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Home My WebLink AboutTR-9040 Glenn Goldsmith,President OF sorry Town Hall Annex 54375 Route 25 Michael J. Domino,Vice-President ,`4 l0 P.O.Box 1179 John M. Bredemeyer III l [ Southold, New York 11971 A. Nicholas Krupski G Telephone(631) 765-1892 Greg Williams '� �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1703C Date: June 3, 2020 THIS CERTIFIES that the construction of a two-story single-family dwellingwith with a 1 612sq ft footprint; install a sanitary system; install a driveway- and construct a 1 050sq.ft. barn/garage; with the condition that the engineer review plan for stormwater be concluded; and to establish and perpetually maintain a 15' wide non-disturbance buffer landward of the 50' proposed road right-of-way; At 4045 Narrow River Road, Orient Suffolk County Tax Map#1000-27-2-2.4 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 24,2017 pursuant to which Trustees Wetland Permit#9040 Dated June 21, 2017,was issued 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 construction of a two-story single-family dwelling with a 1 612sq ft footprint; install a sanijaM system; install a driveway and construct a 1 050sq ft barn/garage; with the condition that the engineer review plan for stormwater be concluded; and to establish and peKpetually maintain a 15' wide non-disturbance buffer landward of the 50' proposed road right-of-way. The certificate is issued to Denise Spatny owner of V the aforesaid property. m Authori Signature Glenn Goldsmith, President Town Hall Annex Michael J.Domino,Vice-President O� y�lO 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J�[ Southold,New York 11971 A. Nicholas Krupski G Telephone (631) 765-1892 Greg Williams �� Fax(631) 765-6641 CpUNT`I,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: 24, r INSPECTED BY:' Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction; haybale line/silt-boom/silt curtain 1St day of construction Y constructed Project complete, compliance inspection COMMENTS: 6A119v CERTIFICATE OF COMPLIANCE: Robert Spatny 15 Bobs Lane Setauket, NY 11733 August 28, 2017 Board of Town Trustees Town Hall Annex 54375 Route 25 Southold, NY 11971 Attn: Ms. Diane Disalvo Re: Deed Covenant Section 27, Block 2, Lot 2.4 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached is a copy of the deed covenant for the above property as requested by the Board of Trustees. Please let me k now if any additional information is needed. Very truly yours, r Robert Spatny RCS:eo Att. D C u v prj AAg➢r- 2 9 2011 Southold Town Board u CC# : C17-35506 COUNTY CLERK'S OFFICE STATE OF NEW YORK COUNTY OF SUFFOLK I, JUDITH A. PASCALE, Clerk of the County of Suffolk and the Court of Record thereof do hereby certify that I have compared the annexed with the original DECLARATION recorded in my office on 08/23/2017 under Liber D00012926 and Page 578 and, that the same is a true copy thereof, and of the whole of such original. In Testimony Whereof, I have hereunto set my hand and affixed the seal of said County and Court this 08/23/2017 SUFFOLK COUNTY CLERK <;Z-e-, L JUDITH A.PASCALE SEAL IIIIIIIIIIIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIIIIIIIII 111111 VIII(IIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DECLARATION Recorded: 08/23/2017 Number of Pages : 5 At: 02 :35:54 PM Receipt Number : 17-0146018 LIBER: D00012926 PAGE : 578 District: Section: Block: Lot: 1000 027 .00 02 . 00 002 . 004 EXAMINED AND CHARGED AS FOLLOWS Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $25 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15 . 00 NO TP-584 $0 . 00 NO Notation $0 .00 NO Cert.Copies $6.25 NO RPT $200 . 00 NO Fees Paid $271 .25 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County P LaserJet,-400 M401 ?CL 6�� ANDRECORDSC07 ' . a t RECEIPT Suffolk County Clerk JUDITH A. PASCALE County Clerk Receipt Number 17-0146018 Payor Name ROBERT C SPATNY ----------------------------------- DESCRIPTION TRANS AMOUNT ----------------------------------- Type of Instrument: DECLARATION Page/Filing $25. 00 Handling $20 .00 COE $5. 00 NYS SRCHG $15. 00 TP-584 $0 . 00 Notaftion $0 . 00 Cert.Copies $6.25 RPT $200 .00 Fees Paid $271 .25 LIBER D00012926 PAGE 578 DATE: 08/23/2017 TIME: 02 :35:54 PM ----------------------------------- RECEIPT TOTAL $271.25 CHECK AMT PAID $271 .25 , TOTAL AMOUNT PAID $271.25 CHECK REFUND $0 .00 ----------------------------------- COMMENTS mail F-iT 21 I RcCOi='DE'i:! JUDITH R. F'ASF*A(_L Number of pages CLERK OF SUFFOLK. COUr IT'•' L D00012926 This document will be public F 5 71131 record. Please remove all Social Security Numbers prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp77 Recording/Filing Stamps 3 FEES Page/Filing Fee _ Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17 (County) Sub Total Spec./Add. EA-5217 (State) TOT.MTG.'TAX Ctls�yyy Dual Town Dual County R.P.T.S.A. c�, OC� CO ��` 4A, Held for Appointment Comm. of Ed. 5. 00 p� Transfer_Tax Affidavit e r` Mansion Tax g'�; '°�+�� ' Z111-S— The property covered by this mortgage is Certified Cop `` or will be improved by a one or two NYS Surcharge 15. 00 - r family dwelling only. Sub Total _ YES or NO Other �. Grand Total ,�°"'� C If NO,see appropriate tax clause on L/ page# of this instrum (to I 4 1 Dist. 3453190 1000 02700 0200 002004 5 Community Preservation Fund Real Propert P T S INllllll01llllllll1l�ll�ll�lll� Consideration Amount $ Tax Service R SpA A Agency 08-,AUG-17 CPF Tax Due $ Verificatior Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land 15 c COS LA 'k TD l 1 j TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Compan-Y Information 310 Center Drive, Riverhead, NY 11901 Co Name ('0 nn&I c)tJ W6AL%LA;,i0 f-(1Q,a- wc.Co www.suffolkcountyny.gov/clerk Title# C4V-k 9 Ll� o , 8 Suffolk County Recording & Endorsement Page This page forms part of the attached 0 C L B'A42-A-0 0^J -�O 0 W-'- 0 made by: (SPECIFY TYPE OF INSTRUMENT) e✓,\1 YS C �'a �`� The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of S L)y•icA o L"o In the VILLAGE of HAMLET of BOXES 6 THRU 8 MUST.BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104..10/08kk (over) DECLARATION OF COVENANTS THIS DECLARATION made this t E 4 day of i(,)�(_y , 20 0', , by residing at i mho kJ S L.A-d it hereinafter referred to as "DECLARANT (S) " : W I T N E S S E T H WHEREAS, DECLARANT (S) is/are the owner (s) of certain real property located on dZ'd tf-"d `�. Town of Southold, County of Suffolk, State of New York, described in the Suffolk County Tax Map as District 1000, Section •p"1 Block `7,• Lot 'Z_oL( which is more particularly bounded and described as set forth in Schedule "A" annexed hereto, hereinafter referred to as the Property; WHEREAS, the Property is situated on lands within the jurisdiction of the Board of Trustees of the Town of Southold (hereinafter the "Trustees") pursuant to Chapter 275 of the Town Code of the Town of Southold or its successor, and various activities conducted upon the property may thus be subject to the regulation and approval of the Trustees prior to being conducted; WHEREAS, the DECLARANT (S) therefore made application to the Trustees for a permit pursuant to the Wetlands Law of the Town of Southold to undertake certain regulated activities; and WHEREAS, as a• condition of the granting of a Wetlands Permit to undertake such regulated activities, the Trustees required that a 9 r uV i n'�Y1, PQolo 01";(Ur- 'Nnon-turf buffer" adjacent to and landward of a k L 5o Ctt,o e0t-4.0 qz�>h,to V?(L q v) t_ L'i 'k"/ NOW, THEREFORE, the DECLARANTS) do/does hereby covenant and agree as follows : 1) Upon the substantial completion of the aforementioned permitted activities there shall be established and perpetually maintained it t ,0ii,, "i `cvki, "non-turf buffer" as defined by Chapter 275 of the Town Code, to wit: "A designated area where turf grass, pesticides and fertilizers are not permitted. " and as depicted on the V 0-V '5,� � d''�' 0 uO 11eek"o-VIi-41 i�� E�� i� c-1 see Exhibit "A„ attached; and 2) These covenants shall run with the land and shall be binding on the DECLARANT (S) , his/her/their heirs, assigns, purchasers, or successors in interest and may only be modified after a public hearing and upon resolution of the Trustees . IN WITNESS WHEREOF, the owner (s) has/have duly executed this instrument this day of ��"�`� d 20 (,-1 . OWNkR'N SIGNATU E OWNER'S SIGNATURE STATE OF NEW YORK ) COUNTY OF S5/10 ) s s: On the (`(:� day of ,foo in the year 201'�-t- , before me the undersigned, a Notary Public in and for said State, personally appeared rUi�;C" , personally known to me or proved to me on the basis of y satisfactorevid nce to be the individual (s) whose name (s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity, and that by his/her/the' -s-ign�at,ure (s) on the instrument, the individual or the persons on beha 'of whic , e ind�vidua -( ) ted, executed the instrument. � r N - ry Public PHIL POLLACK Notary Public,State Of New York No.01 P06071221 Qualified in Nassau ou ty Commission Expires :3 2 party of the second part, WITNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consideration paid by-the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second part forever, ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 4 on a• certain map entitled, "Sub- divisi-on Map of Settlers at Oyster Ponds" filed in the Suffolk County Clerk's Office on May 4, ,1984 as Map No. 7729 . BEING AND INTENDED TO BE the same premises as were conveyed to )ISTRICT. the party of the first part by deed dated October 31 , .19.86 and 1000 recorded in the Suffolk County Clerk' s Office on November 17, 1986 in Liber 10170 cp 186_ 3EMON: )27.00 3IOCK: )2.00 )02.004 _TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second part forever. AND the party of the first partcovenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever, except as aforesaid. r rueq•v SURVEY OF: PROPERTY LOCATED AT ORIENT TEST HOLE DATA PROPOSED RESIDENCE LOT No. 4 AS SHOWN ON BygNOT TO SCwE1 cF DETAIL (N T S I ROY K REISSIG PE 1 = 40 MAP OF SETTLERS AT OYSTERPONDS X OCYOBER 29.2010°900An a FILED: MAY 4. 1984. FILE No. 7729 'GG-9.I TOPSOIL PT TOWN OF SOUTHOLD THE NYS REGULATED FRESHWATER r.3` WETLAND BOUNDARY 01-40 BROWN CLAYEY SRT SM Q`m• °m"�mm h� SUFFOLK COUNTY, NEW YORK AS DELINEATED BY 0 LEWIS ON HATER 'ss Ae a� m a G LP S C.T M. n 1000-27-2-2 4 S 73°5630"E vI7iI7 POND 4 B"90' WET BROWN SAND SP " mg Q AREA = 11.06 ACRES 12.06' 20 EL RAD = 1800 00' LP Lp SCALE. 1'=100' a LEN = 197.92' WETLAND mg's EP ELEVATIONS REFER TO 1968 NAVO NAIL O {, LINE y a ELEVATIONS SHOWN THUS �} FN° \ �$ FOR PC 50 RICHT SI LE rss�s`,s Bm t tF \ FUTURE fIGHWA Y v .t� � ++r aOP \ \ 7,•'?83 DEO C JION+TION 1 LOT BRryoh rr `3e °r \? RAD = 550 DO' VACANT o o• g s \ \ LEN -12855' o- o m An, COMMERCIAL LAND PROPOSED ym •m. m � R4 EgHOAAr� \ -�� S 50.00'0uE "BOAT YARD- / GARAGE 8 / \ T �� \ 9G.0 x 959 S. O 0 x - sLnO EL uLe y ,.9y. a Dp. � � APPROVED B y gy o a m"' g SET ETCH S 08"58'00"W ! NOW. y NATER ROPOSEO / m BgCk ND 25-00' ,�_ " \ LINE ISEE OE AfU gm, EDGE Of / ' �QAAPOF 1 RUSTEES FILL PAO \ .;. TOWN OF SOUTHOLD• "¢x4E Q F1�pF°oyr PR PCs g9 0,. � _� DdJE SUGy 61 ZAl'� 2S�S'YpF 41 m 9 2. f0 i m Sis`Trr. °FrF � + F011GNE0 GRADE OS JO. �y Y HAIL CYR hF [ rnETE `�4 uAG. SEPTIC WI / P p r H WITHIN 150 410 INLET VB PITCH e " / •� o uw ; Ay 6 ; R Exnu HITH eccn wRGxEsr aIPER � T S�1� z 3 a aiN°rPnU�1L''vluuLp/c DUNG xnTCR •Ji,O� / o�� cnnv m , a AENEInN-IA LOT 5PON �'n VACANT GF s%xo nrm cr+AVEL RESIDENCE WITH WELL 8 23 EL i++o .w SEPTIC TYPICAL LEA[NWG PGGL !n F NOTE THE EXISTENCE OF RIGHT OF WAYS TI rJ- WETLANDS AND/OR EASEMENTS OF RECORD How AnrAlrmur Hmr eE L.srAum IF ANY NOT SHOWN ARE NOT GUARANTEED. MST e'EALLeo:mr"wGR / o °m°r°Eiai sEPru:sstEH _,0 POLE y SURVEYED BY: GG rRnnGnm / y9 °dtr+' s GuT PAUL BARYLSKI LAND SURVEYING POLE °" S�Ig14 SJ PATCHOGUE NY 11772 ie 4 x B e e Oln C / PHONE 631-294-6985 PIPING SEPTIC TANK PIPING , LP GRAC NG —i I 1 —1 m °"0 NS FAX 631-627-3186 FF4EL_ y PANES W GE GF •1'120' fa cRrC°'.Ge°'O PAULBARYLSKIaYAHOO COM em 0L 1;�a`^oEHG q pRGPGRGUNG 9 IDasT+° �Nj�POLE� r� DECEMBER 12 2016 can GRADE �N ° TMP I•"IN l MM REI.OF PRGPGSm 5-5-2017 REVISIONS lir z Mx zNnx� PITCH Sm +MIND \ it•'' i u INADRIGWSPO ALTERATON GR mm.m Tws Sllf)YtY IS A VIlD.ARON 4•GU SEPTIC TA 19YM • oO �y 5 I' Y� t,` e� - +re PrtcH ��ff Twos 4PYExMI1GE FAIM�G TILIM AUAVETOS INIFD ma M,N. �fl m 9 G o o Ij l R SJ G A nl o Gu Hw m E10055m sEu sW„x°r e5 rasv>EBm TG GE n vwG TRIS LnPr - 'hs•it' JUL'3 2017 cuRANIEEs IB LTAT0IGTIDAS OIDIGTm xmml swuL Riw Grcr TG pp o° _ § VACANT m r °q EOunALEHT TIE PFILSDN FOR 0M TIE SIWVcI'Li POEPARETI Ata lW 105 BONLF TO m 63>m AHL °•°• TWE TOLE—my. VDNMENTAL AW'LY/JCI LING-QISiRIITIGN ,�I{^,�1.-- - BD 09 SFPTICRTAKK LISIF9IERF•1.Awl TO INE AGAQEES OF TIE lETO1IIG INSTITIRIGN §�� a NISNEST GtU WSIS m LTTG6TG Ns ARE NDT TMN3'EAAOIE TO AmmONAL }2 "OM EXPECT L tO,pT I `yi 1°NnHm xArm GISRM10N9 lm STESE06DIT GNNI L GRGDNG WATER GRD.NATER , • rrPluL Iea°cALLGN sync TAMK 2270 SANITARY SYSTEM DETAIL � Michael J.Domino,President QF Soft Town Hall Annex�0� ol® John M.Bredemeyer III,Vice-President 54375 Route 25 i P.O.Box 1179 Charles J.Sanderscoll Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski �00UNv 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 1 st day of construction % constructed Project complete, compliance inspection TERMS AND CONDITIONS The Permittee Denise Spatny, residing at 4045 Narrow River Road Orient,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to tl:e complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved,but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 11. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. i �o��pE SO!/Tyolo Michael J.Domino,President Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders vs Southold,New York 11971 Glenn Goldsmith �l� �Q Telephone(631) 765-1892 A.Nicholas Krupski "OUNTY, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD _ June 21, 2017 Denise Spatny 15 Bob's Lane Setauket, NY 11733 RE: 4045 NARROW RIVER ROAD, ORIENT SCTM# 1000-27-2-2.4 Dear Mrs. Spatny: The Board of Town Trustees took the following action during its regular meeting'.field;on Wednesday, June 21, 2017 regarding the above matter: WHEREAS, DENISE SPATNY applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated April 24, 2017, and, WHEREAS, said application was referred,to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: limiting the construction to the mapped building envelope; that engineer review for stormwater plan be concluded, and the installation of a 15' wide non-disturbance buffer, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 21, 2017, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, 2 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of DENISE SPATNY to construct a two-story, single-family dwelling with a 1,612sq.ft. footprint; install a sanitary system; install a driveway; and construct a 1,050sq.ft. barn/garage; with the condition that the engineer review plan for stormwater be concluded; and to establish and perpetually maintain a 15' wide non-disturbance buffer landward of the 50' proposed road right-of-way; and as depicted on the survey prepared by Paul Barylski Land Surveying received on July 3, 2017, and stamped approved on July 6, 2017. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $50.00 Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd SV Michael J. Domino,President � �O �p� Town Hall Annex John M.Bredemeyer III,Vice-President ffA:�� Gym 54375 Route 25 Charles J. Sanders ti V ` = y P.O.Box 1179 Glenn Goldsmith >: Southold,NY 11971 A.Nicholas Krupski 'y,� �p� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES "tof TOWN OF SOUTHOLD &2 ,17 D�AII S� �Ar�N� TO: Please be advised that your application dated ri�tC- ��, has been reviewed by this Board at the regular meeting of TWO 2(, Z017 and your application has been approved pending the completion of the following items checked off below. A-T S�� VOLPE V Revised Plans for proposed project PRop Qo,+p Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) / % Constructed ($50.00) i/ Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) The Permittee is required to provide evidence that the non-turf buffer condition of the Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. Permit fees are now due. Please make check or money order payable to Town of Southold. The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. You will receive your permit upon completion of the above. COMPUTATION OF PERMIT FEES: t en ��1 TOTAL FEES DUE. $ BY: Michael J. Domino, President Board of Trustees Robert Spatny 15 Bobs Lane Setauket, NY 11733 June 6, 2017 Board of Town Trustees Town Hall Annex 54375 Route 25 Southold, NY 11971 Attn: Ms. Diane Disalvo Re: Storm Water Management Control Plan Section 27, Block 2, Lot 2.4 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached are four copies of the Storm Water Management Control Plan for my property. The plan is approximately 90% complete and its concept has been discussed and agreed to by Michael Collins, PE of the office of the Engineer. Please add this information to my file for the 6/21/17 meeting. Please let me know if any additional information is needed. Very truly yours, Robert C. Spatny RCS:mr Att. r JUN m 7 2017 k ' 4 i w_ ,� Southold furvci'� - SURVEY OF: PROPERTY LOCATED AT ORIENT TEST HOLE DATA PR LOT No. 4 AS SHOWN ON NOT TO SCALE) PROPOSED RESIDENCE a0 BY: ROY K. REISSIG• PE CF` DETAIL (N.T.S.) MAP OF SETTLERS AT OYSTERPONDS 0' OCTOBER 29. 2016 a 9:00AM m131.49 48' FILED: MAY 4, 1984: FILE No. 7729 s 6 1 uj 0.0'-0.1' TOPSOIL PT g`k O TOWN O F S O U T H O L D THE NYS REGULATED FRESHWATER = q < SUFFOLK COUNTY, NEW YORK WETLAND BOUNDARY 0. tr o 0.1'-4.0' BROWN CLAYEY SILT SM ��Q��,��0 am r AS DELINEATED Bl D. LEWIS ON °i o WATER Q r0 'yre r F... �. S.C.T.M. # 18PJ�J-27-2-2.4 S 73056'30"E POND 4.0'-9.0• WET BROWN SAND SP ss ��F �0m r 8 LP AREA = 11.06 ACRES 12.08' � EP SCALE: 1"=100' L� 2.0 EL RAD = 1800.00' LP LP = rs ELEVATIONS REFER TO 1988 NAVO NAIL LEN 197.92' WETLAND LINE EP m ELEVATIONS SHOWN THUS +++ FNO \ 50 RIGHT OF WAY 3 rs�� rse S FOR POSSIBLE s 6m pRpp \ 6)°38, FUTURE HIGHWAY ��4 DEDICATION LOT 8 °�`LO`� '°, ^3`"J �• �\ �2 RAD = 550.00' VACANTtO QO' s h., LEN = 128.55' ° m T COMMERCIAL LAND PROPOSED h� 0` \\\ eU�p UReq S 81002'00"E GARAGE a a0 ER NcE `�—,____� 50.00' "BOAT YARD" 30.0' X 35.0' SLAB EL 10.0 `S ;L O 00'. \ �l \ 0 02 o I RO • � � � 0 � , w 6JAq P BY CONC. ROPOSED� h� \ SET6 -4,1 Q S O8°58'OO"W / VE MON. p� WATE RESIDENCE �Ck , RD OF TRU (SEE DETAIL) q�•'<EOGE OF ZS.00 STEES FILL PAD � OF SOUTHOLD PROPOSE °�' 9.0 '' Esrvq 6 Zoll cp WELLS 2: HOLE AM FINISHED GRADE SJ6OQ� FOA- I' MIN CONCRETE 2' MAX. CV R lz�4o MAX. 6' 0�' '1 CTIC ONCRETE M20 IN. WITHIN P 50 INLET 0 —f/ 1/8 PITC MIN q• H ❑ ❑ ❑ ❑ x O DIA ❑ ❑ O J J uj < _< N M Ld < a.Q' < < < N 3.0' MIN. o �� p Q COLLAR a > 8.0' DIAMETER > W LEACHING SECTION �0� W E BACKFILL WITH HIGHEST EXPECT ,.7 3,3 x CLEAN SAND AND 3.0' MIN.O GROUND WATER GRAVEL MATERIAL 0 O m�G�J PENETRATION INTO LOT 5 cr ;0 OF SAND IAND GRAVEL RESIDENCE WITH WELL & POND N ^ VACANT / 2.3 E L NCO SEPTIC N o TYPICAL LEACHING POOL o � °aT.s.) NOTE: THE EXISTENCE OF RIGHT OF WAYS. WETLANDS AND/OR EASEMENTS OF RECORD � �� BAR O HOUSE TRAP/CLEANOUT MUST BE INSTALLED � IF ANY. NOT SHOWN ARE NOT GUARANTEED. ON THE SEPTIC TANK INLET WASTEL[NE. IF INSTALLED AT EXTERIOR / IT MUST BE INSTALLED TO GRADE. ALL , d UTILIES REQUIRE A 5 FT MINIMUM SURVEYED B Y: SEPERATION TO THE SEPTIC SYSTEM h POLE PAUL BARYLSKI LAND SURVEYING u�, y �PHONPATCHOGUE NY 11772 10' 4' x 8 10' 8' DIA 10* /, POLE O V s � 751- PIPING SEPTIC TANK PIPING • L.P. GRADING pNp. E 631-294-6985 V�1 FAX 631-627-3186 14.0 FF. EL. 0 P A U L B A R Y L S K I®YAHOO.COM LOCKING CASTING � 9 1�2 , LOCKING CASTING DECEMBER 12. 2016 9y TO GRADE oih PROP. GROUND om EXISTING ONj�1L POLE EO S 6 5 6� TO GRADE 9y C.O. 8 GRADE 0m rL0 5-6-2017: REVISIONS TRAP 9 1' MIN 1' MIN AREA OF PROPOSED -- _ f1 24' 1' MIN. 2+' �- ` °S �J 2' MAX. 6' MIN TOP I/q S 2' MAX q DIA 2- MAX FILL PP L'E {.' tf�� SLAB )'ITCH PROPOSED MIN. A PF), - - (i L<<' �� ^ g q, liq PITCk 20' 20• 0!n UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION SEPTIC TANK 1/B o 0 0 C3 C3 Ll�Y 240i 4' A'B 5 i1 CLASS M! `� OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. p OIA �5 OqS MIN. 0' q ,� O C3 C3 E3 m E OR EOUIVPIPAL 0` o m 1�8 PITCH COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS INKED 0 c�J �� ~ J U L 17 O ENT z -11, v OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. DEPTH m rtisS 2y�J i ` 3 2�1J 111��- fOE m a.e m ss a' DIA MtN. GUARANTEES OR CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO m 1 '- DEPTH CL PIP 2400 THE PERSON FOR WHOM THE SURVEY IS PREPARED. AND ON HIS BEHALF TO 3.0'MIN. G ` VACANT by E THE TITLE COMPANY. GOVERNMENTAL AGENCY AND LENDING INSTITUTION �� COLLAR m? °'Off' C0-MIIR OR EQUIVALENT LISTED HEREON. AND TO THE ASSIGNEES OF THE LENDING INSTITUTION. �m m E 9 a 0•B Sat:",hold z�wn �' a< BACKFILL WITH HIGHEST LENGTH GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL EL 0.0 �= CLEAN SAND AND EXPECT I o!T� + SEPTIC TANK INSTITUTIONS OR SUBSEQUENT OWNERS. HIGHEST EXPECT ACT EL. GRAVEL MATERIAL GROUND WATER GRO. 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Domino, Presi"dQSUFfat,�COG ,tom t. Town Hall Annex John M. Bredemeyer III,Vice-P"resident �� 54375 Route 25 Charles J. Sanders P.O.Box 1179 Cn Glenn Goldsmith ; Southold,NY 11971 A.Nicholas Krupski �, p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: l 7 Completed in field by: Robert Spatny on behalf of DENISE SPATNY requests a Wetland Permit to construct a two-story, single-family dwelling with a 1,612sq.ft. footprint; install a sanitary system; install a driveway; and construct a 1,050sq.ft. barn/garage. Located: 4045 Narrow River Road, Orient. SCTM# 1000-27-2- 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_Z 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/standrds: i 'P ,flit I., y e z C-�e, ► l S �,a h� Present were: VJ. Bredeme er ✓ M. Domino I/ G. Goldsmith N. Kru ski / Y p d C. Sanders Other Page 1 of 2 Michael J. Domino,Preside^� 000Fat0 Town Hall Annex John M. Bredemeyer III,Vice-President �� A 54375 Route 25 Charles J. Sanders c P.O.Box 1179 ca Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski �, �p� Telephone(631)765-1892 1Y Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Robert Spatny on behalf of DENISE SPATNY requests a Wetland Permit to construct a two-story, single-family dwelling with a 1,612sq.ft. footprint; install a sanitary system; install a driveway; and construct a 1,050sq.ft. barn/garage. Located: 4045 Narrow River Road, Orient. SCTM# 1000-27-2- 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 Robert Spatny 15 Bobs Lane Setauket, NY 11733 May 23, 2017 Board of Town Trustees Town Hall Annex 54375 Route 25 PO Box 1179 Southold, NY 11971 Attn: Ms. Diane Disalvo Re: Stake-out Survey Section 27, Block 2, Lot 2.4 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached are four copies of the Stake-out Survey for my property. The house, garage, center line of driveway, parking areas, septic, drywells and the well have been staked out. Please let me know if any additional information is needed. Very truly yours, L , Robert C. Spatny RCS:mr Att. MAY 2 5 2017 r , `. S 73056 '30 "E 12. 08 ' RAD = 1800 . 00 ' LEN = 197. 92 ' a a Q4v a DRZ�EW PY FGF � � PRDP OF p O �Q QQ. e )DRYWELL A A DRYWELL A = STAKE SET �h. A �ST PROPOSED WELL S F NO SEPTIC WITHIN 150' _ 2 5 2017 sOUT,Gla i�wl NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVA'T'ION MOW Facility DEC ID 1-4738-04529 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: Facility: DENISE SPATNY SPATNY PROPERTY 15 BOB'S LN 4045 NARROW RIVER RDI SCTM#1000-27-2- 2.4 SETAUKET,NY 11733 ORIENT,NY 11957 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Orient Facility Principal Reference Point: NYTM-E: 727.888 NYTM-N: 4557.667 Latitude: 41'08'18.01' Longitude: 72'17'05.2" Project Location: 4045 Narrow River Road - Watercourse-FWW# 0-8 Authorized Activity: Construct driveway(associated with construction of a dwelling, garage and septic system more than 100 feet from state regulated freshwater wetlands and therefore beyond Article 24 jurisdiction). All authorized activities must be in strict conformance with the attached plans stamped NYSDEC approved on 4/13/17. NOTE: The parcel is landward of a paved road greater than 100 feet in length constructed prior to August 20, 1977 as evidenced on Tidal Wetlands Aerial Photo 77-2159 and therefore beyond Article 25 (Tidal Wetlands)jurisdiction. Permit Authorizations Freshwater Wetlands -Under Article 24 Permit ID 1-4738-04529/00002 New Permit Effective Date: 4/13/2017 Expiration Date: 4/12/2022 NYSDEC Approval By acceptance of this permit,the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator:LAURA J SCOVAZZO, Deputy Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook, 11790 -34 Authorized Signature: 4'C�� C Date Page 1 of 6 T SW6 j7*^ I �- -. -.-_ s,.=v �.. •"'. Ioto #I Ir r w Photo #2 j lia ICi L' APR 2 4 2017 � -___-Board�t�-J•ast�s ._---_ 1 12/29/2016 Lotinfo Enterprise 2016 M LSMZ l>, J6 ASE< . M LT PA LISTUNG SI ICE A aa..,,,.,. N Bird's eye i I 1 t:. r W �• U i _ t v,,kf ', a ". `" '.• .i' A+iib' ��.. ` i _ • . r ' , h Y d 1 https://Iotinfo.misli.com/Home/Map?lot_name=su_Iots&lot_id=S 1000-027-00-02-00-002-005# 115 t SEE SEC NO 018 a+ u_cN —uNE ewarcN --_—E Ory �2? - MATCH UNE ^m -----_ -------�— '-z— S mp 11 o+sazEOi]iC ma sErm B o w m FOR PCL NO --- -- -- to P 22A p sE SEE SEC NO ,P, 'PO 13 018060149 ,}8` m sNr \ d 1 c PA 21A(c) sy p O c9�u81ERr 25q \ °a h y 21 m ] 14Afc1 N Qj S 1A B BA(c) 1 ye ' ti� Kt SOUfN W.) 2 Y4 m 1'9 9 S,A S '1 4 : 43A(c) b 'bj /fie rronN O 23 \•'\ 23\ \ 6]A yyw• 0 BOA 7 6 m 29 `( 5m za 21 1334 EOA �� e 4 F r9 aD.F 25`s tSA 5 'R 16A �` C NE1vroRK er Y _ w O � 33 ORCHAND PO wi m 19 1 TA(c) Ja '�C+ zto �€ R`P SOA m OO Z 14 4 s. 1} 24 «' ✓ rn 1Z 1A ; 1 TA(c) ST y 2T y u 31 ro Em 1TA(c 1.3A 32 '� O Q 23 - 13A 33 1 34 3A ,SA 25 n 6 35 108A Z o 17A m N 36 d 1TA 313 / 314 190. 1 � 9A \ \ _�.' gym, � ,,>•* � � 41 \ M13Pl T 3 \ w. STATE OF )I NEWYORK\\ .4 anxot0e' \� o �IA7 .FNY o lo 94 2 I 9 ` \\ /t24A(rj/ `10��O \ \ S O \ t0A \\ 1SOF/ O d s 'P2O e( 4 \\\,. TTAIc t. \\-P'�C \ O TOWN OF SOLMH ZLD 16A c) ) 2M 4 UA {t._OR s]wicxsaatftt'- \\\ �?i (c) 92A(Q �\ 5 SiATEOFNMYORK MATCH LINE MD m D d 6�- 2 s c) srEoc 4 d SEESEC NO 032 SEE SEC NO 032 / F/yT'`�ARBp� Os R. a�F65t NOTICE aov,+ COUNTY OF SUFFOLK © E ay.Na SOUTHOLo secnoN No Real Property Tax Service Agenly Y 27 -e#r« -MATCH] ��" a r - .,;;,�' r'`e .. - �.,5- a• - N ^MAT LINE E ISEC PC - OFFICE LOCATION: �a S®��'® MAILING ADDRESS: Town Hall Annex '`® �® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) �s Southold, NY 11971 a� Telephone: 631 765-1938 ff LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Principal Planner LWRP Coordinator Date: June 12, 2017 Re: Local Waterfront Revitalization Program Coastal Consistency Review for DENISE SPATNY SCTM# 1000-27-2-2.4 Robert Spatny on behalf of requests a Wetland Permit to construct a two-story, single-family dwelling with a 1,612sq.ft. footprint; install a sanitary system; install a driveway; and construct a 1,050sq.ft. barn/garage. Located: 4045 Narrow River Road, Orient. SCTM# 1000-27-2-2.4 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 INCONSISTENT with the LWRP Policy 6 and therefore INCONSISTENT with the LWRP. The following is not provided: 1. The limits of wetlands on the survey. "Marsh lands" is referenced with no limits on the western section of the parcel. 2. The setbacks are incomplete and not defined to the "Marsh lands" (wetlands) and therefore it is unclear what'the applicant is applying for. 3. Why was the test hole conducted so far from the building envelope? The building is located outside of the AE FEMA Flood Zone, however, lower areas surround the developable area and the property is at risk from flooding (Figure 1.) Damage to property from flooding is a concern. Further, fluctuations of groundwater is also a concern. The first floor elevation of 14' feet mitigates the potential of flooding of a future structure. VP1 � a �zf J-��'9� _r .��,y� r ., i��1 ��.ie" i^.. ':^�' ,'�' '"r';-.r,:"� '°,� �,r:�' A// t,J An PCTANNUAVCHANCEFLO�o Figure 1. Subject parcel, building area and flood risks. It is recommended that filling of the parcel should be restricted to the building envelope. Once a wetland line is established in the rear yard—consider requiring the establishment of a vegetated, non-turf buffer. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman Town Hall,53095 Main Rd. ca Lauren Standish,Secretary P.O.Box 1179 ! 'F Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., June 14, 2017 the following recommendation was made: Moved by John Stein, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of DENISE SPATNY to construct a single- family dwelling, approx. 1,612 sf.; new barn/garage, and driveway. Located: 4045 Narrow River Road, Orient. SCTM#27-2-2.4 Inspected by: John Stein, Peter Meeker, Keith McCamy The CAC Supports the application, however, has a concern with the test hole data reference of brown clay, water silt and high water table. Vote of Council: Ayes: All Motion Carried M,chael J Domino, vice-Presidc '�� l0 54375 Lvlatn Koad n¢�� r� P O Box L 179 James P[ting,Trustec ` i ` 1` ,uthold. New York 11971-0959 Dave Bergen,TrusteeGf 0 2 � Telephone(631) 765-1892 Charles J. SandersFa—,c(631) 765-6641 X17 BOARD OF TOWN TRUSTEES TOWN O I'SO UTHO LD To: Southold.Towir Building Department Re_ Verification of Building Department Permit Requirements MAY - 2 207 SCTM#: A7— da - �, �-�' B�nvG DEM LD TOWN OF SOU Property Owner(Mame_ S FAI N� Date Sent to Bldg_ Dept_: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: YES NO Will the proposed project require a Building Pen-nit? Will the proposed project require a variance determination from e Zoning Board of Appeals? Will any part of this application be considered as Demolition as described under Town Code? COMMENTS: - -- - --- - -------- ---- --- - - Jam. Signature of Revie 'Date a 80 Michael J.Domino,President `i` Town Hall Annex er III Vice-President 54375 Route 25 John M.Bredeme Y <; P.O.Box 1179 Charles J.Sanders % G>, Southold,New York 11971 Tenn Goldsmith 4 , i Telephone(631) 765-1892 A Nicholas Krupski Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extens.i n. I Received Application: c Received Fee: $Z 50 00 Completed Application: Incomplete: nn", SEQRA Classification: Type T_ Type II Unlisted �b i ^a-- Lead Agency Determination: APR Z 4 2017 ✓ Coordination:(date sent): q• LVi'RP Consistency Assessment Form Sent: CAC Referral Sent: 5��l/�' Soutliold joswn Date of Inspection: 3o�roUlf-T `tis ---— 1 Receipt of CAC Report: Technical Review: Public Hearing Held: 601A I. Resolution: Legal Name of Property Owner(s): Mailing Address: I YJ 1. o Q-Q Phone Number: 1 b 0 Suffolk County Tax Map Number: 1000 Property Location: 4045 N o r re i o -R\v e�r- 'Rog J 0rieK. -, y 1l9E)--7 ,(If necessary,provide LILCO Pole 4,distance to cross streets, and location) AGENT(If applicable). Rpbr r T S pa+11 �4 Mailing Address: J!' D 6'-s Lr) , L4-k c 4- N V -1:375 Phone Number:. 1-.7 M)� A CW Drk) 616 -- qj- -7q-b -D �� Board of Trustees Application GENEPAL DATA Land Area(in square feet): 49N 77 s -Fee- I I- o r e S Area Zoning: Previous use of property: Oi r -m V ac a V I + lavid Intended use of property: 1 AG e2 Covenants and Restrictions on property? Yes Vf No If"Yes",please provide a copy. /Yes Will this project require a Building Permit as per Town Code? 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 V No If"Yes",please provide copy of decision. Will this project require y demolition as per Town Code or as determined by the Building Dept.? Yes I/No Does the structure(s)on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date �v Ys -Dec 13 !,il No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency? ✓ No Yes If yes,provide explanation: Project Description(use attachments if necessary): sl -' I C� Ili 0 O CJ r)K+ [YArh rf4qr1 , ,01505 1 f# DC4P rs'n clr ` yeu0a Board of Trustees ApplicaC"oa WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: A r a D _ y �-r � d r 1 ve ►.v � Area of wetlands on lot: ® square feet Percent coverage of lot: , % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: / feet Does the project involve excavation or filling? No _ Yes -�o r l ase Ime h-) r If yes,how much material will be excavated? cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: _feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: —ort V t -P—KJ D P r ()Lk hot A-f 10 n b Ll< o I I 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): h� � M 04C 61 Z2© Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: SPet4rr,4 Project Location(describe,and attach a location map): 4a q5 Mir roo Fot er FJ Dr ICPI Brief Description of Proposed Action: Cans--mtr_+ton v s4c)r- y) si n'� V-qw,l- 1y Jweldl'tin de+a +c lr eyi -a Sc 6Ln d i V e Name of Applicant or Sponsor: Telephone: b 31— — b - 0e111S'e 4,jpGl,+ 11 Y E-Mail' ee,IseS j Gi Address: LCLht✓ City/PO: State: Zip Code: Se�� k� �- AIv n73 1.Does the proposed action only involve the legislative adoption of a plats,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. Dods the proposed action require a permit,approval or funding from any I other governmental Agency? 1 NO YES HS If Yes,list agency(s)name and permit or approval: 5'C' S-- rjep+I G perm 1 � Qv �ld T�un 3rI ��NNys�CC-ud)a J rmi ( �aekEl Er 3.a.Total acreage of the site of the proposed action? t I, o(o acres pf r m 1-- b.Total acreage to be physically disturbed? f),Ql -1- acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? I I .0,b acres 4. Check all land uses that occur on,adjoining and near the proposed action. ,� Q Urban E]Rural(non-agriculture) ❑Industrial ❑ LJ Commercial Residential(suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, a A permitted use under the zoning regulations? NO YES NIA b.Consistent with the adopted comprehensive plan? El 6. Is the proposed action consistent with the predominant character of the existing built or natural NO El landscape? S 7. Is the site of the proposed action located in,or does it adjoin;a state Listed Critical Environmental Area? If Yes,identify:_ NO - jYES 8. a_Will the proposed action result in a substantial increase in traffic above present levels? NO YES b-Are public transportation service(s)available at or near the site of the proposed action? E" c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ` 9_Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements,describe design features and technologies: (N�O`( YES 10- Will the proposed action connect to an existing publicJprivate water supply? NO YES -1f No,describe method for providing potable water-,-'DIV-1 VA-, e'I ---------- 11.Will the proposed action connect to existing wastewater utilities? ....... 1 NO YES If No,describe method for providing wastewater treatment'- f Y(�1�/ S . E" 12_ a Does the site contain a structure that is listed on either the State or-National Register of Historic I\ Places? 10YES - b_Is the proposed action located in an archeological sensitive area? - 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated b fed y a federal.state or Ioca1 agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: -- -� 14. Identify the typical habitat types that occur oy,or are Ii kelt'to be found on the project site Check all that al ❑Shoreline ❑Forest B. gricultural/grasslands pp y ❑Ear1ymtd-successional Q Wetland Urban ffSuburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the l 00 year flood plain? a NO YES . ;E-L- -31,103r_00 17.esiIl We proposed acti n create storm�yti.e,a�schargz;alttrer from point or non-point sources? r IfYes, NO YES , a_Wil I storm water discharges flow to adjacent properties? EfN O EJYES b.Will storm water discharges be directed to established conveyance systemsrunoffand sto �,grains)? If Yes,briefly describe: MNO il- :r Iy-h diils 1-o - Urn J u-5 s and ct r l vt:o 4t� Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of �NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size; FT 19,1-las 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: F] I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE I Applicant/sponsor name: Date; �Y Signature Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all ofthe,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" ` No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 14 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? P1. El 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or _ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate t __ reasonably available energy conservation or renewable energy opportunities? L _1 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, I� waterbodies,groundwater,air quality,flora and fauna)? LJ Page 3 of 4 . 1 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? '11 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. 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. F] 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 environmentalim accts. Town of Southold-Board of Trustees (e l ( I � . Name of Lead Age Date CK&,, J pfd President Print or Type Name of Resp o sibl Officer in Lead Agency Title of Responsible Officer ignature of Respon ' le Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Applicazmon r AFFIDAVIT 'Deq'15'� :2pa+r\v BEING DULY SWORN DEPOSES AND AFFIRMS IrHAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL.WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE'APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, '- INCLUDING INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Prop rty Owner Signature of Property Owner SWORN TO BEFORE ME THIS Z-� ` DAY OF ,20 —� PHIL POLLACK Notary Public,State Of New York (� No.01 P06071221 Notary Public Qualified in Nassau Co my Commission Expires j APPLICANT/AGENT/RE-PRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouttiold's Code of Ethics prohibits dontlidts'of interost on`the haft of town iiff-icdrs and emnlo ecs.The tstu txisc of t is fonn is to provide i6f6ririntion which edwalertthe town of pn55tble conflicts of interest and allow,it to take whatever action is ricccssarp tn`avaid same YOUR NAME: S;9 A<,%1`( (Last name ,fii-stnank,tpiddle 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.) TaxI'nevance Building --- i _ Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do'pou personally(or,through your company,sponse,sibling,parcfit;or child)have a relationship with any officer or employee ' of the Town o£Souttiold? "RettitiogsF+ip">incltides;lip hlood,nlarciagc,orbusuress interest."IIusutess interest"rnc�ns a business, _ including a partnership,in which the town of ccr or employee has even a partial ownership of(or employment by)a corporation i6 which the towwofTicerorcmployee ownsmore than,5%Q oofthd shares. YES NO ✓ ? If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all'that apply): A)•the owner of greater than 5%of the,s4ares Oethe'carpomte,stock of tlr4 applicant (when the applicant is a;corporaabn); B)the legtil orbencficial owner Jany interest in a non-corporate entity(%tihen the: applicant is not acorliordtion), " C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP J Submitted this 'L day of Nn^`1 209 Ll Signature; �Z c -44:- Print Name w–D A u"T L S PA_tnL11— Fotm TS 1 i Board of Trustees Appli.caLzon AUTHORIZATION (Where the applicant is not the owner) I/We' D6V1 lsc- <Spa- KQ - - , owners of the property identified as SCTM# 1000- a -2 _� -in the town of J O LAV I CL ,New York,hereby authorizes q10 k c r 1` S R Anv to act as my agent and handle all necessary work involved with the application process for permit(s)from the Southold Town Board of Trustees for this property. Property Owner's Si ature Property Owner's Signature SWORN TO BEFORE ME THIS 20�, . DAY OF v f U A-t L_ , 20 � PHIL POLLACK Notary Public,State Of New York No.01 PO6071221 Notary Public ®ualifeed in Nassa Commission Expires r c (g' • I I APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The T):awm of Sobsold s Code ofEthicsprohibitsronflictc of interest on the kart of town officers and employees The Dwose of this fotm is to pp*e infarinatiotiwhich carr aldrtflte.town oftiossible conflicts of interest and allow it to take whatever action is riecessar roto avoid sg ee.C. " -YOUR NAME, J A i 1 C' 1ST (La name,first name,jiiddle initial,uNess you are applyingin the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building ! Variance Trustee t 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 oremploype of the Towwi of Southold? "lielationsli includes by blood,rnarriage�lir busincss interest."Business interest"means,a business, including a partnership,iii,,vhiclt the townofficer or employee has cven a partial ownership`of(oremplaymerit'by)a-corporation in which the town officer or employee owns mi&o than 5%6f tha shares. YES NO V { 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 !);:scribe the relationship between yourself(the appl'icontingeni/representative)and the town officer or employee.Either check -the appropriate line A)throttgh D).and/&describe in the space.provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than S%ofhe shares bf the;�:orporate stock of the applicttrit (when the applicant is a eo"fationN B)the legal br'benefioial owner of any inteiCst in a.non-corporate entity(464 the applicant3s not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRUMON OF RELATIONSHIP Submitted t is__day of Z0 Signatu , Print Name a t5 > Form TS 1 Denise Spatny 15 Bobs Lane Setauket, NY 11733 h:7:.— E E June 7, 2017 13 2017 Board of Town Trustees outhold Town Town Hall Annex -r 54375 Route 25 Southold, NY 11971 Attn: Ms. Diane Disalvo Re: Proof of Mailing Notice Section 27, Block 2, Lot 2.4 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached is the Proof of Mailing Notice for the subject property. This document is being submitted for the Board of Trustees Meeting scheduled for June 21, 2017 at 5:30 p.m. Please let me know if any additional information is needed. Very truly yours, Denise Spatny • DS:mr Aft. PROOF OF MAILING OF NOTICE ICE ATTACH CERTIFIED MAIL RECEIPTS NAME ADDRESS Richard Serra 173-75 Duane Street, New York, NY 10013" Clara Weyergraf Serra 173 Duane Street, New York, NY 10013 Henry H. Bostic, III 246 Warren Street, Brooklyn, NY 11201 Fred Dacimo 5520 Narrow River Road, Orient, NY 11957 NY State DEC SUNY, Budding 40,Stony Brook, NY 11790-2356 NY State DEC SUNY, Building 40,Stony Brook, NY 11790-2356 NY State DEC SUNY, Building 40, Stony Brook, NY 11790-2356 Attn: Bureau of Real Property STATE OF NEW YORK COUNTY OF SUFFOLK r { residing at / 3 being duly sworn, deposes and says that on the day of , "4Le, 20LI,deponent mailed a•true copy of the Notice set forth in the Boar of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment, oll of e Towyn®f Southold; that said Notices were mailed at the United States Post Ofciee at e 0 71 that said Notices were mailed to each of said persons by CEh�Tllli'gED MAYg`/R�'ICgT CEIP'I'o , f Sworn to before me this Day of T , 20_L3 i Notary Public PHIL POLLACK Notary Public,State Of New York No.01 P06071221 Qualified in Nassau.Co my Commission Expires TMTM �ostal Service.S., ° g I ° ...D Domestic lVail OWY !• - �D O Certified Mall Fee $3.35 - 3 O Certified Mail Fee. 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MAIL@ RECEIPT CERTIFIED MAILP RECEIPT fl_I —Domestic • 43 p Domestic Mail Only S ME. DFt kW 1":,1c957,aTkDi ' IY('I'1 91A '-t ! STI rE39 Certified Mall Fee $J.35 0733 i7 3` O Certified Mad Fee �r J M EXtra Services&Fees(checkbox,add tee k p te) U�� 7 I m Extra Service9&Fees(checkbox,add fee e r ate) V��` ❑Retum Receipt(hardcopy) $ k c p �- � ,' i ❑Retum Receipt(hardcopy) $ Una! I I j-3 ❑Retum Receipt(electronic) $ 1 I• postma h _ C,� !�' O ❑Retum Receipt(electronic) $ $0,QUI Postmark ❑Certified Mail Restricted Delivery - p ry $ $lt,-�Il� h., Here .L j E-3 ❑Certified Mail Restricted Delivery $�Y�r�rl� JUN C3 []Adult Signature Required $ t Adult Signature Required $ -" }9 []Adult Signature Restricted Dalrvery$ Iii Y, 1 ��N�,7°fin '•.,'• O ❑ 9 q �iu,�— L �I! C(/ �n ❑Adult Signature Restricted Delivery$ �'rr LrrJ ;r 0 Postage $1 I.49 �� j r Postage ®- $ $0.49 `a Total Postage and Feels +6 fl7/ f_4 �f' $ 8p p $+5.�9 rS ' Total Postage and Feely U 7 rq Sent To FrLn ed i)tac t and r-q ' TFafe' c --- --- ------------------------------------------- _ O D Street andA-t Afo.,of�'f3l3oz No. S"veet an pt.No.,or Pd Box No. _ i L' 5� ----1- ----- r?__-- _ __________________________________ , �___ ISN 40 r _ airy;St"ate'ZI a 6l� N q 5 j Ci State,ZIP+4 a--"�------------------ - - ----------------------------------------- n vcvk bq 117 40-d-35 Denise Spatny 15 Bobs Lane Setauket, NY 11733 June 14, 2017 Board of Town Trustees JUN 1 9 2011 Town Hall Annex 54375 Route 25 Southold, NY 11971 Southold Town Board Trustees Attn: Ms. Diane Disalvo Re: Affidavit of Posting Section 27, Block 2, Lot 2.4 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached is the Affidavit of Posting for the subject property. This document is being submitted for the Board of Trustees Meeting scheduled for June 21, 2017 at 5:30 p.m. Please let me know if any additional information is needed. Very truly yours, Denise Spatny DS:mr Att. � UFfO� Michael J.Domino,President �G��S �C , Town Hall Annex John M.Bredemeyer III,Vice-President ¢�� 54375 Route 25 Charles J. Sanders CM P.O.Box 1179 Glenn Goldsmith D �` Southold,NY 11971 A.Nicholas Krupski ,� a®� .,,`� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of DENISE SPATNY COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE ® ,2 I, �-Z� -✓ , residing at/dba - / d�� o 11 -133 being duly sworn, depos and say: That on the 5, day of , 2017, I personally posted the property known as �— Am( 1 S by placing the Board of Trustees official poster where it can easily b seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, June 21, 2017. Dated: ,J�° vN (signature) Sworn to before me this " day of 20 I�- Notary Public PHIL POLLACK Notary Public,State Of New York No.01 P06071221 Qualified in Nassau co Commissio ires4 // NUTI-- Lt Uim Ht: AKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: DENISE SPATNY SUBJECT OF PUBLIC HEARING : For a wetland Permit to construct a two- story, single-family dwelling with a 1,612sq.ft. footprint; install a sanitary system; install a driveway; and construct a 1,050sq.ft. barn/garage. Located: 4045 Narrow River Road, Orient. SCTM# 1000-27-2-2.4 TIME & DATE OF PUBLIC HEARING : Wednesday, June 21, 2017 — at or about 5:30P. M . If you have an interest in this project, you are invited to view the Town file(s) which are available for inspection prior to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS L. 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: siWgicant beneficial and adverse.effects upon.the coastal area(which includes all of Southold Towel. 1If 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 iiiust be`-ekDlained in detail, listingi both supporting and non- sutiyorting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it-shaltnot be undq#*en. 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 SCTNI# 100 D - 2 2 - Q;� 40 � a, 41 PROJECT NAME Pa- �-h Y ReSl df17ef, The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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: Rejues� -Fbr We41g4,J-s berh�i Location of action: �/O twlo R/Veg Rd 0"--lm /V Site acreage: 0,6 Present land use: V 4 C 4h Present zoning classification: —-2 0 D 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:, en /6 c, s42 a -�n�{ (b) Mailing address: s hltke-�, l✓ (c) Telephone number: Area Code (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?. Al YS Df�'i C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. []yes 1:1 No Not Applicable 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 0 Yes No Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No TNot 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 Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No [�TNot Applicable Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of,Southold.See LWRP Section III —Policies Pages 16 through.21 for evaluation criteria 11ro Yes —] No u 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 III—Policies; Pages 22 through 32 for evaluation criteria. ❑ U Ef Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town'of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. r] Yes No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes F] No ffNot Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. YeSE] No u Not Applicable Attach additional sheets if necessary l WORKING COAST-POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III--Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters.See LWRP Section III—Policies; Pages.57 through 62 for evaluation criteria. YesC] No u Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑Yes ❑' No Not Applicable ,Attach additional sheets if necessary Policy 13. Promote appropriate .use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY _ N A S,P 14-0w TITLE. , DATE c R 1 t Z Robert Spatny 15 Bobs Lane Setauket, NY 11733, April 24, 2017 Board of Town Trustees _ Town Hall Annex f= 54375 Route 25 ._ PO Box 1179 Southold, NY 11971 E APR 2 5 2017 ;W Attn: Ms. Diane DisalvoAI i -- Re: Wetland Application P?ar�+�rT515 1 4045 Narrow River Orient, NY 11957 Dear Ms. Disalvo: Attached are the architectural plans for the house my wife and I propose to build at the above address in Orient. The plans are not fully complete and have not yet been submitted to the Building Department, but the changes going forward will be minor. Please let me know if any additional information is needed. Very truly yours, Robert C. Spatny RCS:mr Att. r , RobertSpatny 15 Bobs Lane Setauket, NY 11733 April 18, 2017 Board of Town Trustees Town Hall Annex 54375 Route 25 PO Box 1179 Southold, NY 11971 Re: Wetland Application Dear Sirs: Enclosed are the completed forms, documents and application fee for a wetland permit. Please advise if any additional information is required. Thank you in advance for your anticipated attention to this matter. Very truly yours, Robert C. Spatny RCS:mr Enc. APR 2 4 2017 Sout;;ald=n„rn