Loading...
HomeMy WebLinkAboutTR-9134 Michael J.Domino, President sorry Town 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 lycoUNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 1659C Date: November 13, 2019 THIS CERTIFIES that the construction of a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; as-built 4.42'x6.25' (27.63sq.ft.)staircase attached to northerly side of deck; install a gravel driveway, install a sanitM system landward of dwelling; and connect to public water,• with the condition to establish and perpetually maintain a 25' non- disturbance buffer;clear and maintain a 4' wide access path through the 25' wide non-disturbance/non- fertilization buffer to the water; At 415 Lakeside Drive, Southold Suffolk County Tax Map#1000-90-3-13 Conforms to the application for a Trustees Permit heretofore filed in this office Dated October 17,2017 pursuant to which Trustees Wetland Permit#9134 Dated December 13,2017,was issued and Amended on March 23,2018 and Amended again on November 13, 2019 and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of a 24'x40' two-story,single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; as-built 4.42'x6.25' (27 63sq ft)staircase attached to nort6rly side of deck; install a gravel driveway,install a sanitary system landward of dwelling; and connect to public water; with the condition to establish and perpetually maintain a 25' non-disturbance buffer; clear and maintain a 4' wide access path through the 25' wide non- disturbance/non-fertilization buffer to the water. The certificate is issued to Michael McCarrick Real Estate,Inc. owner of the aforesaid property. Authorized ignature Michael J.Domino,President QF S0!/TTown 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 November 13, 2019 Michael A. Kimack P.O. Box 1047 Southold, NY 11971 RE: MICHAEL MCCARRICK REAL ESTATE, INC. 415 LAKESIDE DRIVE, SOUTHOLD SCTM#: 1000-90-3-13 Dear Mr. Kimack: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, November 13, 2019. RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#9134 for the as-built 4.42'x6.25' (27.63sq.ft.) staircase attached to northerly side of deck; and as depicted on the survey prepared by Kenneth M. Woychuk Land Surveying, PLLC, dated April 20, 2018, and stamped approved on November 13, 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, y Michael J. Domino President, Board of Trustees MJD/dd •5 S.C.T.M. NO. DISTRICT. 1000 SECTION: 90 BLOCK: 3 LOT(S): 13 #R 10-14-0035 S 85°2952°E — 71.17' 4�14F MON. LOCT 1 y9 ' LL�-JJJ � 90 71WV.WETIANDS BOUNDARY AS FLAGGED [31' 8 21 '12, SUFFOLK ENVIRONMENTAL CONSULTING INC.. JULY 17,, 2012 NON FF NDN Boar of lruMees Z4T STU 6 HOR /O4; Ci F�cF NF ss�sr , oo= \ EL 7:8 ! 6 ! EL 8.3 h� \ P/O LOT 59 110,0' l ° EL 7.0 o2 .s 80. .0 ��o ; .:o , ::_ LOT 60 ::. �Fk� SRM c_ PO WELL. So, Sl COVERED P06-r P0PM EL &5 , (� LOT 61 � 4� ` s� SANITARY LOCATION 0 RG+w AY1 POINT"A" POINT"B" a e LP f LPo S.T. 22.5' 25' Ip EX j P� LP.#1 40' 30.5' ` TRAFFIC BEARING Ip SANITARY SYSTEM EXP#1 49' 25.5' 60.72'1 EXP#2 54.5' 25.5' VA S y 7.7 9000" W 1 V. 36 MON. _ IDA _ _ DRIVE - SIDE - 0w THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL EXISTING DIRT/STONE ROADWAY TO BE IMPROVED wrrlt AND OR DATA OBTAINED FROM OTHERS. LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS ADDITIONAL R BLUE STONE AREA: 16,647.19 SQ.FT. or 0.38 ACRES ELEVAnON DATUM: NAVD88 APPROVE® BY UNAUTHORIZED AL 7ERA 770M OR ADDITION TO THIS SURVEY IS A VIOLA 770M OF SEC770M 7209 OF 7HE NEW YORK STA 7E EDUCA 77ON LA W. COPIES OF THIS SURVEY DRAINAGE CALCULATIONS:C U LATI 0 N S. n MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED 70 BE A VALID TRUE COPY. GUARAN7EES INDICATED HEREON SHALL RUN BOARD OF TRUSTEES ONLY TO 7HE PERSON FOR WHOM 7HE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS777U77ON LISTED HEREON, AND TO THE ASSIGNEES OF 7HE LENDING INS777U770N, GUARANTEES ARE NOT TRANSFERABLEE, THE OFFSE7S OR DIMENSIONS SHOWN HEREON FROM 7HE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE 7HEREFORE THEY ARE TOWN,OF SOUTHOLD NOT 1N7ENOED 70 MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADD177ONAL S7RUCTURES OR AND 07HER IMPROVEMEN7S EASEMEN7S A) DWELLING=984 SQ.FT. AND/OR SUBSURFACE S7RUEYURES RECORDED OR UNRECORDED ARE NOT GUARAN7EED UNLESS PHY5ICALLY EVIDENT ON THE PREMISES AT 7HE 77ME OF SURVEY 984 X 0.166=163.34. < 164cf REQUIRED DATE SURVEY OF: LOT 60 & P/0 LOT 59 CERTIFIED TO: McCARRICK REAL ESTATE INC.; (1) 8'DIA x 4' DEEP DRYWELL=177cf PROVIDED MAP OR CEDAR BEACH PARK FIDELITY NATIONAL TITLE INSURANCE SERVICES, LLC; FILED:DECEMBER 20, 1927 No.90 I _ SITUATED AT: BAYVIEW Tom OF-. SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC + SUFFOLK COUNTY, NEW YORK Professional Land Surveying and Design 4 P.O. Bog 153 Aquebogue, New York 11931 { FINAL SURVEY 02-26-19 FILE # 18-37 SCALE• 1"--30' DATE:APRIL 20, 2018 PHONE (831)298-1588 PAX (631) 298-1588 REVISED 09-25-18 N.Y.S USC. NO. 050882 nndntatntns the records of Robert J. Vannewy&Kenneth Y.Roychnh Michael J. Domino, Presiif �$11FF0(�C Town Hall Annex John M. Bredemeyer III,Vice-f esident � 54375 Route 25 Glenn Goldsmith y a P.O. Box 1179 A.Nicholas Krupski 1_� Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Z D Completed in field by: N Michael A. Kimack on behalf of MICHAEL McCARRICK REAL ESTATE, INC. requests an Administrative Amendment to Wetland Permit#9134 for the as-built 4.42'x6.25' (27.63sq.ft.) staircase attached to northerly side of deck. Located: 415 Lakeside Drive, Southold. SCTM#: 1000-90-3-13 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 earing 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/ eed for outside review/consultant/application(completeness/comments/sta dards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: , Present were: JYG. Williams redemeyer M. Domino Goldsmith N. Krupski Other Michael J. Domino, President oE so�ryo 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 • Q Telephone (631) 765-1892 Greg Williams Ocou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF I SPECTION: 5 Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/2 constructed X Project complete, compliance inspection. INSPECTED BY: CO MENT roT_ i e C` .1 co^ CERTIFICATE OF COMPLIANCE: Michael J.Domino,President �*rjf SDUTjfiO Town Hall Annex John M.Bredemeyer III,Vice-President �� lQ 54375 Route 25 P.O. Box 11 Glenn Goldsmith l Southold, New York 11971 A.Nicholas Krupski G Telephone (631) 765-1892 Greg WilliamskL - O D NT`I,� BOARD OF TOWN TRUSTEEL, OCT 18 2019 TOWN OF SOUTHOLD Southold Town Boardard of Trustees APPLICATION FOR AN AMENDMENT TO A WETLAND PERMIT A DATE 101171,201 ,q IF NICAIW AZ plc CA-RXIC!C OWNER RM4 4-Fr 754,, /NC• PHONE MAILING ADDRESS AGENT /C �L A ZINA Cle PHONE /�1 ( ,63-(9- S b ADDRESS MY, 1/971 PROPERTY LOCATION 416- Z04&6 52A;� DAP. XOOF TAX MAP NO. 1000 - '?0 - 3 - 13 (�Ve HjCV,-W1 AkllfA C/L, request an Amendment to Permit# A 6E/Id7-- qz� 6.25 ' oma &QAZ O�' !s�v«r' sr.��pc,�s� •��. Of'AFFZa V,6P D,c� Signed By: .� Board of Trus-tees App'--)ation A T HOBJZi'LT ION (Where the, applicant is not the owner) Owe, owners of the property identified as SCTM#t 1 OC�0-�� O �» ,��' in the town of QC ' _ New York, hercbv authorizes to act as my agent and handle all necessary work involved with the application process for permits) from the Southold 'Town Board of Trustees for this property. Property Owner's Si natu Pioperty Owner's Signature SWORN TO B1✓F'OI21: ME THIS DAY OF !/G�� 20 Notary Public MICHAEL A. KIMh�,t,, Notary Public,State of New York No.02KI5056823 Qualified In Nassau County Commission Expires March 11, Pn^^ Michael J.Domino,President so 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 �O Telephone (631) 765-1892 Greg Williams �l�`,oU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 19, 2018 Michael McCarrick Real Estate, Inc. P.O. Box 5589 Rocky Point, NY 11778 RE: 415 LAKESIDE DRIVE, SOUTHOLD SCTM# 1000-90-3-13 Dear Mr. McCarrick: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, September 19, 2018: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#9134 from Estate of Fred Adler to Michael McCarrick Real Estate Inc., as issued on December 13, 2017. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, Michael J. Domino, President Board of Trustees MJD/dd r f J cDkD u�-- AC) el vQf u1 JUL 2 6 2018 Southold Town A]PFLICAN T/ACEN T/REDR`ESENTATIVE TRANSACTIONAL DISCLOSURE.FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: R I C- � ' - ' e-- (Last name,first name,{riddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other%name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of th S. 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 br position of that person Describe the relationship between yourself(the applicant/ag(mt/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than S%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this,-)- of J`� 200 ` S ignat Print Name a �- Form TS I Board of Trustees App1,=' -.tion AFFIDAVIT 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 BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signatur�of opert Owner Signature of Property Owner SWORN TO BEFORE ME THIS Z� 1 DAY OF T"y , 20 �g &W kpll� Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. O1 D1475593 ®U011fie4 In Suffolk County MV Commission Expires April 30, 20 � Michael J. Domino,Presi O�QSC®G Town Hall Annex John M. Bredemeyer III,Vice-Trresi ent yam, 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 at A Nicholas Krupski Southold,NY 11971 Greg Williams p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: IF 1V MICHAEL McCARRICK REAL ESTATE, INC. requests a Transfer of Wetland Permit #9134 from Estate of Fred Adler to Michael McCarrick Real Estate Inc., as issued on December 13, 2017. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3-13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related'structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / . Present were: J. Bredemi0e er M y Domino G. Goldsmith N. Krupski G. Williams Other Michael J. Domino, President rjf SOUTy� Town Hall Annex John M.Bredemeyer III,Vice-President �� 01 0 54375 Route 25 P.O.Box 11 Glenn Goldsmith l�[ Southold,New York 11971 A. Nicholas Krupski Telephone(631) 765-1892 Greg Williams COU Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 23, 2018 Bruce A. Anderson Suffolk Environmental Consulting, Inc. 2322 Main Street P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: ESTATE OF FRED ADLER 415 LAKESIDE DRIVE, SOUTHOLD SCTM#: 1000-90-3-13 Dear Mr. Anderson: The following action was taken by the Southold`Town Board of Trustees at their Special Meeting held on Friday, March 23, 2018: RESOLVED that the Southold Town Board of Trustees APPROVE the Administrative Amendment to Wetland Permit#9134 to clear and maintain a 4' wide access path through the 25' wide non-disturbance/non-fertilization buffer to the water; and as depicted on the project plan prepared by Suffolk Environmental Consulting, Inc., received on February 13, 2018, and stamped approved on March 23, 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 ,. - -, -• -. .. - - - ---...:�. - ------�SCDHS Ref.# =RIO-14-0Q3� � - -.; _ - - - - .- - , f SURVEY FOR THE ES TA TE OF FRE® A®LERRE�C�E� 79'52'E #a 71.17' C AT I —— — #' �3 I-14 ?'HOLD #9 >j,rev F '' TOWN OFA S'O U . EL• g•1 t N ` ` � ` 2S• 4s,4 TEST BORING SUFFOLK COUNTY., X h � � 20�� nFvHF� ` �lb i�i�`a �. 1000 90 03 13 V-- ----------- -F100D �S 'l j /O. ! #5 80, 3, �i(i �LEL 8.4 O' SC.4L '. 1 — 30' -----��� Dark Brown Loam AUGUST 20, 2012OL SEPT. lo, 2012 (bldg. oavalopol �j - ✓/ #4 SSj. �4�/ 44'C' Brown SN AIL 1 FEB: 4,-2014 (PRA- HOUSO $ \` x SPOT EL �',Q�h �: �`�? ��i� 4' TO B'ETLANFDSI ° �6 2` ti SF ,�� Pea Brown (BUFFER ooEO) F,Q SIf NLS },, 1 SUBSURFACE SEWAGE DISPOSALr� °� b�O x - moo r0, BOARD O ' i� F SYSTEM DESIGN LOT(60) j� `,SPOT EL� � Brown 1�e to TOWN OF SOUTHOLD BYE JOSEPH FISCHETTE P.E. . .� �` 1 Coarse Seed Will HOBART ROAD 6.0, Q wllA TOY. Gravel .:a SOUTHOLD, N.Y. 11971 ��m �p 2p �' ``, SPOT EL. Sw r`,•: 'DATE IM 1N2Clf �(.g 16311 765 - 2954 n <<y Q a4 A'?011 , Cyt+ 1. 7.0' X �4 21j, p Q ..� Wafer, bl Brows ip'`Zq b #2 Fhe to Coarse Sand With 1016 PROPOSED SEPTIC SYSTEM Q 6� �r� Gravel 3 BEDROOMS �o \ IS' FpV FAL REEL 40T (61) CER77nED TO : 10.5 a s '�,► /. cd ESTATE OF f7�fD AAN" nw wrnca a r _ _ V•� p a-APPIROVEO 44fWM ►•Mb TCOVER LFL E Ee �t E sa ST rE s.® L P. 4• \ I !t om Ess. re ® � E »+.,. 0. a r esw T ' �T OL 60.72•? � - •s'�'�'� p �. � � 8 (LOT) #S REFER TO 'SUBDIVISION MAP OF CEDAR BEACH PARK' r - 1000 G�WATEN_ El, 3CAL.e)`RELLCAST SEPTIC TALC FILED IN THE SUFFOLK COUNTY CLERKS OFFICE DEC20, 1927 S 8`0 SA/�COLLAR(SW) P00VE WITH S79 00 AS MAP NO. 90. GROUND WATER �H�rs ' ��LPOIF � FEB 1 3 2018 BEARING COVERS HAVE TRAFFlC - d6y�E 6.0' D j P Cl. ESIDE v�- IRO 1\1)I OR��AY �JO�G urd of Trustees Southold Town LAK IN STREET GRA Q - A�,�s EXPANSJON POOLS .1P0 BE MTALLW A7 UBUC IIAfiER TETE OF TIE OCTALLAT04 OF T#E SEPTIC SYSTEK (TO BE CATm) TOTAL LOT AREA• - 16,878 sqq.11. ALL LEACHING POOLS XSTALLED BE EATH WETLANDS AREA = 230 sq.ff. THE DRIVEWAY TO HAVE IfJ►VY DUTY LOdGIIG UPLAND AREA = 16,648 s :ll. ®= MONUMENT ,� CAST IRON COVERS +�� IMPERVIOUS SURFACE, - 1260 A= WETLAND FLAG : � LOT COVERAGE = 7.6% LANDWARD EDGE OF TIDAL WETLANDS AS DELINEATED BYG RAIN RtaNOFF C4LClAAT10WS N SUFFOLK ENVIRONMENTAL CONSULTING, 'INC. ON JULY 17, 2012 HOUSE - 960 SO. FT. PU 1JCWA� Rf OF NEW), 960 + I s al-7 r 16A2 CY/.FT. 0 FLOOD ZONES FROM FEMA RATE MAP NO's 36103CO167H &-36103C0169H 163.2/22.$ - 7.3 V.F. g�P ME PROVIDE 2- DWS 6.0 g 4 FT: oEtpAREA' TO WETLANDS (wetlands fl = 16,878 sq.N.: �� ELEVATIONS ARE REFERENCED TO NAVD = -a AREA.= . 16,648 SO.F'T. I am familiar with the STANDARDS'FOR APPROVAL (TO, TIE-LINES) AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES N.Y.S LIC. NO. 49618. and will abide by the conditions set forth therein and on the ANY ALIERA710N OR ADD1flON TO THIS SURVEY ISA vV LAW MORS, P.C. OF SEC77ON 7209 OF NE NEW YORK STATE EDUCATION LAW. permit to construct. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICA77ONS (63 765z-5020 FAX (631) 765-1797 HEREON ARE VAUD FC? THIS MAP AND COPIES THEREOF ONLY IF P.0. BOX' 909 The location of Wells and cesspools shown hereon are SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREETq2_�Z� " from field observations and or from data obtained from others. WHOSE SIGNATURE APPEARS HEREON SOUTHOLD, N.Y. 11971 1 �ut Suffolk Environmental Consulting, Inc. Newman Village, Suite E,2322 Main Street,P.O. Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President HAND DELIVERED February 12, 2018 Michael Domino, President Southold Town Trustees E (� E E P. O. Box 1179 D v Southold, NY 11971 Re: Estate of Fred Adler FEB 1 3 2018 PS 415 Lakeside Drive —Southold SUM 1000-90—3-13 Southold Toarn B ar f Tru°c Dear Mr. Domino, Request is hereby made for an administrative permit amendment authorizing the clearing of a 4-foot path through the 25-foot non-disturbance/non-fertilization buffer. Attached herewith please find one highlighted version of the survey prepared by Peconic Surveyors, P.C. last dated May 7, 2015 which depicts the 4 foot wide path through the buffer. I enclose an additional two copies of the survey for your files along with a check made payable to the Town of Southold in the amount of$50. Kindly process the requested amendment at your earliest opportunity. Thank you in advance for your anticipated cooperation. Yours truly, , Bruce Anderson cc: Estate of Fred Adler Michael J Domino, Presi �QSUFFO(�-Co Town Hall Annex John M. Bredemeyer III, Vice-President �� y� 54375 Route 25 Glenn Goldsmith y z P.O Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams ti ® O! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: -3 Completed in field by: Suffolk Environmental Consulting on behalf of ESTATE OF FRED ADLER requests an Administrative Amendment to Wetland Permit #9134 to clear and maintain a 4' wide access path through the 25' wide non-disturbance/non-fertilization buffer to the water. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3-13 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 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith dc,,N. Krupski V//G. Williams Other Page 1 of 2 Michael J. Domino, PresidgUFfatIr CD Town Hall Annex John M. Bredemeyer III, Vice-Presfdent ��� GyV, 54375 Route 25 Glenn Goldsmith N z P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971 Greg Williams 'y ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Suffolk Environmental Consulting on behalf of ESTATE OF FRED ADLER requests an Administrative Amendment to Wetland Permit #9134 to clear and maintain a 4' wide access path through the 25' wide non-disturbance/non-fertilization buffer to the water. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3-13 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 G. Williams E. Cantrell D. Di Salvo Other Page 2 of 2 S rry Michael J.Domino,President �q soTown Hall Annex� Ol0 John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders N PICSouthold,New York 11971 Glenn Goldsmith • a0� Telephone(631) 765-1892 A.Nicholas Krupski 2 100UNTIFax(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 compliance Project complete, inspection P Y„ .• ° ,`'��;.:�=r^. , b.r i/rYy ` ;` 1 1��y° &Yah y �rr i'qtr p- �,, 'I'I� b, r' hl 'fIS�VrjSr • Vii:• r ' c BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK t ° PERMIT NO. 9134 DATE: DECEMBER 13, 2017 y ISSUED TO: ESTATE OF FRED ADLER fb PROPERTY ADDRESS: 415 LAKESIDE DRIVE, SOUTHOLD `= SCTM# 1000-90-3-13 ' AUTHORIZATION >s .tr x ` Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on December 13. 2017, and in consideration of application fee in the sum of$250.00 paid by Estate of Fred Adler and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits " } the following: ^,r Wetland Permit to construct a 241x40' two-story,single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway,install a sanitary system landward of dwelling; ; ' and connect to public water; with the condition to establish and perpetually maintain a 25' non- -=f disturbance buffer; and as depicted on the survey prepared by Peconic Surveyors,last dated May 7, 2015,and stamped approved on December 13,2017. ; A IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Sea]to be affixed, ; Y� and these presents to be subscribed by a majority of the said Board as of this date. 'T. gpFFOt Ir . Ct!r `� 0 • � a K � ii }abi s 4 ppyyo� "S�' A`S S �itSaS'OKC tt's` 4 •..�t t"• � ��+,ibi 4,`��• ' gr:i r r;.•�'°si�ta�^�.ytS9�. .��_4.• ��. 'r 6�rl4r.� ,fi � �.f...'��•t' 4^. '},•S3:, +- � . _ f� r TERMS AND CONDITIOP The Permittee Estate of Fred Adler, 415 Lakeside Drive, Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months,which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice,to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. H. 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. Michael J.Domino,President OF SOUry� Town Hall Annex John M.Bredemeyer III,Vice-President h0 l 54375 Route 25 P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith �Q Telephone(631) 765-1892 A.Nicholas YCpUM'1, Kru ski O Fax(631)765-6641 p �' �1� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 13, 2017 Bruce Anderson, President Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: ESTATE OF FRED ADLER 415 LAKESIDE DRIVE, SOUTHOLD SCTM# 1000-90-3-13 Dear Mr. Anderson: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 13, 2017 regarding the above matter: WHEREAS, Suffolk Environmental on behalf of ESTATE OF FRED ADLER 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 October 17, 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 issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 13, 2017, at which time all interested persons were given an opportunity to be heard, and, 2 WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of the ESTATE OF FRED ADLER to construct a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway, install a sanitary system landward of dwelling; and connect to public water; with the condition to establish and perpetually maintain a 25' non-disturbance buffer; and as depicted on the survey prepared by Peconic Surveyors, last dated May 7, 2015, and stamped approved on December 13, 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: $50.00 Very�truly� yours, Michael J. Domino President, Board of Trustees MJD/dd J CIA SCDHS Ref.# RIO-14-0035 ` RED ADLER EDGED N SUR VEY FOR THE ES TA TE OFF S8579 52 E 1 A T BA,YVIEW _ #8 "•" c TOWN OF SOUTHOLD % E �� COUNTY N. Y. ` y SUFFOLK �S. w'4r ' TEST BORING COUNTY 2p >1F �. FR by McDonald Geosdnhee. 1000-90-03-13 �� 4HF qr !/13/14 SCALE: 1 30' #5 Q?�. Op EL 8.4 O' AUGUST 20, 2012 �3 NE ClNF RFIihF, F'QT�Pk�� Dark Brown L04M OL SEPT. 10, 2012 (bldg. envelope) CIO. 1 ` #4S`S 4T'Q6 1' Brown SO ML FEB. 4, 2014 (PROP. HOUSE) OCF 4. pIARCH 31,-20/4 (AREA TD WETLANDS) Os i_ �_x SPOT EL ryh i 2 ; 8� MCH 2014 (addltlons) �y g 2; ` , / t 6F 11>4 14 Pale own Sandy Sx AIL DEC. 10, 2014 (BUFFER ADDED) NOTE$ MAY 7, 2015 (REVISIONS) SUBSURFACE SEWAGE DISPOSAL rQ o,` ``\��o ,' A_ #3 67 6• —ECE � ,� SYSTEM DESIGN LOT(60) ���x - O 70' 4 �� BY1 JOSEPH FISCHETTE, P.E. x SPOT EL� rs Brown Fine /o n J Corse Sand With HOBAR T ROAD o 6 a��',\ • Di-D SOUTHOLD N.Y. 11971 m ` @ 2p q. SPO EL. wllh !0% Grovel SW f631) 765 2954 <��<<y� ,OQ Q�� �� ��ti moo yo ��' j \�`.�\� 7 0� X woler Jn Brown �4 OCT 1 7 2017 y� io 1p' GS t, #2 F1ne Lo'Corse A _ S ,p, F ` .' Sand With 10% 4o• X '% �� rod 40 Grovel Southold Town PR 3PBEDROOMS IC SYSTEM / ' /p p�\ �. 15' Board of Trus eo ti } ' HOUSE � � / \ �� \� • LOT 61 j%. F114 FLR. EL ( ) � ,,s? /� EST nTE OF FRED ADLER FIED TO10.5 E4 f Fri auaE a _ .1I s /i* - or I / o CER A 4'APPROVED 4'APPROVED I•mN if `Off_ • v� 1/� .,(A j +� #1 COVE7RR -"��' ✓/ PpIE ,E T i '�' ��ti PROVE[) 'BY`,-.",. Y` ., s.s es ST IE IEs6 LP. r „'° �a ° 6�°' �� LF ua 1 i OARD OF TRUSTEES (LOT) #'s REFER TO "SUBDIVISION MAP OF CEDAR BEACH PARK" GROUND WEER— E1- .7 I - 1000 GAL. PpRECAST SEPTIC TANK 1 ,W 60.72 TOWN OF SOUTHOLD f7LED IN THE SUFFOLK COUNTY CLERKS OFFICE DEC.20, 1927 5 3B Ajr ND 21 Deep LEACHING ABOVE WITH � � - 579 30 0� AS MAP NO. 90. ' z GROUND WATER I DATEa '�- [�`�e7 ' L.P.s To HAVE TRAFFIC Hers UTIL•P0� Ivy,, BEARING COVERS - V�J �, v /� 18IDE ROAD/ D LA GRAVEL J� �O HAIR W STREET f EXPANSION POOLS Tp BE NSTALLF�'AT' 7WFpUgUC '• _ �a TRME OF THE NSTALLA77ON OF THE T Af# � sEPrlc sYsrEM (TO BE CAPPED) TOTAL LO16,878 sqq,It. ALL LEACHING POOLS INSTALLED BENEATH WETLANDS AREA 230 sq.11. ■= MONUMENT � .. W CaET IRON DRIVEWAY VECO To HAVE WAVY DUTY LOCKING UPLAND AREA = 16#648s .f .� IMPERVIOUS SURFACE, = 1260 'S .It.. �= WETLAND FLAG : - 5 SUNG LOT COVERAGE = 7.6% LANDWARD EDGE OF TIDAL WETLANDS AS DELINEATED BY •?i RAN RUNOFF CALCULATIONS SUFFOLK ENVIRONMENTAL CONSULTING, INC. ON JULY 17, 2012 HOUSE - 960 SO. FT. LIC 960 r I y 0.17 A, 1632 CU.FT pUB ��of NEW}-® FLOOD ZONES FROM FEMA RATE MAP NO's 36103CO167H &-36103CO169H 1632/22.1 r 7.3 V.F. PROVIDE 2- DWS 6'I +$ 4 FT DE1D' @` �e1 E Ta ELEVATIONS ARE REFERENCED TO NAVD AREA TO WETLANDS (wetlands flags) = 16,878 Sq.ft.• AREA= -16;646 SQ.FT. µP �: I am familiar with the STANDARDS FOR APPROVAL ' 70: TIE LINES ` v ~ AND CONSTRUCTION OF SUBSURFACE SEWAGE J DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES .4- N.Y.S. LIC. NO. 49618 and will abide by the conditions set forth therein and on the ANY ALTERATION OR ADDITION TO THIS SURVEY 1S A VIOLA77ON OF SECT70N 7209 OF IIHE NEW YORK STATE EDUCATION LAW. MORS, P.C. permit to Construct. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS ( )-765-L5020 FAX (631) 765-1797 HEREON ARE VALID FOR 77-IIS MAP AND COPIES 77-IEREOF ONLY IF P.O. BOX" 909 The location of wells and cesspools shown hereon are SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF 77-IE SURVEYOR from fie/d observations and or from data obtained from others. WHOSE SIGNATURE'APPEARS HEREON. 1230 TRAVELER STREET 1,2=-,2,2,2 SOUTHOLD, N.Y 11971 �G Michael J. Domino, Pr--.Dent ,�I gUfFO(k i, Town Hall Annex John M. Bredemeyer, III, Vice-President {}o`� c°G 54375 Route 25 '-ACharles J. Sanders �� Y P.O. Box 1179 Southold, NY 11971 Glenn Goldsmith Telephone 631 765'=1892 A. Nicholas Krupski �y o��O P ( ) ��1 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD c1T� AXOX- �o QVFFX e- UW, TO: Please be advised that your application dated 10,17-1-7 has been reviewed by this Board at the regular meeting of I2-13-1and your application has been approved pending the completion of the following items checked off below. Revised Plans for proposed project Pre-Construction Hay Bale Line Inspection Fee ($50.00) 1St Day of Construction ($50.00) % Constructed ($50.00) Final Inspection Fee ($50.00) Dock Fees ($3.00 per sq. ft.) 30-Year Maintenance Agreement(complete original form enclosed and submit to Board of Trustees Office) V 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: 1�3 �g TOTAL FEES DUE: $ BY: Michael J. Domino, President Board of Trustees Michael J. Domino, Pres' i 0�0 Of F04 Town Hall Annex John M. Bredemeyer 111, Vice-President 54375 Route 25 Charles J. Sanders y x P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski y p! Telephone(631)765-1892 ��l �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD nad P- Date/Time: l� C-�� Completed in field by: C l 3 Suffolk Environmental Consulting on behalf of ESTATE OF FRED ADLER requests a Wetland Permit to construct a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway, install a sanitary system landward of dwelling; and connect to public water. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3-13 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment and 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: v11 ,�e9 I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: _ J. Bred eyerM. Domino Goldsmith L-N. Krupski Sanders Other Page 1 of 2 Michael J. Domino,Pres �O�QgufFO(,��oG Town Hall Annex John M. Bredemeyer I1I,Vice rresident yJ, 54375 Route 25 Charles J. Sanders ro z 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 TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: Suffolk Environmental Consulting on behalf of ESTATE OF FRED ADLER requests a Wetland Permit to construct a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway, install a sanitary system landward of dwelling; and connect to public water. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3-13 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 " j f i 1� A . ° 1 Estate of Fred Adler ` 415 Lakeside Drive,Southold SCTM#: 1000-90-3-13 12/5/17 3,>'' ' t ff :r r J ' �Y - R s i - r ' 7 ' .`"� �. .- ✓. "'c,.� ;. �,,,�� �y'i'.°y 'fir ��..."r_ ,i`.�-.,cc-+ �� .:�" n 1 • 4 .T. ,. 7 ,�,., y+R�„g• r'.• �,', to IT �+ .. : '�`�'a`�,�� .,, A M, V X, L AMA 5r BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK W C _2 PERMIT NO, 8436 DATE: MAY 11,2014 ISSUED TO: ESTATE OF FRED ADILER f .~7 PROPERTY ADDRESS: 445LAKESIDE DRIVE; SOUTHOLD SCTM#90-3-13 2- AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southoldand in 'accordance with the Resolution of the Board of Trustees adopted'-at the meeting held on May_21,2014,and in t) consideration of application fee in the Win of,$250.00 paid by Estate of Fred Adler and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits the following: `T�O Wetland Permit to construct,a 24'x40' two-story single family dwelling with a ;w 15'x2O' attached deck; install a gravel driveway; install a septic system; connect to t. public water; with the conditions to establish and subsequently maintain a nofi- disturbance buffer from flood zone line to edge of wetlands with a 4' wide path to water; and the installation of a line of staked hay bales and silt fencing along the flood zone line during construction; and as depicted on the survey prepared by John T. Metzger, Land Surveyor, last dated March 31,2014 and stamped approved on May 21, 2014. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Sea]to be affixed, l Ir t and these presents to be subscribed by a majority of the said Board as of this date.' Flit VV 2017 OCT 1 7 MIN aveA bs,e _t Southold Town ISR nrdAf—Trulces Charl J. Sanders-Absent V ..... Ig qe rn _g y. f4li VI% HN I�4M 3—Ld, TERMS AND CONDITIONS The Permittee Estate of Fred Adler, residing at 415 Lakeside Drive Southold,New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages,or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. I 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 provic id�;c ata,cqpy ee permit has been recorded with the Suffolk County I &AISL Siot%ce e a and deed restriction to the deed of the subject parcel. S idence shall be provide w in ninety(90) calendar days of issuance of this p ! OCT 1 7 2017 ! I 9. That the said Board will be notifie i by he Permittee of the co m` leti n_ of the work authorized. scuthcid 6m ard of T(L'S ces 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. 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. z l�� John M.Bredemeyer III,President ��®f S0Town Hall Annex�® Michael J.Domino,Vice-President �® �® 54375 Main Road En P.O.Box 1179 James F.King,Trustee 013 Southold,New York 11971-0959 Dave Bergen,Trustee Charles J.Sanders,Trustee ®��tTelephone(631) 765-1892Fax(631) 765-6641 9 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 21, 2014 Mr. Bruce Anderson Suffolk Environmental Consulting, Inc. ---- PO Box 2003- ---- ---- --- -�—��---�--------------- ------------- Bridgehampton, NY 11932 RE: ESTATE OF FRED ADLER ; OCT 1 7 2017 415 LAKESIDE DRIVE, SOUTHOLD SCTM# 90-3-13 L_________ Southold Dear Mr. Anderson: ar of Trustee The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 21, 2014 regarding the above matter: WHEREAS, Suffolk Environmental Consulting, Inc. on behalf of ESTATE OF FRED ADLER 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 14, 2014, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the application be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 21, 2014, 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, 1 WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees have found the application to be Consistent with the Local Waterfront Revitalization Program, and, RESOLVED, that the Board of Trustees approve the application of ESTATE OF FRED ADLER to-construct a 24'x40'_two-story_single family-dwelling with a_15'x20' attached deck; install a gravel driveway; install a septic system; connect to public water; with the conditions to establish and subsequently maintain a non-disturbance buffer from flood zone line to edge of wetlands with a 4' wide path to water; and the installation of a line of staked hay bales and silt fencing along the flood zone line during construction; and as depicted on the survey prepared by John T. Metzger, Land Surveyor, last dated March 31, 2014 and stamped approved on May 21, 2014. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. - Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $100.00 Very truly yours, .,7, John M. Bredemeyer III President, Board of Trustees E E JMB/amn OCDO T172017 J` --�J Southold Town ar of Tru ee SURVEY FOR THE ES TA TE, "'"' OF FRED ADLER sas2>a s2•e O 7N AT BA YVIEW __ "B #7 S6,1 cy TOWN OF-SOUTHOLD —` — 73 �' EI. 5,j +8F_ ( diskurbance- TEST 60RNG COUNTY, N.Y. 20 TiF• i� �� 5� 67 McOcrAk G uciwe. —90-03-13 '1'� uNe b 1173114 LE,' 1�= 30' ---`y� ---- -- 0 IpA f u 9`"d qt�aR f 85 80.2 EL&4 0. e.o.n Low o. ST 20, 2012 F� OL 017.1 0,2012(bldg..nvWop.) Q4 SS1' 2014(PROP.HOUSEI ,, ` 1 Brom SII AIL 4c31,2014 CAREA TO WETLANOSI , 'b,S•T EL. 2Pd.8rovn Sid/SRIMLS - SUBSURFACE SEWAGE DISPOSAL NOTE, h o d3 6T 6 C SYSTEM DESIGN ; L 0 T(60), X_ 0 70 c v BY'JOSEPH FISCHETTE, P.E. x SPOT �� 0�s�F]w�wlb = HOBART ROAD G O Y. will,lo•/, 6rw.1 ,�, APPROVED BY SOUTHOLD,N.Y.11971 B 20 / 1 6 6' SPOT L sW O (631) 765 2954 7 0' x &4 BOARD OF TRUSTEES yc v v rQ�q #2 FN.b Coors. TOWN OF SOUTHOLD �� , X 4jl,l d n s.nd w/h lox ATE PROPOSED SEPTIC SYSTEM •o �o Q O �6 b Grov.l 15' J< Z� FIN FLA. LOT(61) `\\\"11� /. hm b C£RnInE 10.5 0•G Foe 8nA06 0.r � 0.�CS Q r Am.ovro �AFrllovm z� a * �+. m f u h S 1'I ri c i n kt p orlon Plao ee.s cw sT z �I, f g^ryry 7�11� , eau cs. zWT Q M� Lp C ' (LOT)/g REFER TO 'SUBDINSION MAP OF CEDAR BEACH PARK- I-1000 PRECASTSEPTICTIC TA �1 Ex.- ' ' 6x•72 FILED IN THE SUFFOLK COUNTY CLERKS OFFICE DEC.20, 1927 5-WO.2' LEACHING POOLS WITH • 1X1 W t AS MAP NO. 90 3'SAM COLL9 gAR(SW)2'ABOVE 571 I rL'Ap01•�pWHAVE TRAFFIC yNv/s.l UTL,p01� ' C *(�BEARW6 COVERS CL.EL 60' D+'1• L,Ai(ESIDE EE EL ROAOI DRIVEWAY QJO G APR 1 4 1014 pUBLjO . JwJi„ m,,fi d� T ■= MONUMENT 'ry,� A= WETLAND FLAG �9 -If�SOFNEIV)0 LANDWARD EDGE OF TIDAL WETLANDS AS DELINEATED BY RAWRLWOFF CALCLLATVM D.SLOOG 9 at MET2 SUFFOLK ENVIRONMENTAL CONSULTING, INC. ON JULY 17, 2012 HOUSE.960 SO.FT. r pUBUC WAS p'� C 960-I+a i7-1632 CU.FT 4 at- I FLOOD ZONES FROM FEMA RATE MAP NO's 36103CO167H k 36103CO169H 1632/Z2.� 73 VF.ELEVATIONS ARE REFERENCED TO NAVD PxovnE z-OWs 6I.4 Fr.DEEPAREA TO WETLANDS (wetlands Nags)= 16,878 Sq.f(.am familiar with the STANDARDS FOR APPROVAL AREA= 16,W SQ FT. Vo 4„`+618 AND CONSTRUC77ON OF SUBSURFACE SEWAGE (TO•TIE LINES) DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES N.YS LIC. NO 49618 and will abide by the conditions set forth therein and on the ANY AL7ERA770N OR ADD177ON TO 7HIS SURVEY IS A WOLA710H ECONIC S YORS, P C. permit to construct. OF S£C710N 7109 OF THE NEW YORK STA7E EDUCA77ON LAW EXCEPT AS PER SEC71ON 7209-SUBDIWSON 2. ALL CERTIRCARONS (631) 765-5020 FAX (631) 765-1797 The location of wells and cess Dols shown hereon are HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.0 BOX 909 P SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREETFl-2-222from field observations and or from data obtained from others WHOSE SIGNA7URE APPEARS HEREON SOUTHOLD, NY 11971 ADLER Property —del Situate: 415 Lakeside Drive (South) ■ Southold ■ New York SCTM #: 1000—090—03 - 013 " • - (Photo taken on October 2, 2017) t�. Photograph indicating the flagged wetlands boundary along the northeastern shoreline of subject property and the dredged channel, facing southeast. . 3 LIU i h LI CD n W a. m , ADLER Property Situate: 415 Lakeside Drive (South) ■ Southold ■ New York _ SCTM #: 1000—090—03 - 013 (Photo taken on October 2, 2017) W � Photograph indicating the flagged wetlands boundary along the northeastern shoreline of subject property and the dredged channel, facing west. _ ADLER Property � Situate: 415 Lakeside Drive (South) ■ Southold ■ New York SCTM #: 1000—090—03 - 013 (Photo taken on October 2, 2017) Photograph indicating the flagged wetlands boundary along L the northeastern shoreline of subject property and the dredged channel, facing west. 1. U N c � d LIE 0 O L 1!i CD L ADLER Property Situate: 415 Lakeside Drive (South) ■ Southold • New York= E. SCTM #: 1000—090—03 - 013 ' (Photo taken on October 2, 2017) r F Photograph indicating the staked out northwestern corner of - ;a the proposed deck. Photograph taken from the central section 'e of the property, facing northeast. , . . rs •. �• `$ 3 � ADLER Pro ert Situate: 415 Lakeside Drive (South) ■ Southold ■ New York SCTM #: 1000—090 —03 - 013 F ' (Photo taken on October 2, 2017) t _ Photograph indicating the staked out northeastern corner of t �� the proposed deck (front stake) and northwestern corner of the ro osed dwelling (rear stake). Photograph taken from the ntral section of the property, facing northeast. _ 3-7 r� � ' 's °`�! �..`j'"0�Vi -..x { + �✓..a..���°* * ;yrs,. x ti 1 l „,moi ADLER Property Situate: 415 Lakeside Drive (South) ■ Southold ■ New York , SCTM #: 1000—090 —03 - 013 (Photo taken on October 2, 2017) Photograph indicating the staked out northeastern corner of the proposed dwelling. Photograph taken from the central section of the property, facing northeast. ' J A* _ s i ADLER PropertyF d Situate: 415 Lakeside Drive (South) ■ Southold • New York SCTM #: 1000—090— 03 - 013 4 1 i I (Photo taken on October 2, 2017) 1 ' Photograph indicating the staked out location of the sanitary ;► ra . p system. Photograph taken from the southern section of the Y g property, facing northeast. ilk sl CD .. i . y- k d r t � • a ' Suffolk Environmental Consulting, Newman Village,Suite E,2322 Main Street i ADLER Property P.O.Box 2003,Bridgehampton,NY,11932; Situate: 415 Lakeside Drive (South), Southold, NY • SCTM#: 1000 — 90-03-0013 I 1%4 I%j III R., V41L� IYIlA11�l4 - %v M '10 � Financial c Ccer yy, Pd Solutions A�d Protection Plus Alarm Service Inc ` ( . r - t tr 'a �t4y p ;IIIA N1 a ata 2014 o le FYE avT 1 7 L) n Southoid Town Bud of Trustees AF 15 I ^. TOWNOF "I S SOUT Ow "4 /< m 13 ,snlc> 23n(ct 1 2 IV Of nn ^a / (33 7 SE t Z Z na r, 4 0 0 tDa 12 s laag nm "'� ----------------- 13 ______________13 nwl` g O 3` n� / TOM OF 0 CEDAR ' SOUTHOI-D m 51 , TOMOFSO,1,HOLO nr MITT w T 14 IV ZONC) 11 arc) 9 na m S 27 = 29 F iq nm 1 1d°l is 8 23 WEsr wrE s _ z. a n,° a Fp so to 1 n.eore.. ______-_ rte{- 2g nw TOWN OF ;N' to m b 4p SOUOIOID ,, e+i 17 �„ a ta,: � '° T � t ze "r DR. E " W LAKE . / ze t 25 s /8 20 i is ny, zf 22 " e p,>) 1_ :17A(c) Ie v ,9 le YU S s e t 112N.) t HOG -- - t N--C/( BAY >ss mw� COUNTY OF SUFFOLK © SOUTHOLD NOTICE K Twm os SECTION NO Real Property TaxSernceAgenLyy v 090 P laic,vD 7000 r .• Z" '.y',4i:,-'"yw5"`+B1a.:x -s2. •=a'=*q,,• ^'•�.yy.-•� ", ..�' _ _ PROPERTY MM I - - :•�'"' .d5 :`4`'^}:�'. '. i`f.'.,.r ,fir .,.,.�.: - .o.. - .« S _ ;-F vim`"Y '$.$.^#,h C�.. �' y.� _ N;R:3 ..'iLe ,-DRi'2'E'_'�'4.,Y•«^°, - ,s,e l Suffolk Environmental Consulting, Inc. Newman Village, Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President December 29, 2017 Mr. Michael Domino, President Board of Trustees , E � E � V E Town Hall 'RI P.O. Box 1179 II Southold, NY 11971 JAN — 3 2018 Re: ADLER Property Soa{h^Id Town Situate: 415 Lakeside Drive-Town of Southold,NY _ �; uE SCTM#: 1000-090-03-013 Dear Mr. Domino, Enclosed herewith please find a check made payable to the Town of Southold in the amount of $50.00 in satisfaction of the final inspection fee for the above referenced permit matter. A certified copy of the required Declaration of Covenants will be provided to you shortly. Yours truly, Bruce A,Anderson CC. Estate of Fred Adler OFFICE LOCATION: 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 � Y� Telephone: 631 765-1938 Q Fast: 631765-3136 I�COUNTY,� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: December 7, 2017 Re: LWRP Coastal Consistency Review for ESTATE OF FRED ADLER SCTM# 1000-90-3-13 The Board of Trustees issued a Wetlands Permit(8436) in 2014 for the property and action. The permit included the establishment of non-disturbance/non-fertilization buffer from the edge of the flood line to the edge of wetlands. A 25' wide non-disturbance, non-fertilization buffer is shown on the survey, however, is not included within the legal description. The addition of the language to the description is recommended. Suffolk Environmental Consulting on behalf of ESTATE OF FRED ADLER requests a Wetland Permit to construct a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway, install a sanitary system landward of dwelling; and connect to public water. Located: 415 Lakeside Drive, Southold. SCTM# 1000-90-3- 13. The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP provided that the following is required to further Policy 6: 1. The 25' non-disturbance/non-fertilization buffer is required. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. { 1 Peter Young,Chairman Town Hall,53095 Main Rd. Lauren Standish,Secretary P.O.Box 1179 �► ' ' Southold,NY 11971 Telephone(631)765-1889 Fax(631)765-1823 Conservation Advisory Council Town of Southold At the meeting of the Southold Town Conservation Advisory Council held Wed., December 6, 2017 the following recommendation was made: Moved by Keith McCamy, seconded by Peter Meeker, it was RESOLVED to SUPPORT the application of the ESTATE OF FRED ADLER to construct a 24'X 40' two-story single-family dwelling with a 15'X 20' attached deck, gravel driveway, septic system and to connect to public water. Located: 415 Lakeside Drive, Southold. SCTM#90-3-13 Inspected by: Peter Meeker, John Stein The CAC Supports the application, however, there is a concern with the alignment of the proposed footprint and the impacts on the rear setback. Vote of Council: Ayes: All Motion Carried ✓ It59:3/S (vlatn K030 Michael J Dorn"no. V+cc-PrcSIdCnC O ! s P O Box 1179 James F LGng.Trustcc 9 ,,")Id Nc— York 1 197 1-0959 Oa,•e Bergen. Trustee Telephone(63l) 765-1892 Charles J- Sanders. Trustee 0 Fax(631) 765-6691 BOARD OF TO%V\-T TRUSTEES TOWN OF SOUTHOLD D To: ;Southold-Town Building Department D Re- Verification of Building Department PermiL Requiremen s NOV 1 2017 BUILDINGDEPT. SGTM#= q®—���J 5719.!ToWN F SODER Property Owner Blame. PLEA- 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 belov{r_ YES t�lO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered as Demolition as -described under Town Code? COMMENTS_ 1-7 Anature of Reviewer Date John M Bredemeyer III,President � *�a$ ";�, Town Hall Annex Michael J. Domino,Vico-President is 54375 Main Road P.U.Box 1179 James,F.King,Trustee _ Southold,Now York 11971-0959 Dave Bergen,Trustee � , � Charles J.Sanders,Trustee ' ,¢r Telephone(631)765-1898 -���E Fax(631)765-6641 (t� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only Coastal Erosion Permit Application X Wetland Permit Application Administrative Permit Amendment/Trans fer/Extens ion Received Application: - Received Fee:$ - �Completed Application: p Incomplete: rjD E C" E 0 V©� E SEQRA Classification: Type I Type II Unlisted Coordination:(date sent) OCT 1 7 2017 10, LWRP Consistency Assessment Form: 17-1-17 CAC Referral Sent: 11.2041 Date of Inspection: 12-5-4-1 Southold Town Receipt of CAC Report: Board of Trudees Lead Agency Determination Technical Review: Public Hearing Held: 17-139 7 Resolution: Name of Applicant ESTATE of FRED ADLER c/o Jenifer Gould, Esq.(Adrien Adler—Executor) Address P.O. Box 988 - Southold -New York • 11971 Phone Number: ( 631 ) 765 - 8375 Suffolk County Tax Map Number: 1000— 090—03 —013 ri orV Property Location: 415 Lakeside Drive - Town of Southold -New York (provide LILCO Pole#, distance to cross streets, and location) AGENT: Bruce A. Anderson- Suffolk Environmental Consulting, Inc. . (If applicable) Address: P.O. Box 2003:Bridgehampton,NY 11932 Phone: (631) 537—5160 Board of Trustees Application GENERAL DATA Land Area(in square feet): 16, 648 square feet Previous use of property: Residential Intended use of property: Residential Covenants and Restrictions: 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 a decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? Yes X No Prior permits/approvals for site improvements: Agency Date Southold Trustees' Wetlands (No. 8436.) May 21, 2014 (renewed in 2016) 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): The applicant proposes to construct a 24'x 40' two story single family dwellingwith a 15'x 20' attached deck,gravel driveway, septic system and to connect to public water. Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purposes of proposed operations: The Applicant proposes to construct a 24'x 40' two story dwelling with a 15'x 20' attached deck, gravel driveway, on site septic system. Dwelling to be served by public water. Area of wetlands on lot: 0.0 square feet Percent coverage of lot: 0.0 (8°o at project completion) Closest distance between nearest existing structures and upland edge of wetlands: 0 feet (vacantparcel) Closest distance between nearest proposed structures and upland edge of wetlands: 56' feet Does the project involve excavation or filling? No X Yes (Basement&Septic Installation) If Yes, how much material will be excavated? 350 (cubic yards) How much material will be filled? N/A (cubic yards) Depth of which material will be removed or deposited: - 10.0 f feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Typical Excavator/Backhoe for the majority of excavation; remainder by hand. 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): No impact to the surrounding environment is anticipated because all qppropriate erosion controls will be implemented in connection with the construction of the dwellingand nd septic system. Thereafter, full runoff controls Gutters/drywells will be installed. Board of Trustees Application COASTAL EROSION APPLICATION DATA N/A Purposes of proposed activity: Are wetlands present within 100 feet of the proposed activity? No Yes Does the project involve excavation or filling? No Yes If Yes, how much material will be excavated? (cubic yards) How much material will be filled? (cubic yards) Manner in which material will be removed or deposited: Describe the nature and extent of the environmental impacts reasonably anticipated resulting from implementation of the project as proposed. (Use attachments if necessary) E _ 617.20 Appendix B Short Environmental Assessment Form Instructions for Completin;: Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: ADLER Project Project Location(describe, and attach a location map): 415 Lakeside Drive(south),Southold,New York(SCTM#- 1000-090-03-013) Brief Description of Proposed Action: Applicant proposes to construct a 24'x 40'two story single family dwelling with a 15'x 20'attached deck,gravel driveway,septic system and to connect to public water Name of Applicant or Sponsor: Telephone: (631)537-5160 Matt D [vans-Suffolk Environmental Consulting, Inc. E-Mail: mdivans@optonline net Address: P.O Box 2003 City/PO: State: Zip Code: Bridgehampton NY 11932 1.Does the proposed action only involve the legislative adoption of a plan,local law, ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑✓ F may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: 1:1LZ New York State Department of Environmental Conservation Wetlands Permit;Suffolk County Department of Health Services Permit;Town of Southold Budding Permit 3.a.Total acreage of the site of the proposed action? 0 38 acres b.Total acreage to be physically disturbed? 0.13 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.38 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial [:]Commercial ®Residential(suburban) ❑Forest ❑Agriculture El Aquatic El Other(specify): ❑Parkland Page 1 of 4 5,. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑✓ ❑ b. Consistent with the adopted comprehensive plan? ❑ ❑✓ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑✓ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes, identify: Pecomc Bay(including its tributaries) ❑ 0 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES ❑✓ ❑ b.Are public transportation service(s)available at or near the site of the proposed action? ❑ ❑✓ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑✓ ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ ' 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ N/A 11.Will the proposed action connect to existing wastewater utilities? NO YES If No, describe method for providing wastewater treatment: ❑ On site septic system. 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ❑✓ ❑ b.Is the proposed action located in an archeological sensitive area? '7 ❑ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑✓ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑✓ ❑ 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 m Forest ❑Agricultural/grasslands ❑Early mid-successional Z 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? V ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? ❑NO DYES b.Will storm water discharges be directed to established conveyance systemsoff and storm drains)? run If Yes,briefly describe: NO DYES 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: ❑ ❑ 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: Z ❑ 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: Z ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE ApplicantisponsoAnag(. Matftt D.[vans-Suffolk Environmental Consulting,Inc. Date: October 2,2017 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning 1:1regulations? Ef 2. Will the proposed action result in a change in the use or intensity of use of land? LL/J 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 1:1establishment of a Critical Environmental Area(CEA)? 21 J 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? ; 7. Will the proposed action impact existing: FA- ❑ 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, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 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 1:1problems? 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. ❑ Check this box if you have determined,based on the information and analysis above, and any supporting documentation, that the proposed action will not result in any significant adverse environmental im acts. Name of LeaU Age Ply-"4 Date Print orT e Name o esponsibl O cer in Lead Agency Title of Responsible Officer Signature of Responsibl fficer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT7 Page 4 of 4 YKOOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 90.-3-12 Albert F and Joan Murray PO Box 1618 Southold,NY 11971 90.-3-16 Lin Buckfield and Melissa Jane Kelly 428 Hudson St Apt 2 New York,NY 10014 90.-3-17 Ralph E and Marie A Gerchak 2011 154th St Whitestone,NY 11357 STATE OF NEW YORK COUNTY OF SUFFOLK Bruce A. Anderson residing at Suffolk Environmental Consulting, Inc, P. O. Box 2003, Brid e�pton,NY 11932,being duly sworn, deposes and says that on the day of , 2017, deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Bridgehampton, that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to be re me this Day of z , 20 L7 Notary Public Matthew D Ivans Notaiy F-biic of New York No 011V13052859 Qualified in Suffolk County Commission Expires January 22, 2017 0 NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: ADLER Project SCTM# 1000—090—03—013 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to conduct regulated activities: The A1212licant 12rol2oses to construct a 24' x 40' two story dwelling with a 15' x 20' attached deck, gravel driveway, on site septic system. Dwelling_ to be served by public water. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 415 Lakeside Drive -Southold - New York 3. That the project which is subject to Environmental Review under Chapters 96, 111 and/or 275 of the Town Code is open to public comment on: DATE: December 13, 2017 You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. PROPERTY OWNERS NAME: ESTATE of FRED ADLER c/o Jenifer Gould,Esq_(Adrien Adler—Executor) MAILING ADDRESS: P. O. Box 988. Southold,NY, 11971 PHONE #: (631) 765-8375 AGENT: Bruce A. Anderson a- Suffolk Environmental Consulting Inc. MAILING ADDRESS: P. O. Box 2003, Bridgehampton, NY 11932 PHONE #: (631) 537 -5160 Enc: Copy of sketch or plan showing proposal for your convenience. ' . .. ` � TM � l U.S. PottalService CERTIFIED MAILO RECEIPT ^~ Domestic AW1 Only '" El Retu.Receipt(hardcopy) $ r-3 El Rqtum Receipt(electronic) $ $0 �a C3 El Certified Mail Restricted Delivery $ Postmark' Here r3 Adult Signature Restricted Delivery$ —rNOV 3 0 2017 m Postage ) i M o I Postage and Fees 11/30 2017 knt to Stre ox No. to tv CERTIFIED MAI RECEIPT _ ru . ED (TerUTtea man t-ee $3.35 ^ r-3 El Retum Receipt(electm $ Postmark C3 El Adult Signature Requi $ 3 [O]Adult Signature Resin Delivery$ ---------------------------- W left / -" . � ru 41 Pul AT M Certified Mail Fee $7,35 . C3 . . PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: ?-:3 '•:+. T.:^ •'.. ket `}•w'tet YY ito. / pv • .r M1,p '`` ^,{' «}'3 eft C1„ S STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of . 20___, deponent mailed a-true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite there respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at , that said Notices were mailed to each of said persons by CERTIFIED MAII,IRETURN RECEIPT. Sworn to before me this Day of ,20 I i i Notary Public NUTILL Ulm - HtAtiING 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: ESTATE OF FRED ADLER SUBJECT OF PUBLIC HEARING : For a Wetland Permit to construct a 24'x40' two-story, single family dwelling with a 15'x20' attached deck on northwesterly side of dwelling; install a gravel driveway, install a sanitary system landward of dwelling; and connect to public water. Located: 415 Lakeside Drive North, Southold. SCTM# 1000-90-3-13 TIME & DATE OF PUBLIC HEARING : Wednesday, December 13, 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 B a.m. and 4 p.m. BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892 Michael J.Domino, President �o�QSUFFO(,��oG Town Hall Annex John M.Bredemeyer III,Vice President yam, 54375 Route 25 Charles J. Sanders o P.O.Box 1179 C Glenn Goldsmith ® Southold,NY 11971 A.Nicholas Krupski y p! Telephone(631)765-1892 ��� �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of ESTATE OF FRED ADLER COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I, PwnA , residing at/dba SUFFOLK ENVIRONMENTAL CONSULTING,INC. BOX 2603 �.�. BRIDGEFIAMPTON,NY 11932-2003 being duly sworn, depose and say: That on the day of 9f8vu-.6­_- , 2017, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, December 13,2017. Dated: -'V1,31"7 (signature) Sworn to before me this ISM day ofD!(, 20/1 Notar blic Matthew o. vans Notary Pdb'r Ut Nevd York NU �i i i'JF 05;; 59 QuaUfietl r:. Suri(*, Gounty Commission Expires January 22, 201 Board of Trustees Application County of Suffolk State of New York Adrien Adler 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 SOUT-HOLD TOWN-BOARD-OF TRUSTEES.-THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMELESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY BIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENTATIVES, TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. Signature SWORN TO BEFORE ME THIS DAY OF 19C I�-5 k e-1- ,20 /1— Notary 0f 1Notary Public SARA D. NICHOLSON A Notary public in and for the Province of Nova Saba Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, Adrien Adler—Executor(Estate of Fred Adler) c/o Jenifer Gould, Esq. residing at (print owner of property) P. O. Box 988, Southold,NY 11971 do hereby authorize (mailing address) Suffolk Environmental Consulting, Inc. to apply for permit(s)from the (Agent) Southold Board of Town Trustees on my behalf. 4, z & (Owner's signature) APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of the town officers and employees. The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: _ _ Adler, Adrien (Last name,first name,middle initial,unless you are applying in the name of someone else of other entity, such as a company.'If so, indicate the other person's or company's name.) NATURE OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other - (If"Other,"name the activity.) Do you personally(or through your company, spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold?"Relationship"includes by blood,marriage, or business interest. "Business interest"means a business, including a partnership, in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5% of the shares. YES NO X If you answered "YES," complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between you—elf(the pplicant/agent/representative)and the town officer or employee.Either check 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 rr Submitted this _51k day of c`C 20il- Signature Print name Adrien Adler 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",then the proposed action may affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus,the action should be analyzed in more detail and, if necessary, modified prior to making a determination that it is consistent to the maximum extent practicable with the LWRP policy standards and conditions. 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# 090 - 03 - 013 The Application has been submitted to (check appropriate response): Town Board ❑ Planning Dept. ❑ 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: Applicant Proposes to construct a 24'x 40' two story dwelling with a 15'x 20' attached deck, gravel driveway, on- site septic system. Dwelling to be served by public water. Attach additional sheets if necessary Location of action: 415 Lakeside Drive(South),Southold,New York Site acreage: 0.32 acre f Present land use: vacant 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: Estate of Fred Adler c/o Jenifer Gould,Esq. (Adrien Adler,Executor) (b) Mailing address: P. O.Box 988; Southold,NY 11971 (c) Telephone number: Area Code(631)537—5160(Agent) (d) Application number, if any: N/A 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? DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure, makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ® Yes ❑ No ❑, Not Applicable As indicated within Policy 1, "Development that does not reinforce the traditional land use pattern of the Town of Southold would result in a loss of the community and landscape character of Southold.", this proposal is to construct a new dwelling in keeping with the residential character of the area. 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 ® Not Applicable Policy 2 is not applicable in that subiect lot and the surrounding neighborhood cannot be deemed a substantial historic and/or archaeological resources Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See L"P Section III—Policies Pages 5 through 7 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal will not adversely impact the visual quality of the surrounding area in that the neighborhood is characterized by similar residential development. Subject parcel is a wooded lot whose character will remain after construction including a buffer to wetlands as appropriate. The siting, scale are compatible with the neighborhood. The remaining sub policies are not applicable. Attach additional sheets if necessary i 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 ® Not Applicable Dwelling to be constructed in an "X"zone. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III -Policies Pages 16 through 21 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subject proposal incorporates compliant septic system and drainage control all of which will protect surface waters. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria ® Yes ❑ No ❑ Not Applicable Subiect proposal protects the quality by avoiding the loss of ecological components . In addition impacts relating to the proposed development are fully mitigated by septic design and placement, drainage design, the expectation that a buffer will be established and suitable erosion control implemetned. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section IH -Policies Pages 32 through 34 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 7. 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 HI —Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑. No ® Not Applicable Subject proposal is not applicable to Policy 8. Attach additional sheets if necessary 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 r ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 9. Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependence uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Subject proposal is not applicable to Policy 10 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 Subject proposal is not applicable to Policy 11. 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 Subject proposal is not applicable in that the proposal does not involve agricultural lands(Le the conversion of farmland, the establishment and/or maintenance of new coastal agricultural production, etc...) 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 Subject proposal is not applicable in that the proposal does not involve the conservation of energy resources on a commercial level and/or the promotion of alternative energy sources,proper maintenance of fuel storage facilities and/or the extraction of mineral extraction Attach additional sheets if necessary Created on 5/25/05 11:20 AM Suffolk Environmental Consulting, Inc. Newman Village,Suite E,2322 Main Street,P.O.Box 2003,Bridgehampton,New York 11932-2003 (631) 537-5160 Fax: (631) 537-5291 Bruce Anderson,M.S.,President HAND DELIVERED October 17, 2017 E C E Q V DE PD Mr. Michael Domino, President 1� L! OCT 1 7 20 17 Board of Trustees Town Hall P.O. Box 1179Southold Town Board of Trus'e�s Southold, NY 11971 Re: ADLER Property Situate: 415 Lakeside Drive ■Town of Southold, NY SUM #: 1000—090—03 - 013 Dear Mr. Domino, This Firm represents the owner of the property referenced above, who was issued a Town of Southold Board of Trustees' Permit (No. 8436) on May 21, 2014. In that the permit has since fully expired and the work has not commenced, renewal of same is hereby requested. Please find enclosed herewith for your review: (1) Town of Southold Trustees Wetlands Permit Application (original and three [3] copies); (2) Local Waterfront Revitalization Program application (original and three [3] copies); (3) Short Environmental Assessment Form (original and three [3] copies); (4) Location Map for reference (four [4] copies); (5) Photos of the property indicating the staked out locations of the proposed improvements therein (four (4] sets); J Hammarth/ 2 (6) Survey of subject property, prepared by PECONIC SURVEYORS, last dated May 7, 2015, indicating conditions thereon (four [4] prints); (7) Copy of the original Southold Trustees' Permit for reference (four [4] copies); and (8) Check made payable to the Town of Southold in the amount of$250.00 covering the requisite application fee. By way of this correspondence, and on behalf of the owner, I request that you commence review of this application and schedule before the next available Trustees Board meeting for discussion and subsequent permit issuance. Should you have any questions regarding this matter, or require additional information, please feel free to contact this office at any time. Thank you in advance for your cooperation. Sincerely, Matt D. Ivans enc. cc: A. Adler