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1000-51.-1-8
.I OFFICE LOCATION: ®� S®Ury®l® MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) ris �s Southold, NY 11971 ® �p� Telephone: 631 765-1938 ®l�04UNTi,�c� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Leslie Weisman, Chair Members of the Zoning Board of Appeals From: Mark Terry, LWRP Coordinator Date November 16, 2017 Re: LWRP Coastal Consistency Review for ZBA File Ref LORI AND NEIL KEARNS #7112 SCTM# 1000-51-1-8. LORI AND NEIL KEARNS #7112 — Request for a Variance under Article IV, Section 280-19 and the Building Inspector's July 14, 2017 Notice of Disapproval based on an application for a permit to make roof alterations to an existing accessory building (pool house); at: 1) less than the code required minimum setback from the property line of 15 feet; located at: 18075 Soundview Avenue (Adj. to the Long Island Sound), Southold, NY. SCTM#1000-51-1-8. 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, the proposed action is recommended as EXEMPT from LWRP review pursuant to: § 268-3. Definitions. MINOR ACTIONS item "F" which states: F. Granting of individual setback, lot line and lot area variances, except in relation to a regulated natural feature or a bulkhead or other shoreline defense structure or any activity within the CEHA. Pursuant to Chapter 268, the Southold Town Zoning Board of Appeals shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: William Duffy, Town Attorney BOARD MEMBERSOF so Southold Town Hall Leslie Kanes Weisman,Chairperson �x yo 53095 Main Road•P.O.Box 1179 Southold,NY 11971-0959 Patricia Acampora [ Office Location: Eric Dantes Town Annex/First Floor,Capital One Bank Gerard P.Goehringer 0 �Q 54375 Main Road(at Youngs Avenue) Nicholas Planamento l�'C®U Southold,NY 11971 http://southoldtownny.gov ZONING BOARD OF APPEALS 1� TOWN OF SOUTHOLD Tel.(631)765-1809•Fax(631)765-9064 Town Southold gaatd piann�n9 August 24, 2017 Mark Terry, Principal Planner LWRP Coordinator Planning Board Office Town of Southold Town Hall Annex Southold,NY 11971 Re:, ZBA File Ref. No. # 7112 KEARNS,Neil Dear Mark: We have received an application for roof alterations to existing accessory building. A copy of the Building Inspector's Notice of Disapproval under Chapter 280 (Zoning Code), and survey map, project description form, are attached for your reference. Your written evaluation with recommendations for this proposal, as required under the Code procedures of LWRP Section 268-5D is requested within 30 days of receipt of this letter. Thank you. Very truly yours, Leslie K. Weisman Chairperson By: Revisms 04-22-98 09A5.98 03-23-99 04-10-01 �L316.7W CT7�2-01 03-19-02 05.1"2 4� 7 0, OB-25-04 11-10-G4 03-28-05 Or,22-05 07-20-05 09-15-05 In 0- 01-27-06 03-15-06 11-01-06 12-01-06 ryvAl 05-31-07 SEE SEC NO 130 orll&07 09-09-14 08-02-16 67(- 1 LONG I L-z .c (Ab p.D.70 20.1 21 1 43 16 1 D G A3 A, is 22- 2 SCH.D-5 4 31 F-412 a 21.11,11, m 11 3.15 316 2,9 3.14 13URGANDycr.- -11 Z12 31, 33_ 5 2A 2,AA PECON[C LANOTRUSTINC. (CONSERVAnONEASUCUM 34 eg 0) Ajo i.Ax g, 0.) 3.10 49 &6 22.OA VVI r (To"OFSOW"111D T1, kopol S, DEVrL0PUfWrMGHTS) 8.2 0 0) 3.OA 4.1 S. 9 7A(c) 8.5 m I SA X.oN to- pf 39 Z6 Ic 1.6A(c) 36 Ts ko ON 3.7 10 25 84 (n I 5A(c) 2.QA 21-11-1111, NOR _N3313U L E (21) G —T— 2' E .3 N D 23 12 1�(d).,12 IA 12 1 A(.) 7� FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL DATE: July 14, 2017 TO: Robert Brown Architect 205 Bay Avenue Greenport,NY 11944 Please take notice that your amendment datgd July 14, 2017 To amend Building Permit#41376Z to make roof alterations to an existing accessory building at Location of property: 18075 Soundview Avenue, Southold County Tax Map No. 1000—Section 51 Block 1 Lot 8 Is returned herewith and disapproved on the following grounds: The proposed accessory garage on this 40,000 square foot lot in the R-80 District is not permitted pursuant to Article IV Section 280-19, which states; Section 280-15 states that, on lots measuring between 40,000 and 59,999 square feet in total size require a minimum setback of 15 feet. The existing accessory building is+/-4 feet from the property line. Authorize Signat e Cc:File, ZBA Fee:$ Filed By: Assignment No. APPLICATION TO THE SOUTHOLD TOWN BOARD OF APPEALS AREA VARIANCE House No.1$D 7 Street&LL11dV10,1,17 I/L. Hamlet SCTM 1000 Section, Block�Lot(s) 0 i Lot Size �Zone I(WE)APPEAL E WRITTEN DETERMINATION OF THE BUILDING INSPECTOR DATED__%hj4 LASED ON SURVEY/SITE PLAN DATED Applicant(s)/Owner(s): Mailing Address: Telephone:-57k-6-2617 ax: mail: (/z' kid (Y -21/ I71Jj'1./LP NOTE:In addition to the above,please complete below if application is signed by applicants attorney,agent, architect,builder,contract vendee,etc.an_0 name of person who agent represents: Name of Representative: aawl 1?16 for q Owner( )Other: Address:11-6 / Telephone l�77-97S1r Fax3�77- 973 Email; (y►,tl) (cam►-'1/�YQ1,!)hQ,y Please check to specify who you wish correspondence to he mailed to,j om dhe"above names. ( )Applicant/Owner(s), ko Authorized Representative ( )Other Name/Address below: I WHEREBY THE BUILDING INSPECTOR REVIEWED SURVEY/SITE PLAN DATED '7/I o/17 and DENIED AN APPLICAiION DATED FOR: ( )Building Permit i ( )Certificate of Occupancy ( )Pre-Certificate of Occupancy ( )Change of Use ( )Permit for As-Built Construction Other: Provision of the Zoning Ordinance Appealed. (Indicate Article,Section,Subsection of Zoning Ordinance by num rs.`Do not quote the code.) Article: Section: 2fo,L1 Subsection: °— Type of Appeal. An Appeal is made for: N)A Variance to the Zoning Code or Zoning Mop. ( )A Variance due to lack of access required by New York Town Law-Section 280-A. ( )'Interpretation of the Town Code,Article Section ( ),Reversal or Other A prior appeal N has, ( )has not been made at any time with respect to this provelly, UNDER Appeal No(s).�S _Year(s). �/ Q .(Please be sure to research befpre completing this question or call our office for assistance Name of Owner: ZBA File# I I I REASONS FOR APPEAL (Please be specific,additional Iheets maybe used with preparer's signature notarized): I 1.An undesirable change will not be produced in the CHARACTER of the neighbor or a detriment to nearby properties if granted,because: 2.The benefit sought by the applicant CANNOT be achieved by some method feasible for the applicant to pursue,other than an area variance,because: 3.The amount of relief requested is not substantial because: aAd n°S c6� 1 4.The variance will NOT have an adverse effect t or�niplaact on the ph sical oir env iroonnm a al con it�n the e neighborhood or district because: �- � � wnt 5.Has the alleged difficulty been self created? { ) Yes,or{ No Why: Are there any Covenants or Restrictions concerning this land? No {}Yes(please furnish a copy) This is the MINIMUM that is necessary and adequate,and at the same time preserve and protect the character of the neighborhood and the health,safety and welfare of' the community. gna e of A lic t A thorized Agent (Ag must sub "t wri ri7ation from Owner) Sworn to before me this /0 day of 4y& 14 a' ,20_L—Z__. DIN181 A. NAVARRA NOTARY pu6LIC-STATl OF NEW YORK �z C No. O1 NA 191295 Notary Public Qualified in S�ffoik County My Commission Expi�e �e 2(Z�) i i APPLICANT'S PROJECT DESCRIPTION APPLICANT:/ ��/� �� DATE PREPARED: 8 1 1. I�For Demolition of Existing Building Areas Please describe areas being removed: I � I � I H.New Construction Areas(New Dwelling or New Addihons/Extensions): Di ensions of first floor extension: l� A- I Di ensions of new second floor: Di Lunsions of floor above second level: He fight(from finished ground to top of ridge): Is basement or lowest floor area being constructed?If yes,pi`lease provide height(above ground)measured from natural existing grade to first floor: III Proposed Construction Description(Alterations or structural Changes) (A ach extra sheet if necessary).Please describe buildingeas: Number of Floors and General Characteristics FORE Alterations: I � I Number of Floors and Changes WITH Alterations: j luh4 /W-,6U 1�j IV Calculations of building areas and lot coverage(fro ): Existing square footage of buildings on your property: Nb Proposed increase of building coverage: n Sgµµare footage of your lot: Pe.centage of coverage of your lot by building area: 70 , V.Purpose of New Construction: P.0— J VI.Please describe the land contours(flat,slope %,heavily wooded,marsh area,etc.)on your land and hoit relates to the difficulty in meeting the code requirier (s): � 3 PI ase submit 8 sets of photos,labeled to show different angles of yard areas after staking corners for new construction,and photos of building area to be altered with yard view. 4/2 12 i QUESTIONNAIRE FOR FILING WITH YOUR ZBA APPLICATION A. Is the subject premi es listed on the real estate market for sale? Yes No B. Are there any proposals to change or alter land contours? �d_No Yes please explain on attached sheet. C. l.)Are there areas that contain sand or wetland grasses? 2.)Are those areas shown on the survey submitted with this application? 3.)Is the property bulk headed between the wetlands area and the upland building area? ��Q�It 2�17� 42z"__ 4.)If your property contains wetlands or pond areas,have you contacted the Office of the Town trustees for its determination of jurisdiction?Please confirm status of your inquiry or application with the Trustees: , and if issued,please attach copies of permit with conditions and approved survey. D. Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean sea level? IJp E. Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you are submitting? Please show area of the structures on a diagram if any exist o state non on the above line. 7J 9�1J "ils F. Do you have any constructingp acee con erring your premises? - If yes,please submit a copy of your building permit and survey as a proved by the Bui ding Department and please describe: �'b9''1�(.i h�,�,( �l G. Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are lacking,please apply to the Building Pepartment to either obtain them or to obtain an Amended Notice of Disapproval. H. Do you or any co-owner also own other land adjoining or close to this parcel? A10— If DIf yes,please label the proximity of your lands on your survey. - I. Please list present use or operations conducted at this parcel and the proposed use ! (ex:existing sin le famity,proposed:same with gara e,pool or other) Auth zed si atur ,Kyate �,�/ BOARD MEMBERS $ Southold Town,Hall Q ' Leslie Kanes Weisman,Chairperson d r 53495 Main Road,-RO,.Box 1179 'Southold,NY 1:1971.-0959 Eric Dantes SEL%cbszlltign: Gerard P.Goehringer " Town Annex/FirstPoor,Capital'One Bank George Horning ° 54375 Maim 9oad:(at Xoungs Aventine) Kenneth Schneider Q� ; Southold,,NY'11971 httpJ/southoldtown.norddl rk.net R Cf� ZONI, N,G RO OF APFF,�' TOWN OF.SOQTJ�%T3 Tel.(631)7654809 Fax(¢31)765-9064 A %�oldTbv clerk 11ei /yg�Cpy� �+yj�' gt'rt} A/.■A/ ���i^°•n.v_ *:Y''". 4...d-a«w,.. . ZBA FILE 6962 NAME,OF'APPLICANT:Neil and Lori'Kearns PROPERTY LOCATION:18075 Soundview Avenue,Southold,NY I SEQRA DETERMINATION: The Zoning Board of Appeals has visited,the property under consideration in this application and determines that this review falls,under the Typo 11,category of the 8tato's Lis#of Actions,without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIV,F CQDE: This application was rcferred as required under the Suffolk County Administrative Code Sections.A 1414 to 23,.and the.Suffolk County.Department.of Planning issued its reply dated May 9, 2016stating that this application-is considered a matter for,local determination as there appears to be no significant county-Aide.-or inter-communityImpact. LWRP DETERMINATION: This application was referred for review under Chapter 2681 Waterfront Consistency review of the Town of Southold Town Code and the Local Waterf Qnt Revitalization Program (LWRP) Policy Standards. The LWRP Coordinator issued commenis dated June ?3, 2616 recommending that based upon the information,provided on the LWRP Consistency Assessment'Forrtt submitted,as well ars the records.available that the proposed action is EXEMPT from Coastal Consistency Review PROPERTY FACT,S_DESCRIP TQN;,.The-;property is aa-non-conforming,52,287, square-foot waterfront parcel located in an R-80 zone with 106 feet of frontage along the Long Island, Sound, 100 feet along Sound View Avenue, 588.59 feet on tho West,side, and.5.60 feet-on,the East side. The,parcel is improved with a single story frame house and an attached garage,an accessory frame building,a wood deck,a concrete walk,a staircase leading to the beach as shown on a survey by John C. Ehlers dated March I% 20,10: The building department issued certificate of occupancy, No. 38144 on March 10, 2016 for in ground swimming pool as shown �on site plan prepared by Robert L.Brown,Architect,dated April 11,2016; BASIS OF APPLICATION: Request for Variance(s)from Sections 280-124 and the building,inspector's April 27, 2016 Notice of Disapproval based on an application for building permit for additions and alterations to an existing single family dwelling,at less than the code required minimum side yard setback of 20 feet;2)less than the code required total side yard setback of 40 feet, located at 18075 Soundview Avenue (adj to long Island sound) Southold,NY. RELIEF REQUESTED: The applicant requests variancesto,make additions and alterations that will result in a non-conforming side yard setback of+/-3A feet where code requires 20 Chet and a combined side,yard setback of 14.8 feet where code requires 40 feet. Page 2,July 2 16 #6962,Keams SCTM No. 100041-1-8 ADDITIONAL INFORMATION: The existing single famQy dwelling,has apre-existing certificate of occupancy No:Z-34051 dated November,4,2,009-. FINDINGS OF FACTI REASONS FOX OARD AL-V, —On- The Zoning Board of Appeals held a public hearing on this application on July 7,2016,at which time written And oral evidence were presented. Based upon all testimony,documpatatioi4personal inspection ofthe property-and surrounding neighborhood,and other evidence,the Zoning Board,finds the following facts to be true and relevant and makes the followhigfindings: 1. Town LawI267;;;b(3A)(-I).- Grant,of the.,variance(s),will,not,p r9dupp,;m-und4sirOlo...cho, c , cter of the neighborhood or a detriment to nearby. properties. The neighborhood consists of single-family waterfront homes. The existing dwelling was built prior to zoning and therefore did not have to meet current conforming,side yard setbacks.at the time it was built. The proposed second story additions and alterations will meet the code required,minimum side yard and combined side yard setbacks. The proposed addition,onthe first floor is within the existing non-conforming side yard setback. 2. Town Law 4267-bQ)(h)JJ2 .The benefit sought by the appricant'gannot be,achieved by.some method, feasible for the applicant to pursue,other than an area variance. The,existing dwellifig,,bAs,it,,uon-conforming side yard and combined side yard setback. Any additions and altem-tion&wIll nqtw.`oAho bengfit ofanarea variance. 3. Town Law §267-b(3)(b) 3). The variance(s)granted herein are matbem4ticaUy substantial,representing 83% relief from the code for the single side yard setback and 63% relief from the code for the combined side yard setback.However,the house is an older.home which pre--dates:.zonmg. 4. Town Law 4267-b(3)(h)ffi No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant must comply with Chapter 236 of the Town'sStorinWAI�rl444nageiiient-Oode, i 5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created. The applicant purchased the parcel Mer the Zoning Code was in effect and it is presumed that, the applicant,hadactualor constructive knowledge of the limitations on the use of the parcel under the Zoning Oade iti,effect-prior tobr at,tho time,of'purchasei 6. Town Law §267-b "Grant-of,�requested-,relief�is,,die-mininiunr=tion:.necessaiy,and-Weiquato-to enable-the applicant to enjoy the benefit of a renovated home while preserving and protecting the character of the neighborhood and the health,safety.and:welfare of the community. RESOLUTION OF THE BOARD: In,considering 41 of the above ,factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Dantei; seconded by Member W'sman (Chairperson),and duly carried,to GRANT the variances as.applied for, and shown on the building;plans prepared by Robert.I.,Drown, Architect, labeled Al-6 and dated April 11,2016,and the survey prepared by John C.Ehlers,datedNarch 10,.20.10. i Any deviation from the survey, site plan.and/or architectural drawing's cited in this decision will result iii 44.y and/or a possible denial by the Building-.0eponment ofa building permit,andi?iqyxequIre a new application and public hearing before the Zoning Boaraaf-4ppeals. Any deviation from the variance(s)granted herein as shaven on the architectural drawings,site plant vndlor'survey i Page 2,July 21,2016 #6962,Kearns SCTM No. 1000-51-1-8 cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving nonconformities under the zoning code, This action doe$•n'ot authorize or condone,any current orfilure use, setback or other feature of the subject property that may vioidle the Zoning Code, other than such uses, setbacks and otherfeatures es as are expressly addressed in this-action. The Board reserves the right to substitute a similar design-that is de;mininds,in mature for an alteration chat does not increase the degree,of nonconformity— Pursuant onconformityPursuant to Chapter 280, 146(B) of the,Code of thoTown of Southold any,varianmgranted by the Board.of Appeals shall become null-and void where a Certificate of Occupancy has notbeen procured,and/or asubdivislon,na4p has not,bpm-filed,with-the Suffolk-.Co. uty Clefk within three (3)years,frowth-w4ty-suchvurxance v+�as-garanteti:. ie Board;o a pc s ay 9iugc�u�ww,.I t0i�.N...,, request prior to the date of expiratiout grants an�extension�not to exceed three,j3 'consecutive one (1)year terms. You of the Board: Ayes. Members Weis,man (Chairperson), Scinelder, Dantes, Horning, Goehringer. This Resolution,was duly adopted(5-0). l Leslie tunes Weisman,Chairperson, Approved for filing 10?4�/20116 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 34052 Date: 11/04/09 THIS CERTIFIES that the building DWELLING AND ACCESSORIES Location of Property 18075 SOUNDVIEW AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tac Map No. 473889 Section 051 Block 0001 Lot 008 Subdivision Filed Map No. ' Lot No. conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which CERTIFICATE OF OCCUPANCY NUMBER Z- 34052 dated NOVEMBER 4, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY STORAGE BUILDING AND CONCRETE WALK AND TERRACE.* The certificate is issued to ELIZABETH P & ROY I MARTIN TRT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. NIA PLUMBERS CERTIFICATION DATED N/A *PLEASE SEE ATTACHED INSPECTION REPORT. //Xuthoi-ized signature Rev. 1/81 FORM NO. 4 , TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-21048 Date SEPT EPER 28 1992 THIS CERTIFIES that the building ADDITION Location of Property 18075 SOUNDVIEW AVENUE SOUTHOLD N.Y. Rouse No. Street Hamlet County Tax Map No. 1000 Section 51 Block 1 Lot 8 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 1, 1992 pursuant to which Building Permit No., 20703-Z dated JUNE 10, 1992 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to ROY IVAR MARTIN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A i UNDERWRITERS CERTIFICATE NO. N-250288 - SEPTEMBER 15 1992 PLUMBERS CERTIFICATION DATED N/A PM(fing-'Inspector Rev. 1/81 i FORM NO. •4 I I TOWN OF SOUTHOLD BUILDING DEPATMENT Office of the Building Inspector Town Hall Southold, N.Y. i CERTIFICATE OF OCCUPANCY I I No: Z-35051 Date: 11/04/09 I THIS CERTIFIES that the building RAMP ADDITION I Location of Property: 18075 SOUNDVIEW AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 51 Block 1 Lot 8 Subdivision Filed Map No. Lot No. i conforms substantially to the Application for Building Permit heretofore I filed in this office dated SEPTEMBER 23, 2009 pursuant to which 1 Building Permit No. 35075-Z dated OCTOBER 16, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for whI}ch this certificate is issued is "AS BUILT" RAMP ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. i The certificate is issued to ELIZABETH P & ROY I MARTIN QPRT (OWNER) of the aforesaid building. i SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. ! N/A PLUMBERS CERTIFICATICQN DATED N/p, i � u�thi�zeSi�gnatulre I Rev. 1/81 i r � ��o�g11FFOt,��oGy Town of Southold 3/10/2016 P.O.Box 1179 c�• 53095 Main Rd Southold,New York 11971 i i i CERTIFICATE OF OCCUPANCY No: 38144 Date: 3/10/2016 THIS CERTIFIES that the building IN GROUND POOL j Location of Property: 18075 Soundview Ave.,Southold SCTM#: 473889 Sec/Block/Lot: 51.-1-8 Subdivision:, Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated i 1/11/2016 pursuant to which Building Permit No. 40398 dated 1/11/2016 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: ACCESSORY IN-GROUND SWIMMING POOL FENCED TO CODE AS APPLIED FOR The certificate is issued to Kearns,Neil' of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 35423 10-15-2010 PLUMBERS CERTIFICATION DATED rize Signature :Ir't'�10""'"'Mryt :1k.- • '.4,7'"Mt 'A?'?M`MRF/;'r'i,, LO ` ,,►gip ;. ,<13 .iL .�L�l ti3i, F ''111. t1 ' r �-' +S�i••j611 fr (THIS PE RMI-Tv MW.T-13 E KEPT ON-- HE P;REM$�,E$` WITH'.-,ONE.`SET,-'CO.,,,AP?,PRGIUEG=.PLANSI5:ANDaaPEGIF�iCA'TI UNTIL PULL,GQ,CVDPLET,C011161-=TH ;'w Permit#' 41376- bate," 'KI 011' :Permission,is bpreby grahted to: Miami Neil, Z5�Cefftral Or Manhassett,,NY 11.030= To: construct'altera#inns to ex st1 g.aceaa ry:bui1d7jpg aqd'<to,congtrppt,'add.itio.ns.and !,i1Y.adWe-11l;�ig as�pplk� Via° �O�19D:�ppr�vais. TVo.' 'sr , equiri< ' r� aii; 4atsj At premises,iocated at: 18075,Spundylew. Aye,.S,authald, SCTM•#473839 SeclBlock/Lot-#51.1:8.. Pursuant'to'application,dated. -, 1 Q1 017, arida pro-ued.,by.the'Building„Inspector. To expire on 21231 018. , Fees: ,ACC .r"SQILt • $1.00;UQ'` co..-r;��"CE sC Y$T J[ ?I�1.q” $S��OU S t E `�1kMiLY 3 S T:411 = III '1'QT !Q ; R . C}I $1,466.00 Cts- D'01 'IQN"TQpw?)BL $50 00 ' otalc ' $1;666:00 017 AT K'R A MR-1 i1r il " III IRA !15 .............. zol", wea 7-A-fir-7,EE.,. 40, '�,r i "'U!E'�o 2m�I PIZ, WE f' ,HR *� n i., < '(�����r11'�A',=f:2:-Ja?:.Lrx£.--}:. 'vn."5:f•,-'^a�i:.:K ae-pw'•tai^ - u _ .c . w-at- W, zY_ r. V� H 7 drzb, llf 7- Wrzv_�.' t3, i-4 i'In in 1�1 'A N-7, 'AW1, 2-7� Z, 'Z Ist 'Udsi "to 9 .2, R" - A I Wkk 'A .-A MT��' 7m"-Z'4-r 7k,71, TM -K7 is, tOME., M �tk-'-,"'Up 10-041 "'R eik C� MIRK R R-k an V_ 7�V n 'v" CT CTxi - i00 FFI' 40 rT yet, OL W-, - TD, -H 777 4� Scot Aa .R. :s #e1 ; 41�A\', E�[� SUPERVISgg, r Ll` ;tGilE C;JE1��]C` SOUTHOLD TOWN FALL-P:Q:Bbx 1179 53095 Main Road=SOUTHOLD,'NEW YORK 11'971 N,' lG rror �' �;g � thp• CHAPTER 236 - SQ Ni AER- -AGER EN-TVOR,,SHEET ( TG BE COMPLETED;BY TW x:11 UC A►:'N'i' 1 "DOES, THIS PRQ7,ECI'_..tI111VQI:VE AW, OF' THE FOLLOWING. 1CHEGK ALf-;f HAT Fiaf?Lyl� ! _ �- Yes No � ® A. Clearing; gru.b,bira,g, grading "or str{ipp ,rig of.,1`4,nd'. which affects, more }I than 5;000=-.square feet of 1 TI-QUnd surfaire, t B. :Excava'tion or filling -involving snore th an 200•;+ 1aic yards of material within any, parcel.,or any eons lgu:.ou„arm- � ®IAC, Site ;prepara.flm on slopes whioh .exceed 1k-0 :reet �tert�ical rise to t,J ,• to 100 feet of harizonGal=d,istance> {' Site preparation within 1:0.0 feet :of wetfa.ad:, beach,,•Muff or coastal is erosion hazard area. ® E. Site preparation within the one-hundred-year floodplain as dep.,icted � Oon FIRM Map,of any watercourse. 1j F. Installation of new or resurfaced, .,irnpUrvious surfaces of 1,000 square E ' :feet or -snore, unless prior approval,of a Stormwater Management Contxdl Plan 'was reoeivcd by the `Pow,,'n:and the'paropos. 1-i ncludes I _... in-kind,;rgplace Tient=of Impervious sur” • If you.answered N.Ot4 a]I of(Ii'e•�uestlons above;.SOpL :4�eu►plt�:4tlie jptcatjr ecttn► oth:yourtNanae, Signature, Contact InformatioA,,'Date,&,-.Connty.Tax Map•'ATumbcf!. Chapter 23 ��loes:itol pppI*to-,your protect. If you'answered M to,ono or inose of,thq'alipve,,please submit.T.w0:copies.pf,a,t5tq nt�r tic' anagnmenlrControl:Pian: and a completed,Mck List lFof'm to the,BulldiagJ)0.4rtment tvit y ur Buiiding• 'e it Applfcati'on. rrYA-WC ANT: (properly Owner,t�rsi�n-ProfeaslomL Agem.Contractor.Otherl! '�' i���;t Dale NAME +� Section. :Htack 1-:ot lF'C�;t�_.t�UjL•DJNQ,:DEPA']'ITMI"NT USL"'ok, ** Comact Infornulror� •{rih,Eoo8 Armon t '�' '��,. f} 11 Re�t�wedrB.y: t Propery Address!Location of Cot�strnct:to►i Work; ': _ _ _ — _, _ _t_ #: a # �►phi'o�=edF�or:pro�essir�g;8irldi :Pgl`mlt. ' �3 �' �1'=i �l�ir�a��1:_e�:Liar%i�g�ri�grit�C'nir`'trolrPl'aiz,l�]ot;R�quired._' �E fN,7 y, '.�,I LollnlwaXecy�ar��g�ni ot,Cai7tiol-PI aIl=ts ftenuired { . swirlalagtiseTn'g'a6ir:,ttrierlt;iorReslewva, FORM " SMGP-TOS'MAY"26T,4 i APPLICAn 1 i - t S.C.T.M_'_: 1000 CHAPTER 236 (Property Owner. ign i'ro[ 1./�4ot.Contractor,Other) ..... � ��`>��yS= _ - ' Win, 5� 1 p.g 5torinwater Management Control-Plan CHECK LIST NAME _%C1 ban Brock LotS M C P -Plan Requirements: Provide ONE copy or the Building Permit Application. Date: - - c�� �c The applicant must provide a Complct'e Explanation and/or Reason for not prot•idhtg all information that has been Required by the following Checkhstl 1. A Site Plan drawn to scale Not Less that 60'to the inch MUST YE NO If You answered No or NA to any Item. Please Pro%-'ide Justification Herel show all of the'following items: If you need additional room for esplan_ation_s_.Please_Provide additional Paper_ a. Lbcat ion,&,Description of Property Boundaries- b. Tot al-Site`Aci-cage. 7�]H H c. Existing-Natural &Man Made Features within 500 L.F. of the Site 1Boundary as required.by§23o-imp, d. Test Hole Da6a'6dicating:3u11 Characteristics&Deptha to Crotu dVater. e. Limits ref fiieatlhg-& Area of Proposed Land DlMurbance, - - f. Exi>tingA_Plx,-jpo..sed.Contours cif the Site ([�u�tmum Z+1twal-4- a,0 6 , g. Location of all existing&proposed structures,roads, d weWa)-,�s-td`ewalks,drainage_impro ements&,utilities. h. Spot Grades& h FinisFloor Elevations for all eAsttng& Aki71.� - propasedtructtire�. V i. Lncttt-on ol`plriaposed S+�riintning Pool and dlschar a ring _ J_ Lo,anon ,prpposed"Sol[Stockpile Arealsl:_ - - _ k.- Location',or-t� i ed Cat traetion Eiiirar�celStaging-Areatsl. , ~ p 1, Location ofi -r _used_ oricrete_��rashout aiea(51, - - - - - - t - - - - m._Li3ratiatti of_5il t'v 5aed e[c�ion,8�eciitnenl cuotro];muauulre5. - - ----- - T-Sto�ntivaret-Miiiiag`e'ment Control Plan mtik'inciode Caicuiat ons sfi`&%do J C�NTE300:S: that the itnrm%%VW improvvinents,are tiized to capture;More,and tnfilltat� .• ; on-site the run-off rrnm all impervcous surfaees generated by a two 1 'l jrtgh; _- -, _ _.,.- „ - rainfall Istitrrti tent: A M AC $: DeiaiL�B Seet2 iut:Q�u��=inks Rir-gfc,rm_k,,,ater pr_cti- are're.UIV d�forapjiro�al. _ - - It6ms requtrit g,details.shali_Include but not-be Iimited.tb. a."Erosion&!8't imeni Controls. _ b. C'onstrut:1`6 i E'iitrance& Site Access.' -valifawt c. Inlet Drai-a`e Structure.. (e.g catch basial,a"ench dram, etc? ffilli . rig � s - � 10 d.;leaching tructtires (e. .infiltration,basins s�rali ,etcJ_ FOR ENGiNEE NG DEPARTMENT USE ONLY Additional Information isRequire8. ; 11 Retie% ed & Stormtarater Management Control Plan is Not`•Complete. i' Approved By: — — 1 Stormwater Management Control Plan is Complete. Date- 2 17 /� l SMCP has been approved by the Engineering,D pai•tment. FORM & SWCP -eck List -TOS MAY 2014 '„tlfFaw�, CQw r I =,,An ..: Receipt Yeo. .$;� Received of - � --�---�1:00.D61lars. For - .Fee kzr Nwfor Fee fbr Fee for sFe�`fgr Ceitiffci#s' Electritdl ElSign ❑ Flood Developmenf Pmt. BuAldiog>Permih ; ; _,Qf>Occupernry ❑'- 'Inspection D cm `Builctiti�-D�pgt�ment r 4' 'ti .r<; r =-w,f•-.,„-r_ M"'.�' ..". , ...4 �i `rzl..>1i`�4.Y=;i • lt4t x`n'`: '1 .EKG rag) -Shalt,-,IncIU-di-,b�n-6,- ".�' ° .' t-b i r+� d#o:; Zb'r ' erc'fir' 1Y` A'weli tin intained ,• ;B ' 'r" �.,r 'P r.. <. 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UNLESS AFdNG. 7NDEA§1 D�REOGIO$G1pF'A L10E�VSED 14irCI31"� r;TOACT,ERANY rr MON ` Z; THtSiDRAW�ING W:t1NY W IY.ANY AUTUORIZED • £ ALTEI A�'IQN Mu �F,.;N TED;;`SBALSD;,AND :D�txRTB�CIr��4�CQR�3t�1� l t Ftizti C`i R' b 1' '�, t 1 r f s , t .'µ •r , t^ DRAINAGE INSRECtIQNS ARERFti<UIREp- Contect TOS Englneeringat6 =.I6! befi�rt Backfill,OR-prauCda,,Engineees,:Ce�ifimtiori, that the,draxna E%r TO IAMONNS 1 i _ �l�s; �.Iroj�crT �U�:D ,��'�'T• �r 1 �Yif,N�llsli�5`.4,wW ' REA LFEET W,WMA AF a�DASCAM jAIAT�R Date:- Z', r3 F�b.,3l07 NQ? 17►: ri0N, p I pproyed'by,: '' _ DRAINID�G No: t c .BIJ;I I 't 1C'�DEPAR, 11r1�t T , TOWN-MERIM$fJId RVIL-C Nwia-sPERMIT ITHI&PER-MIT"M;ST B11'KEPT F N"T,i=iE::i''RF IIS-ES WITR 'NE-S.ET,C3 'APPRO?EM�4PL,,A AN,`WSPE&l f A*7,f 'NS, UNTIL�FUL"L�OOMPLI IO OP'T' W'O`t�K SIU.a'E ;�C D} Permit#: 41-376 :Qat ; .7121ID ?` Permission is-,hereby,granted to: ;Kearns, Nelt 25,Central'!Dr - Manhassett'r-NY 11,030' To: constr=uct alterations to-existing ace''ssary.Wldiho�4nd"to goh'9truct additions and alterations to existing single-fainIly,dvuaf(tog as;appiie.01'1 pair ZOA.&SCND-approvals. 7woC0's'aretreq,uired;simutfaaneaualy: _ V At premises jocated":at: ; 18Q7b°Spun i iew*Ay%Southold SGTM4 473885' Sec/Bfock/Lot��51:1=8'' . Pursuant to application,dated, '1,120/281.7 an.d-,.app�:pved,byith i tilldirig`;lJ sp tor.. To expire,on '812312,018:, Fees: AWEssORY' $100:00 C }-AC $50:00 SINGLEFA itlis l W8l1LTi - DI i~tN A TERA'3' $1,466.00 CO' -'TDj6,-Ok,'T 7-D EIA,NG $50:00 To $I;f 66.00 elm r ri, ,-2' ®R U,;,&7111, �o214 °�rc.. jl Vg� ----------- Y�"�?�!rl ,:<,'-se„�'ARD J T, 31 ew------ to"U'll'. I alle-.' 1�1" cin, i, -Cl--Nok M1,I),pt T f xv fu, , n 54 N S. ' 'Aw �HD�`El R- OFF, 0 To N,714777, 4�� 7- -M, )5 3'4'x G'd' 2 PANEL MDP PAIR' R4JI>hqY NEW:DOfJ(i IN, XIr�rt1�16.JAtv1Q 5ti' 6ET 4'O'x G8' 2 PANEL MRP i'A!R DUMINY w/t�1ACNETIG;CATCtt`_ � r b�'o vn'arclutect:c0 ~. 2 PANEL MDP POCKET. 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'1otglijuil�A � (S 1 O�.lhi0�l(S)Z'-1 OSY`E y�.�= 09C^�59 'fi� ieltiBoikk0j."polu ;• tddW'tN �3d) Man E13117t�S!Wo t i tii( Z'J.M!Il (Z'101 PN l9'v1 J3d) '(S',EO.Z S.IND*S,(Z)Z'I'OSN,'.1035?l3 D (9JOZ-,5.1N021db)V,I'OS 'OIA,l3d) (510Z',�J1N721 (5)^Z"I OES *VJ I= 4' �►��Lr ;I J r t. ii:'^„a�fiP�d7nr:a'r+M'^rx?',�tY�'!Y:'.:.^ •'lr°rw`�1�z �,•%'•'��_�'�'�' .•,-•,, V N at <� : t F ,.r�.., _,:;'t.7:;"�a.r., a �' ,.: .� NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Division of Environmental Permits,Region 1 SUNY 4 Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-p3661 F:(631)4440360 www.dec.ny.gov June 6, 2016 Mr. Neil Kearns 25 Central Drive Manhasset, NY 11030 RE: Permit No.: 1-4738-04448/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECS.) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit for the referenced activity. Please carefully read all permit conditions and special permit conditions contained in the permit to ensure compliance during the term of the permit. If you are unable to comply with any conditions please contact us at the above address. Also enclosed is a permit sign which is to be,conspicuously posted at the project site and protected from the weather and a Notice of:Commencement/Completion of Construction. Please note, the permit sign and Notice of Commencement/ Completion of Construction form are sent to either the permittee or the facility application contact, not both. Sincerely, Mary A. MacKinnon Environmental Analyst MAM/Is NEW YORK oepartment of SFATEOF wroatur+nt Environmental Conservation AM tubma NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION IRW Facility DEC ID 1-4738-04448 PERMIT Under the Environmental Conservation Law ECU Permittee and Facility Information Permit Issued To: Facility: NEIL KEARNS KEARNS PROPERTY 25 CENTRAL ISR 18075 SOUNDVIEW AVE MANHASSET,NY 11030 SOUTHOLD,NY 11971 Facility Application Contact: EN-CONSULTANTS 1319NSEA FJ) SOUTHAMPTON,NY 11968 (631)283-6360 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Southold Facility Principal Reference Point: NYTM-E: 715.648 NYTM-N: 4551.459 Latitude: 41'05'08.9" Longitude: 72°25'57.5" Project Location: 18075 Soundview Ave - Watercourse-Hashamomoque Beach Authorized Activity: Remove and replace existing wooden portion of bluff stairway with a new elevated timber bluff stairway, consisting of a 4'x 4'platform, 3'x 19' steps, 5'x 6' landing and 3'x 12' steps to beach. Install an 83 linear foot rock revetment along the toe of bluff(including 75 linear feet on subject property and 8 linear feet on westerly adjacent property,to tie into proposed revetment to west). Excavation of approximately 160 cy of sand,the sand will be used for bluff restoration. The revetment will consist,of three ton stone placed over 50 lb core stone and filter cloth. Restore bluff face by constructing terrace retaining walls, adding approximately 265 cy of clean sand(160 cy from site and 105 trucked in) and vegetate with native plantings. All authorized activities must be in strict conformance with the attached two page plan prepared by Jeffrey T. Butler last revised 4/11/2016 and stamped NYSDEC approved 6/2/2016. (MAM) Please note,the area landward of the "top of the bluff' as shown on the survey prepared by Nathan Taft Corwin III dated 8/25/2015 is beyond Tidal Wetlands Act(Article 25)jurisdiction. Permit Authorizations Tidal Wetlands-Under Article 25 Permit ID 1-4738-04448/00001 New Permit Effective Date: 6/2/2016 Expiration Date: 6/1/2021 Excavation & Fill in Navigable Waters -Under Article 15,Title 5 Permit ID 1-4738-04448/00002 New Permit Effective Date: 6/2/2016 Expiration Date: 6/1/2021 Water Quality Certification-Under Section 401 -Clean Water Act Permit ID 1-4738-04448/00003 New Permit Effective Date: 6/2/2016 Expiration Date: 6/1/2021 Page 1 of 6 NEW YORK STATE.DEPARTMENT OF ENVIRONMENTAL CONSERVATION � Facility DEC ID 1-4738-04448 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the EOL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: SUSAN ACKERMAN, Deputy Regional Permit Administrator Address: NYSDEC Region 1 Headquarters SUNY (ate Sto y BrookJ50 Circle Rd Stony Brook, Y 790-3409 Authorized Signature: Date Distribution List EN-CONSULTANTS Habitat- TW MARY A MACKINNON Permit Components NATURAL RESOURCE PERMIT CONDITIONS WATER QUALITY CERTIFICATION SPECIFIC CONDITION GENERAL CONDITIONS,APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS; EXCAVATION & FILL IN NAVIGABLE WATERS; WATER QUALITY;CERTIFICATION 1. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 2. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 3. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. Page 2 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04448 4. Storage of Equipment,Materials The storage of construction equipment and materials shall be confined to the upland area landward of the bulkhead or on a barge. 5. Clean Fill Only All fill shall consist of clean sand(not asphalt, slag, flyash, broken concrete or demolition debris). 6. Backfilling All peripheral berms, cofferdams,rock revetments, seawalls, gabions, bulkheads or other approved shoreline stabilization structures shall be completed prior to placement of any fill material behind such structures. 7. No Equipment below Apparent High Water Equipment operation below(seaward) apparent high water is strictly prohibited. 8. Revetment Rock revetment shall consist of natural capstone a minimum of capstone 3 ton in size, c;orestone a minimum of corestone 50 lb. in size and the toe shall be installed a minimum of 2 feet below apparent low water or 3 feet below mean sea level and all shall be underlain with filter cloth. 9. No Runoff Over or Through Bulkhead or into Wetland There shall be no discharge of runoff or other effluent over or through any bulkhead or shoreline stabilization structure or into any tidal wetland or protected buffer area. 10. No Alteration of Bluff for Stairway Alteration of the existing grade of the bluff or hill during construction of the stairway is prohibited. 11. Stairway Design The stairway must be elevated a minimum of 3 feet over grade to minimize disturbance or loss of the natural vegetation and reduce the potential for causing or accelerating erosion of the bluff or hill. Disturbance to the natural vegetation or topography seaward of the crest(top) of the bluff or hill must be restricted to an 8-foot wide area,including the width of the stairway, as shown on the approved plans. 12. Long-term Plant Survival The bluff face shall be planted with as per plan specifications and the permittee shall ensure a minimum of 85%survival of plantings by the end of five growing seasons. If this goal is not met,the permit holder shall re-evaluate the restoration project in order to determine how to meet the mitigation goal and submit plans to be approved by the office of Regional Habitat-TW NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY 11790-3409 13. No Interference With Navigation There shall be no unreasonable interference with navigation by the work herein authorized. Page 3 of 6 r NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-04448 14. State May Order Removal or Alteration of Work If firture operations by the State of New York require an alteration in the position of the structure or work herein authorized,or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 15. State May Require Site Restoration If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may lawfully require,remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration, 16. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments,fuels, solvents, lubricants, epoxy coatings,paints,concrete,leachate or any other environmentally deleterious materials associated with the project. 17. Conformance With Plans All activities authorized by,this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Jeffrey T. Butler last revised 4/11/2016 and stamped NYSDEC approved 6/2/2016 . 18, State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. WATER QUALITY CERTIFICATION SPECIFIC CONDITIONS 1. Water Quality Certification The authorized project, as conditioned pursuant to the Certificate, complies with Section 301, 302, 303, 306, and 307 of the Federal Water Pollution Control Act,as amended and as implemented by the limitations, standards,and criteria of state statutory and regulatory requirements set forth in 6 NYCRR Section 608.9(a). The authorized project, as conditioned,will also comply with applicable New York State water quality standards,including but not limited to effluent limitations, best usages and thermal discharge criteria, as applicable,as set forth in 6 NYCRR Parts 701, 702, 703, and 704. Page 4 of 6 s� NEW YORK STATIs DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC 1D 1-4738-04448 QXNERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation(the Department)to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions,must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms,conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals,Modifications or Transfers The permittee must submit a separate written application to the Department fpr permit renewal,modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC Region 1 Headquarters SUNY @ Stony BrookJ50 Circle Rd Stony Brook,NY 11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Excavation &Fill in Navigable Waters,Tidal Wetlands, Water Quality Certification. ' 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; Page 5 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION +' Facility DEC ID 1-4738-04448 e. noncompliance with previously issued permit gonditions,orders of the commissioner, any provisions of the Environmental Qonservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies,expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York,its representatives, employees, and agents ("DEC")for all claims, suits,actions, and damages,to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of,the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits,or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing, its independent contractors,employees,agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities,and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits,approvals, lands,easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: 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. Page 6 of 6 NOTICE OF COMMENCEMENT OF CONSTRUCTION RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631-444-0297 Bureau of Habitat-TW lobw 50 Circle Road Stony Brook, NY 11790-3409 PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Dear Sir: Pursuant to the special conditions of the referenced permit;you are hereby notified that the authorized activity shall commence on . We certify that we have read the referenced permit and approved plans and fully understand the authorized project and all permit conditions.We have inspected the project site and can complete the project as described in the permit and as depicted on the approved plans. We can do so in full compliance with all plan notes and permit conditions.The permit,,permit sign,and approved plans will be available at the site for inspection in accordance with General Condition No. 1. (Both signatures required) PERMITEE: DATE CONTRACTOR: DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS AT LEAST TWO DAYS PRIOR TO COMMENCEMENT OF THE PROJECT AND/OR ANYASSOCIATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HAVE THE PERMIT AND APPROVED PLANS AVAILABLE AT THE,WORK SITE FOR THE DURATION OF THE PROJECT MAY SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANOTIONS•AND PENALTIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. Cut alpng this line X X X X X X X NOTICE OF COMPLETION OF CONSTRUCTION RETURN THIS FORM TO:COMPLIANCE Or Fax to: 631444-0297 Bureau of Habitat-TW 50 Circle Road ei,i Stony Brook,NY 11790-3409 NOW PERMIT NUMBER: EXPIRATION DATE: PERMITTEE NAME&PROJECT ADDRESS: CONTRACTOR NAME&ADDRESS: TELEPHONE: Pursuant to special conditions of the referenced permit,you are hereby notified that the authorized activity was completed on We have fully complied with the terms and conditions of the permit and approved plans. (Both signatures required) PERMITEE: DATE CONTRACTOR:' DATE THIS NOTICE, WIT14 PHOTOGRAPHS OF THE COMPLETED WORK AND/OR A COMPLETED SURVEY,AS APPROPRIATE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 36 DAYS OF COMPLETION OF THE PROJECT. 95-20.1 (8187)-9d New .York State Department of. Environmental Conservation AM- Aft. MON %JT �! The Department of Environmental Conservation (DEC) has- ssued - permit(s). . pursuant to . the, Environmental Conservation Law for work- being conducted at this site: For" further information. regarding the nature and - extent of work approved .and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please .refer to the permit number shown when contacting the DEC.. Regional Permit Administrator Permit -Number ROGER EVANS .Expiration Date , 6/ 1 / NOTE: This notice is NOT a permit AGRICULTURAL DATA STATEMENT ZONING BOARD OF APPEALS TOWN OF SOUTHOLD WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit, site plan approval,use variance,area variance or subdivision approval on property within an agricultural district OR within 500 feet of a farm operation located in an agricultural district All applications requiring an agricultural data statement must be referred to the Suffolk County Department of Planning in accordance with Section 239m and 239n of the General Municipal Law. 1. Name of Applicant: UL6 % 2. Address of Applicant: 3. Name of Land Owner(if other than licant),. 4. Address of Land Owner: 5. Description of Propos Project: 446k4 awd - 6. Location of Property:(roaif ind Tax map number) 2, 7. Is the parcel within 500 feet of a farm operation? Yes { },.No 8. Is this parcel actively farmed? { ) Yes N No 14 9. Name and addresses of any owner(s)of land within the agricultural district containing active farm operations. Suffolk County Tax Lot numbers will be provided to you by the Zoning Board Staff,it is your responsibility to obtain the current names and mailing addresses from the Town Assessor's Office (765-1937)or from the Real Property Tax Office located in Riverhead. NAME and ADDRESS ,-? 2wzAt 2. S0ZC7W&U=> 3. 4. 5. 6. (Please use the back of this page if there are additional property owners) Signator f ican Date Note: 1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement. 2.Comments returned to the local Board will be taken into considemtion as part as the overall review of this application. 3.Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified above. The cost for mailing shall be paid by the Applicant at the time the application is submitted for review. F M 'SWAMPIENNA Ad 'OIL own of Sbuthold 'Tax,Map Inquiry ' 77 %W 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part -Project and Sponsor Information 49 Name of Actio or Project: Project Lo ation(describe,and attach a location map): Brief Description of Proposed Action- ate . Name of Applicant or Sponsor: Telephone: 3�,L�177 soZ p E-Mail: Address: City/PO: State: Zip Code: 1.Does the proposed acti n only involve the legislative adoption of a plan,local law,ordinanc , NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that XV 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 A ency? NO YES If Yes,list agency(s)name and permit or approval: �L/� G� }D 3.a.Total acreage of the site of the proposed action? Z8 acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site'and any contiguous properties)owned or controlled by the applicant or project sponsor? /Z�' .acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban Rural(non-agriculture) ❑Industrial ❑Commercial ❑Residential(suburban) o 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? V9 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: 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? xJ 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 publ c/private w er supply? NO YES If No,describe method for providing potable water: ��la& 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: 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? 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?&)�q 30 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 ❑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? 16.Is the project site located in the 100 year flood plain? NO YES 1-10 1 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? �M NO❑YES b.Will storm water discharges be directed to established convey ce systems(runoff and storm drains)? If Yes,briefly describe: ,U 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: 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: f� I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons r nmfip.. Date: Signatu 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 regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or 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 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. 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 impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) residing at (Print property owner's name) (Mailing Address) do hereby authorize f , r (Agent) to apply for variance(s) on my behalf From the Southold Zoning Board of Appeals. (Owner's Signature) ecli�2rjt�l,,E (Print wner's Name) Board of Zoning Appeals Application AUTHORIZATION (Where the Applicant is not the Owner) residing aty �r' (Print property owner's name) (Mailing Address) do hereby authorize �; (Agent) to apply for variance(s) on my behalf from the Southold Zoning Board of Appeals. 4 � v4v� (Owner's Signature) I L YIPA JZQ—S (Print Owner's Name) APPLICANT/OWNER 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 i�hatever action is necessary to avoid same. YOUR NAME : �, , 1, (Last name,first nanf ,middle initial,u leas 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.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning Do you personally(or through your company,sponse,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 that 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 day of ,20A Signature X Print NameQ�, z APPLICANT/OWNER TRANSACTIONAL DISCLOSURE FORM 1'lic 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 • (Last name,first name,middle initi 1,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.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance 14 Trustee Permit Change of Zone Coastal Erosion Approval of Plat (Mooring Other(activity) Planning 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 that 5%of the shares of the corporate stock of the applicant(when the applicant is a corporation) 13)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 Submitte his d y of , 0 Signat re C tf Print Name 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 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 : (Last name,first name,middle initial,unles!(Yod 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.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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 that 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 day of Signatur Print Name 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 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 : (Last name,first name,middle initlaf,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.) TYPE OF APPLICATION: (Check all that apply) Tax grievance Building Permit Variance zv Trustee Permit Change of Zone Coastal Erosion Approval of Plat Mooring Other(activity) Planning 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. I - 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 that 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 ju Submitted this day of ,20/7 Signature Print Name 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 Trustee_s Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# .'!!�—/ - =z— The Application has been submitted to(check appropriate response): Town Board Planning Dept. 0 Building Dept. © Board of Trustees 0 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital 0 construction,planning activity,agency regulation,land transaction) (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent pf action: � k / Location of action: Site acreage: Present land use: ' Present zoning classification: �Q 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: , (b) Mailing address: (c) Telephone number:Area Code (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No W 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 0 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 11 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 IH—Policies Pages 6 through 7 for evaluation criteria 0 YesE] NoNot 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 IH—Policies Pages 8 through 16 for evaluation criteria 0 Yes [3 No�ll 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 0 Yes © No A Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. © Yes R No_W Not Applicable ti 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 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No [�U 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. © YeD No-5 Not Applicable Attach additional sheets if necessary WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses iw suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. 7 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. ❑ Yes ❑ No® Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No-R Not Applicable Created on 512510511:20 AM 4 4'rt 4 �'�. "•�,,,� airy _�' � •r" ` ." a! J . a-, f c w FACING NOR°i H—sou'TH SIDE ELEVATION rAt ;K'iw`4Y e y 41 I r� MA is, .f At - y , FACING SOUTH--1 IORTH ELEVATION 1� k ", $�.r, *fit'= ` � •-� ;�„ � ��: KEARN'S POOL HOUSE- 18075 SOUNDVIEW AVE., SOUTHOLD, NY - SCTM #:1000-51-1-8— PHOTOS TAKEN o8/o2/2017 A +L � �n�sw"..'•""""�"^'+w,-��.�.:,..f..:.._� •, .,, ",� ': ��rzMw'w".^��"'�x.•+ws.+w.n^esfr�'*+*^">�•+rb�ww� i i � ��R~ fir',` • -.Je ��-�'. .1�. r 01. Not w � 40( V-4 FACING EASTERLY- WEST ELEVATION '� .,,,,; - dam• � "........�.�e"'•�"... .....- - .w .......�. •- POOL HOUSE— • •UNDVIEW AVE., SOUTHOLD, • •• • • o8/ol-/2017 F r f Y� e ` � s e •,M AND SOUND LONG ISL - ;' I I I APPARENT LOW WATF,R MARK I A I I I 1 c0i I I I x 1 I I 1 I I I I o I + I' N 88'43'35" E N �6q3 ' 55.48' / WOOD STEPS k LANDINGS I I T�TIE UNE ALONG P 0 K STEPOVER OU)BROKEN CONC. HIGH WATER MARK ON 08/25/15 l3J S k LANDINGS x W000 STEPS �\ - •-6 0 �4 -__BO m u� Z, 0 —-10 rd BOTTOM OF BLUFF - -12X. •P --- 325 , - -11220 •cr� CONC �7^ i34 \\ -36 40- -35 42- - --40 p4- q6- 48 _ -42 48 -- -- \ \ _ mow'-� _ _ -44 JL4x -46 .5.Ux 1 n cx.51a ' / f 50 -52 n I r/ _�pN_C,WALL -54 REMAINS OFMAXX0.2 CONC.WWAA,,,L¢¢¢L/� A FENC -58 E X56 PENCE- 0 I" NCE 2 F.l x52&- / M 50A�•D FPO a9 �4.4�C i /62 NEpS AO OF 54— .�,Rp v 5NF•Et _.T._N 6Pp5`ON NP 55�5�5-11 £ x61'9 / 'a OOASSPL NOjO N°• z� �/Jt xFLA 61.5 / N o FENCE / o m• FENCE BRICK W SHED 4.4' 14.5 CONC WALK / / 4 9 x ER PATO �g �'G O 40 •o w UT r cn A o IHGROUND POOL = 37'W. m 160 190 m• try ❑ _POOL O O EQUIPMENT 'a " Z 4.1' 3 �V$E GAT 2.0'W SURVEY OF PROPERTY Fos�E. �4fFL 5�4, $�ORt FRP�6 N � 195 , 4' GulWRELn SIT UA TE GARA E SOUTHOLD q2 a 263 1350 O • POLE TOWN OF SOUTHOLD 5 �y�N A+ METAL 18,, �£ �r £� SUFFOLK COUNTY, NEW YORK SHEO 4 m cN An 8 c� S.C. TAX No. 1000-51 -01 -08 SCALE 1 "=40' m AUGUST 25, 2015 a� Fp3w r� AREA 52,287 sq. ft. (TO TIE UNE) 1.200 CIC. %v W, 4 •p �A NOTES. " 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM x EXISTING ELEVATIONS ARE SHOWN THUS:SO.a •° EXISTING CONTOUR LINES ARE SHOWN THUS:————5Q———— m FFL.- FIRST FLOOR I GFL.- GARAGE FLOOR TB - TOP OF BULKHEAD " POLE B B,- BOTTOM OF BULKHEAD 6 T.W - TOP OF WALL Y BW- BOTTOM OF WALL m o f x / WIRE PREPARED IN ��gtNJ IT NI FENCE STANDARDS V SH 0.71 BY THE A. 0 D FOR S TITLE SOCIA % E FE CE 1 Q 1 ✓� LTI J 113 • � � w z 1 " x c. No. 50467 m / MEAL FENcE UNAUTHORIZED ALTERATION OR ADDITION d CONC Mi Nathan Taft Corwin III SEolA THIN SURVEY IS A VIOLATION OF FON0 0 SECTION 7209 OF THE NEW YORK STATE COB,RMNS GATE / Oi5 e g X%4 EDUCATION LAW. / Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING w 5 FENCE P0� 0 •� THE LAND SURVEYOR'S INKED SEAL OR z MSA`' �IUi E �0• "° ' EMBOSSED SEAL SHALL NOT BE CONSIDERED a-n WR TO BE A VAUD TRUE COPY .TQ S.S. fEN�p O'S ERNS •° , f i1RE " CERTIFICATIONS INDICATED HEREON SHALL RUN 3 Ag5� ROP zm GUY ++ w Successor To: Stanley J. Isaksen, Jr. LS ONLY TO THE PERSON FOR WHOM THE SURVEY jNOVs FENCE +�jO Joseph A. Ingegno I.S. IS PREPARED,AND ON HIS BEHALF TO THE LGN MEIN• / / ?J'`Z7 EMENT A , �•,�_T TIRE COMPANY. GOVERNMENTAL AGENCY AND 5 7 E OF ON •� 11v Title Surveys - Subdivisions - Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON,AND �q-EOG TO THE ASSIGNEES OF THE LENDING INSR- PHONE (631)727-2090 Fox (631)727-1727 TUTION CERTIFICATIONS ARE NOT TRANSFERABLE '4 . • - ,° ?I�(�T ,,' J • '� I vv�� OFFIS5CAAES LOCATED AT MAILINGADDRESS ' •° .,�'(� \VI James�brts H&A?pd11947 JamespcW'NE9xY1Fk 11947 THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF v 1 ANY, NOT SHOWN ARE NOT GUARANTEED. o-t 35-178-1 Z� • N ): >( )( 4 •7 N -4Z251.4 >(49.5 49.3 >< 49.4 49.3 ) >(52UO �1 • CONC. WALL �F ONC. WALL 1 NC Bow. x G x60.6 RPM >( 60.0 E� E —FENCE )(59.6o S SCP' E 4g • P '\ 0 am 61.9 m .�•�'os\0 NP R g1 93 N =.I Idddlam Z x 61.9 D o 'oN QN0�0 No, J M Cfl r� C000VORM CONSTRUCTION v` EXISTING FRAME DEBRIS BARRIER i_ SHED EXISTING 1-STORY FRAME POOL HOUSE TO BE RESIDED I AND REROOPED AND TRIMMED TO MATCH HOUSE. 0.9 E FENCE PROVIDE REPLACEMENT ANDERSEN WINDOWS AND ZONE 2 DRYW L SLIDING GLASS DOOR IN KIND WITH EXISTING. 4 L NEW 4" CAST IRON DRAIN PIPE SLOPED 6�XISTIN PAT,p AT%4"/FT FROM POOL HOUSE TO 4 9, PAVER o E IgTING INGROUND POOL 0 ; M U D ROO M TO EJECTOR PUMP IN NOTE: ABANDON EXISTING BASEMENT EXISTING S _ , APPROX LOCATION G� , ' — PROPOSED 1-STORY � ADDITION C3NEW ROOF ON z � � EXISTING I -STORY POOL O _ ESIDENCE - - EW ROOF ON EXISTING 1 'STORY— Lz] �MENT STRUCTURE. FRONT OF GARAGE '� ►� GUTTER (TY TO DRAIN ONTO DRIVEWAY AND tt-1 GATE DRIVEWAY DRAIN b FENCE X11.4' L/1 0 6E' SED SECON �� GUY 0 WIRE BRICK NE�1 RO ORY ADDITION '�..� ENCE ARAGE EX15�ING TING FI �` �•o U E NOTE: P A5 E D ON I N F P S�RUCSI Z� ,p PROVIDED 5Y NEIGriB AND CE55POOL5 ON .5 �, OP05�p I-STORY �, SHED — �.—� ooITION TO TI�i E EA5T ARE I N E 4 1, N � I ABANON 150 FT FROM PROP O m����.� ( E(I TTING WE L, vZ ; � ATE: APPROXIMAT �. A ROX LOCATION AND CE55POOL5 FOR )CATION OF �� ,I5TING SEPTIC i _ �, � PROJECT. �5TEM TO BE drYWe115 - �� m 3ANDONED. MAC � � LEA h I 20' 20 NSWPROPOSED POOL- 03Z N I DRYWELL ERS � 200IHOUSE ROOF c� x jI; CHANGES .� U1 NOTE: APPDXIMATE I NOTE: PROP SED t', ( � July 10. 2017 LOCATION OF NEW 0) v I S KEARNS BURIED 500GAL m I CONC ETE N ESIDENCE IT IS A VIOLATION F THE LAW FOR ANY PER ON, ,`; ,•,:: S�EaED ARp SCALE: i' = 20' UNLESS ACTING U DER THE DIRECTION OF A LI ENSED Robert 1. Brown ARCHITECT,TO AL ER ANY jsr= Q 2 ITEM ON THIS DR A ING IN ANYWAY ANYAUT IZED ;;;E ��; * Architect, P.C. ALTERATION MUST NOTED,SEALED,A D :;�_� �, , 41 ,E. 20,�? Bax Ave. Greenport NY DESCRIBED INACC RDANCE ': • - '9 a �tOP info@ribrownarchitect.com WITH THE LAW. NEW • 631-477-9752 PROPOSED ROOFLINE PROPOSED ROOFLINE EXISTING ROOFLINE I EXISTING ROOFLINE — — — — — — — — — — — — — — — — — — — — — — — — I i a Y7A ACCESSORY NON-HABITABLE POOLHOU5E ACCE550RY NON-HABITABLE POOLHOU5E EAST ELEVATION WEST ELEVATION VQ SCALE: 1/4".= I'-O" SCALE: 1/4" = I'-O" IT IS A VIOLATION!OF THE FOR ANY PERSON UNLESS ACTING UNDER THE DIRECTION OF A LICENSED 00 ARCHITECT,TO ALTER ANY ITEM ON THIS DRAWING IN ANYWAY.ANY xJHORIZED - / ALTERATION MUST BE P % � / �/ AND DESCRIBED IN ACCORDANCE ROPOSED ROOFLINE �O \�� i��� WITH THE LA`N. NEYd EXISTING ROOFLINE EXISTING ROOFLINE / j j 12 00 5 PROPOSED ROOF N CHANGES o July 10. 2017 � N O KEARNS RESIDENCE SCALE: 1/4" = i o" ACCESSORY NON-HABITABLE POOLHOU5E ACCE550RY NON-HABITABLE POOLHOU5E Robert I. Brown 50UTH ELEVATIONArchitect, P.C. NORTH ELEVATION 20 Bay Ave. Greenport NY SCALE: I/4" = I'-o° SCALE: 1/4" = 1'-0" in o@rtbrownarchitect.com 631-477-9752 TOWN OF SOUTHOLD- PROPERTY RECORD- CAR® Uff�Ek dl keCteljS STREET % J VILLAGE DISTRICT SUB. LOT ti t t r .,,FORMER OWNER 11 N E ACREAGE r `'O t ' 2({b y � r. cl '���%� ; S W TYPE OF BUILDING RES. I SEAS. I VL. FARM COMM. I IND. I CB. I MISC. LAND IMP. TOTAL DATE REMARKS nzrz V ,� f) +-o �'i s `O - ` "ocn c_, 1 b -- 3 � g 0,90l.2 q a� ��, �� z— O1 qsl 17- YPalh ' t `� ` !W.-- &A 'ke 1�,vlaq- L_ i ��4 8-/93 _719-0 10 Lq Ito I/ 09, Tillable 1 9'—I�(,�Y1 Tillable 2 v f Tillable, 3 Woodland Q.6 — 5wampiand 4 /1016 Brushland 67�� 3 House Plot " Tota I tuif■■i■■■■■■■■■■■■■■■■■ � ME MOMMENNEUMMEMEMM � L F �- ■■■■■■M®M■D■D■®■M■■■ ■■■■■■■■p5M■■■■■■■■■ MMMMEMMMNUMMMONUMNIM ._ -� ..� � �� ,�#,� �. � _��.... ,.�.� x r� .t � R�fi iii ■�®f■ v F�'fr C� �L�r.fi ( "'S.'! to t'4'J ��■ jjE2nM■■M'67j- ■■■jWH■■■ S An Foundation Floors Interior FiWish Fire Place Porch Porch Rooms Ist Floor • , • ooms 2nd Floor c0