Loading...
HomeMy WebLinkAboutTR-9132 Michael J.Domino,President *QF SU(/j Town Hall Annex John M.Bredemeyer III,Vice-President ,`Oy�lO 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski N G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 13, 2019 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: RK3 ESTATES, LLC 835 TARPON DRIVE, SOUTHOLD SCTM# 1000-53-5-8 Dear Mr. Herrmann: 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 grants the One-Year Extension to Wetland Permit#9132, as issued on December 13, 2017. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, 0 Michael J. Domino President, Board of Trustees MJD:dd suFFoc�`�, i J. Domino, Presic Town Hall Annex demeyer 111, Vice-P, •,, ,.ent ��� yJ, 54375 Route 25 /Glenn Goldsmith N Ze� P.O. Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: /6 7- 3 11,q Completed in field by: WN En-Consultants on behalf of RK3 ESTATES, LLC requests a One-Year Extension to Wetland Permit #9132, as issued on December 13, 2017. Located: 835 Tarpon Drive, Southold. SCTM#: 1000-53- 5-8 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 Noticeof Hearing Card Posted: Y / N/ Ch. 275 y Ch. 111 SEQRA Type: I II Unlisted,Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: r( fe t%t UIJ C)✓ I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. BredemeyerM. Domino G. Goldsmith N. Krupski G. Williams Other EN-CONSULTANTS C IF �� E ,,r � September 26, 2019 OCT - 1 2019 Southold Town Rn-qrd nf Trijefano PERMIT EXTENSION REQLTF_ST Town of Southold Board of Trustees Post Office Box 1179 Southold,New York 11971 Re: RK3 Estates,LLC 835 Tarpon Road, Southold SCTM#1000-53-5-8 Permit#9132 Dear Board of Trustees: The above referenced permit,transferred to RK3 Estates,LLC on March 20,2019 is due to expire December 13, 2019. As we've been advised that the approved work has not been completed, please accept this letter as a request for a one year extension. The permit fee of$50.00, a copy of the permit and permit transfer are attached. Thank you in advance for your attention to this matter. Yours truly, Robert E.Herrmann Coastal Management Specialist /khs Enc. 1319 North Sea Road I Southampton,New York 11968 p 631283 6360 f 631283 6136 www.enconsultants.com environmental consulting o� (/yOl Michael J.Domino,President �QF S0j Town Hall Annex 54375 Route 25 John M.Bredemeyer III,Vice-President h P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams 'cOlye 0 �o Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD March 20, 2019 Robert Herrmann En-Consultants 1319 North Sea Road Southampton, 'NY 11968 RE: RK3 ESTATES, LLC 835 TARPON DRIVE, SOUTHOLD SCTM# 1000-53-5-8 Dear Mr. Herrmann: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, March 20, 2019: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Wetland Permit#9132 from Robert & Rita Reis Wieczorek to RK3 Estates,_ LLC, 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, 0 Michael J. Domino, President Board of Trustees MJD/dd 1 1 - Michael J. Domino, Pres .- QSVFF�(6�el r Town Hall Annex II i nt ��� John M. Bredemeyer I,Vic `�ra--esde „ ��,& 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: 33 o9 Ib dl) Completed in field by: 7✓� En-Consultants on behalf of RK3 ESTATES, LLC requests a Transfer of Wetland-Permit#9132 from Robert & Rita Reis Wieczorek to RK3 Estates, LLC, as issued on December 13, 2017. Located: 835 Tarpon Drive, Southold. SCTM# 1000-53-5-8 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: I 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: S_4 1 -^ I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Michael J.Domino,Presidents�F SoUTy� Town Hall Annex John M.Bredemeyer III,Vice-President �® 1p 54375 Route 25 r ,,rr•� P.O.Box 1179 Glenn Goldsmith ts1 :`J `2 ' Southold,New York 11971 A.Nicholas Krupski Telephone(631) 765-1892 Greg Williams O CpUNI'� { Fax(631) 765-6641 y ,�c� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD JAN 2 Q APPLICATION FOR A TRANSFER OF A WETLAND PF_RM&T;_ 58 Pleasant Ridge Road DATE January 24, 2019 3 RK3 Estates, LLC OWNER PHONE 917-613-4545 MAILING ADDRESS c/o Angelo Rigas, 1063 85th Street, Brooklyn, NY 11218 AGENT En-Consultants PHONE 631-283-6360 ADDRESS 1319 North Sea Road, Southampton, NY 11968 PROPERTY LOCATION 835 Tarpon Drive, Southold TAX MAP NO. 1000-53-5-8 I/We En-Consultants for RK3 Estates, LLC request a Transfer of Permit# 9132 from Robert Wieczorek to RK3 Estates, LLC Signed By: Robert E. Herrmann, Coastal Management Specialist Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) UWe, Angelo Rigas,Member,RK3 Estates,LLC owners of the property identified as SCTM# 1000- 53-5-8 in the town of Southold New York,hereby authorizes En-Consultants to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this,p perty. J N/A Property Own is Signature Property Owner's Signature Angelo Rigas,Member,RK3 Estates,LLC SWORN TO BEFORE ME THIS ZL� DAY OF � _ , 2019 Notary Pubh EUGENIA TSATSARONIS Notary Public-State of New York No.O1TS6224501 Qualified in Kings County My Commission Expires Jul 6, 2022 7 Board of Trustees Application County of Suffolk State of New York Angelo Rigas,Member,RK3 Estates,LLC BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSS ES,�TPIEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROP�E T���TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW�OF MILICATION. l Signature,Angelo Rigas,Member,RK3 Estates,LLC SWORN TO BEFORE ME THIS _ DAY OF �C� ) ' 20 Notary Public EUGENLI T;ATSARONIS Notary Public-State of N�w York NO.01TS622450 i Qualified in KutgS County My Commission Expires Jul G,2022 i 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puMose oQ 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. Angelo Rigas,Member YOURNAME: RK3 Estates,LLC (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building _ 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 the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the 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 7q doy o 20pq Signature Print Name An eIo i as ,Member,RK3 Estates,LLC Form TS 1 1 APPLICANT/AGENT/IEPRESENTATIVE TRANSACTI®NAI.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 rovide 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: Herrmann Rn]vprf- F (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION. (Check all that apply) Tax grievance Building _ 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 the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person_ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation), B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant,or D)the actual applicant DESCRIPTION OF RELATIONSHIP Submitted this 24 of January 20 12 Signature Print Name K. Hermam Form TS 1 EN-CONSULTANTS PERMIT TRANSFER REQUEST January 24, 2019 Town of Southold Board of Trustees `- j ~` � Post Office Box 1179 Southold,New York 11971 �;�;,� ' ry T'. j'-"' gji�_4�1 Attn.: Elizabeth Cantrell I l Re: Permit#9132 835 Tarpon Drive, Southold SCTM#1000-53-5-8 Dear Board of Trustees: Please accept this letter as a request to transfer the above referenced permit from Robert Wieczorek to the current owner of record, RK3 Estates, LLC, whose address is c/o Angelo Rigas, Member; 1063 85th Street, Brooklyn,NY 11218. An application for Transfer of Wetlands Permit, copy of Permit#9132, and transfer fee of$50 is attached. Since e y, Robe �He=ann Coastal Management Specialist /khs Enc. "t 1319 North Sea Road I Southampton,New York 11968 p 631283 6360 f 631.283.6136 www.enconsultants.com environmental consulting T Michael J.Domino, Presidentvg SO�Tyol Town Hall Annex h O John M.Bredemeyer III,Vice-President 54375 Route 25P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Q Telephone(631) 765-1892 A.Nicholas Krupski COU Ti Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction, % constructed compliance ins ection Project complete, p p L i BOARD OF SOUTHOLD TOWN TRUSTEES `t tl SOUTHOLD, NEW YORK PERMIT NO. 9132 DATE: DECEMBER 13,2017 ISSUED TO: ROBERT & RITA REIS WIECZOREK .f J~ PROPERTY ADDRESS: 835 TARPON DRIVE, SOUTHOLD SCTM# 1000-53-5-8 AUTHORIZATION ' 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$250.00 paid by Robert & Rita Reis Wieczorek and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: �? Wetland Permit to construct a±14' (max.)by±26' (max.)in-ground swimming pool,raised±18" above grade with approximately 80 linear feet of"Redi-Rock" retaining wall and approximately 25 cubic yards �> of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing,and pool drywell; replace approximately 285sq.ft.of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property; and as depicted on the survey prepared by Nathan Taft Corwin III,Land Surveyor,last dated November 6, 2017,and stamped approved on December 13,2017. IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, 1` and these presents to be subscribed by a majority of the said Board as of this date. ' gUFF0t o coo `r!r i • x :l sPaSS ` vd'Pat5E .4.$iH "no'Cih4�G4�.tiusYCEru�ca`i:. s3a,"�Fssia�'a, swYX55AYe5rIcs.P.'S'ra)'Sul"Y�SS.KekfirsT,"„1 .'v.Xaa?tAYae',Szemi,aoxtcm,edYx�lXteK:.*taSE,,:,au�ue ^` �'`• r tm�n 6' Y r% ,•t :l,.�� S'qt a... .�-ri �..,n•..a �.Edo,�h yt' .•�~i'• � .1-.``,,.r'i .�1 i TERMS AND CONDITION, The Permittee Robert&Rita Reis Wieczorek, 835 Tarpon 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 SOUTy� Town Hall Annex John M.Bredemeyer III,Vice-President �� l0 54375 Route 25 P.O.Box 1179 Charles J. Sanders Southold,New York 11971 . Glenn Goldsmith G • Q Telephone(631) 765-1892 A.Nicholas Krupskiyc0 'O Fax(631) 765-6641 � UN1`I,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 13, 2017 Robert E. Herrmann En-Consultants 1319 North Sea Road Southampton, NY 11968 RE: ROBERT & RITA REIS WIECZOREK 835 TARPON DRIVE, SOUTHOLD SCTM# 1000-53-5-8 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 13, 2017 regarding the above matter: WHEREAS, En-Consultants on behalf of ROBERT & RITA REIS WIECZOREK, 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 November 8, 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, 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 ROBERT & RITA REIS WIECZOREK to construct a t14' (max.) by±26' (max.) in-ground swimming pool, raised t18" above grade with approximately 80 linear feet of"Redi-Rock" retaining wall and approximately 25 cubic yards of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approximately 285sq.ft. of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property; and as depicted on the survey prepared by Nathan Taft Corwin III, Land Surveyor, last dated November 6, 2017, 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$50.00 per inspection. (See attached schedule.) Fees: None Very truly yours, Michael J. Domino President, Board of Trustees MJD/dd FOGF°F P LOT AREA DATA SURVEY OF PROPERTY 1'RO FH c0�2q w�ta .'>-<� �s c� � � 1000-53-05-08S TAX . 26,185.91 sq. ft. SITUATE ^� ,11 "'S°�°S 1ARSHAlVI01VIAQUE YWIpF ✓SN�A�GfOe! 11, E19 11 dll S.C. TAX N0. 34,137.94 T4�p ?0r El8 (b S 111, , LA, E17 1000-57-01-39.2 0.784 cc. TOWN O F S O U T H O L D EDGE OF FRESH WATER - M 63es E20 EN-CONSULTANTSSONO NE GGED 6Y 2017 El & TOTAL 60,323.85 Sq. ft. SUFFOLK COUNTY, NEW YORK ,111, �5� ^ ` e130 = 1.385 cc. ^ � , F ���2� �y¢� E15 E2, S.C. TAX No. 1000-53-05-08 �y 00°0 1000-57-01 -39 .2 �y E23 9� 0 `� ��'s�+�' 2r�� E14 NOTES: ® L �c01p00 ���� ` ' 1. LOT NUMBERS SHOWN THUS: LOT 50 REFER TO SCALE 1 "=30' Tf °y MAP OF SOUTHOLD SHORES l, g // d ° `may E13 FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY SEPTEMBER 20, 1999 ON AUGUST 29, 1963 AS FILE No. 3853 E24 'V/ yj2 ' "�' '' 2. METES & BOUNDS DESCRIPTION of FEBRUARY 5, 2001 RE—CERTIFY SURVEY 1L 1 Fp G per. 100 S.C. TAX LOT No. 1000-57-01-39.2 IS JUNE 19, 2017 UPDATE SURVEY / 14.4C0 0•�? tiR 0� faro �WN ' REFERENCED TO DEED LIBER 11812 PAGE 730 NOVEMBER 6, 2017 ADD PROPOSED POOL �O / �N/rs�Gu/pR poo �\ E12 3. APPROX. 25 CY FILL MATERIAL TO BE OBTAINED 40.4. »: ......:>::'' eo F a ylsy 2� FROM ON-SITE EXCAVATION; NO ADDITIONAL OFFSITE CERTIFIED TO: O E25 FILL REQUIRED 11 ROBERT R. WIECZOREK °a� S s . f\4'� 2js �, ,Z 4A,,* 3 � a/N -7b/ 1, 111, RITA R. WIECZOREK 10 Np 3 4 U s bO( _ NF ��� EXISTING IMPERVIOUS LOT COVERAGE PROPOSED IMPERVIOUS LOT COVERAGE E26 °• NP A h� -^^ OVER N.Y.S.D.E.C. ADJACENT AREA (22,925 sq. ft.) OVER N.Y.S.D.E.C. ADJACENT AREA (22,925 sq. ft.) 1.1 1, m o�2 1.7, .1 (31 30 3, E9 E1 G��P� rev• V' DESCRIPTION AREA X LOT COVERAGE DESCRIPTION AREA X LOT COVERAGE 1 J� 4•� �2 ?.0• ES 1�. � `� / o N F HOUSE do PORCH 2,350 s ft. 10.3X HOUSE do PORCH 2,350 s ft. 10.3X o"4i 4i� a 77s q• q. X28$a E28 �� duo c J% Wo ap [y e W �� PQQvg O0 o A[ / DECK 265 s ft. 1.1% DECK 265 a ft. 1.1% 'R��Ebt op b I Q co ^�� N� �fPs O°K / .111, 57. q• q. O _ WALKS STOOPS Nb5 711���C e „15? ' OOPS ° 4a E7 ; & CELLAR ENTRANCE 210 sq. ft. 0.9X &ACELIART ENTRANCE 210 aq. it. 0.9Y. 6>�qs c=� F a u 020 DRIVEWAY 1,600 sq. ft. 7.OX DRIVEWAY 1,315 sq. ft. 5.7% 5 bRl L eM E2 1 Z' ?4/, �U / E6 00p W M� TOTAL 4,425 sq. ft. 19.3% PROPOSED POOL 410 sq. ft. 1.8% CO Q�2� E5 11 A[k A[ RAgq a MAXIMUM LOT COVERAGE: 20X OF UPLAND AREA = 4,585 sq. ft. TOTAL 4,550 sq. ft. 19.8% MAXIMUM LOT COVERAGE: 20% OF UPLAND AREA = 4,585 s ^ m // � 11 (11C EXISTING LOT COVERAGE OF TOWN q. ft. j 16O i1i, �� $ BUILDABLE LAND (22,542 sq. ft.) 00'= /v Q 1 E4 — O opo PROPOSED LOT COVERAGE OF TOWN DESCRIPTION AREA X LOT COVERAGE 3 BUILDABLE LAND (22,542 sq. ft.) / oN i1 S.C. TA No. 1000-53 05 08 HOUSE do PORCH 2,350 sq. ft. 10.4Y. LOT 51 / O� Plteti•• DESCRIPTION AREA X LOT COVERAGE A DECK 265 sq. ft. 1.2% HOUSE ✓¢ PORCH 2,350 sq. ft. 10.4%' E3 ' � �' TOTAL 2,615 sq, ft. 11.6% DECK 265 aq. ft. 1.2% O ` Op.. .'p'q 11 ?/ V 30'' 1 0 0 1111, PROPOSED POOL 410 sq. ft. 1.8% ��yE90 ,y1RF • .d W TOTAL 3,025 sq. ft. 13.4% S 63 00, 5 79e 3�,()��� E2 � Lre UNDERWATER LAND OF E1�O, ROBERT R. WIECZOREK J & RITA R. WIECZOREK �. v•... !`4 .. `4 BOAT BASIN S.C. TAX No. 1000-57-01-39.2 � rn oD ..... ....... 1 ORA --,,—UTILITYEO O PROPOSED POOL ELEVATION 'O 00100 NOV - 8 2017 - �—• APPARENT HIGH WATER MARK I � I 60.00, PPROV D BY LOT LOT @ BOARD OF 1 RUSTEES PREPARED IN ACCORDANCE WITH THE MINIMUM TO• •w' ` OF S UTHOLD ,, <<1 STANDARDS FORTITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.5. AND APPROVED AND ADOPTED DATE FOR SUCH USE BY THE NEW YORK STATE LAND TITLE ASSOCIATION. j 312Q�'f �O , OF ti ✓ t/ 1� f a7 1 ° t0. ! WOOD BULKHEAD Z 0 CP d yLN •si9� /Y.S. Lic. No. 504670)A • � ISU CAN Nathan Taf -� o r w i n III UNAUTHORIZED ALTERATION OR ADDITION fTl 161 .13' TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE Land Surveyor EDUCATION LAW. c 97 COPIES OF THIS SURVEY MAP NOT BEARING .7 t34e 30 00 THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. Successor To: Stanley J. Isaksen, Jr. L.S. CERTIFICATIONS INDICATED HEREON SHALL RUN Joseph A. Ingegn0 L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Title Surveys — Subdivisions — Site Plans — Construction Layout IS PREPARED, AND ON HIS BEHALF TO THE Y Y TITLE COMPANY, GOVERNMENTAL AGENCY AND LOT 3@ LENDING INSTITUTION LISTED HEREON, AND LOT 3� PHONE (631)727-2090 Fax (631)727-1727 TO THE ASSIGNEES OF THE LENDING INSTI- OFFICES LOCATED AT MAILING ADDRESS TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. 1586 Main Road P.O. Box 16 THE EXISTENCE OF RIGHT OF WAYS Jamesport, New York 11947 Jamesport, New York 11947 AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. 21-147B Michael J. Domino,Presjr_ O\OSVFFQ��COG tim Town Hall Annex John M. Bredemeyer,III,Vice-i�€sident '54375 Route 25 Charles J. Sanders y z P.O.Box 1179 Glenn Goldsmith 7 Southold,NY 11971 A.Nicholas Krupski ?' p! Telephone(631)765-1892 Olt �a Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD J Date/Time: -6 DEC L� Completed in field by: & (2jaV( ESc, wdo'yj En-Consultants on behalf of ROBERT & RITA REIS WIECZOREK request a Wetland Permit to construct a ±14' (max.) by ±26' (max.) in-ground swimming pool, raised ±18" above grade with ,approximately 80 linear feet of"Redi-Rock" retaining wall and approximately 25 cubic yards of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approximately 285sq.ft. of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property. Located: 835 Tarpon Drive, Southold. SCTM# 1000- 53-5-8 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment 'Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Present were: - J. Bre 'eyer L--< Domino . GoldsmithyN. Krupski Sanders Other Page 1 of 2 Michael J. Domino,Pres'��� ��S�FFU(K�D Town Hall Annex John M. Bredemeyer III,Vice-President ��� Gym 54375 Route 25 Charles J. Sanders y a P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski ?� • p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in Work Session by: En-Consultants on behalf of ROBERT & RITA REIS WIECZOREK request a Wetland Permit to construct a ±14' (max.) by ±26' (max.) in-ground swimming pool, raised ±18" above grade with approximately 80 linear feet of"Redi-Rock" retaining wall and approximately 25 cubic yards of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approximately 285sq.ft. of existing impervious driveway with pervious - driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property. Located: 835 Tarpon Drive, Southold. SCTM# 1000- 53-5-8 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 I iii`�l ��, �;' . ,►a a1.1 . r 1• / ILIi I1 1 I 1 1 1 , zwo IT art 06 1 J + 1 1 y . - N 1 R� '•.'tiSkN'� sri�-.: •w- ,�I'..J' _. Z� ►; � r ..'� Y.�l � .. "� ! +rIR� S /.v ♦r+•. •• 'YIc ,�1 h` _ •�.. • A yam}' .. � AlF •' �: a. �; �rte;�� 1; .�, ;a /'. '* � ��° : .a .R-�' ��'+� ,• .r r �� # � , R 4P •. ) 4 t iY' yrt 4 alb •.r. -P 835 Tarpon Dr V� ' Goo Ie earth AL r t' r � 'y'�ti� —'` - - --_ s •L � ,{� .vim--f w ` � 4 x ' r. i ^ • by _ s i r / *, ' � s 5 yr T.-.-iii•', e�p� A t W7—W- .477 I 14 X51.`♦ .r f r sk, y. wm�l 46, ,> M fi 4u.-r • L Rl i�iG 5�'� '3-..\ y.�/ f I , . , T r " u � � Y 1 . .cam ,,... rte, ,a• +q� „ �, # - AC, '`�. .iPM', "S.�• .1115„x! •1Q r "'t ...,.. ��- �. Vis. ✓•. 77 —C" SEESEC NO 00.5 VH y0 O - SEE SEG NO OIS 3 HATCH ONE FOR PCL NO0' 1D ° b iTA(c) SEESEC NO C 3 \\ ] TOWNOF O<SQS-0Oq q1�% JJ/ C S SOUTHOLD N W / ZA ..0\ S d o' FOR PARrt1 NO / 2 3 Tg4(C B SEE SEG NO / COUNTY//OF SUFFOLK Wµ y A t0 A IOWNOF SOUTHOLD iq TOWN OF SOUTHOLD 1p / / p b / � � ?/PFS 6 S y�. 4 � :a d� 1 • It m sena) /1 132A(c) d d I SO mole 8 /, / a3: ,' C NTY OF SUFFOLK It � 'B-� A�,r y e •, � � TowN OF Q�5 r+ 2 ,, SOUTHOID Q A 11 IA(c) O o SANG >'• ,Q To—OF SOUTNOLD � PIPEEEK .. c d d' vim, S � O 1JA(q 9 B 4a � ziE'e see y � l� y5a``°� r s,��' �a'�6FC`F fft• j 'Bbe�`� Fi B ♦ 9 0 9'�'` ,� B � � ,,, R e m STA 4'7 ^,, 4 a 4 e •� F� 0 m A:2,fa /�r' . '¢ o 1 e��Bp+,,n�`a' 4 `r° puGV'� •� 4 � e ��, B rY re rB r'� a � N b m ° 4v '4� 4`b 4.z •.�°� '� ,� x+< ., z0 zr�.r"t' Me O b �� �� � y b� t� v°�i •fie a ,,�„�� �.�,A` 4s p a All a .e' 7m I (' � 9 r11Z • b� d'4,e2`p9+' O .v ,ay3h �b.a _I 12aa �6 7S4 ,;� Sg• I g _ FOR PCL NO ♦ 489 C bN, `'" SEE SEC NO a1nTs---- _ I Y q 6 1MTCN ----- ONE MIITLH ONE �, ,�.�°O.j cis' OR m SEE SEC NO ov SEE SEG NO OST SEE SEC NO OS/ NOTICE awc COUNTY OF SUFFOLK © SOUTHOLD NSECTION NO E ---_ -- O� -- —_— —_— -- wnrweaOTICE cgn EK Rea�Property Tax Service Agency Y ' ru.wp«.zy - W— - uMY Canis.WrsN+wq,NY1t901 M o52 OSJ 053 s .s.yi'•.d'bid'M".' t..:ai.'f,'.hdt'M•.0;.b�. _ p - _ _ P 1000 PROPERTY MAP l= .., w.x.._ - ....._._: -.....:' .-i'.:: 5:.... is •.y;':F.. _ _ .. - �.( -, 821.97 P. 90 x . - _' }1 •SEE SEC NO 050- \ \ OFFICE LOCATION: � S® y® MAILING ADDRESS: Town Hall Annex �® �® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) e� Southold, NY 11971 ® Telephone: 631 765-1938 ® Fax: 631765-3136 c®U ,� 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 ROBERT & RITA REIS WIECZOREK SCTM# 1000-53-5-8 En-Consultants on behalf of ROBERT & RITA REIS WIECZOREK request a Wetland Permit to construct a ±14' (max.) by ±26' (max.) in-ground swimming pool, raised ±18" above grade with approximately 80 linear feet of"Redi-Rock" retaining wall and approximately 25 cubic yards of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approximately 285sq.ft. of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property. Located: 835 Tarpon Drive, Southold. SCTM# 1000-53-5-8 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: 1. The pool de-watering drywell is located less than 50' from the tidal wetland. It is recommended that the de-watering drywell is located the greatest distance from the tidal wetlands as practicable. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Peter Young,Chairman ti -� 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 Greg Williams, seconded by Keith McCamy, it was RESOLVED to SUPPORT the application of RITA REIS WIECZOREK & ROBERT WIECZOREK to construct +/-14' X 26' in-ground swimming pool, raised 18" above grade with approx. 80 If. of Redi-Rock" retaining wall and approx. 25 cy. fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approx. 285 If. of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated buffer areas within 10' of tidal and freshwater wetland boundaries on the property. Located: 835 Tarpon Drive, Southold. SCTM#53-5-8 Inspected by: Keith McCamy, John Stein, Peter Meeker The CAC Supports the application with the Condition the drywells are upgraded to contain the roof run-off. Vote of Council: Ayes: All Motion Carried ✓�O l� 54J/J [Aa,n Iio3d M chael J Oom:no. V+cc-PrestdcnC Ir ) P O Sox 1179 James F 1G ng- Trustee Soft �)(d. Ne•� tock it971-0959 Oa,e Bergen. Trustee yCl� Telephone(631) 765-1892 Charles J. Sandcrs. TrusteeFax(631) 765-6641 BO.AJZD OF TOWN TRUSTEES p TOWN OF SOUTHOL,D D To- Southold.Town Building Department NOV 8 2017 Re- Verification of Building Department Permit Requirements BUILDINGDEPT. TOS OF SOU THOL D SCTM#: r� Property Owner Name: ' W IL=C,xDP.�K Date Sent to Bldg- Dept_: The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Departments permitting requirements stated below: YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any-part of this application be considered as Demolition as 'described under Town Code? COMMENTS: ---------- - -- Date Signature of Review r A �OgpFFO��-C John M. Bredemeyer III,President ��.� Town Hall Annex Michael J.Domino,Vice-President54375 Main Road ti P.O. Box 1179 James F.King,Trustee D Southold,New York 11971-0959 Dave Bergen,Trustee y�/0� 0�' Telephone (631) 765-1892 Charles J. Sanders,Trustee Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only —/Coastal Erosion Permit Application Wetland Permit Application Administrative Permit _Amendment/Transfe/ xtension Received Application: j� °�7 _ Fee: t� r ��eceived �D�flQompleted Application E , E r---- f 1 Incomplete _ SE RA Classific fon: Type Q Type II Unlisted NOV 2017 11 ' Coordination- (date sent) LWRP Consistency Assessment Form Sr;t to r)en CAC Referral Sent: Board Date of Inspection: Receipt of CAC Report: _Lead Agency Determination: Technical Review: Public Hearing Held: 12-0. Resolution: Name of Applicant Rita Reis Wieczorek&Robert Wieczorek P.O.Box 1725 Address Southold,NY 11971 Phone Number: 631 477-6045 Suffolk County Tax Map Number: 1000 - 53-5-8 Property Location:835 Tarpon Drive,Southold (property is located on north side of Tarpon Dive,762'east of Main Road) (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road, Southampton,NY 11968 Phone:631-283-6360 � 1 Board of Trustees Ap cation GENERAL DATA Land Area(in square feet): 26,186 sf Area Zoning: R-40 Previous use of property: Residential,single-family dwelling Intended use of property: Same with swimming pool Covenants and Restrictions: Yes X No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept. Yes X No Does the structure(s) on property have a valid Certificate of Occupancy X Yes No Prior permits/approvals for site improvements: Agency Date Southold Trustees#5118 March 1,2000 NYS DEC#1-4738-02477/00001 January 26,2000 USA COE#1999-12970-L2 January 26,2000 NYS DOS#F-99-919 January 12,2000 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): Construct a+/-14' (max.)x+/-26'(max.)inground swimming pool,raised+/- 18"above grade with approximately 80 linear feet of "Redi-Rock"retaining wall and approximately 25 cy fill to be obtained from on-site excavation of swimming pool;install pool equipment,pool enclosure fencing,and pool drywell;replace approximately 285 sf of existing impervious driveway with pervious driveway surface;and maintain naturally vegetated buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated November 6,2017. Board of Trustees AppH4 ion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To construct a swimming pool in rear yard for recreational use. Area of wetlands on lot: 3,644 square feet Percent coverage of lot: 13.9 0/0 Closest distance between nearest existing structure and upland edge of wetlands: +/-19 feet (dwelling) Closest distance between nearest proposed structure and upland edge of wetlands: +/-50 feet (retaining wall) Does the project involve excavation or filling? No X Yes If yes, how much material will be excavated? +/-55 cubic yards(for installation of inground swimming pool) How much material will be filled? +/-25 cubic yards (to raise pool partially above grade) Depth of which material will be removed or deposited: +/-2 feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: Standard construction practices. 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): The project consists of the construction of an inground swimming pool that will result in an increase in Town-defined lot coverage by only 410 square feet to approximately 13.4 percent. In order to avoid interference with the groundwater table,the swimming pool will be limited in depth and raised partially above grade(+/- 18")using approximately 25 cy of fill(obtained from the on-site excavation of the proposed swimming pool)contained with a"Redi-Rock"retaining wall system,which allows the fill to be placed over the top of the retaining wall. The retaining wall and swimming pool will be set back no less than 50 feet from wetlands,as required by Section 275-3(D)(1)(a)(5)of the Wetlands Law of the Town of Southold. A temporary project limiting silt fence will be set in place between the work site and the surrounding tidal and freshwater wetland areas to control and contain site disturbance and potential runoff during construction;and a pool drywell will be installed upon completion of construction to permanently capture pool backwash. In order to mitigate the additional lot coverage,approximately 285 sf of existing impervious dnveway will be converted to a pervious driveway surface;and approximately 2,380 sf of naturally vegetated buffer areas will be maintained within 10 feet of the wetland boundaries on the property. Therefore,the project will be fully compliant with Chapter 275 and will not result in the physical loss,degradation,or functional loss of ecological components or otherwise adversely impact the adjacent tidal or freshwater wetland areas. L 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-Project Information.The applicant or project sponsor is responsible for the completion of Part 1.Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1.You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information Name of Action or Project: Wieczorek Swimming Pool Project Location(describe,and attach a location map). 835 Tarpon Drive,Town of Southold, Suffolk County,NY,SCTM# 1000-53-5-8;property is located on north side of Tarpon Drive+/-762'east of Main Road,location map attached. Brief Description of Proposed Action: Construct a+/-14'(max.)x+/-26'(max.)inground swimming pool,raised+/- 18"above grade with approximately 80 linear feet of"Redi-Rock"retaining wall and approximately 25 cy fill to be obtained from on-site excavation of swimming pool;install pool equipment,pool enclosure fencing,and pool drywell;replace approximately 285 sf of existing impervious driveway with pervious driveway surface;and maintain naturally vegetated buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated November 6,2017. Name of Applicant or Sponsor: Telephone: 631-477-6045 Robert&Rita Reis Wieczorek E-Mail: wieczore@optonline.net Address: P.O.Box 1725 City/PO. State, Zip Code: Southold NY 11971 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2.If no,continue to question 2. X 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: NYS DEC X 3.a.Total acreage of the site of the proposed action? 26,185 sf b.Total acreage to be physically disturbed? +/-9,000 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 26,185 sf ; 4. Check all land uses that occur on,adjoining and near the proposed action. ❑ Urban ❑Rural(non-agriculture) ❑ Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑ Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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: Name:Peconic Bay&Environs,Reason:Protect public health,water,vegetation& scenic beauty,Agency: Suffolk County,Date: 7-12-88 X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: N/A 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: N/A 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? X X 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? X b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply. ® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ® Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 16 Is the project site located in the 100 year flood plain? NO YES X 17.Will the proposed action create storm water discharge,either from point or non-point sources? YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO❑YES 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: X 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: X 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: X I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: RobertHerrmann,Coastal Management Specialist Date: November 6,2017 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 I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning regulations. 2. Will the proposed action result in a change in the use or intensity of use of land? / 3. Will the proposed action impair the character or quality of the existing community? I/ 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a. public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action 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 c No,or Moderate small to large impact impact may, may occur 10. Will the proposed action result in an increase in the potential for erosion, flooding or drainage problems? 11. Will the proposed action create a hazard to environmental resources or human health? 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 I 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, ^ thatthe pose a n will ngt result in any significant adverse environmental impacts. ame of Lead Agn Date 1L/ a_— JJ Print or Type Na of Responsible fficer in Lead Agency Title-of Responsible Officer Signature of Respondble Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 E Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, Rita Reis Wieczorek _ owners of the property identified as SCTM#1000-53-5-8 in the town of a fSouthold New York,hereby authorizes 9 1 En-Consultants to act as my agent and handle all necessary work involved with the application process for permits)from the Southold Town i C S Board of Trustees for this property. N/A *RZitaPReisW1eczorek igna re Property Owner's Signature SWORN TO BEFORE ME THIS 1� DAY OF t ;20 / E I Notary Public i SABRINA M BORN Wotery Public,State of New York No.01606317038 ®ualified in Suffolk County Commission Expires Dec.22, 2018 \ 1 i Board of Trustees Application I AUTHORIZATION (Where the applicant is not the owner) I/We, Robert R.Wieczorek , owners of the property identified as SCTM#1000-53-5-8 in the town of s Southold ,New York,hereby authorizes En-Consultants _ to act as my agent and handle all 's necessary work involved with the application process for permit(s)from the Southold Town r. Board of Trustees for this property. N/A VPr erty Owner' Signature in Owner's Signature R ert R.Wreczor SWORN TO BEFORE ME THIS DAY OF g� ,20±Z_ Notary Public SABRINA M BORN i Notary Public,State of New York No.01B06317038 Qualified in Suffolk County Commission Expires Dec.22,2018 Board of Trustees Application County of Suffolk State of New York Rita Reis Wieczorek 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 HISMER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO SPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLI ATION. 1 j2 a—t re,R' R s wieczo. SWORN TO BEFORE ME THIS 1� �_ _DAY OF _ __ V-a Notary Public + SABRINA M BORN Notary Public,State of New York No. 01 BO6317038 (qualified in Suffolk County Commission Expires Dec. 22, 2018 Board of Trustees Application County of Suffolk State of New York Robert R.Wieczorek 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 HISMER 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 I AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR a REPRESENTATIVES(S),TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW OF THIS APPLICATION. P Ygnature,Robert R.Wie r SWORN TO BEFORE ME THIS 5� __DAY OF 20_d Notary Public SABRINA M BORN Notary Public, State of New York No.01 B06317038 Qualified in Suffolk County Commission Expires Dec.22,2018 k s i a APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's'Code of Ethics prohibits conflicts of interest on the part of town officers and employees The numose of this form is to provide information which can alert the town ofpossime conflicts of interest and allow rt to take whatever action is necessary to'avoid same: YOURNAME Wieczorek,Rita Reis (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) k 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 If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); -- B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted th' day of la 2Q#-7 Signature ®_ Print Name Rita Reis iemor Form TS 1 h APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's'Code of Ethics prohibits conflicts of intotest on the part of town officers and employees the purpose of s this form is to provide infomtation which can alert the town of jssible conflicts of interest and allow it to take whatever action is ngcessay to avoid same. YOUR NAME: Wieczorek,Robert R. (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building 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 If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicantlagentlrepresentative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a noncorporate entity(when the applicant is not a corporation); { C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. f , I DESCRIPTION OF RELATIONSHIP Submitted this day of ( �s iV_ Signature 11 Print Name Robert R. ieczor Form TS 1 - APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL]DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The ouMose 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: Herrmann Robert F (Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name) NAME OF APPLICATION: (Check all that apply) Tax grievance Building 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 Southold9 "Relationship"includes by blood,marriage,or business interest "Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent;or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 6t y of N:Zber 209 17 Signature Print Name - E. He Form TS 1 ' S�FFU(,� Michael J.Domino,rfcsident O�Q -ro Town Hall Annex John M.Bredemeyer I11,Vice-President h� y� 54375 Route 25 Charles J. Sanders y P.O.Box 1179 Glenn Goldsmith Southold,NY 11971 A.Nicholas Krupski y ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD --------------------------------------------------------------- In the Matter of the Application of ROBERT & RITA REIS WIECZOREK COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING TO BE COMPLETED AFTER POSTING REMAINS INPLACE FOR AT LEAST SEVEN DAYS PRIOR TO THE PUBLIC HEARING DATE I� Robert E. Herrmann , residing at/dba En-Consultants 1319 North Sea Road, Southampton, NY 11968 being duly sworn, depose and say: That on the 1st day of D ece m ber , 2017 , I personally posted the property known as 835 Tarpon Road, Southold, S C T M $1000-53-5-8 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 Wednes av,December 13 2017. Dated: (signatu- Sworn to before me this 13tihay of Dec 20 17 4blicb KIM H . STEPHENS NOTARY PUBLIC STATE OF NEW YORK COMMISSION N0 . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AL+6UST 2 . 20W NOTICE TO ADJACENT PROPERTY OWNER BOARD OF TRUSTEES, TOWN OF SOUTHOLD In the matter of applicant: Robert&Rita Reis Wieczorek SCTM#1000-53-5-8 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a+/-14'(max.)x+/-26'(max.)inground swimming pool,raised+/- 18" above grade with approximately 80 linear feet of"Redi-Rock"retaining wall and approximately 25 cy fill to be obtamed from on-site excavation of swimming pool;install pool equipment,pool enclosure fencing,and pool drywell;replace approximately 285 sf of existing impervious driveway with pervious driveway surface; and mamtain naturally vegetated buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated November 6,2017. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 835 Tarpon Dnve, Southold 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: Wednesday,December 13,2017 @ 5:30 p.m. 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. Robert&Rita Reis Wieczorek PROPERTY OWNERS NAME: P.O.Box 1725 MAILING ADDRESS: Southold,NY 11971 PHONE #: 631-477-6045 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road,Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. c PROOF OF MAILING OF NO' E ATTACH CERTIFIED MAIL RECEIPTS Name: Address: 53-5-12.8 P.O.Box 438 Kedjierski Familiy Share Living Trust Southold,NY 11971 57-1-39.2 P.O.Box 1725 Robert Wieczorek&Rita Reis Southold,NY 11971 53-5-7 23 William Penn Drive Matthew&Elizabeth Broderick Stony Brook,NY 11790 57-1-9 PO Box 902 Edouard&Carol Beaugard Southold,NY 11971 57-1-10 940 Tarpon Drive MC Dileone Irrevocable Trust Southold,NY 11971 STATE OF NEW YORK COUNTY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 , being duly sworn, deposes and says that on the 1st day of_ Prem hPr ,20 17 , 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 Southampton , that said Notices were Ma' ed to each of said persons by (certified)(per mail. Robert E.Herrmann Coastal Managment Specialist Sworn to before me this 1st day of , D ece m ber 2017 HIM H . STEPHENS NOTARY PUBLIC STATE OF NEW YORK 6UMMISSION NO . 5015931 Notary 0,tCblic GUALIF1ED IN SUFFOLK COUNTY EXPIRES AUGUST 7 . 20( ®- d=- ( CZX/ CO ®• • Ir ru = 1 = ? Certified Mal Fee LU C UEImo. E6 U f A, L U t E -0 Certified Mall Fee Extra Services&Fees(checkbox,add fee asappropnate) �.!"� A `� $ 0 ❑RetumReceipt(harcicoo') $ Extra Services&Fees(checkbox,edd/eeasappropnate) ��°���h�� �- O El Return Receipt(hardcopy) $ P ❑Return Receipt(electronic) $_ 1!-� �j ° � ❑Certified Mall Restricted Delivery $ J �"� Postmark ,.y C3 ❑Return Receipt(electronic) $ ^� Postmark D ❑Adult Signature Required $ (klerep � i I3 []Certified Mall Restricted Delivery $ rd Here ❑Adult Signature Restricted Delivery$_ co ��°' 6 �� ~ ❑Adult Signature Required $ (n DEC 0 �� 0 Postage - -- El Adult Signature Restricted Delivery$ Ln $ �' / Postage _ 1 r /J m Total P r - 1 m Total Pc Sent Ti Kedjierski Family Share Living Trust -n $ anrro 1 o si�eeri P.O. Box 438 Robert&Rita Reis Wieczore i r` Southold,NY 11971 --- N Si7eeiar P.O.Box 1725 Cts Southold,NY 11971 • -c E ® A t3 . • WINE C31. ® 1 o s P— • m s. m -13 ir- nJ Certfed Mall Fee $ rU Certified Mail Fee � ExtraSBNICes&Fees(checkbox,add fee as appropriate) l�'�} O ❑Return Receipt(hardcopy) $ /'y Extra Services&Fees(checkbox,add fee as epp7 fate). ❑Return Receipt(electronic) $ �� POStmal �j I O [I Retum Receipt(hardcopy) $ / O 11 Certlfled Mall Restricted Delivery $ "Alp ❑Return Receipt(electronic) $ ��� Postmark []Adult Signature Required $�� DEC m p N ll -4 I IZ-3 ❑Certlfled Mall Restricted Delivery $ I Cq -ry r ❑Adult Signature Restricted Delivery$ __ O ❑Adult Signature Required $ ) y Postage \ Y- E]Adult Signature Restricted Delivery$ ,} \ { u1 - - -- - `n !r� Postage j ft I Total - x(638 IJ� Total Po: \ �+ t V b m - o $ anr Matthew&Elizabeth Broderick a Sent To Edouard&Carol Beaugard C3 - 23 William Penn Drive ------------ P.O. Box 902 Sfree Stony Brook,NY 11790 §«eeta� -------- Ctry,, ------------ ! Southold,NY 11971 U-1 a. Q' M 00 117 � � L Certified Mail Fee $ MP� Extra Services&FeeS(checkbox,add fee as appropriate) O ❑Return Receipt(hardcopy) $�f ! p ❑Return Receipt(electronic) $.�/(� POStmar ! p ❑ DECertlfled Mall Restricted Delivery $ u I C3 ❑Adult Signature Required $-j�, LYIs Y, E3 1 ❑Adult Signature Restricted Delivery$� -00 Postage Ln $ \?� _ M Total Po: �o8-aa��° _U SanToMC Dileone Irrevocable Trust -i eera;t, 940 Tarpon Drive City Stat Southold,NY 11971 ,NUTILL Ulm HtAKING 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. OWNERS) OF RECORD: ROBERT & RITA REIS WIEZCOREK SUBJECT OF PUBLIC HEARING : For a wetland Permit to construct a ±14' (max.) by ±26' (max.) in-ground swimming pool, raised ±1,8" above grade with approximately 80 linear feet of "Redi-Rock" retaining wall and approximately 25 cubic yards of fill to be obtained from on-site excavation of swimming pool; install pool equipment, pool enclosure fencing, and pool drywell; replace approximately 285sq.ft. of existing impervious driveway with pervious driveway surface; and maintain naturally vegetated non-turf buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property. Located: 835 Tarpon Drive, Southold. SCTM# 1000-53-5-8 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 '0WtFQ� Town of Southold ;' Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM 1 PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Q� 1000 53 5 8 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN i13 sf I—H Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No a.What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within 26,185 sf Generated by a Two(2")Inch Rainfall on Site? X ❑ the Scope of work for Proposed Construction) (S F./Acres)) (This item will include all run-off created by site b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed +/-9,000 sf Site improvements and the permanent creation of construction activity? (5 F/Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed ❑ PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location This item shall include all proposed Grade Changes and Slopes Controlling Surface Water Flow, Construct a+/-14'(max.)x+/-26'(max.)inground swimming 3 Does the Site Plan and/or Survey describe the erosion X ❑ pool,raised+/- 18" above grade with approximately 80 linear and sediment control practices that will be used to feet of"Redi-Rock"retaining wall and approximately 25 cy fill control site erosion and storm water discharger This to be obtained from on-site excavation of swimming pool;install Item must be maintained throughout the Entire pool equipment,pool enclosure fencing,and pool drywell; Construction Period replace approximately 285 sf of existing impervious driveway 4 Will this Project Require any Land Filling,Gradin or ❑ Excavation where ere is a change to the Natt i with pervious driveway surface;and maintain naturally Existing Grade involving more than 200 Cubic Yards vegetated buffer areas within 10 feet of tidal and freshwater of Material within any Parcel? wetland boundaries on the property,all as depicted on the site 5 Will this Application Require Land Disturbing Activities plan prepared by Nathan Taft Corwin III Land Surveyor,last Encompassing an Area in Excess of Five Thousand dated November 6,2017. (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site?Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements, or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes Elare part of a larger common plan that will ultimately disturb one or more acres of lands, which Exceed Fifteen(15)feet of Vertical Rise to Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges-lQ SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit O Will Driveways,Parking Areas or other impervious or Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X 1 The SWPPP shall be prepared prior to the submittal of the NOI The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity n 2 The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ❑ required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit. In addition,the SWPPP shall Areal(This item will NOT include the installation of Dnveway Apmns.) identify potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges NOTE If Any Answer to Questions One through Nine is Answered with a Check Mark 3 All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F &1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of that is component sknowledgeable in the principles and radices of Storm Water Licensed int. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. P P P g (NOTE: A Check Mark(X)and/or Answer for each Question is Require for a Completed Application). STATE OF NEW YORK, COUNTY OF Suffolk ss That I, Robert E.Herrmann ---------being duty sworn,deposes and says that he/she is the applicant for Permit, (Name of individual signing Document) And that he/she is the -Agent-for-the-Owners - ---- ---- ----------------- ---------------------------------------------------------------------------------------- (Owner,Contractor,Agent,Corporate Officer,etc Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application,that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed.in the manners set forth in the application filed herewith. Sworn to before me this; 6tht November d o , ,20 17 Notary Pu io KIM R . �fi��H�X-�-- . ---- ---------N-9fiA-R-Y---F-UBt-1-E ---------------- - -- ------------------- ature of Applicant) STATE OF NEW YGRI( FORM - 06/10 COMMISSION N0 . 5015931 QUALIFIED IN SUFFOLK COUNTY EXPIRES AUGUST 2 , 20-2'1 i Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS I , 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 si nificant beneficial and adverse effects upon the coastal area (which includes all of Southold Town). If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 53 - 5 - 8 PROJECT NAME Robert&Rita Reis Wieczorek The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees Category of Town of Southold agency action (check appropriate response): (a) Action undertaken directly by Town agency (e.g. capital ❑ construction, planning activity, agency regulation, land transaction) (b) Financial assistance (e.g. grant, loan, subsidy) ❑ (c) Permit, approval, license, certification: Nature and extent of action: Construct a+/-14'(max.)x+/-26'(max.)inground swimming pool,raised+/- 18"above grade with approximately 80 linear feet of "Redi-Rock"retaining wall and approximately 25 cy fill to be obtained from on-site excavation of swimming pool;install pool equipment,pool enclosure fencing,and pool drywell;replace approximately 285 sf of existing impervious driveway with pervious driveway surface;and maintain naturally vegetated buffer areas within 10 feet of tidal and freshwater wetland boundaries on the property,all as depicted on the site plan prepared by Nathan Taft Corwin III Land Surveyor,last dated November 6,2017. Location of action: 835 Tarpon Drive,Southold Site acreage: 26, 185 sf Present land use: Residential,single family dwelling 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: Rita Reis Wieczorek&Robert Wieczorek (b) Mailing address: P.O.Box 1725 Southold,NY 11971 (c) Telephone number: Area Code631-477-6045 (d) Application number, if any: Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ® No❑ If yes, which state or federal agency? NYSDEC C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III- Policies; Page 2 for evaluation criteria. ❑Yes ❑ No VN Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III - Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III - Policies Pages 6 through 7 for evaluation criteria ❑Yes 1:1No ® Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III - Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ® Not Applicable 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 Consistent with the Policy 5 goals of protecting and improving water quality,the proposed shallow and partially raised swimming pool has been designed to avoid interference with the groundwater table;a temporary project limiting silt fence will be set in place between the work site and the adjacent wetlands areas to control and contain site disturbance and potential runoff during construction;a pool drywell will be installed upon completion of construction to permanently capture pool backwash;approximately 285 sf of existing impervious driveway will be replaced with a pervious driveway surface;and approximately 2,380 sf of naturally vegetated buffer areas will be maintained within 10 feet of the wetland boundaries on the property. 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 LWRP CONSISTENCY ASSESSMENT FORM ADDENDUM FOR ROBERT & RITA REIS WIECZOREK 835 TARPON DRIVE SOUTHOLD,NY SCTM#1000-53-5-8 Policy 6 The project consists of the construction of an inground swimming pool that will result in an increase in Town- defined lot coverage by only 410 square feet to approximately 13.4 percent. In order to avoid interference with the groundwater table,the swimming pool will be limited in depth and raised partially above grade(+/- 18")using approximately 25 cy of fill(obtained from the on-site excavation of the proposed swimming pool)contained with a"Redi-Rock"retaining wall system,which allows the fill to be placed over the top of the retaining wall. The retaining wall and swimming pool will be set back no less than 50 feet from wetlands, as required by Section 275- 3(D)(1)(a)(5)of the Wetlands Law of the Town of Southold. A temporary project limiting silt fence will be set in place between the work site and the surrounding tidal and freshwater wetland areas to control and contain site disturbance and potential runoff during construction; and a pool drywell will be installed upon completion of construction to permanently capture pool backwash. In order to mitigate the additional lot coverage, approximately 285 sf of existing impervious driveway will be converted to a pervious driveway surface; and approximately 2,380 sf of naturally vegetated buffer areas will be maintained within 10 feet of the wetland boundaries on the property. Therefore,the project will be fully compliant with Chapter 275 and will not result in the physical loss,degradation, or functional loss of ecological components or otherwise adversely impact the adjacent tidal or freshwater wetland areas. See attached. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No® Not Applicable Attach additional sheets if necessary Policy S. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III - Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III - Policies; Pages 38 through 46 for evaluation criteria. ❑ Yes ❑ No® Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES I r Policy 10. Protect Southuiu s water-dependent uses and promo,ty siting of new water-dependent uses in suitable locations. See LWRP Section III - Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III - Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 for evaluation criteria. 1:1Yes ElNo ® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III - Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No ® Not Applicable PREPARED BY TITLECoastal Management specialist DATE 11/6/17 Robert E.Ue Amann Amended on 811105 1 I EN-CONSULTANTS November 6,2017 D E L V E Town of Southold Board of Trustees NOV ® 8 2017 54375 Main Road Post Office Box 1179 SoutWd?obvn Southold,New York 11971 Re: Rita Reis&Robert Wieczorek 835 Tarpon Drive, Southold SCTM#1000-53-5-8 Dear Board of Trustees: In regard to the above referenced property,enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Short Environmental Assessment Form; b) Authorization&Affidavit Forms; c) Applicant/Agent/Representative Transactional Disclosure Forms. 2. Survey prepared by Nathan Taft Corwin III Land Surveyor, last dated November 6,2017. 3. One(1)set of site photographs. 4. Application fee of$250.00. 5. Three(3)LWRP Consistency Assessment Forms including: a) Survey(as referenced above). I trust this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sincer y, Robert E.Herrmann Coastal Management Specialist V /khs Enc. 1319 North Sea Road I Southampton,New York 11968 1 p 631.283.6360 1 f 631.283.6136 www.enconsultants com environmental consulting