HomeMy WebLinkAboutTR-9008A Michael J.Domino,President *QF SO Ur Town Hall Annex
John M.Bredemeyer III,Vice-President ,`O� yOIO 54375 Route 25
P.O.Box 1179
Glenn Goldsmith l�[ Southold,New York 11971
A.Nicholas Krupski G Telephone(631) 765-1892
Greg Williams �� Fax(631) 765-6641
COU
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 1585C Date: July 8, 2019
THIS CERTIFIES that the additions to the existinq two-story dwelling consisting of constructing a
new 116sg ft front porch; a 1 059sa ft addition to existing second floor an 84sg.ft. addition to the
existing first floor and to remove existing 467sq ft waterside deck and construct new 562sg.ft. deck;
relocate hot tub to be installed seaward of the shed; and to remove the shed which will not be replaced;
At 415 Harbor Lights Drive, Southold
Suffolk County Tax Map#1000-71-2-4
Conforms to the application for a Trustees Permit heretofore filed in this
office dated March 28. 2017 pursuant to which Trustees Administrative Permit#9008A
Dated May 17, 2017,was issued and Amended on July 18, 2018 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 additions to the existing two-story dwelling consisting of constructing a new 116sg.ft. front porch; a
1 059sa ft addition to existing second floor an 84sg ft addition to the existing first floor: and to remove
existing 467sq ft waterside deck and construct new 562sg ft. deck: relocate hot tub to be installed
seaward of the shed• and to remove the shed which will not be replaced
The certificate is issued to James&Kathleen Blackley owners of the aforesaid
property.
Authorized Signature
Michael J. Domino,President ��OF S0(/T�,O Town Hall Annex
John M. Bredemeyer III,Vice-President ,`O l0 54375 Route 25
P.O.Box 11
Glenn Goldsmith lx[
Southold, New York
11971
A.Nicholas Krupski G
� O Telephone(631) 765-1892
Greg Williams �cOU
O Fax(631) 765-6641
� NT`1,N�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: -718M
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
Y2 constructed
Project complete, compliance inspection.
INSPECTED BY: ��� Ud 1 ,4,-,-
COMMENTS:
�Sn-S &e—
CERTIFICATE OF COMPLIANCE: �� 7-� -3�Aj e
� I
Samuels and Steelman Architects
25235 Main Road, Cutchogue, NY 11935
June 14, 2019 E 0 E y 1
Southold Town Board of Trustees JUN 17 2019
Town of Southold
PO Box 1179 Southold Town
Southold, NY 11971-0959 —Boardof Tru tees
RE: BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM# 1000-71-02-04
Administrative Permit#9008A
Dear Board of Trustees:
We have decided not to implement the permitted actions of the recently amended Administrative
Permit #9008A, to expand an existing at grade terrace. If we decide to move ahead with that
work, it will be only after we receive permission from you again.
In the meantime, please schedule a FINAL COMPLIANCE INSPECTION, and thereafter
prepare a Certificate of Compliance for the Building Department.
Sincerely,
Samuels and Steelman Architects
Thomas C. Samuels,Architect
Michael J. Domino,President QF SOUTTown Hall Annex
John M.Bredemeyer III,Vice-President ,`O ��� 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
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
May 15, 2019
Thomas C. Samuels
Samuels & Steelman Architects
,25235 Main Road
Cutchogue, NY 11935
RE: JAMES & KATHLEEN BLACKLEY
415 HARBOR LIGHTS DRIVE, SOUTHOLD
SCTM# 1000-71-2-4
Dear Mr. Samuels:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, May 15, 2019:
RESOLVED that the Southold Town Board of Trustees grants a One Year Extension to
Administrative Permit#9008A, as issued on May 17, 2017, Amended on July 18, 2018
and Amended again on April 17, 2019.
This is not an approval from any other agency.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
4.A
Michael J. Domino
President, Board of Trustees
MJD:dd
Michael J. Domin esident I �Q C� Town Hall Annex
John M. Bredemeyer III,Vice-President ��� 'yJ, 54375 Route 25
Glenn Goldsmith y z P.O.Box 1179
A.Nicholas Krupski j Southold,NY 11971
Greg Williams pr Telephone(631)765-1892
dol �a Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: q43 1,/1 I Completed in field by: 'M
JAMES & KATHLEEN BLACKLEY request a One-Year Extension to Administrative Permit#9008A, as issued
on May 17, 2017, and Amended on July 18, 2018 and Amended again on April 17, 2019. Located: 415
Harbor Lights Drive, Southold. SCTM#: 1000-71-2-4.
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required
1. Residence: 100 feet
2. Driveway: 50 feet
3. Sanitary Leaching Pool (cesspool): 100 feet
4. Septic Tank: 75 feet
5. Swimming Pool and related structures: 50 feet
6. Landscaping or gardening: 50 feet
7. Placement of C&D material: 100 feet
TOP OF BLUFF:
1. Residence: 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:
cot*4
I have read & acknowledged the foregoing Trustees comments:
Agent/Owner:
Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski
G. Williams Other
S A M U E L S &
S T E E L M A N
April 25, 2019 U ,�}
APR 2 6 2019
Southold Board of Trustees
PO Box 1179 Southold Town
Southold, NY 11971 ��. Board of Trustees j
Re: JAMES & KATHLEEN BLACKLEY
415 Harbor Lights Drive
Southold, NY 11971
SUM # 1000-71-2-4
ADMINISTRATIVE AMENDMENT TO
ADMINISTRATIVE PERMIT PERMIT #: 9008A
Please extend the above mentioned PERMIT# 9008A for one year. The current
expiration date is 5/17/2019. Enclosed is the $50 fee.
If you need any additional information from me, please contact me.
As always, I appreciate your efforts.
Sincerely,
UtU4 .
Tom Samuels, Architect
enc.
ARCHITECTS
25235 MAIN ROAD
CUTCHOGUE,NEW YORK 11935
(631)734-6405
FAX(631)734-6407
Michael J.Domino,President �QF SOUTH, Town Hall Annex
John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25
P.O.Box 1179
Glenn Goldsmith l�[ J [ Southold,New York 11971
A.Nicholas Krupski G Telephone (631) 765-1892
Greg Williams Fax(631) 765-6641
COUNT`I,�
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
April 17, 2019
Samuels & Steelman Architects
25235 Main Road
Cutchogue, NY 11935
Attn: Thomas C. Samuels
RE: JAMES &.KATHLEEN BLACKLEY „
415 HARBOR LIGHTS DRIVE, SOUTHOLD
SCTM#: 1000-71-2-4
Dear Mr. Samuels:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, April 17, 2019:
RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative
Amendment to Administrative Permit#9008A to extend by 408 sq. ft., the existing at-
grade stone terrace; runoff to be contained in existing drywell; and as depicted on the
site plan prepared by Samuels & Steelman Architects last dated February 19, 2019, and
stamped approved on April 17, 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,
A-0��
Michael J. Domino
President, Board of Trustees
MJD/dd
REVISIONS
-1/101 DECK REVISION
2/IQ/Iq TERRACE
'E P�� D A` `1 ENLARGEMENT
SCTM # 1000-71-02-04
PROPERTY: 415 HARBOR LIGHTS DRIVE
FREDERICK AND HAROLD REESE ADDRESS SOUTHOLD, NY 11971
PARK AND PLAYGROUND EXISTING FLOATING WOOD DOCK
(GREEK OR CANAL) OWNER: JAMES BLACKLEY
EXISTING METAL RAMP KATHLEEN BLACKLEY APPROVE[ Y
BOARD OF 'I RLJ EES
EXISTING FIXED WOOD DOCK SITE: 20,000 SQ. FT. = 0.459 ACRES TOWN OF SOUT OLD
EXISTING 6' WIDE WOOD
WALK AT GRADE EXISTING BULKHEAD ZONING: R-40 DATE APRIL (� �l�
SURVEYOR: Nathan Taft Corwin III
uj
S 64'05'10" E / - , , .,wr,� .
5. 2.3 5.1� 100.00' s. 1586 Main Road O
Jamesport, New York 11947
LICENSE # 50467
DATED OCTOBER 4, 2011
6 EX I5TI NG FLAGPOLE W
N o TEMPORARY STORM WATER RUNOFF O
� �l - `V CONTROL MEASURE: SILT FENCE DURING
7 XCONSTRUCTION SEE DETAIL 1-5P2 NOTES:
- Z W N 6 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUMiz Q
EXISTING ELEVATIONS ARE SHOWN THUS:-.Q
V < ? Z EXISTING CONTOUR LINES ARE SHOWN THUS: 8
~ UL — FIRST FLOOR
EXISTING GUNITE POOL w N (3 — O
Lu
z >=
TERRACE ON 5LAB AT GRADE, G.FL - GARAGE FLOOR 0
EXISTING TERRACE
EXISTING UNDERGROUND LEACHINGS \ � wFEB ) 9 2019 puj
POOL w/TRAFFIC COVER TIED TO
EXISTING GUTTERS AND DOWNSPOUTS =NJ
lu
EXTEND EXISTING TRAVERTINE I REPLACE EXISTING WOOD DECK w/NEW I
� SITE _ ..
( 'P, 25'-3 J AS SHOWN, APPROX. 535 SF
APPROX. 405 5F, w/DRAINAGE TO \ ,� -� �i//% (����; ii; ,�%' i/; .; ;; ' �: Shelter
EXISTING DRYWELL - —-� z / O O
PROPANE FEED FOR FIREPIT _ „� I_6r__ -� N Parish Dr 'ii" F--
_ -- NEW WOOD BENCH SEAT, Q'� S O U n d
� .
REMOVE EXISTING SHED L -- ----- 8 p PERMANENTLY ATTACHED TO DECK �'� „, Q
EXISTING POOL EQUIPMENT
0
o N
i
a -
O
NEW4 SU D
ERGROUND LEA H
I NG POOL
a
rb
O
L
TIED TO GU ER5 AND DOWNSPOUTS
r
h
EXISTING SEPTIC SYSTEM TO REMAIN
TT A
1
\
G
_ \
i
I
5
I 1000 GA SEPTIC TANK T
L
o W
NEW CRAW SPACE G
A
n
(5) 8 DIA x 3 HIGH LEACHING POOL (LP)
L ACCESS
C
r
.
flf
-�
LIMITS OF CLEARING 4NEW HVAC UNITS
d
( 1 AREA OF P O
POSED LAND
L
<
O
DISTURBANCE
W COVERED ENTRY PORCH
O
r
O
L
REMOVE PORTION EXI STi
G FENCE
_.
i
D
NEW ADD
2160
-loll
ADDITION TO EXISTING RESIDENCE
a'
J � �
............................................:.:::.......:.:.:..:.
EXICT'G POWER GENERATOR L -r 1 NEW 4xa UNDERGROUND LEACHING POOL i O
PROVIDE NEW FENCING DOUBLE 1 I ( TIED TO GUTTERS AND DOWNSPOUTS
'i es
GATE, APPROX. 45' TOTAL / &r (� 1 \ / m 4. 06 Z.
..... .......
Ln
SOIL STOCKPILE AREA a I co <. L o
EX I CT G UNDERGROUND WATER LINEL C) CAmi"101ftmm MAP
NEW COVERED ENTRY PORCH Y
RELOCATE EXISTING COBBLESTONE o 1 EXISTING DRI AY J o 0
REMOVE EXISTING PAVERS. PROVIDE NEW
CURB $ INFILL DRIVEWAY RANDOM BLUESTONE PAVED TERRACE ON SLAB, w J• c a Z LL
;'� i� o TO ALIGN WITH STAIRS W• o
EXI5T'G UNDERGROUND PROPANE TANK / a " "
Z / 3 �,_ ,� NEW UNDERGROUND LEACHING POOL (8' w• "
RE-WIRE LIGHTS N DIA x 4' HT) TIED TO NEW GUTTERS AND Mm
1 V) DOWNSPOUTS AT EXISTING RESIDENCE Q H• v
EXIST'G OVERHEAD POWER LINE
WATER METER N 64'05 1 6 " W 100.00' TEST HOLE BY MARK McDONALD
_.._.._ _.._.._ _.._.._.._.._.._.._. _.._. „_.. OVERHEAD WIRES _ GEOSCIENCE
SOUTHOLD,
UTILITY POLE LIL 4 WATE /i' CATCH BASIN NEW YORK 11971
VALVE EDGE OF PAVEMENT TEST HOLE DATA 7/28/98 ELEV +9.9'
1.0 FT. DARK BROWN SANDY LOAM OL
PPS d
3.0 FT. BROWN LOAMY SAND SM
8.2 FT. PALE BROWN FINE SAND SP f'f
HARBOR LIGHTS DRIVE
9 FT. WATER IN PALE BROWN FINE SAND SP
3�" �if+s Cis` "
22 FT. WATER IN BROWN SILTY SAND SM ...Ctar
W WATER IN BROWN FINE TO PROJECT NO:
28 FT. MEDIUM SAND SM 1701
COMMENTS: WATER ENCOUNTERED DRAWN BY: UT
I-� 8.2' BELOW SURFACE, ELEV +1.7'
CHECKED BY: TCS
DATE:
H 7/11/18
LOT COVERAGE TABLE SCALE: 1„ = 20' - 0111
SCALE: 1 il = 20imovi SHEET TITLE:
51TE AREA TOTAL: 20,000 sf
STRUCTURES EXISTING PERGENTAGE PROPOSED PERCENTAGE SITE
HOU5E: 2,642 sf 15.2 961 2,155 sf 15.b%,
AGG 5TRUG: 15 5f 0.5% 0 5f 0.0% PLAN
PORGHE5: 562 sf 2.5% 6q4 5f 5.5%
POOL: 56q 5f 2.5% 56q Cf 2.5%
TOTAL: 3,5-11 sf Ici.4% 3,1150 5f Icl.ci%
SHEET NO:
AMENDED PERMITS
Samuels and Steelman Architects
25235 Main Road, Cutchogue, NY 11935
February 19, 2019
Southold Town Board-of Trustees
Town of Southold
PO Box 1179
Southold, NY 11971-0959
RE: BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM#1000-71-02-04
Administrative Permit#9008A
Dear Board of Trustees:
We hereby request an AMENDMENT to the ADMINISTRATIVE WETLANDS PERMIT for the
above referenced project. The proposal is to extend the at-grade stone terrace as shown,-
adding 408 square feet to existing terrace, following a curved line 45 feet long by 19 feet wide.
It is shown as ,hatched in the attached SITE PLAN. The new area will be drained into an
existing drywell in that location.
Please also find check for$50.
Please place us on the agenda of the next available Trustees meeting/public hearing, and call
us with any questions or concerns.
Sincerely,
Samuels and Steelman Architects
!'I FED 19 201 ' -,
Thomas C. Samuels,Architect
enc.
Michael J. Domino, President �*Of SU�lyo Town Hall Annex
John M. Bredemeyer III,Vice-President ,`O l0 54375 Route 25
P.O. Box 1179
Glenn Goldsmith Southold,New York 11971
A.Nicholas Krupski G Q
p Telephone(631) 765-1892
Greg Williams O Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION:
V Ch. 275 Ch. 111
INSPECTION SCHEDULE
- J
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
Y2 constructed
Project complete, compliance inspection.
INSPECTED BY: �
COGMYENTS:
CERTIFICATE OF COMPLIANCE:
Michael J.Domino,President �F S0�o�� y�lO 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 Telephone(631) 765-1892
Greg Williams yCOU Fax(631) 765-6641 NTl,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
July 18, 2018
Samuels & Steelman Architects
25235 Main Road
Cutchogue, NY 11935
RE: JAMES & KATHLEEN BLACKLEY
415 HARBOR LIGHTS DRIVE, SOUTHOLD
SCTM#: 1000-71-2-4
Dear Mr. Samuels:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on Wednesday, July 18, 2018:
RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative
Amendment to Administrative Permit#9008A to remove existing 467sq.ft. waterside
deck and construct new 562sq.ft. deck; relocate the hot tub to be installed seaward of
the shed; and to remove the shed which will not be replaced; and as depicted on the
site plan prepared by Samuels & Steelman Architects dated July 11, 2018, and stamped
approved on July 18, 2018.
Any other activity within 100' of the wetland boundary requires a permit from this office.
This is not an approval from any other agency.
If you have any questions, please do not hesitate to contact this office.
Sincerely,
Michael J. Domino
President, Board of Trustees
MJD/dd
SITE DATA
SCTM # 1000-71-02-04
JUL 122018
FREDERICK AND HAROLD REESE PROPERTY: 415 HARBOR LIGHTS DRIVE _�...�
`------
PARK AND PLAYGROUNDWADDRESS SOUTHOLD, NY 11971 EXISTING FLOATING
WOOD DOCK s„a:1;.:,1 iuwn
(GREEK OR CANAL) OWNER: JAMES BLACKLEY 'r
EX15TINO METAL RAMP KATHLEEN BLACKLEY
EXISTING FIXED WOOD DOCK SITE: 20,000 SQ. FT. = 0.459 ACRES
EXISTING 6WIDE WOOD ZONING: R-40 uj
WALK AT GRADE EXISTING BULKHEAD
S s4•o5'10" E SURVEYOR: Nathan Taft Corwin 111 X UJ Se
1586 Main Road
5.1 2.3 5.1 � \ 100.00' S, 1 Jamesport, New York 11947
\� .� LICENSE # 50467 O 0
�.\� �\ �� + DATED OCTOBER 4, 2011
6 777
EXISTING FLAGPOLE (u
o
o z
o Z
N N TEMPORARY STORM WATER RUNOFF O
;�D - Q CONTROL MEASURE: SILT FENCE DURING
7 t � W 6 --j CONSTRUCTION SEE DETAIL I-SP2 NOTES:
1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM < uj
f 0EXISTING ELEVATIONS ARE SHOWN THUS:.0
iF X \ N _� EXISTING CONTOUR LINES ARE SHOWN THUS: s
N F.FL. - FIRST FLOOR
w G.FL. GnRCE FLOOR 6UNITE POOL
O
_ XZ
z >=
EXISTING TERRACE Z
w
l
W W
EXISTING UNDERGROUND LEACHING U Vii,% \ T ' z REPLACE EXISTING WOOD
POOL w/TRAFFIC COYER TIED TO Z DECK w EW AS SHOWN
uj
EXISTING GUTTERS AND DOWNSPOUTS tWfl
r — - - - - - - - - - - -I w SITE 0
NEW LOCATION FOR EXISTING, J W Z Q
FREE5TAND I NG HOT TUB ( /
01
Z %j�j/ O o
EXISTING UNDERGROUND LEACHING POOLS 3:N
Dr
Parish
---� TIED TO EXI5TIN6 6UTTER5 AND
REMOVE EXISTING SHEDL — J I -------- - 8 O DOWNSPOUTS AT EXI5TIN6 RESIDENCE
EXISTING POOL
EQUIPMENT I I o
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0
O
a
r
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EXISTING SEPTIC SYSTEM TO REMAIN 9►h
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I 1000 GAL SEPTIC TANK ST
\
1
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NEW CRAWL SPACE
ACCESS W
k 1
A
n
c
€ ii h
(5) 8 DIA x B HIGH LEAGHIN6 Pool (LP) or or
C
n
��1 e
NEW HVAC UNITS �1
LIMITS OF CLEARING
r
r_
AREA OF PROPOSED i
1' 1
LAND
D I STURBANGE
NEW COVERED ENTRY PORCH 14 3 O
r
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a�
L
r �
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NEW ADDITION TOE v�
26 -lollxx
X15TING RESIDENCE DENGE
O -le
A
EXIST'& POWER GENERATOR ` ' '' ' I EXISTING UNDERGROUND LEAGHIN6 POOLS L- O
: +� I r TIED TO EXISTING GUTTERS AND `•
DOWNSPOUTS AT EXISTING RESIDENCE m a08 Z
— — —
501L STOCKPILE AREA LO
EXI5T'G UNDERGROUND WATER LINE C A` T1 N MA"
cn Q
w
EXISTING DRI AY NEW COVERED ENTRY PORCH L AD � A
J �• °a o
CONSTRUCTION ENTRANCE - STAGING o REMOVE EXISTING PAVERS. PROVIDE NEW 3
• o APPROVED BY w J• _ 3 ..
AREA AND PROPOSED CONCRETE RANDOM BLUESTONE PAVED TERRACE ON SLAE3, a Z
LL
WASHOUT AREA ,r, ,r, TO ALIGN WITH STAIRS w• o
N NEW UNDERGROUND LEACHING POOL 8' BOARD OF 1 t�USTEES m w• a N 0 '?
z
EXIST'G OVERHEAD POWER LINE / 3 N DIA x 4' HT) TIED TO NEW GUTTERS AND TOWN OF SOUTHOL Q
N DOWNSPOUTS AT EX 1 STING RE51 DENGE
DATE , TUL� 191 tel$ CO N
WATER METER N 64-05'1 W 100.00' BY MARK McDONALD
OVERHEAD WIRES TEST MOLE GEOSCIENCE -� -n--�•�
UTILITY POLE LIL 4 .. WATER _.._.._ _.._.._.._.._.._.._. _.._. —.. _.._.._.._ SOUTHOLD,
GATGH BASIN NEW YORK 11971
VALVE \�--ED&E OF PAVEMENT TEST HOLE DATA ( 7/28/98) ELEV +9.9'
1.0 FT. DARK BROWN SANDY LOAM OL �E of�Fw�
O�Nr's C S9 0
3.0 FT. BROWN LOAMY SAND SM
HARBOR LIGHTS DRIVE 8.2 FT. PALE BROWN FINE SAND SP ` ,'��
�i 9 FT. WATER IN PALE BROWN FINE SAND SP
22 FT. WATER IN BROWN SILTY SAND SM -
w WATER IN BROWN FINE TO PROJECT NO:
28 FT. MEDIUM SAND SM 1701
H COMMENTS: WATER ENCOUNTERED DRAWN BY: UIT
�i 8.2' BELOW SURFACE, ELEV +1.7'
CHECKED BY: TCS
DATE:
BLACKLEY RESIDENCE 7111118
LOT COVERAGE TABLE SCALE: 1" = 20' - 0"
SCALE.. � — 2O -O SHEET TITLE:
SITE AREA TOTAL: 20,000 sf
STRUCTURES EXISTING PERCENTAGE PROPOSED PERGENTAGE SITE
HOUSE: 2,642 sf 13.2% 2,135 5f 15.6%
AGG STRUG: q8 Sf 0.5% 58 5f 0.5%, PLAN
PORCHES: 562 5f 2.8016 618 5f 3.10/0
POOL: 561 5f 2.8% 561 sf 2.a
TOTAL: 3,8-11 of 11.4% 3,180 5f 11.1%
SHEET NO:
AMENDED PERMITS
r-- -------------------------------------------------------------
I
REMOVE EXISTING HOT TUB AND DECKING.
I
PROVIDE NEW TREATED WOOD FRAMING,
ADDED TO EXISTING, TO CONFIGURATION SHOWN.
4'-Sy2" i PROVIDE NEW 1x4" IPE DECKING AND TREADS,
AND PV0 RISERS AND FRAMING GAPS
1 I
I I
"40
b'-
bye° by2" � bye°
I 1I/v
121-011
- , 00 -
.00
I
------ ' - ------- �,....� Na DEG
tj
- -J
EXISTING
TERRACE -
��,' �, m LINE OF EXISTING DECK AND HOT TUB Lu UJ Y
RELOCATE EXISTING �� , .0� +
�- ------- ----------- lOy2"[ STRAP 0 O
PROPANE GULATOR � - -
FOR BARB QUE r ,' N I —_--�`` - -,
- ------ ---------- O
3.0
PROVIDE IMPSON HDUZ I ,' , i I - ` -- �� -- 1
STRAP LuWHOLD-DOYC
4"x4'xY4" STL. COL. 1 _ I 1 =N Z
DHG2046 DH 5046 DHG2046 I �-DHG3 66+ I I GP1180 I DHG3 6+ �`
_ z U
sk
— A Aft
�
tt x I \ C } XIi ------------------ I �
-J i I ✓O1� KYLIGH i O+` R�' HADA EA>.,.RtM0 I KYLIGH — > r- I Quj
EXIT fNG FRAMCN�'BELOW ' ABOVE 11 I I =
<<I>1f111 \f 11�1 1 \/ _ 1�?R0. IIDE r=K FLOOR I y�li jl�
K I TGHEN i \ \\i FRA i IN6,$'FINISH t, \\ I / I < ` r�ifne'
2) NEW FIXED SKYLIGHTS I
CABINETRY QI :p � L___1_� I p > f I I�IL�_,-J dj (ABOVE: LUX #MOb
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Samuels and Steelman Architects
25235 Main Road, Cutchogue, NY 11935
July 16, 2018 u
Southold Town Board of Trustees 1
Town of Southold JUL , ���$
PO Box 1179
Southold, NY 11971-0959
Southold Town
ar
RE: BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM#1000-71-02-04
Administrative Permit#9008A
Dear Board of Trustees:
Regarding,the request for an AMENDMENT to the ADMINISTRATIVE WETLANDS PERMIT for
the above referenced project, please note that we propose to remove and not replace the
existing accessory shed on the property.
Please place us on the agenda of the next Trustees meeting/public hearing, and call us with any
questions or concerns.
Sincerely,
Samuels and Steelman Architects
Thomas C. Samuels,Architect
enc.
r
`v
Michael J.Domino,President ��oF so�ryo Town Hall Annex
John M.Bredemeyer III,Vice-President �� lQ 54375 Route 25
P.O. Box 1179
Glenn Goldsmith Southold,New York 11971
A.Nicholas Krupski G • Q Tele hone (631) 76R
Greg Williams �OIyC � � MO
JUN 1 5 2018
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD DUELDING DEPT.
To: Southold Town Building Department TOWN OF SOUTHOLD
Re: Verification of Building Department Permit Requirements
SCTM#:
Property Owner Name: J�me,3 a " IeeA �1ac.UeZ
Date Sent to Bldg. Dept.: 5
The Office of the Board of Trustees is forwarding the above referenced application for
verification of the Building Department's permitting requirements stated below:
YES NO
ill the proposed project require a Building Permit?
v7`�w
the proposed project require a variance determination from
/he Zoning Board of Appeals?
Will any part of this application be considered as Demolition as
described under Town Code?
II ,
COMMENTS: As cV14S� dakJ
-7111 lift
ignature of Reviewer Date
S A M U E L S &
S T E E L M A N
May 7, 2018
Southold Town Board of Trustees
Town of Southold
PO Box 1179
Southold, NY 11971-0959
RE: SLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM#1000-71-02-04
Administrative Permit#9008A
Dear Board of Trustees:
We are requesting an AMENDMENT to the ADMINISTRATIVE WETLANDS PERMIT for the
above referenced project, for the renovation and addition of the existing residence. We propose
to replace the existing deck of 467 sf with a new deck of 662 sf. The portable hot tub will be
moved.
Please place us on the agenda (June 20, 2018) and call us with any questions or concerns.
Sincerely,
Samuels and Steelman Architects
Ff P-7
� .l
MAY 8 2018
Thomas C. Samuels,Architect 4 ?
enc.
ARCHITECTS
25235 MAIN ROAD
CUTCHOCUE,NEW YORK 11935
(631)734-6405
FAX(631)734-6407
_ j r
S A M U E L S &
S T E E L M A N
April 30, 2018
Southold Town Board of Trustees
Town of Southold
PO Box 1179
Southold, NY 11971-0959
RE: BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM# 1000-71-02-04
Dear Board of Trustees:
We are requesting an AMENDMENT to the ADMINISTRATIVE WETLANDS PERMIT (#9008A)
for the above reference project, for the renovation and addition of the existing residence. The
deck facing the water has been slightly altered and the portable hot tub moved.
A check in the amount of $50 for this amendment is included along with (3) revised site plans.
Please place us on the agenda (June 20, 2018) and call us with any questions or concerns.
Sincerely,
Samuels and Steelman Architects
Thomas C. Samuels,Architect
enc.
MAY , 2018 J
I
ARCHITECTS
25235 MAIN ROAD
CUTCHOGUE,NEW YORK 11935
(631)734-6405
FAX(631)734-6407
Michael J. Domino, P, ,fin O�QSVFFD('�-C j Town Hall Annex
John M. Bredemeyer III,Vice=rresident 54375 Route 25
Glenn Goldsmith o P.O.Box 1179
C!1 Z
A.Nicholas Krupski JS Southold,NY 11971
Greg Williams Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: 7 Completed in field by: jjdL
C
Samuels & Steelman Architects on behalf of JAMES & KATHLEEN BLACKLEY request an
Administrative Amendment to Administrative Permit#9008A to remove existing 467sq:ft. waterside
deck and construct new 562sq.ft. deck; and to relocate the hot tub to be installed seaward of the
shed, approximately 89.5' from existing bulkhead. Located: 415 Harbor Lights Drive, Southold.
SCTM# 1000-71-2-4
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required
1. Residence: 100 feet
2. Driveway: 50 feet
3. Sanitary Leaching Pool (cesspool): 100 feet
4. Septic Tank: 75 feet
5. Swimming Pool and related structures: 50 feet
6. Landscaping or gardening: 50 feet
7. Placement of C&D material: 100 feet
TOP OF BLUFF:
1. Residence: 100 feet
2. Driveway: 100 feet
3. Sanitary leaching pool (cesspool) 100 feet:
4. Swimming pool and related structures: 100 feet
Public Notice f 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 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:
Xi - I , --/I'M '1�
I have read & acknowledged the foregoing Trustees comments:
Agent/Owner:
Present were: �/Bredemeyer Domino Goldsmith /N. Krupski
G. Williams Other
Michael J. Domino, Presid �c,�FFO(Ire! Town Hall Annex
John M. Bredemeyer III,Vice-President �� �� 54375 Route 25
Glenn Goldsmith y P.O.Box 1179
A.Nicholas Krupski Southold,NY 11971
Greg Williams ® �� Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: /�//� Completed in field by:
Samuels & Steelman Architects on behalf of JAMES & KATHLEEN BLACKLEY request an
Administrative Amendment to Administrative Permit#9008A to remove existing 467sq.ft. waterside
deck and construct new 562sq.ft. deck; and to relocate the hot tub to be installed seaward of the
shed, approximately 89.5' from-existing bulkhead. Located: 415 Harbor Lights Drive, Southold.
SCTM# 1000-71-2-4
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required
1. Residence: 100 feet
2. Driveway: 50 feet
3. Sanitary Leaching Pool (cesspool): 100 feet
4. Septic Tank: 75 feet
5. Swimming Pool and related structures: 50 feet
6. Landscaping or gardening: 50 feet
7. Placement of C&D material: 100 feet
TOP OF BLUFF: `
1. Residence: 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:
r
I have read & acknowledged the foregoing Trustees comments:
Agent/Owner:
Present were: J. Bredeme er M. Domino G. Goldsmith V_/
N. Kru ski
Y �/ P
d G. Williams Other
1
, r
_``�QF S®(/�y Town Hall Annex
Michael J. Domino, President �oVv Ol0
John M.Bredemeyer III,Vice-President 54375 Route 25
] i Jt P.O.Box 1179
Charles J.Sanders Southold,New York 11971
Glenn Goldsmith ® �Q Telephone(631) 765-1892
A. Nicholas Krupski oli�COU Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES
72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN
APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO
SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE
PERMIT.
INSPECTION SCHEDULE
Pre-construction, hay bale line/silt boom/silt curtain
1St day of construction
Y2 constructed
Project complete, compliance inspection
Michael J. Domino,President h0� Ol0 Town Hall Annex
John M.Bredemeyer III,Vice-President 54375 Route 25
P.O.Box 1179
Charles J.Sanders &* Southold,New York 11971
Glenn Goldsmith ell- � Telephone(631) 765-1892
A.Nicholas Krupski ��C0UNTI Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 9008A
Date of Receipt of Application: March 28, 2017
Applicant: James & Kathleen Blackley
SCTM#: 1000-71-2-4
Project Location: 415 Harbor Lights Drive, Southold
Date of Resolution/Issuance: May 17, 2017
Date of Expiration: May 17, 2019
Reviewed by: Board of Trustees
Project Description: For proposed additions to the existing two-story dwelling
consisting of constructing a new 116sq.ft. front porch; a 1,059sq.ft. addition to
existing second floor; an 84sq.ft. addition to the existing first floor; and to add a
76sq.ft. addition to the existing 469sq.ft. deck attached to the seaward side of the
dwelling.
Findings: The project meets,all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Samuels & Steelman, dated February 1, 2017, and
stamped approved on May 17, 2017.
Special Conditions: None.
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
This is not a determination from any other agency.
Michael J. Domino,
President Board of Trustees
Michael J. Domino,Presi o�0 COG �.' Town Hall Annex
John M. Bredemeyer III,Vice-President �� 'lj, 54375 Route 25
Charles J. Sanders P.O.Box 1179
Glenn Goldsmith Southold,NY 11971
A.Nicholas Krupski Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Date/Time: 'KckL,4 Completed in field by: Cud CI G1__ c-04-kyj
Samuels & Steelman Architects on behalf of JAMES A KATHLEEN BLACKLEY request an
Administrative Permit for proposed additions to the existing two-story dwelling consisting of
constructing a new 116sq.ft. front porch; a 1,059sq.ft. addition to existing second floor; an 84sq.ft.
addition to the existing first floor; and to add a 76sq.ft. addition to the existing 469sq.ft. deck attached
to the seaward side of the dwelling. Located: 415 Harbor Lights Drive, Southold. SCTM# 1000-71-2-
4
- - i
CH. 275-3 - SETBACKS
WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required
1. Residence: 100 feet
2. Driveway: 50 feet
3. Sanitary Leaching Pool (cesspool): 100 feet
4. Septic Tank: 75 feet
5. Swimming Pool and related structures: 50 feet
6. Landscaping or gardening: 50 feet
7. Placement of C&D material: 100 feet
TOP OF BLUFF:
1. Residence: 100 feet
2. Driveway: 100 feet
3. Sanitary leaching pool (cesspool) 100 feet:
4. Swimming pool and related structures: 100 feet
Public Notice of Hearing Card Posted: Y / N
Ch. 275 \- ofCh. 111 SEQRA Type: 1 II Unlisted Action
Type of Application: Pre-Submission Administrative Amendment Wetland
Coastal Erosion Emergency Violation Non-Jurisdiction
Survey :5 5 years: Yo Wetland Line by: C.E.H.A. Line
Additional information/suggested modifications/conditions/need for outside
review/consultant/application completeness/comments/standards:
&LcAu A2� s01 L v 0 d a-S e/\
Present were: �/J. Bredemeyer Domino Goldsmith 1 N Krupski
ZX—C. Sanders Other
Page 1 of 2
Michael J. Domino, resinU+rFQ(�-
P p CCG Town Hall Annex
John M. Bredemeyer III,Vice-President ��` yA 54375 Route 25
Charles J. Sanders P.O.Box 1179
Cn
Glenn Goldsmith Southold,NY 11971
A.Nicholas Krupski 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 JAMES & KATHLEEN BLACKLEY request an
Administrative Permit for proposed additions to the existing two-story dwelling consisting of
constructing a new 116sq.ft. front porch; a 1,059sq.ft. addition to existing second floor; an 84sq.ft.
addition to the existing first floor; and to add a 76sq.ft. addition to the existing 469sq.ft. deck attached
to the seaward side of the dwelling. Located: 415 Harbor Lights Drive, Southold. SCTM# 1000-71-2-
4
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
SITE, D""ATA
" ? ? PEAR 2 8 2017 1'
SCTM # 1000-71-02-04 „- y
Snit51d t,wloy
FREDERICK AND HAROLD REESE PROPERTY: 4.15 HARBOR LIGHTS DRIVE
PARK AND PLA4YGROUNDADDRESS SOUTHOLD, NY 11971
EXISTING FLO>4T1 iNG WOOD DOCK
(GREEK OR CANAL) OWNER: JAMES BLACKLEY
EXISTING METAL RAMP KATHLEEN BLACKLEY
r
SITE: 20,000 SQ. FT. = 0.459 ACRES
EXISTING FIXED WOOD DOCK
EXISTING 6' WIDE WOOD ZONING: R-40
WALK AT GRADE EXISTING BULKHEAD uj
SURVEYOR: Nathan Taft Corwin III UJ
i S 64°05'10" E , 1586 Main Road A AL
5.1 2.3 5.1 %,';' �;' ' 100.00' S 1 Jameaport, New York 11947
LICENSE # 50467
1 ' DATED OCTOBER 4, 2011
i 6 iy .
' EX I STING FLAGPOLE uj
;I _ --- o
z O N TEMPORARY STORM NATER RUNOFF
N cf _ CONTROL MEA4SURE: PROPOSED HA,r BALES
7� W 1 6 1$ SILT FENCE DURING CONSTRUCTION SEE NOTES:
a
O U) W DETAIL 1-5P2 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM
\� t- Z EXISTING ELEVATIONS ARE SHOWN THUS: 6-0 UJI
\ -� I— TEMPORA4RY STORM WA4TER RUNOFF EXISTING CONTOUR LINES ARE SHOWN THUS: s
LQ
iSJ X / N N F.FL. - FIRST FLOOR
�_ �' 1 — G.FI_. - GARAGE FLOOR
iu —� ' - O CONTROL MEASURE: PROPOSED" H>4Y BALES
i"
i EXISTING &UNITE POOL W SILT FENCE DURING CONSTRUCTION
>=
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\� wAd*T& AL Lu
I EXISTING UNDERGROUND LEACHING �tl EXISTING WOOD DECK1 0% IL 9 M AL MIR&,
I POOLS TIED TO EX I STING GUTTERS AND 7
DOWNSPOUTS AT EXISTING RESIDENCE EXISTING HOT TUB LOG IM I A
NEW ENTRY DECK. SEE FIRST FLOOR ' ®I
PLAN FOR LAYOUT 0
i EXISTING FRAME SHED
' 10.6 � EXISTING UNDERGROUND LE,4GHING POOLS ;'';ii�%%%! � ' ;"!%'% � ' ;'/ h�0��r. �
Q TIED TO EXISTING GUTTERS AND
- DOWNSPOUTS AT EXISTING RESIDENCE
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f _ :< ( _ TIED TO EXISTING GUTTERS AND
DOWNSPOUTS AT EXISTING RESIDENCE .� � ® � z,
f 3 SO 1 L STOCKPILE AREA p® � � <
EXISTING 00\/ERED ENTRY TO BE RECONSTRUCTED M. o
CONSTRUCTION ENTRANCE STA61NG
EXISTING DRIV AY REMOVE EXISTING PA4VERS. PRO\/IDE NEW ' 0 °
AREA A4ND PROPOSED CONCRETE � � RANDOM BLUESTONE PA \/ED TERRACE,E, TO A4L16N BY MARK McDONALD � � W a Z
W,45HOUT AREA 0 WITH STAIRSTEST
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APPROVA
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SURVEY OF
LOT 46
MAP OF
HARBOR LIGHTS ESTATES
SECTION TWO
FILE No 4681 FILED JULY 26, 1966 „
SMIATf
of
BAYVIEW6 " Rte°
S 'F.o
TOWN OF SOUTHOLO "td G� - _ __ -� 4 OS'/p„ 9R,f(c�Efa�A ✓Qal
SUFFOLK COUNTY, NEW YOR - 8�84�A �f° °,p cq'0'° REQ
S.C. TAX No. 1000-71-02-04
SCALE 1"=20'
AUGUST 11, 1998
SFPTEMBER 3, 1998 ADDED PLOT PIAN „
OCTOBER 31, 1998 REVISED PLOT PLAN \ '°,, ;:.,
NOV DEC 8318998 REVIISEDPPIROPY HOUSEATION �, � 10p 00
MAY 17, 1999 REVISED PROP SLPHC SYS y 7 `�• /
JAN 19, 2000 REVISED PROP (,RAOLS o >P -
FEB 17, 2000 ADDED ROW OF HAY BALES & BUFFER
MAY 8, 2000 FOUNDAHON LOCATION
DSURVE
JUNE 23, 2012000PUAILL SURVLYY �" t&TC�
NOVEMBER 17, 2010 ADDED PROPOSED POOL & PATIO ' +•09 / / O
JANUARY 5, 2011 REVISED SITE PLAN
JANUARY 13, 2011 REVISED PROPOSED POOL 4 ,4•F ,{O.7r / / O'
JUNF 79, 2011 REVISED PROPOSED POOL
AREA = 20,000 sq. ft. 1P ,
0.459 cc.
CERTIFIED TO ° wa �Po 'r/ W
JAMES BLACKLEY
KATHY BLACKLEY 0
•7� ���''�� PSP°tea � o
AUG -3 2011
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_ _PROPOSED LOT COVERAGE
EXI.S77NG 1,07' COVERAGE DESCRIPTION AREA X LOT COVERAGE
sLAND
DESCRIPTION AREA #LOT COVERAGE HOUSE 7675 q ft 131% lA2 NYS La Nn 50467
HOUSE 2,625 sq ft 131% SHED 96 sq ft 05Y. iEgY g„>NNo a„�N
SPA ON CONE PAD 57 sq It o3x mEr¢NmRvsun Nathan Taft Corwin III
SHED 96 eq ft 059 _ __ ___ _ _ sE°1WAT0N F
DECKS & STEPS a12 if 2IX m+N,s aRYn wv xm wARRa Land Surveyor
01 C slnlrcroA s akm E I.an
SPA ON CONC. PAD 57 eq ft 03% sy - .o e°is:°vumwNO,* C0N5i�"ED — — — —
DECKS 575 sq R, 2 9# 1DINING EXTENSION 64 vq H 03% CEWiPAlON9PNOM 1mgCR[ON S,VlI NNN suaesmr T.sl°nkY a inm•en,>r 1 s
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TOTAL 3,654 Nq (1 19 3x nmDN[ErtlinuTpNs AAE um 1-0+AR'.E PHONE(631)721-2090 Fox(631)727-1777
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`; �" "`"""� • �_....� 15 Harbor Lights Drive,Southold
CTM#: 1000-71-24
/9/17
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BLACKLEY RESIDENCE, 415 HARBOR LIGHTS DRIVE
10/30/13, 11 .00 .am, View South
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BLACKLEY RESIDENCE, 415 HARBOR LIGHTS DRIVE
10/30/13, 11 .00 am, View North
BLACKLEY RESIDENCE, 415 HARBOR LIGHTS DRIVE
10/30/13, 11 :00 am, View East
BLACKLEY RESIDENCE, 415 HARBOR LIGHTS DRIVE
10/30/13, 11 :00 am, View West
trj_ L
f s® Town Hall Annex
John M.Bredemeyer III,President �°®
�® ,, �®
Michael J.Domino,Vice-President 54375 Main Road
:': P.O.Box 1179
James F. King,Trustee 0 Southold,New York 11971-0959
Dave Bergen,Trustee
Telephone(631) 765-1892
Charles J. Sanders,Trustee `a
®�� U Fax(631) 765-6641
9
ROAD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 8407A
Date of Receipt of Application. March 25, 2014
Applicant: James & Kathleen Blackley
SCTM#: 71-2-4
Project Location: 413 Harbor Lights Drive, Southold
Date of ResolutionlIssuance: April 23, 2014
Date of Expiration: April 23, 2016
Reviewed by: Trustee Michael J. Domino
Project Description: To construct a new 52sq.ft. water side deck; and construct
an 84sq.ft. addition for entry foyer onto landward side of existing (totaling 2,726
sq.ft. first floor footprint) dwelling with attached garage.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Samuels & Steelman Architects, last dated March 20, 2014,
and stamped approved on April 23, 2014.
Special Conditions: None
Inspections: Final Inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a
Wetland Permit will be required.
r
This is not a determination from any other agency.
John M. Bredemeyer III, President
Board of Trustees
SURVEY OF
LOT 4.6 g \ ted
MAP of 4�
HARBOR SECTION LIGHTS `�
STATES '�q� \ S � . F�\
FILE No. 4681 FILED JULY 26. 1966 s r `�A `
SITUATED AT
BAYVIEW C5 9
TOWN OF SOUTHOLD -
SUFFOLK COUNTY, NEW YORK o _
S.C. TAX No. 1000-71-02-04
SCALE 1"=40'
AUGUST 11, 1998
SEPTEMBER 3, 1998 ADDED PLOT PLAN 4 r tom. 4 7
OCTOBER 31, 1998 REVISED PLOT PLAN, 1 I !
NOV.19, 1998 REVISED SEPTIC SYS. LOCAT16N
DEC. 8, 1998 REVISED PROP. HOUSE
MAY 17. 1999 REVISED PROP. SEPTIC SYS.
AREA = 20,000.00 sq. ft.-0,459
� /y Thy ��yyy,��90 �g`M
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DATE Oka,
APPRO H 1
Pmt of o�
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Apprevodl in accordance witty Boaro of Review LP%Ps
48fierI1'+i111 l o}7 daled 3 f 4? �L
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TEST HOLE DATA =�
(TEST HOLE DUG SY A40DONALD lEMCE ON JULY 28, 1998)
aw amom saw LOAM G
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BY HSALTH DEPARTMENT
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Z pOSTIHG ELEVATIONS ARE SHOWN THUS:AL'
EXISTING CONTOUR LINES ARE SHOSYN THUS: - - - -5- --
o4t O4 r g _ TOP OF BULXHFAD
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2.THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROW FIELD
OBSERVATIONS AMD/OR DATA DETAINED,FROM OTHERS.
3. FLOOD ZONE INFORMATION TAI(EN FROM: FLOOD INSURANCE RATE MAP COMMUNITY-PANEL Na. 3610300167 G
ZONE AE(EL 9): BASE FTDOO ELEVATIOPLS OETER}mm-
ZQ7aE X. AREAS OF S�-YFl6E FLOC•AREAS OF 100-VEAR FLOOD*qH AVERAGE
Donvis OF tFSi TWW 1 FOOT OF YATH ORA*&-4E AREAS LESS THAN
I SQUARE ArAE.AND AREAS PROIECTED Ur LEVEES FROM EDO-YEAR FLOODOR SIIBSTANDMJX IMPROVED
Cff11
COASTAL FL00D WSURANGE NOT AVMJ1�-E FOR NM CDI6nwanok
(WCOSFlEQ„-76-90) STRUCI,=ON OR AFIER NOVELLBER 16, 7990.IN D6KiG PM COASTAL AREAS-
4, IF CLAY OR BOG IN THE LEAC-40 POOL AREA is FOUND. IT HOST BE i
EXCAVATED AND REPLACED WITH CLEAN SAND.
PROPOSED EXPANSION POOL
• �+�4� {�/!a PROPOSED LEACw=POOL
PROPOSED 5EFnC TANK
6Gy7� s. 250 $au.Ydv. WILL BE NEEDED.
O 6_ S.C.D.H.S. REFERENCE No. RIO-98-145
To N.TEEPAT TADDITION
THS SURVEY IS SOAR
ION OF
$COCK 7209 OF THE NEW YOM STATE
�!i E01SCA110N LAW.
NORTH' CWPAXY COPIES OF THIS SURVEY Wf NOT '
THE LMM SURVEYOR'S NCED SEAL OR
El£RAL3CE STPCICLE Tp 7 OOPtt• 9E CONSIDERED
CERTSFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PEFmm FOR WPM TLE SURVEY
IS pWpARM AND ON m BEHALF TO THE
TITLEGowgmeff&AGENCY AND
tFtX.NdSTHSJIWN LISTED HEREON.AND
TO THE ASSIGPEFS OF THE tDow DI50-
TUMN. CERf7FPGLTtONS ARE NOF TRAnSFERABLE
THE EXISTENCE OF RtGIET OF WAYS
ANO/OR EASEMENTS OF RECORD. IF
ANY.NOT SHOWN ARE NOT GUARANTEED.
IN IVCCE WIN THE MOSAUM
STNWADS FO St>fIVEYS AS ESFABISHM
BY
E 91d SrAATE I FaPHWE (516)727-2090
eph A. Ingegno
�QN�r� y�� and Surveyor
o O
- Subdhiwons - Site Plana - Construction LCYOLI
Z'
727-2090 FDX (516)722-5093
A70 A7AyggfAl6 Atm49se8SguoroP.o. Box 1931
York 11931 RiwrlPaad. Navy Yank 11901
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OFFICE LOCATION: ®��®f S® MAILING ADDRESS:
Town Hall Annex ® P.O. Box 1179
54375 State Route 25 Southold, NY 11971
(Cor.Main Rd. &Youngs Ave.)
Southold, NY 11971 Telephone: 631765-1938
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: May 16, 2017
Re: LWRP Coastal Consistency Review for JAMES & KATHLEEN BLACKLEY
SCTM# 1000-71-2-4
Samuels & Steelman Architects on behalf of JAMES & KATHLEEN BLACKLEY request an
Administrative Permit for proposed additions to the existing two-story dwelling consisting of
constructing a new 116sq.ft. front porch; a 1,059sq.ft. addition to existing second floor; an 84sq.ft.
addition to the existing first floor; and to add a 76sq.ft. addition to the existing 469sq.ft. deck
attached to the seaward side of the dwelling. Located: 415 Harbor Lights Drive, Southold. SCTM#
1000-71-2-4
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 proposed action is CONSISTENT with the LWRP policies and therefore 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.
Cantrell, Elizabeth
From: Tom Samuels <tom@samuelsandsteelman.com>
Sent: Friday, May 05, 2017 10:55 AM
To: Cantrell, Elizabeth
Subject: Re: BLACKLEY dimensions
Elizabeth,
The area of the existing waterside deck,to which we propose to add (and were formerly given a permit) is 469 sf.
Best,
Tom
On 5/4/2017 2:15 PM,Cantrell, Elizabeth wrote:
>Tom,
> Please give me the sq.ft.of the existing waterside deck that the addition is being added on to.
> In your application description you are applying for a new back porch which I do not see on the plans. Did you mean
"addition to waterside deck"? Please advise.
> Elizabeth
>-----Original Message-----
> From:Tom Samuels [mailto:Tom@samuelsandsteelman.comj
>Sent:Thursday, May 04,201711:28 AM
>To: Cantrell, Elizabeth
>Subject: BLACKLEY dimensions
> Elizabeth,
> For the Blackley Administrative permit, please note the following areas:
> Addition to existing waterside deck: 76 sf
> Addition to existing first floor: 84 sf
> New front porch: 116 sf
> Addition to existing second floor: 1059 sf
> Please let me know if there is additional information needed.
>Thank you,
>Tom Samuels
1
Cantrell, Elizabeth
From: Tom Samuels <tom@samuelsandsteelman.com>
Sent: Friday, May 05, 2017 10:47 AM
To: Cantrell, Elizabeth
Subject: Re: BLACKLEY dimensions
Elizabeth,
Yes,that is an addition to waterside deck.
Tom
On 5/4/2017 2:15 PM, Cantrell, Elizabeth wrote:
>Tom,
> Please give me the sq.ft.of the existing waterside deck that the addition is being added on to.
> In your application description you are applying for a new back porch which I do not see on the plans. Did you mean
"addition to waterside deck"? Please advise.
> Elizabeth
>-----Original Message-----
• From:Tom Samuels [mailto:Tom@samuelsandsteelman.com]
>Sent:Thursday, May 04,2017 11:28 AM
>To: Cantrell, Elizabeth
>Subject: BLACKLEY dimensions
> Elizabeth,
> For the Blackley Administrative permit, please note the following areas:
> Addition to existing waterside deck: 76 sf
> Addition to existing first floor: 84 sf
> New front porch: 116 sf
> Addition to existing second floor: 1059 sf
> Please let me know if there is additional information needed.
>Thank you,
>Tom Samuels
1
Michael J Domino. Voce-Presiders;--v '�Q lQ 54375 Main Ro3d
P O Box 1179
James F ling. Trustee f'tliold. New York 1 197 1-0959
Dave Bergen. Trustee � P�
�O Telephone(631) 765-1892
Cliarles J- Sanders. TrusteeFax(631) 765-6641
leeouffi� \X
- - -
BOA1RD OF FD) [EC[EuW[E TOWN TRUSTEES DQ
TOWN OF SOUTHOLD APR Q 2017
To: Southold-Town Building Department
Re- Verification of Building Department Permit Requirements gUII.DII
TOWN OF 30U'sOUTHO
17iOLD
SCT(VI#: `f
Property Owner[Mame: - 8AC4_1Lq_ I v��5� rt ERl
Date Sent to Bldg_ Dept_:
The Office of the Board of Trustees is forwarding the above referenced application for
verification of the Building Department's permitting requirements stated below:
YES NO
V1YiII the proposed project require a Building Permit?
P _
Will the proposed project require a variance determination from
he Zoning Board of Appeals?
Will any part of this application be considered as Demolition as
described under Town Code?
COMMENTS:
Si t re of evie r Date
John M.Bredemeyer III,President Town Hall Annex
64375 Main Road
Michael J.Domino,Vice-President
P.O.Box 1179
M, 4
g, Southold,New York 11971-0959
James F.KinTrustee
C13
Dave Bergen,Trustee
Telephone(631)765-1892
Charles J.Sanders,Trustee Fax(631)765-6641
COUNT4
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Office Use Only
—Coastal Erosion Permit Applicaflov,
—Wetland Permit Application P" Administrative Permit
—Ainendment/Transfer/Extensioii
Received Application:
EReceived Fee:$
Completed Application liq-,
Incomplete
_V
'I r
—SEQRA( assificafion: r 1�
0
Type'----Type It\/ Unlisted MAR 2 8 2017
Coordination:(date sent)
-r"- 56,11
_LWRP Consistency Assessment Form—
CAC Referral Sent:
Z_Date of Inspection: Sauttiold lown
—Receipt of CAC Report:
Lead Agency Determination:
Technical Review:
_Technical
Hearing Held:
—Resolution:
Name of Applicant James and Kathleen Blackley
Mailing Address 5 Hargale Court,Rockville Centre, NY 11570
Phone Number:(51� 238-8053
Suffolk County Tax Map Number: 1000- 71-02-04
Property Location: 415 Harbor Lights Drive,Southold,NY 11971
UTILITY POLE LIL POLE#4,50'from the intersection of Windjammer and Harbor Lights Drive
(provide LILCO Pole#, distance to cross streets,and location)
AGENT: Tom Samuels, Samuels and Steelman Architects
(If applicable)
Address: 25235 Main Road, Cutchogue NY 11935
Phone: 1 631 734 6405
Board of Trustees Application
GENERAL DATA
Land Area(in square feet): 20,000 sq.ft.
Area Zoning: R-40
Previous use of property: 1 Family Residential
Intended use of property: 1 Family Residential
Covenants and Restrictions on property? Yes X No
If"Yes",please provide a copy.
Will this project require a Building Permit as per Town Code? X Yes No
If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review
and Elevation Plans will be required.
Does this project require a variance from the Zoning Board of Appeals? Yes X No
If"Yes",please provide copy of decision.
Will this project require any demolition as per Town:Code or as determined by the Building Dept.?
Yes X No
Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No
Prior permits/approvals for site improvements:
Agency Date
Suffolk County Department of Health Services R10-98-145 May 25,1999
Southold Trustees Permit (No. 8407A) 4/23/2014
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):
New back porch,Rebuilt front porch,Adition to the second story,New
addition to the first floor
1
PROJECT DESCRIPTION
RENOVATIONS &ADDITIONS TO BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY
SCTM# 1000-71-02-04
Renovations and additions to existing two story frame residence.
Propose to add 84 square foot EntryFoyer to existing 2,642 square foot first floor/footprint,
which includes existing two car attached garage, totaling 2,726 square foot first floor/
footprint.
Propose to add 1,138 square foot Master Suite addition to existing 360 square foot second
floor, totaling 1,498 square feet.
Proposed total size of residence on two floors equals 4,224 square feet.
There is no basement in existing residence, nor any proposed.
Renovations will include re-framing portions of existing roof to enclose new second floor, and
replacement of all existing windows/doors and siding. There will NOT be an increase in the
number of bedrooms, as one existing bedroom will be renovated into a Mud Room, Pantry
and closet area. No work is proposed to existing terraces nor to hardscape. Changes to
landscape will conform with provisions of prior Trustees permit granted-at time of swimming
pool construction.
i
Board of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: Additions to an existing residence
Area of wetlands on lot: 0 square feet
Percent coverage of lot: o
Closest distance between nearest existing structure and upland
edge of wetlands: 56'-9" feet 1
Closest distance between nearest proposed structure and upland
edge of wetlands: 83'-11" feet
Does the project involve excavation or filling?
No X 'Yes
If yes,how much material will be excavated? x cubic yards
How much material will be filled? 0 cubic yards
Depth of which material will be removed or deposited: 4 feet
Proposed slope throughout the area of operations: Level
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
}
61 Z20
Appendix B
Short Environmental Assessment Form
Instructions for Completing
Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses
become part of the application for approval or funding,are subject to public review,and may be subject to further verification.
Complete Part i based on information currently available. If additional research or investigation would be needed to fully
respond to any item,please answer as thoroughly as possible based on current information.
Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attach additional pages as necessary to supplement any item.
Part 1-Project and Sponsor Information
Name of Action or Project: Blackley Residence
Project Location(describe,and attach a location map):
415 Harbor Hights Drive Southold,NY 11971
Brief Description of Proposed Action:
New back porch,Rebuilt front porch,Adition to the second story,New addition to the first floor
f
Name of Applicant or Sponsor: Telephone: 516 238-8053
James and Kathleen Blackley E-Mail:
Address: 5 Hargale Court
Ci /PO: State: Zip Code:
City/PO: 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
maybe 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 trustees- Building Department ElQ
Suffolk County Department of Health Services
3.a.Total acreage of the site of the proposed action? .459 acres
b.Total acreage to be physically disturbed? .0937 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? .459 acres
4. Check all land uses that occur on,adjoining and near the proposed action.
E]Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban)
❑Forest ❑Agriculture C1 Aquatic []Other(specify):
❑Parkland
Page 1 of 4
i ,
5. [s the proposed action, NO YES N/A 3
a.A permitted use under the zoning regulations? ❑ ❑ ❑
I
b.Consistent with the adopted comprehensive plan? ❑ ❑ ❑
6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? ❑ a
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: '
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
0 ❑
b.Are public transportation service(s)available at or near the site of the proposed action? ❑ ❑
i
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ ❑
4.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: I
Meetc NY� code energy ode ❑ X❑
1"
,
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: ❑ a
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: ❑ ❑
I
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES f
Places? o ❑ 1
b.Is the proposed action located in an archeological sensitive area? !
k El
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES 1
wetlands or other waterbodies regulated by a federal,state or local agency? ❑
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? a ❑
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply:
❑Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
❑ Wetland ❑Urban ®Suburban
15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or federal government as threatened or endangered? 0 ❑
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, Ela.Will storm water discharges flow to adjacent properties? NO YES
b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)?
If Yes,briefly describe: 0 NO QX YES
Existing drMells are installed for all roof runoff
Page 2 of 4
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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:
X❑ ❑
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: ❑
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe: a ❑
1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: Tom Samuels Date: 3/3/2017
Signature: jj
I .
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
I. 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?
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 I/{ ❑
affect existing infrastructure for mass transit,biking or walkway? j
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate FA ❑
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing: ❑ l
a.public/private water supplies?
b.public/private wastewater treatment utilities?
S. Will the proposed action impair the character or quality of important historic,archaeological, ❑
architectural or aesthetic resources? 1J
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
i
I
No,or Moderate
small to large
impact impact f
may may r
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Will the proposed action create a hazard to environmental resources or human health?
i
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 1
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.
4
4
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3
f
F1Check this box if you have determined,based on the information and analysis above,and any supporting documentation, j
that the proposed action may result in one or more potentially large or significant adverse impacts and an i
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 environmentavimpaos.
Town of Southold-Board of Trustees C/,/ r 7
Name of Lead Agency ate
Y-- 1t I
President
Print or Type Name f Re onsib a Officer in Lead Agency Title of Responsible Officer
Signature ofRespon . le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
Board of Trustees Application
County of Suffolk
State of New York
Kathleen Blackley BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE
TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK
WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY
BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT
AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES
HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING
UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS
APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR
REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE
PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION.
Signature of Property Owner
7
SWORN TO BEFORE ME THIS / I DAY OF /v ` ,20/
Notary Public
LOREEN M.C(MSN
NOTARY PUBuC.ftr C)f yak
OwdNed In ZMaILCCU
NOV.10,
Board of Trustees Application
County of Suffolk
State of New York
James Blackley 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 MAI-NER 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.
J
Signature of Property OwnerV A
SWORN TO BEFORE ME THIS / DAY OF /� � ,20 17
e ��
rL �� .
Notary Public
L OSEEN WCOHEN
wtARY P 1B C. New York
Board of Trustees Application
AUTHORIZATION
(where the applicant is not the owner)
I, James and Kathleen Blackley residing at. 5 Hargale Court
(print owner of property) (mailing address)
Rockville Centre,NY 11570 do hereby authorize
(Agent)
Tom Samuels to apply for peffnit(s)from the
Southold Board of Town Trustees on my behalf.
X y.
Owner's signature)
i
I
1
1
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part oftown officers and employees.The nurnose of
this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOURNAME: Kathleen Blackley
(Last name,first name,middle initial,unless you are applying iii-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 X
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'I own 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
i,
Describe the relationship between yourself(the applicant/agent/representative)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 ai 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
Submitted th's ay of �' 20�► 1 I
Signature
Print Name Kathleen M-Eldey
Form TS 1
t
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of E tichibits conflicts of interest on the nart of town officers and emnloye_es.The nuroose of
this form is to provide information which car!alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOURNAME: James Blackley i
(Last name,first name,toddle 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 X
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,nlarriage,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); i
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
da /� ��2�/�v 2fi
Submitted tht �tJ y
S ignature
Print Nam ames Blackle
Form TS 1
i
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part!2f town officers and employees The 0uroose of
this farm is to provide information which cavi alert the town of passible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME: TOM SAMUELS
(Last name,first name,middle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building X
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
I
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 I
j
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 this2-� day of 200
Signature _c(/l,{�l oEk{
Print Name TOM Samuels
Form TS 1
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area(which includes all of Southold Town).
3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each answer must be explained in detail, listing both supporting stnd 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# 71 _ 02 _ 04
PROJECT NAME Blackley Residence
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: 0
Nature and extent of action:
New back porch,rebuilt front porch,addition to the second story,new additon to the first floor.
Location of action: 415 Harbor Light Drive,Southold,NY 11935
Site acreage: .459 ac
Present land use: Single Family Residence
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: lames and Kathleen Blackley
(b) Mailing address: 5 Hargale Court, Rockville Centre, NY 11570
(c) Telephone number: Area Code( 5)16 238-8053
(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?
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.
MYes ❑ No ❑ Not Applicable
Renovating an existing building preserves open space around the existing residence and makes efficient use
of the existing structure and property. Also the addition to the property is far less than the 20%lot
coverage allowed by zoning.
Attach additional sheets if necessary
Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See
LWRP Section III—Policies Pages 3 through 6 for evaluation criteria
❑ Yes ❑ No El Not Applicable
I I
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
Yes ❑ No ❑ Not Applicable
The renovations of existing building are 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
L Yes ❑ No ❑ Not Applicable
All rainwater runoff is and will be retained on site with the use of underground drywells.
Attach additional sheets if necessary
Policy S. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section IH
— (Policies Pages 16 through 21 for evaluation criteria
u Yes ❑ No ❑Not Applicable
All rainwater runoff is and will be retained with the use of underground drywells. The sanitary
system for the residence meets current Suffolk County DP tp of Health Services Gtandards fuer
s
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22
through 32 for evaluation criteria.
❑ ❑ Y not applicable
Yes No Not Applicable
i
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.
Yes Q No❑, Not Applicable
The development will not add pollutants into the air. All construction vehicles meet the Federal standards
for air pollution discharge The mechanical systems of the residence meet the fedaraLstaDAards
for air pollutions discharge
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluatiop criteria.
MYes Ell'
No ❑ Not Applicable
The construction and use of the building will make use of the town's disposal and recycling center.
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.
u Yen� No❑ 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 P1 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.
Yes ❑ No ❑ Not Applicable
This project will protect and preserve the living marine resources by
maintaining all rainwater discharge and sanitary flow from the
residence on site by approved SCDHS sanitary system and drywells
for rainwater runoff.
Attach additional sheets if necessary
Policy 12. Protect agricultural lands in the Town of Southold. See-LWRP Section III — Policies; Pages
62 through 65 for evaluation criteria.
❑ Yes ❑ No Not Applicable
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.
Yes ❑ No ❑ Not Applicable
The construction will be using equipment approved by the Federal government
for energy usage. The residence will meet Federal standards for conserving
_energy "energy Star Program" and will use "NY State Enemy Conservation and
C'onstrnrtinn C ode"for renovation of the building
PREPARED BY Tom Samuels TITLE Architect DATE 3/3/17
S A M U E L S &
S T E E L M A N
- March 6, 2017
Southold Town Board of Trustees MAR 2 8 2017
Town of Southold
PO Box 1179 outhold Town
Southold, NY 11971-0959 TrusteesLL
RE: BLACKLEY RESIDENCE
415 Harbor Lights Drive, Southold, NY 11971
SCTM# 1000-71-02-04
Dear Board of Trustees:
We are requesting an ADMINISTRATIVE WETLANDS PERMIT for the above reference project,
for the renovation and addition of the existing residence. All drainage will be directed to
subsurface systems. The new construction will take place entirely within the existing footprint.
For your review we are submitting the following documents:
1. Completed application with project description
2. Short Environmental Assessment Form
3. Authorization Form
4. Agent Authorization Form
5. Agent & Owner Transactional Disclosure Forms
6. LWRP
7. Survey of property in current state
8. Photographs
9 Four (4) SITE PLAN, FLOOR PLANS and ELEVATIONS
10. Application Fee - check for$100
Please place us on the agenda and call us with any questions or concerns.
Sincerely,
Samuels and Steelman Architects
—Ru"61U 11
Thomas C. Samuels,Architect
enc.
ARCHITECTS
25235 MAIN ROAD
CUTCHOGUE,NEW YORK 11935
(631)734-6405
FAX(631)734-6407