.6 G.PD. 321.6 G.P.D. (PROPOSED) < 561•4 G.P.D. (ALLOWABLE) // •` '^\ _ ' I �- / EL. 20.0' _ _ \ �' i � ��' \ 'v S< PROPOSED SANITARY SYSTEM, NOTES= "` _ ,(I -A___ SURVEY INFORMATION FROM SURVEY SEPTIC TANK 6 ______ -- o \O JG ' - - PREPARED BY -JOHN . EHLERS LAND p VOLUME TO STORE 2 DAYS FLOW /� -__---- - - KEY MAP ,.� 'y� �� / G SURVEYOR LAST DATED SEPTEMBER I, 2C'15 / \ I 1� 2 x 321.6 G.P.D. - 643.2 GAL. __-- --- p < O ' �! - `\ \ I ' �� 810x4' LIQUID DEPTH SEPTIC TANK \\ SG.: 1 =200 TOPO BASED ON APPROX. MSL DATUM F, ' VOLUME PROVIDED: 1,200 GAL. EXISTING CONTOUR -- 22'-------- ----- LEACHING POOLS O PROPOSED CONTOUR -22' PROVIDE 1.5 S.F. OF SIDEWG.ALL LEACHING EXISTING SPOT ELEVATION + 18.6' - - 15.6' --------------------- AREA -------------- I i rig �. .- PROPOSED SPOT ELEVATION \ J ' - ----------------------- -------- \ I N \' AREA FOR EVERY GALLON OF DAILY FLOW � � �` �L 321.6 G.P.D. / 1.5 / 25.1 - 8.5 V.F. 2 \ ` PROVIDE (I)-8'0x10' DEEP LEACHING POOLS /.� '' ```\ j -- - - , 10 V.F. > 8.5 V.F. OK 2a' -- -- �,<°�O II \` i, //jJ111 y2' RADIUS `�' �IS ?3 I� 1' �Q `` I%" TOP WEARING COURSE PARKING CALCULATIONS: ��J ��' t,,'' \ OII� i��1• I \ i OVER 2%2' ASPALT BINDER LOT COVERAGE= �s <° \ �IT ` :a .(� \ .'' FIRST FLOOR OFFICE SPACE: 704 S.F. ---_Citi-___-- ; °p�' < �1�II ` / '� ` ,O '1 1 6" RGA BASE ON 12" STABILIZED LOT AREA - 40,761 S.F. �� I(� I TOTAL OFFICE SPACE. 704 S.F. so1L BASE PROPOSED BUILDINGS (FOOTPRINT) - 4,1q6 S.F. 4 196 S.F. / 40,761 S.F. x 100 - 10.3% 1 PARKING SPACE PER 100 S.F. -III-III=III - III - 0"'Ic E CONCRETE -III=III=III=III-III, PARKING SPACES REQ'D - 8 �G/ ;/ ` ' ~ STS <� /� I / I ` As SPEC f, DRAINAGE CALCULATIONS= ti < GONG. CURB DETAIL (TYPE A) STORAGE BUILDING: 6,984 S.F. T1, ' < k LP S `� �< °` '' . �� /' ��. NTS CONTRIBUTING AREAS: TOTAL STORAGE BUILDING: 6,984 S.F. ��s �� ��, \ S ' \ �`�' o `` �' 1.ALL CONCRETE TO BE 4000 PSI AIR ENTRAIN® SYSTEM "A" I PARKING SPACE PER 1000 S.F. ro L \ 4 `�� � � 2.STEEL FORMS OR EQUAL SHALL BE USED PAVING: 3,653 SQ.FT. PARKING SPACES REQ'D - 7 S �<� \ ��� I 1 ' ` s, �� � / 3.EXPANSION JOINTS 1/2"THICK 20 O.C.SHALL BE USED ROOFING: 750 5Q.FT. G t ` �� 4.ALL CONCRETE SHALL BE TAMPED IN PLACE.NO REO'D STORAGE: TOTAL PARKING R EQ'D - 16 O�i �� ��o(PP \\ `` I \`' t� 1\` OPG �`\ \ / /' HONEY-COMB WILL BE SMOOTH&EVEN-RUBBED WITH iyp 4� � _` `� C4. .e Vic, /' A WOOD FLOAT i OTAL PARKING PROViDED - 20 LIRADJ1JSED 4,403 SQ.FT. x 0.167 X 0.9 - 662 CU.FT. (REQ'D) �� Gj - , �. `, .1y� ¢ _ \ `�. ' �.ALLE^'v'ESSIIALLBE'00 ^"^ PROVIDE= - (I)-10' DIA x 12' DEEP LEACHING POOLS TOTAL HANDICAPPED ACCESSIBLE 5PACEE ,,-'' : \`�__� r \ mss, ---------- _ _ --------- - -IA' 821 CU.FT. STORAGE (PROVIDED) - REQUIRED - 5X OF 21 - 1 SI ACES G \ �p , ---- X SYSTEM "Bo -- ---- �� " - - \ +18.6 __ --- PAVING: 3,447 SQ.FT. <j ------------------ ROOFING: 1,500 SQ.FT. `� A <° ° ,' ,� - \ O ASPHALTIC CONCRETE-TYPE C. REQ'D STORAGE: 24" DIAMETER CAST IRON COVER, 4 947 SQ.FT. X• 0.167 X 0.9 - 744 GU.FT. (REQ'D) FINISHED GRADE FLOCKHART FOUNDRY COMPANY so �' @ <° " PATTERN NO. G1128 OR EQUIVALENT < in PROVIDE: (ADJUST TO FINISH GRADE) �� 6 C °p \ �` ! S h ASPHALTIC CONCRETE-TYPE 3 15„ DIA CPP , cz?� �` p` - � � CRUSHED STONE/RECYCLED CONCRETE (i)-10' DIA x 12' DEEP LEACHING POOLS 1' riiN. AGGREGATE (RCA) COURSES OF BRICK MAX. 11-011) ' s' - 821 GU.FT. STORAGE (PROVIDED) 6 OR REINFORCED PRECAST EXTENSION � .3 �� 4i� ° -1 i-1 = - I- I-III- -I - - = I-Ti=1Ti-til ITI-1iI-ITi---IT TI=1Ti-ITi-it-ITI- (MAX. 4'-O") \ \ I III=ISI=III- -III=III=III-III-_= STABILEZED SOIL BASE-95Y COMPACTION T M 1 I- -III-I =I (STANDARD PROCTOR) SYSTEM "C" 8 8" P.G. REINFORCED SLAB P \ PAVING: 3,065 SQ.FT. Ok, \ IT ROOFING: 1,242 5Q.FT. z# a SELECT GRANULAR SOIL TYPICAL PAVEI"IENT SECTION w BACKFILL FOR PERIPHERY AND : �0 BOTTOM LEACHING d 0 ' \ REQ D STORAGE: 0 z 4" (SEE NOTE) �?' \ NTS 4,307 SQ.FT. x 0.167 X 0. - 647 CU.FT. (REQ'D) w 9 MAXIMUI I \ (0 ' Z ID 12' (I)-10' DIA x 10' DEEP LEACHING POOLS z ® WRAP WITH Gcz. (MIN.) L "Z NONWOVEN GEOTEXTILE / ` _J 684 CU.FT. STORAGE (PROVIDED) to a" �j, 1 1 z ® ® (FILTER FABRIC) + O SYSTEM "D" W Q 3'-0" MIN. ® ® ® 3'-0" MIN. x L z V. F _ PAVING: 2,784 SQ.FT. Q ALL WALL SECTIONS # TOPS 6" REINFORCED CONCRETE a ® SHALL BE SET IN A BED OF �• +19.3' \ /' '• ' ROOFING: 704 SQ.FT. p� o ® + MORTAR '�' CRUSHED STONE/RECYCLED CONCRETE REQ'D STORAGE: AGGREGATE (RGA) 3,485 SQ.FT. x 0.167 X 0.9 - 524 CU.FT. (REQ'D) i III=III=1 I I_ I= = I = STABILEZED SOIL BASE-95% COMPACTION - - -"_ Eli I-1 III-III- _ 1= (I)-10' DIA x 10' DEEP LEACHING POOLS III �I (STANDARD PROCTOR) 684 CU.FT. STORAGE (PROVIDED) GROUND WATER ���\10��P CONCRETE DUMPSTER PAD SYSTEM "E" 2'-0" MIN. - EXCAVATION BACKFILL WITH (� o��• c'�' ���<F' ¢ NOTE NTS /� /,, 6"REINFORCED SLAB WITH 6X61010 WWM PAVING: 2,498 SQ.FT. ACCEPTABLE LEACHING MATERIAL (SEE NOTE) S< < �' J GO Gj�P� REQ'D STORAGE: DRYWELL DETAIL NOT TO SCALE �A O �•' /�GOJ�O LAPPED MIN.OF ONE FULL MESH&WIRED 2,498 5Q.FT. x 0.167 X 0.9 - 375 CU.FT. (REQ D) o� G� , G ` : NOTE TOGETHER AT 48"O.C. (I)-8' DIA x 12' DEEP LEACHING POOLS ALL DRAINAGE STRUCTURES SHALL BE PLACED IN ACCEPTABLE O 507 CU.FT. STORAGE (PROVIDED) LEACHING SOILS AS APPROVED BY THE MUNICIPAL ENGINEER. -' IN THE EVENT POOR LEACHING MATERIAL IS ENCOUNTERED, EXCAVATION IS TO BE CONTINUED TO SUITABLE MATERIAL 4t ' TA BACK FILLED AS DETAILED. TYPICAL LEACHING POOL DETAIL ;Ii lYlrlr SITE PLAN FOR "IN LIEU OF DOME A 8" TRAFFIC TAX MAP BEARING COVER MAY BE SUBSTITUTED" BE I � , NrNETT PR ��,` VAR � e zo17 APER TIES, LLC �4- DISTRICT 1000 NTS SECTIONd tOCdii Rµ 122 SITUATE BLOCK 06 LOT 29.4 - SITE DATA: MA TTIT UCK AREA: 40,761 50.FT. (0.9357 AC.) TOWN OF SOUTNOLD - SUFFOLK COUNTY, N .Y. TAX MAP NO. 1000-122-06-29.4 - SCALE: I " INCA-I = 20' FEET SHAIAN LEONARD, A. T OWNER: BENNETT PROPERTIES1• A. , LLC 11 1 PREPARED: S/IS/17 GRAPHIC SCALE: I -20 AREA: 40,761 SQ.FT. (0.g357 AG.) A R C H I T E C T 320 Hampton Road, Southampton N.Y. 11968 ZONING; B (GENERAL BUSINESS) (631) 287-5557 Fax (631) 287-5558 PROPOSED USE: OFFICE 20 0 20 40 60 2017/03/28 10:33:08 so e� SEWAGE DISPOSAL SYSTEM DESIGN: ti G a ALLOWABLE DENSITY: (GROUNDWATER MANAGEMENT ZONE IV) 1 201 `O. TOTAL SITE AREA: 40,761 S.F. (O.g357 AC.) _` ���' �D' CF' C c� 0.19357 AC. x 600 G.P.D./AC. - 561.4 G.P.D. �P\ �O�p� 113, PROJECTED FLOW: � OFFICE SPACE �I` op SITE' IST FLOOR - 704 S.F. 0 N A' - 704 S.F. 0��� 704 S.F. x 0.06 G.P.D./5.F. OF BLDG. AREA - 42.2 G.PD. STORAGE SVG �� �� S W E IST FLOOR - 3,4g2 S.F. ��1 �� -�P �< <p 2ND FLOOR - 5,4q2 S.F. - 6,C184 S.F. �P 0��� ��• // � < S Q /! ��O <p p5, /' �,.\ �� ' FRESHWATER WETLANDS AS 0 6,884 5.F. x 0.04 G.P.D./S.F. OF BLDG. AREA - 27g.4 G.PD. ` 0 �(p �\ // �o �� `, DELINEATED BY EN-CONSULTANTS (19 0I ® '- \ '\� NOV. 10 2015 TOTAL - B21.6 G.PD. - �\ r// �r Ololl \� 321.6 G.P.D. (PROPOSED) < 561.4 G.P.D. (ALLOWABLE) %/ O.K. I-ol It Q � AS 20.0' - �` �¢� i' '� \-11 < I / '' P �� goob PROPOSED SANITARY SYSTEM: NOTES: T.o. j4'- -�/ \\- ' - 4¢GJ�(O �x���� <�p� �, I a � � ,L +�' s� - SURVEY INFORMATION FROM SURVEY \ SEPTIC TANK _____- o �O \ ' -( PREPARED BY JOHN G. EHLERS LAND O _ ✓� I` � , ; / / VOLUME TO STORE 2 DAYS FLOW SURVEYOR LAST DATED SEPTEMBER i, 2015 -- KEY i"IAP 2 x 321.6 G.P.D. - 643.2 GAL. f--- - 8'0x4' LIQUID DEPTH SEPTIC TANK TOPO AS - -- ---- � � \ �' ^^ : `�S/U \ ' f SC : "- ' BASED ON APPROX. MSL DATUM F _\ V, 1 200 VOLUME PROVIDED: 1,200 GAL. . T �{j �i' N EXISTING CONTOUR ---------22'-------- -__--_ ---------- 2O','�< �---- LEACHING POOLS PROPOSED CONTOUR .221 - --' O 'P PROVIDE 1.5 S.F. OF SIDEWALL LEACHING EXISTING SPOT ELEVATION + 18.6' AREA FOR EVERY GALLON OF DAILY FLOW PROPOSED SPOT ELEVATION - --- \ I J N 321.6 G.P.D. / 1.5 / 25.1 - 8.5 V.F. PROVIDE (1)-8'(Px10' DEEP LEACHING POOLS - , 10 V.F. > 8.5 V.F. OK Q) Q) , ' �'�� r+ I r rr �` 6.. /_' RADIUS PARKING CALCULATIONS: ' I I+ I �� ' `' �� i' '� \ Q�I i "'I. I '\ '1,', �' `` JL 142" TOP WEARING COURSE, ,� S -< OVER 2i2" ASPALT BINDER LOT COVERAGE= ,� tp o� \ f' , FIRST FLOOR OFFICE SPACE: 704 S.F. 26'_____________ / '' ,' •� ,, NL l _ LOT AREA - 40,761 S.F. 1 f. b" RGA BASE ON 12" STABILIZED TOTAL OFFICE SPACE. 704 S.F. / rye \ S '� I I �s„, PROPOSED BUILDINGS (FOOTPRINT) - 4,Ig6 S.F. ' _ \ �O G,Q: I m - r solL BASE 4,Ig6 S.F. / 40,761 S.F. x 100 - 10.3% 1 PARKING SPACE PER 100 S.F. �� PARKING SPACES RE - 8 i `� i -i1 '� I �� l I -I I III-I �(, ST < / ' / I �' ' `� V AS SPEC CONCRETE =III III-III=III-III 00 DRAINAGE CALCULATIONS= - 1-� STORAGE BUILDING: 6,884 S.F. "X CONC < LP i /S /� \. �L /- �,\ CU RB DETAIL (TYPE A) VIP p. r /- NTS CONTRIBUTING AREAS: TOTAL STORAGE BUILDING: 6,1984 S.F. CS ' � i � ' SYSTEM "A" �\ ' /- 1.2.STEEL ALL CONCRETE FORMSR BE 4000 0SPSI HALL E USED I PARKING SPACE PER 1000 S.F. 0 to EQUAL PAVING: 3,653 SQ.FT. PARKING SPACES REQ'D - 7 lSQ <� \ ,/, � I ''s, '•,\ �• ��� � /- 3.EXPANSION JOBdTSI/2"THICK200.C.SHALL BEUSED 4.ALL CONCRETE SHALL BE TAMPED IN PLACE.NO ROOFING: 750 SQ.FT. REQ'D STORAGE: TOTAL PARKING REQ'D - 15 Gi� �,\ �y {PALE- \ �� � , ` ` `` :�� �p,NG �` � /' 2A \ 5 HONEY-COMB WILL BE SMOOTH&EVEN-RUBBED WITH 4,403 SQ.FT. x 0.167 X O.q - 662 CU.FT. (REQ'D) TOTAL PARKING PROVIDED - 20 A d J ��O� �,--- \ `� '�. ` y� 5 �� / A WOOD FLOAT PROVIDE: LEACHING c __-- - 12' \ ` - 5.ALL EDGES SHALL BE TOOL RADIUSED (1)-10' DIA x 12' DEEP EACING POOLS TOTAL HANDICAPPED ACCESSIBLE SPACES (" , �� % --� 821 CU.FT. STORAGE (PROVIDED) REQUIRED - 5% OF 21 - I SPACES �G r \ �� 1 --- I - - lA X 22 SYSTEM 1:B:: 0 \ \ + ------ ------------------- -_ O` 18.6' PAVING= 3,447 50.FT. < C� S< < \ - - - - ROOFING: 1,500 SQ.FT. O \ O REQ'D STORAGE= 24" DIAMETER CAST IRON COVER, ' N F ' N -----___ '� ASPHALTIC CONCRETE-TYPE 6 4,g47 SQ.FT. x 0.167 X O.q - 744 CU.FT. (REQ'D) FINISHED GRADE FLOCKHART FOUNDRY COMPANY i N CL PATTERN NO. 61128 OR EQUIVALENT r s ,� S< PROVIDE: 15" DIA CPP (ADJUST TO FINISH GRADE) @cQ� pO� / \ � I S h ////ii, ,////, /i• ASPHALTIC CONCRETE-TYPE 3 (I)-10' DIA x 12' DEEP LEACHING POOLS 1' MIN, CRUSHED STONE/RECYCLED CONCRETE COURSES OF BRICK MAX. XT .' S' _ _ - - - - - _ _ _ AGGREGATE (RGA) 821 CU.FT. STORAGE (PROVIDED) �' - - - OR REINFORCED PRECAST EXTENSION ��q.3' 0 4i�� ! `9 I=111-III=III=III-III=III=III=III=III-III= SYSTEM "C" ITI-III-Ti-ITI IT-III-111=-II -III-III-III-��I-���_ (MAX. 4'-O") �,.' '' \Q 1.. \ III-III- -III-III-III-III- _ STABILEZED SOIL BASE-q5% COMPACTION 811 ' \ + ' - _I III-III-III=III= STANDARD PROCTOR) PAVING: 3,065 SQ.FT. r 8" P.G. REINFORCED SLAB PO �4 Iq'I �- III ISI ROOFING: 1,242 SQ.FT. m# 0 \\ IT zW 4SELECT GRANULAR SOIL Si(v TYPICAL PAVEMENT SECTION BACKFILL FOR PERIPHERY AND � 0 REQ'D STORAGE: BOTTOM LEACHING d� 0 \ NTS (SEE NOTE) 4,307 SQ.FT. x 0.167 X O.q - 647 CU.FT. (REQ D) aN MAXIMUM NTS MAXIMU (1)-10' DIA x 10' DEEP LEACHING POOLS Z ® WRAP WITH hoz. (MIN.) L \\ 2� • ��'� - 684 CU.FT. STORAGE (PROVIDED) mQ4" NONWOVEN GEOTEXTILE oa ® ® (FILTER FABRIC) mm S F SYSTEM "D:' W Q 3'-O" MIN. ® ® ® 3'-0" MIN. Fz O PAVING: 2,784 SQ.FT. �� ® ALL WALL SECTIONS It TOPS ROOFING, 704 50.FT. 30 SHALL BE SET IN A BED OF < ' + \ s " +' 6" REINFORCED CONCRETE MORTAR ��� 19.3' \\ / j: REQ'D STORAGE: m ® ® ® \ / CRUSHED STONE/RECYCLED CONCRETE AGGREGATE (RGA) II IIIIIIIIIII i IIII;III II I II II II I II I II II I I_III=_ STABILEZED SOIL 5ASE-195% COMPACTION 3,488 SQ.FT. x 0.167 X O.q - 524 CU.FT. (REQ'D) -III- (STANDARD PROCTOR) (I)-10' DIA x 10' DEEP LEACHING POOLS o C � � /, - -- F::1II=I "-lil=Iii-III- _II 684 CU.FT. STORAGE (PROVIDED) GROUNDWATER \ SYSTEM "E„ c .��� 2�� CONCRETE DUMPSTER PAD PAVING: 2,488 SQ.FT. 2'-0" MIN. - EXCAVATION It BACKFILL WITH azo°� �J\ �G�� -'' ��� ¢' NTS ACCEPTABLE LEACHING MATERIAL (SEE NOTE) S < GO � NOTE REQ'D STORAGE: DRYWELL DETAIL NOT TO SCALE <p O +��G �� e p F,GO�4/ \ 6"REINFORCED SLAB WITH 6X6 t 10 WWM 2,488 SQ.FT. x 0.167 X O.q - 375 CU.FT. (REQ'D) NOTE: ao �" Gpj , �� LAPPED MIN.OF ONE FULL MESH&WIRED (I)-8' DIA x 12' DEEP LEACHING POOLS ALL DRAINAGE STRUCTURES SHALL BE PLACED IN ACCEPTABLE "-� @ p TOGETHER AT 48"O.C. 507 CU.FT. STORAGE (PROVIDED) LEACHING SOILS AS APPROVED BY THE MUNICIPAL ENGINEER. O IN THE EVENT POOR LEACHING MATERIAL IS ENCOUNTERED, EXCAVATION IS TO BE CONTINUED TO SUITABLE MATERIAL :t i BACK FILLED AS DETAILED. TYPICAL LEACHING POOL DETAIL SITE PLAN FOR "IN LIEU OF DOME A 8" TRAFFIC TAX MAP SEARING COVERMAY NTS BE SUBSTITUTED" BEN1vETT PROPER TIES, LLC DISTRICT 1000 r�� ---- I• I� `' �(� SECTION 122 I ' )�., MAR 3C 2011i '; 8LOCK O6 SITUATE LOT 219.4 C I...._. .,....,.j SITE DATA: MATTITUCK u �,+,0't'70� I,j Pianninrl Sc„js AREA: 40,761 5Q.FT. (OA357 AC.) TAX MAP NO. 1000-122-06-2g.4 TOWN OF SOUTHOLD - SUFFOLK COUNTY/ N .Y. SHAWN LEONARD.) A. I. A. OWNER: BENNETT PROPERTIES, LLC SCALE: I " INCH = 20' FEET GRAPHIC SCALE= I"-20' PREPARED: 3/13/17 A R C H I T E C T AREA: 40,761 SQ.FT. (0.g357 AC.) 320 Hampton Road, Southampton N.Y. 11968 ZONING: 6 (GENERAL BUSINESS) (631) 287-5557 Fax (631) 287-5558 PROPOSED USE: OFFICE 20 O 20 40 GO 2017/03/28 10-.33:08 SUR\/EY OF PROPERTY SITUATE: MATTITUCK N TOWN: 5OUTHOLD 5UFFOLK COUNTY, NY Iti SURVEYED OQ-0I-2015 SUFFOLK GOUNTY TAX # 1000-122-6-211.4 S CERTIIFfED TO: BENNETT FROIIERTMS,II.LC ABSTRACTS,INCORPORATED Land Now ' I or former/ of: Land Now or formerly�{{ of: MAR 3 0 201/ 'I� Matt Med�LG 11025 Main Road LL �a�u Scutno:d Town Planning Bcard N65005900"E N61036'50"E 98.42' 30.56' - -----12- 00� --22------- ------ \ v ' q , 1 Od / E 4 ELx1e.6 N 1 111 I EL 19.3 \ I 1 ♦\ \ ' ,1_ to bo II ELX19.I ELXiB.B / ELX19. / / \\/� I/0.Ot-�• / Cll CvJ ELX 19.0 / e ht ewA / oon�re 9e ° Ppvement '126-19' OHM 'L'B conG. curb c�n�\�� --- S51°58'50� A Alt AdwA I6 \ _�"'"" lMthorizee alteration er aeeitbn b a survey NOTES: ---------'"" mapvbl.aa tbeFnd 9 oaf muacNnt�loao•ow«.nrgeY�1 3knhk.l oSoar tufitthreeeEyoAr.b.asllb nw Mbe2a,—ol LfN ofwna ey MONUMENT FOUND tMp.. el="ali M coroldered b fts veli.fzm copies PROPERTY ZONE B (GENERAL BUSINESS) tfa °°ea m�"m' tw bttg code of Ractice iar lme 5urveya adoptee by the New York Stats Aesoclatkm W Profeaslonal Lme Seveyon. Sale c.rtNKatWe atoll nin only t'the person For Mom the—,..q'.pr.p—.4 oW on Ma belnlf b the lttls conpary, FLAGS SHOWN THUS 1 DELINEATE EDGE OF FRESHWATER WETLANDS t,= B t.. gn..,at aw BOUNDARY AS DELINEATED BY EN-CONSULTANTS, 11-10-15 `— —f- '' JOHN C. EHLERS LAND SURVEYOR AREA = 40,761 S.F. OR O.g36 ACRE 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 GRAPHIG 5GALE 1"= 40' RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287 REF.C:\Usm\Yohn\Dropbox\15\15-176.prn 00 • 00 kn c 00N ' c Q W � w a/ w z 44'-On O W �D 24'-0 1 0 20'-011 0 � v0 00 I I Mcn � I I \00, I I h< I � v STORAGE m I I I m rD W I I G4 I I I 0 I � I I I \ I I I Q I OFFICE SPACE � - - - - - - - 441-011 44'—o" No. Date Title REVISIONS: FIRST FLOOR PLAN Drawn By: R 1"I i"f SCALE: %4"=I'—O" , 4"=I'—0" i (.. Date: Ii r 1 V'i [ �,' 3/13/17 M A R 3 C, 2 017 Drawing No.: W w A OF SHEETS 2017/03/13 11:29:33 ET- 00 00 V) ►--1 rn Ln ~ 00 00 W W-IFIL 11111w z N, Ll IL Lj I LLJ Li I L�iiiij Li � H o � a O � W � a --t� p �_ N M M � T� � V 1 FRONT ELEVATION (SOUT4-4 ) LEFT ,ELEVATION ( wEST) SCALE: %4"=1'-0" SCALE: %4"=I'—O" V �O z W ool F—I M� I—I F� O r W � �D TF -ILIO W - W 3°xa° No. Date Title REVISIONS: � ) Drawn By: RIGHT ELEVATION EAsT REAR A ION [ -ln � �- `c ' Jnr` MAR ' 2017 Date: SCALE: %4"-1'-0" SCALE: %4"—I'-0" 3/13/17 ._n.sou(j,`dTOwn Drawing No.: Pannkn W � A OF SHEETS 2017/03/13 11:35:24 FORM NO. 3 TOWN OF SOUTHOLD � � BUILDING DEPARTMENT Southold 7ba vrr SOUTHOLD,N.Y. l6ar...ing board NOTICE OF DISAPPROVAL DATE: June 12, 2017 TO: Shawn F. Leonard (Bennett Properties, LLC) 320 Hampton Road Southampton,NY 11968 Please take notice that your application dated May 11, 2017: For permit to construct public warehousng"self-storm&)bpj1�1I11g with-office building for self-storage use at: Location of property: 8155 Route 2-5. Laurel,.NY, County Tax Map No. 1000—Section 122 Block 6 Lot 29.4 Is returned herewith and disapproved on the following grounds: Pursuant to Article XXIII. Section 280-127. the proposed use requires site plana roval fromthe Southold Town Planning Board. You may now apply to this agency directly. Author rh� g, Lure Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Planning Board P 17 - FOR INTERNAL USE UNLY D P SITE PLAN USE DETERM[N _ �kouthocld:�bwn Planning Board efermiation lnifial n ._ Date Sent _. Project _ Project Address.�.. ,.. District .. .._. � Zoning No.:1000-_ . ..� I Suffolk County Tax Map- � uef con's� � y C docucet n as to . .-. dir Permit Pl Note: Cop �lic,ation and su Porting of Iut1� �g rropoed use or uses should I , tlnitted.) - _ .' ,. - Initial Determination as to whether use is Permitted:_ Initial Determination as to whether site plan is required:® ®X; PI&O V Si� natur f� ~- Ins ector 9 of l ut ding P Planning Dep (, Date of Coa �— �" artment P_ ��n�ter�t. �I � �-- � �.. P.D.Hate Received: Comments: tv� '. .. °� t CA i t Staff Revie wer Sig nature of annin ..n eP . I . Final Determination to C f , "tJ Decision: — � --�— i {�I I I��1 n r(5'{1� ,- P C, FP . -:a a. �' � OR INTERNA. USE u�t�--Y F � A � I SITE PLAN USE DE Zru� u Planniq Board Determination Initial Date Sent:-_2��- -� Date: .) . � " " --- Ik m .. ject Name' Pro . _ �� �� Pry ��. _ Project Address: - r Zoning - �- . � D`sirict: Ax Ma No.:1000-_ r7 Suffolk County T P w j &A 1l 1Re �jest -=-fUMtion ar�d - (Note: . Copy of Iu �id�ng Permit Apl ltc supporting documentation,a5 to Propos se or uses stlor�id he submitted.) m ,ped u initial Determination as to whether use is permitted: Initial-Determination as to whether site pi I an is � .l " f Budding k . M _ Inspeefor Signature o Planning Department (P-D.) Referral: . pate of Comment: P.D. Date Received: ,5--[�j — Comments: Nw� L Signa#ure of iannin epi.-Staff Reviewer final Determination Dr.. " ate,--b Decision: 4�c f d...,. tO-,.,u��...�..� f - nectn-II TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health-..------ SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX:(631)765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 20� Single&Separate Storm-Water Assessment Form Contact: Approved ,20 Mail to: Shawn F.Leonard,Architect Disapproved a/c ,: 320 Hampton Rd,Southampton,NY 11968 .............. Phanc: 631-287-5557 Expiration.__,20 Bui ding Inspector 0 � PPROVALAPPLICATION FOR BUILDING PERMIT MAY 1 1 2017 20 17 Date M�9__„ INSTRUCTIONS BUILDING DE 'PO Agit 0RDST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scaQe.Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas,and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant.Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f.Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold,Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) 320 Hampton Road,Southampton,NY 11968 (Mailing address of applicant) State whether applicant is owner,lessee,agent,6rchitec engineer,general contractor,electrician,plumber or builder Name of owner of premises Bennett Protaerties fLC (As on the tax roll or latest deed) If applicant is a corporation,signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 8155 Route 25 Mattituck House Number Street Hamlet County Tax Map No. 1000 Section 122 Block 6 ___.......-, Lot 29.4 Subdivision ...............Filed Map No... ...... _Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacancy ............ b. Intended use and occupancy Self Storage 3. Nature of work(check which applicable):New Building._ ...............—Addition Alteration Repair ............................ Removal. Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units NIA Number of dwelling units on each floor If garage, number of cars N/A 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7. Dimensions of existing structures,if any:Front N/A —Rear-------,,—' Depth Height Number of Stories — etye T:xuo Pj Dimensions of same structure with alterations or additions: Front —Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot: Front 126.79' -Rear 128.98' Depth 333.89' 10.Date of Purchase Name of Former Owner 11.Zone or use district in which premises are situated B(General Business) 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO X 13.Will lot be re-graded?YES X NO Will excess fill be removed from premises?YES—NO X 14.Names of Owner of premi SeS Bennett Properties LLC Address P.O.Box 851 Southampton Phone No. Name of Architect Shawn F.Leonard,Architect Address 320 Hampton Rd,SouthamptoPhone No 631-287-5557 Name of Contractor Address Phone No. 15 a.Is this property within 100 feet of a tidal wetland or a freshwater wetland?*YES x NO •IF YES,SOUTHOLD TOWN TRUSTEES&D.E.C.PERMITS MAY BE REQUIRED. b.Is this property within 300 feet of a tidal wetland?*YES NO X •IF YES,D.E.C.PERMITS MAY BE REQUIRED. 16.Provide survey,to scale,with accurate foundation plan and distances to property lines. 17.If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18.Are there any covenants and restrictions with respect to this property?*YES NO X *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF .... ) Richard M.Mato for Shawn F Leonard,Architect P.C. being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Agent_._._......_._ ............... (Contractor,(S;�enr.Corporate Officer,etc.) of said 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 knowledge and belief-,and that the work will be performed in the manner set forth in the application filed therewith. Sworn to b-fore me this Sworn 'o r' ' N T day of 141�� 20 1, 4 P RICIA E LE04� Notary Public.State.of New or Notafy',Public Registration#0 1 LE6349132 Signature of Applicant Qualified In Suffolk County Z0, Commission Expires Oct.11 20 S4 � Submission ff ithout a Cover Letter Shatw n Sender: Subject: 'be,r VAR- r PY'D �r`act�s SCTM#: 1000 - v a oL- (D - act l+ Date: 31 s D 11-7 Comments: St+f 0 plax\ A pkLCO:hon o C kW-CJh 13 0 No-hcP- 0 S AV(a1LuLy-iS A �ridayt+ I -w2p EM • E- lt\ra;h cyk5 .4 Su�rve.�s SOUTHOLD PLANNING BOARD SITE PLAN APPLICATION FORM Site Plan Name and Location Properties, 3 8 Site Plan Name: Bennett ProLLC 17 Application Date: / / Suffolk County Tax Map#1000- 12 2 - 0 6 _ 2 9 .4 Other SCTM#s Street Address: 8155 Route 25 Hamlet: Mattituck Distance to nearest intersection: 16801 to Factory Ave . Type of Site Plan: x New Amended Residential Zoning District B (General Business) Owners/Agent Contact Information Please list name, mailij? r addresM and hone number or the peTle below. Property OwnerJohn Bennett Street P.O. Box 851 Citi Southampton State N.Y, .dip 11969 Home Telephone Other Applicant John Bennett Street P.O. Box 851 Zip Citi Southampton State N.Y. 11969 Home Telephone. __vv Other Applicant's Agent orRepresentative: Contact Person(s)* Shawn F. Leonard Architect Street320 Hampton Road City Southampton State Zip 1 P N.Y. 1193 631-287-5557 Office Telepl�one� Other *Unless otherwise requested, correspondence will be sent only to the contact person noted here. Site Plan Application Form 2/18/2010 Site Data Proposed construction type: New Modification of Excisting Structure .....Agricultural Change of use Property total acreage or square footage: 0 . 9357 ac./sq. h. Site Plan build-out acreage or square footage: 0 . 5152 ac,/sq Is there an existing or proposed Sale of Development Rights on the property? Yes—No x Ifyes, explain: . ........................ .................. ....................................... Does the parcel(s) meet the Lot Recognition standard in Town Code §280-9 Lot Recognition? Y X N If"yes", explain(and attach any necessary documentation–title report, subdivision approval, etc.) Building Department Notice of Disapproval Date: 6 / 27 / 16 Is an application to the Southold Town Zoning Bois required? Yes—No x If yes, have you submitted an application tote ? Yes No If yes, attach a copy of the application packet. ............... Show all uses proposed and existing. Indicate which building will have which use. If more then one use is proposed per building, indicate square footage of Q I bor area per use. List all existing property uses: Vacant List all proposed property uses Business , Storage Other accessory uses: Existing lot coverage: 0 % Proposed lot coverage: 10 .3 % Gross or area of existing sure(s): 0 sq. ft. Gross floor area of proposed structure(s): 7, 6 8 8 s f .......................— Parking Space Data: #of existing spaces: 0 -9 of proposed spaces: 2 0 Loading Berth: Yes No x LLandscaping Details: Existing landscape coverage: 0 % Proposed landscape coverage:. % .............. Wetlands: Is this property within 500' of a wetland area? Yes x No Maybe_ ............. 1, the undersigned, certify hat all the above informati p is true. Signature of Preparer: „ /I Date: Site Plan Application Form 211812010 APPLICANT'S AFFIDAVIT APPLICANT'S AFFIDAVIT STATEF NEW YORK COUNTY OF SUFFOLK eing my sworn, eposes and says that he .... . resides at �� • �������, � - �����. �.m�.���� _, .. � " �, . _...... .......... the State of New fork, and that he is the owner of property located t f-a I ®LA--e- 25 SC"Tf #� �00 n� .° .. U, .._ yep 4- , or at he is e Ow r)'O-c of the ) a v,I n -e (Title) (Specify whether Partnership or Corp.) and said Corporation is the owner of the above property, which is hereby making a Site Plan application; that there are not existing structures or improvements on the land which are not shown on the Site 1 at the title to the entire parcel, including l rights-of-way,has been clearly established and is shown on said Plan at no part of the Plan infiinges upon any duly led plan which has not been abandoned both as to lots and as to roads; that he has examined all les and regulations adopted by the P I anning,Boardfor the filing of Site Plans and will comply with same; that the plans submitted, as approved, will not be alter or changed in any manner without the approval of the 1 n pard that the actual physical improvements will be installed in strict accordance with the plan as approved by the Planning Board. Sign ed � , ner Signed (Partner or Corporate Officer and Title Sworn to met this day of.bkrdh J 0 PATRICIA E L CHIC Notary Public, State of New York d Registration#01LE6349132 Qualified In Suffolk County o � Commission Expires Oct. 11,2020 ary Public Southold Planning De]2artment Applicant Transactional Disclosure Form The Town of Southold's Code of Ethics proliibits conflicts of interest on the part of town officers and employees. The purpose of this form is to provide infonnation which can alert the to of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. Your Name: Last,First,middle initial unless you are applying in the name ofsomeone else or other entity,such as a company. Ifso, indicate the otherperson's or coinpaiai,s name. Nature of Application: (Check all that apply) Subdivision or Re-subdivision Site Plan Other(Please name other activity) Do you personally(or through your company,spouse, sibling,parent or child)have a relationship with any officer or employee of the To of Southold? "Relationship includes by blood,marriage or business interest. "Business interest"means a business,including a partnership, in which the to officer or employee has even a partial ownership of(or employment by)a corporation in which the to officer or employee owns more than 5%of the shares. Yes No If you answered"Yes"complete the balance of this form and date and sign where indicated. Name of the person employed by the To of Southold Title or position of that person_ Describe the relationship between yourself(the applicant)and the town officer or employee. Either check the appropriate line A through D and/or describe in the space provided. The to 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 an.N,interest in a noncorporate 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/0 day o 7 Signature ............ Print Name— A, Disclosure Form Sihawn F . Leonard, Architect P . C . To Whom It May Concem: 1, John Bennett/Bennett Properties LLC, owner of the property identified as SCTM#1000-122-06-29.4 in Mattituck, NY hereby authorize Shawn F Leonard, Architect P. C. to act as my agent and handle all necessary or involved with the site plan application process for this property with the Southold Planning Board. Property Owner Sworn before me this J(P dayof�Iarci') 20 1 PATRfCIA E LEONARD [Notary Plubfic, state of Newoork 3 y egi�tr n *0 1 L E#3,34 91 a"t ex. Registratio 2 Qu'ajifi ty Co Qualified In Suftk County Notary Public mm� mission 2 commission Expires Oct. 11, 2020 320 Hampton Road Southampton, NY 11968 Tel:(631)287-5557 Fax: (631)287-5558 E-Mail:shawn@shawnleonardarchitect.com FM NO. 3 TOWN OF' SOUTHOLD BUILDING DEPARTMENT SOOT N.Y. NOTICE I DISAPPROVAL DATE June 27, 2016 T Properties LLC 8155 Route 25 Laurel,NY 11948 Please take notice that your application t .l'aa�ne 7, 201.6. For permit to constrn:net a eonun rclal office btfil : at Location of property: 8155.Route 25, ural, Y County Tax Map No. 1000—Section 122 t lock 6 Lot 29.4 Is returned herewithand disapprovedthe toll vw ing grouti ls. k e gposed n oiistr clion,requires site jan ppro I r sF the Sc old Tow aiming card. ---- Authorized i a e Cc:File,planning PSI" FOR INTERNAL_ USE UNLY yh SITE PLAN USE ETER[VINA�T[O �; eteri ination ���r�����mingi���,;",:� Initial D .� � " Date Sent Date _° , wyj � Project Name 4 Project Address:----. - �2 � AZoning District:. Suffolk County Tax Map NoA 00 P equest o- ,w . (Note: Copy" of tuiidir�g l�ern�it ,ppl�cation and Supp orting documentation as to proposed use or uses siouid he submitted.) � -Initial Determination as to whether use is permitted:11L-111�-11-1 . G Initial-Deterrnination as to whetsite plan san is required:_ _, ,o Signature of Building 1 (P-D.) Referral: Planning Department ( - -� �7 P.fl.Hate Reeeived:�t 3 J-1 Date of 0MMent:� 1 Comments: ., " 4� Signature of an in t Staff Revie nin wer �n-al Det rnilyiation Date: 1 of nP�tnr Rtoldin❑ in TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 survey. SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application__-_ Flood Pemik, Examined ,20 Single&Separate Storm-Water Assessment Form Contact: APPTOved '20. Mail to: Shawn F. Leonard,Architect Disapproved a/c 320 Hampton Rd,Southampton, NY 11968 Phone: 631-28.7-5557 Expiration 20 a V[E —� Building Inspector MAY 1 1 2017 APPLICATIING ON FOR BUILDPERMIT Date May 9 520 17 INSTRUCTIONS BUMDING DEPT. ToVaWp�OtTnMDST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) 320 Hampton Road, Southampton, NY 11968 (Mailing address of applicant) State whether applicant is owner, lessee, agent,(architec engineer, general contractor, electrician,plumber or builder ...........-- Name of owner of premises Bennett Properties, LLC (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License NO. Other Trade's License No. 1. Location of land on which proposed work will be done: 8155 Route 25 Mattituck ...... House Number Street Hamlet County Tax Map No. 1000 Section 122 Block 6 —Lot 29.4 .livisio � Filed Map No. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacancy b. Intended use and occupancy Self Storage 3. Nature of work(check which applicable):New Building X Addition Alteration Repair Removal.- Demolition Other Work, (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units N/A Number of dwelling units on each floor If garage, number of cars NIA 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. .... 7. Dimensions of existing structures, if any: Front N/A Rear Depth Height Number of Stories Std �►° ° Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot Front 126.79' Rear 128.98' Deptll 333.89' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated B (General Business) 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO X 13. Will lot be re-graded?YES NO gr X _ Will excess fill be removed from premises?YES NO X 14.Names of Owner of prerniseS Bennett Properties LLC Address P.O.Box 851 Southampton Phone NO. Name of Architect Shawn F. Leonard„Architect Address 320 Hampton Rd,SouthamptoPhone No 631-287-5557 Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X NO * IF YES,,SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? *YES NO X * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF .) Richard M.Mato for Shawn F Leonard,Architect P.C. being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the Agent (Contractor, gen orporate Officer,etc.) of said 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 knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. o b fore _s _ — da of �� 20 �� worn Y PATRICIA E LE R y�Public, Stat �. Notary ublic Registration#01LE6349132 Signature of Applicant Qualified In Suffolk County Commission Expires Oct. 11. 2020 FORM NO. 3 � :n TOWN OF SOUTHOLD BUILDING DEPARTMENT I! ; if% 2 7 r 9 SOlw7 HOLD, N.Y. swjlkod TUM NOTICE OF DISAPPROVAL ��� ����� ua s: DATE: June 27, 2016 TO: Bennett Properties LLC 8155 Route 25 Laurel,NY 11948 Please take notice that your application dated Juiie 7, 2016 For permit to construct a commercial office bui� , ilk&, at Location of property: 8155 Route 25, Laurel,NY County Tax Map No. 1000—Section 122 Bloch 6 Lot 29.4 Is returned herewith and disapproved on the fb I 1c)wiag grounds: The proposed construction requires site pj"In approval f oin dig, o _....:� 4� p lila. o a- . Authorized Signature Cc: File,,planning TOWN OF SOUTHOLD BUILDING PLS-.MIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey ..... IT SoutolTown. ortor .net PERMIT NO. Check Septic Form N.Y.S.D.E.C. ............ Trustees C.O.Application Flood Permit Exa¢lairied 20_ Single&Separate Storm-Water Assessment Foran Contact: IIZ9' —7 r Approved ......... ,20 m Mail to: rd wArchitect 320 Hampton R Disapproved a/c mm d,Southampton, NY 11968 Phone: 631-287-5557 Expiration —,20, rlang ecton PLICATION FOR BUILDING PERMIT Date June 1 16 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector wvith 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building;Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. QA&M (Signature of apoli ant or nauiiN if a corporation) 320 Hampton Road, Southampton, NY 11968 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architec engineer, general contractor, electrician, plumber or builder Name of owner of premises Bennett Pro ernes LL C (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 8155 route 2.5 Mattituck House Number Street Hamlet County Tax Map No. 1000 Section 122 Block 6 Lot 29.4 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Vacancy b. Intended use and occupancy Office Space 3. Nature of work(check which applicable): New Building X Addition Alteration Repair —Removal -Dernolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units N/A Number of dwelling units on each floor If garage, number of cars N/A 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front N/A ®Rear Depth Height Number of Stories Dimensions of same structure with alterations or,additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front 53' Rear 53' Depth 83' Height_ 20' Number of Stories 2 9. Size of lot: Front 126.79' Rear 128.98' Depth 333.89' 10. Date of Purchase Name of Fortner Owner 11. Zone or use district in which premises are situated B (General Business) 12. Does proposed construction violate any zoning lav, ordinance or regulation? YES NO X 13. Will lot be re-graded? YES X NO Will excess fill be removed from premises? YES--.--NO X 14.Names of Owner of premises Address Phone No. Name of Architect Shawn F.Leonard, Architect Address 320 Hampton Rd,SouthamptoPhone No 631-287-5557. Name of Coratrdactor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? *YES NO X * IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY O "_ SS: l Shawn F. Leonard being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the Agent (Contractor, gent, orporate Officer,etc.) of said 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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith.. Sw9m to before me this day,o � � 20 _. ava ? lica.n Public Si atur- ot"A Notary NoW, btu. � or � pp a esti-��iT VVMMS._�. . FOR INTERNAL. USE c.f._ �+ Y L�mm �Sou hoid Planning oBonn and i i�U' inafion G 10 Date Date:_-1�? .J_J.L. r �—Uxm ------------- Project Name: .: ...: .. s ddress: � .-- Project Suffolk County Tax Map No.:100=_ Zoning District:___ INI �..� g documentation t I uiidlr q I'errnit I i I caliori and supportin -as to (Note: Cole propo�ed use or use should Lie s ahrifitted.) -Initial Determination as to whether use is perrnitted:� Mc—,W `tial Ieter� ina s to whether site plan is required:. _ 1ni etor BUIMINGDEM Signature nature of ns Building 1pe TOWN OF SOUTHOLD De attment (P.D.) Referral: Planning p ate of COM ent: P.D- Date Received: Col-nrn ntsw t 01 � gnature of PIT Reviewer Host DeterminatJOI1 Date: n�firP ()f n I Rrulciina c„... ._. na InP.ctor FOR INTERNAL USE uN�Y : � J , SITE PLAN USE DETERMINATIO 7,7�� w � 7 _ Initial Deterrnination �° fo I Date Sent._, Dater Project-Nar_ e: ° ,. ..� 4 Project Address: 2Zonin - t: County Tax Map NO-1-000- Z_°T - _ g Dstric Suffolk Cv '� m Requ"est'' =--- di Permit gip& doctimen(aation as to (Note: Copy" of Building ai�cation and supporting proposed use or uses should he sub itted.) K „ . 1ni{gal D eterniination as to whether use is peranit��ted: m �t " - „ site tan is required:,, h ©_ 'on as to whether s P 1. Initial-DetemnEnati - Sig re of Building Inspector Planning Department (P.D.) -Date of Comment P.D.Hate Received: - �o Co�nC eTits: iAk w - w Sinatre of Piani Dept.-staff Reviewer Final Determination Date: ! — Decision:_ c=,,.,ati mp of Rri I o In_qnnntnr.-��.�....�.�._ TOWN OF SOUTHOLD BUILDING I-r,RMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey.............................................................................................................................. SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O..App i ication Flood Permit Examined. ...._,20 Single&Separate D ggam Storm-Water Assessment Form IGi-�q 1R'Da 7 Contact: � l:proveds,20 Mai 8 rd,Architect Disapproved a/c: BVrL" p p Y 11968 320 Hampton TOWX 01i out am ton, 'O Phone: 631-287-5557 E pi:raflord 20 Building Inspector APPLICATION FOR BUILDING PERMIT Date June 1 _, 20 16 INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans,accurate plot plan to scale.Fee according to schedule. b.Plot plan showing location of lot and of'buildings on premises,relationship to adjoining premises or public streets or areas,and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. £Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension of the permit for an addition six months.Thereafter,a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York,and other applicable Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and regulations,and to admit authorized inspectors on premises and in building for necessary inspections. ,r (Signature of api Brant or narnb,if a corporation) 320 Hampton Road, Southampton, NY 11968 m _ (Mailingaddress of applicant) State whether applicant is owner, lessee, sgeut,6,,'i c tec i' engineer, general contractor, electrician,plumber or builder Name of owner of premises Bennett properties, LLC �........... ... on the tax roll ................... ( or latest deed) If applicant is a corporation, signature of duly authorized officer .......... ._...... . (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done; 8155 Route 25 M,attituck House Number Street Hamlet County Tax Map No. 1000 Section.... 122 Block 6mmmmmmmITmm Lot 29.4 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancyyn b. Intended use and occupancy Office Space ------------ ...............-.............. uqqwTZT 3. Nature of work(check which applicable):New Building X Addition Alteration Repair.................................Removal Demolition Other or (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units N/A Number of dwelling units on each floor If garage, number of cars— NIA 6. If business, commercial or mixed occupancy, specify, nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front NA Rear ................Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth_ Height Number of Stories 8. Dimensions of entire new construction: Front 53Rear 53' Depth 83' Height_ 20' Number of Stories 2 9. Size of lot: Front 126.79' Pear28.918' Depth 333.89' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated B (General Business) 12. Does proposed construction violate any zoning law,ordinance or regulation?YES—NO X 13.Will lot be re-graded? YES X NO Will excess fill be removed from premises?YES NO X 14.Names of Owner of premises Address Phone No. Name of Architect Shawn F. Leonard,Architect Address 320 Hampton Rd,SouthamptoPhone No 631-287-5557 Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X NO •IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO X • IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? *YES NO x * IF YES,PROVIDE A COPY. STATE OF NEW YORK) S& COUNTY OF50A ' ) Shawn F. Leonard ...... being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the—Ag.ent ................. (Contractor,(�g=enf',Corporate Officer,etc.) of said 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 knowledge and belief-, and that the work will be performed in the manner set forth in the application filed therewith. Swqrn t before me this J day of 20 ........... Notary Public vowupawMc,ftV lAeToIrMk49ignature of Applican Na 01AM7M 0=85W in sum*C—Orl Fqk.lWaM14, Town of Southold 41I I , LWRP CONSISTENCE'' ASSESSMENTFORM 91 � A. INSTRUCTIONS mm 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 lmat'ed 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 a on the coastal area which includes all of Southold Town.:;):. 3. If any question in Section C on this furan 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 ex lai.ned in detail listin both supporting and non- suDDortine 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# M- _ 0(p _ 2q. Q- PROJECT NAME LL The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board�Building Dept. ❑ Board of Trustees El 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: 11 Location of action: "AW tv+T) -rJcAe— ..................................... Site acreage: a-9�'5--7 Present land use: V ACIA V-r Present zoning classification: (6rf�tj"'Vql- 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall eraovided: (a) Name of applicant" (b) Mailing address:.................................................................. (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a to or federal agency? Yes E�NoEl If yes,which state or federal agency? fJY6VEC— 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— i .iteria. Applicable .......... ......... Attach ad(htional sheets if necessaly Policy 2. Protect and preserve historic and a rchaeological resources of the Town of Southold. See LWRP Section M—Policies es 3 through 6 for evaluation criteria 1:1 Yes 1:1 No Not Applicable ........................-- ................... .............. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LW%S cation M—Policies Pages 6 through 7 for evaluation criteria Y Applicable ...................................................................................................... ................................. .................... ............................................................................................. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Secti —Policies Pages 8 through 16 for evaluation criteria Applicable .................... ...................... ...................... .......... ............. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section M P , * Pages 16 through 21 for evaluation criteria olmis E] No 1:1 Not Applicable ............................. ............................ ................................................................................................ Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section M—Policies; Pages 22 through 32 for evaluation criteria. r---I Yes L_j No Not Applicable Zr Attach tio sheets if s Policy . Protect and improve air quality in time Town of Southold. See LWRP Section — Policies Pages 32 through 34 for evaluation criteria. Applicable Attach 'o sheets if s Policy degradation in Town of Southold from solid waste and hazardous substances and . See LWRP Section —Policies crit 11 Yes .1 No ffNot Applicable PUBLIC COAST POLICIUES Policy v 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. Yes 1:1 No Not Applicable Attach °additional sheets if necessary Policy 10. Protect 1 's water-dependent rises and promote siting - i suitabi locations. —policies; Pages 47 through 56 for evaluation . Applicable .........................................._.— ...... _........ Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources 1 l y the PeconicEstuary and Town waters. See LWRP Section — policies; Pages 57 through 62 for evaluationcriteria. ElR"Notis �. — ........ Attach additional sheets if necessary Policy c in the 'Town of Southold. i —Policies; through 65 for evaluation i . F Yes 1:1 No D'Not Applicable Attach additional sheets if necessary Policy to appropriate use and development pent energy and mineralresources. Section —Policies; Pages 65 through 68 for evaluation criteria. [2, �Yes [:1 NoEl Not Applicable F42) PREPARED BYE,, . TITLE - L' DA T Amended on 811105 Short Environmental Assessment Form Part 1 Project:Information Instructions for Com l ttu a ti , :1 ire i'l4E�Griu, '8"O ("! �. 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: Bennett Properties,LLC Project Location(describe,and attach a location map): 8155 Route 25 Mattituck,N.Y.11952 Brief Description of Proposed Action: Proposed Office Building and Self Storage Buildings Name of Applicant or Sponsor: Telephone: John Bennett E-Mail: Address: P.O.Box 851 City/PO: State: Zip Code: Southampton N.Y. 11969 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: NYSDEC Freshwater Wetlands,Town of Southold Wetlands 3.a.Total acreage of the site of the proposed action? 0.9357 acres b.Total acreage to be physically disturbed? 0.5152 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial m Commercial ❑Residential(suburban) ❑Forest ❑Agriculture El Aquatic F1 Other(specify): ❑Parkland Page 1 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 was management facility? IfYes,describe:...................................................... ....... ................. ............... ........................ 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? IfYes,describe:................................................................................___...................................................................................................._............_......................................................................_........................................................................................................................ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNONMEDGE, Applicaw/,p )r is awe: Shaw )Leonard rchi ect ate Signature: PRINT FORM Page 3 of 3 Agency Use Only [If applicable] Project: Date: Short Environmental Assessment Form Part 2 -Impact Assessment Part 2 is to be completed by the Lead Agency. 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 zomng F-1 regulations? Z ........................ ............................................. 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 571 7 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 renewableenergy opportunities? ....... .................. ................................................... 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? El 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, waterbodies,groundwater, air quality,flora and fauna)? Li 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 0 11. Will the proposed action create a hazard to environmental resources or human health? ..............—-----........................................................................................................—JR] El ............. ............... PRINT FORM Pagel of2 Agency Use Only[it aillicablej Project: Date: Short Environmental Assessment Form Part 3 Determination of Significance 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 finpact 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. 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. Shawn R Leonard Architect, RC, 3/8/17 Name of Lead Agency Date Shawn F. Leonard Principle Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer ................................... ............... Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) ...................................................................................................... .............................................................. T FORM Page 2 of 2