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HomeMy WebLinkAboutRebell, Jonathan & Levine, Noah F Michael J.Domino, President o���F S0UlyDl Town Hall Annex John M. Bredemeyer III,Vice-President O 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �p� Telephone (631) 765-1892 Greg WilliamsFax(631) 765-6641 �y00iJNTl,� FFRM t7o BOARD OF TOWN TRUSTEES 1 TOWN OF SOUTHOLD Permit No.: 9291AVC. Date of Receipt of Application: July 9, 2018 Applicant: Jonathan Rebell & Noah Levine SCTM#: 1000-74-1-35.56 Project Location: 4790 Blue Horizon Bluffs, Peconic Date of Resolution/Issuance: July 18, 2018 Date of Expiration: July 18, 2020 Reviewed by: Board of Trustees Project Description: Remove existing one-story frame cottage (670sq.ft.) and abandon existing water supply and existing sanitary system; to conduct construction activity within 100' from the landward edge of wetlands for the construction of a new 1,779sq.ft. two- story dwelling with a 265sq.ft. screen room, a 435sq.ft. deck with trellis and 50sq.ft. stairs to ground, a 120sq.ft. side porch with 30sq.ft. stairs to ground, a 152sgf.t rear porch with 97sq.ft. stairs to ground; a 576sq.ft. garage; a 232sq.ft. pool house with outdoor shower and 205sq.ft. trellis area; an 800sq.ft. swimming pool; install new water supply well and new sanitary system landward of dwelling; and install gutter to leaders to drywells to contain roof runoff, and in accordance with Chapter 236 of the Town Code— Stormwater Management. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Young &Young Surveyors, dated July 9, 2018, and stamped approved on August 15, 2018. Special Conditions: (Building envelope falls within 20 feet of Trustee jurisdiction.) Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees Michael J. Domino, President °�guFFD(,��oG Town Hall Annex John M. Bredemeyer, III, Vice-President y� 54375 Route 25 Glenn Goldsmith co ,r P.O. Box 1179 A Nicholas Krupski �y • �� Southold, NY 11971 Greg Williams �'ol , �a° Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction '/ constructed Project complete, compliance inspection; (1)UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW (2)DISTANCES SHOWN HEREON FROM PROPERTY LINES TO ETOSTING STRUCTURES ARE FOR A SPECIFIC PURPOSE AND ARE NOT TO DE USED TO ESTABLISH PROPERTY LINES OR FOR ERECTION OF FENCES.(3)COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY (4)CERTIFICATION INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION USTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INSTITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS (5)THE LOCATION OF WELLS(W),SEPTIC TANKS(ST)&CESSPOOLS(CP)SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS AIS FINISHED FLOORS ELEVATION TO BE _ LOT GO�/ER�tGE 400 Ostrander Avenue,Riverhead,Neal York 11901 VERIFIED BY ARCHITECT _ tel.651.1212505 fax. 651.'721.0144 y( LO��° IS�O„ �Ng4°4rj'OI"E _ _ PROPOSED admrn®youngengineering.com �J2 1 2 STORY FRAME HOUSE = 1,119 50.FT. = 3.4% Nat fir,2-( \ SCREEN ROOM = 265 50.FT. = 05% Na6°OCI'22��� 401-55 \ DECK WITH TRELLIS = 455 50.FT. = 0.8% Y Y 11 5A 1 REAR PORCH = 152 50.FT. = 0.5% GARAGE = 576 50.FT. = 1.1% Howard W.Young,Land Surveyor TIE LINE ALONG APPROX. �' POOLHOUSE WITH OUTHDOOR 5HOWER= 252 50.FT. = 0.4% Thomas G.Wolpert,Professional Engineer s - - - Douglas E.Adams,Professional Engineer MEAN HIGHWATER MARK / TRELLIS AREA = 205 50.FT. = 0.4% 9 9 aON 6/2015 _-'�"��' �' ==_ \ POOL = 800 50.FT. = 15% Robert G.Tost,Architect < TOE OF BLUFF- C-4 LUFF '` _` `��0_ TOTAL = 4,444 50.FT = 8.4% ry HEALTH DEPARTMENT USE r 10 .11�1171 01 N \ /// r - - X40 --�j // _ j�$/ - CREST OF SLUFF \ ��p ! ,1 , APPROVED BY ;ec�1 O� sJUL 9 2018 1; BOAR® OF TRUEEEJ ' - \ 09� �3O \,a,bJ, s46-N l� 9ti TOWN OF SOUTHOLD WOODS 1IMIT- 6 i 44L PRINCIPAL S BUILDING -16 S O �j _.•_-�- }_":III + p2_ ! ®ATE /S v&vvST i -'-- -42- - - \ �Gj � SETBACK LIN OE %9�� LOQ / \�0� ! �O SILT E 8 STAKED HA ALES a \ 22.a' WOODS SILT"A.-NCE S+p 0, 0 -40- _ A'STAKED ry L O c I APPROXIMA ATION OF BALES EXISII NIT Y TO BEYE"POR'S- R. ARAN DIN ACC RDANCE \ 150' WITH S.C.D.H.S. ST DARD i 22.1' \ O©® PROPOSED \ o °�1 r •, ® ©�\�F2 7-1 C� .y SGREIFN-PORCH \ "WE HEREBY CERTIFY TO JONATF1A,N R LC"THAT R g� EXISTING \ 8'DIA.x N 9� SURVEY WAS PREPARED IN ACCORDANCE• Tf�&OEMI C•_ �. I - COTTAGE TO y IO'ED O (� PRACTICE FOR LAND SURVEYS ADOPTED_ �T VIEW YOR�-�S A TEST HOLE I r BE REMOVED \ - 9G`� _ - - - - -\ ASSOCIATION OF PROFESSIONAL LANA VEYORS~ h FROM FILED MAP �'^ hZ�s \\ tPS Q. `� 40- ' WOODS 0.01 ...... ,_, PROPO5�D DECK \ L sdi. `�' -38- \ Wit- TOPSOIL i , TOPSOIL b W SN TRELLIS L$' °'s 6 - _ _ _ `� LOAM \ / \ _ \ l PROPOSED - _ - (f arYV�/�®�- C ' '• i .\ ° °p�3g ;\Q ELECTRIC/GABLE •Y \ 3.0' \ 56/ EXISTING WELL TO \ I oo. \ g- _ \ 1 BE ABANDONED SAND, - - 1 \` /-AND CJ GRAVEL 3 \y \ V3� / is \ p PROPOSED O� �a J HOWARD W.YOUNG,N.Y.S.L.S.NO.45895 e. Q •� m CLAY �' \t- WATER SERVICE wide Right 10.0' District (RR o0 Zoning Use a 34- \ 's �� a5 SURVEY FOR O =, I \ o®g Use District �'`� �� a9, °° o JONATHAN PEBELL SAND ® \ �� ry�� 5\� LOT 6, "MAP OF BLUE HORIZONS" GRAVEL \ / PROPosED 2 STORY \\ YI p \ at Peaonic, Town of Southold a \ \ _ - _ Suffolk County, New York York O� 4 BEDROOM \ $ tip" " \ PROPOSED GARAGE \ FFEL=40.0 \ 6FEL-54.0 a 9b q o o; BUILDING PERMIT SURVEY 1601 \\ �0 C>e \ \ I °o \ P41THOP�POOL R� County Tax Map DI.trict 1000 Section 74 Block OI Lot 55.56 51TE DATA '� �?/C13 (fib E.D LF \ \\ S s \\ oSED TRELLIS FIELD SURVEY COMPLETED NOV.06,201? /�d \\ 9 (400 S.F.5.W.A) �� O opo MAP PREPARED FEB.o7,2018 A AREA = 1.21'18 ACRES OR 55,0441 50. FT. SO`Y0 *SUBDIVISION- "MAP OF BLUE HORIZON5"FILED IN THE OFFICE OF �,�� \ O�9 y \ / Record of Revisions THE CLERK OF SUFFOLK COUNTY ON SEPT.50, 1985 AS MAP NO. ^�79 S Oh 6 \ .0-�p \ , RECORD OF REVISIONS DATE 7974. \ GO %i �� \ / Oh \\ ADDRESSED AIGA ND. I JUL GENERAL AMENDMENTS 09.2018 d " VERTICAL DATUM = N.A.V.DATUM(1988) O a ZONING USE DISTRICT = RESIDENTIAL LOW DENSITY I ACRE(R-40) �b9��6 \ � 9 'S�% PROPOSED \ \\ \ a 0 0 1 `Y,y �� SANITARY SYSTEM \ \ \ M o 4 RESORT RESIDENTIAL(RR) S� S J 0' o • PROPOSED GAS SERVICE NOT AVAILABLE 4 0L Aye m GROSS FLOOR AREA �0 Bn \ \ \JQ LF3 c BASEMENT FLOOR = 1503 50.FT. �J A.X 6'ED N 40 O 20 40 8p �+ PRINCIPAL BUILDING \ g \ (� 'S Fa FIRST FLOOR ' 1,779 50.FT. SETBACK LINE O O IL SECOND FLOOR = 1355 50.FT. \ \ 9 O� Scale: 1" = 40 GARAGE = 516 50.FT. \ \ �`SO• \\ a� C 0JOB NO.2017-0214 POOL HOUSE = 221 50.FT. \\ \` ` \ \ < DWG.2015_0061_2011-0214_bp I OF 5 O = MONUMENT SET ■= MONUMENT FOUND = STAKE SET ®= STAKE FOUND UTILITY POLE 0.003 3>V15 =. 135 3NVIG =Q aNnOd 1NMMNOH =0 135 LNMK*NOH = 0 E d0 � dq-t�IZO-LIOZ-L900-SIOZ'9MQ / irIZo-LIoZ'ON sor }(/ 0 a, 0•b = NI 'BIn05 )� ld'05 IZZ- 3snOH IOOcI c IDS�p / Jd �S 91.5 = 39v21V9 Jv 0 / 0 'Id'OS 558'I = SOO-rd aNOVa5 ",os b1XI = NOOI4 152114 �OJo�O�p`Z'p�s / Id*09 SO91 = 2100'14 1N3H3Sde o �/ l,,Q vaav NOOI�SSOa9 . `) �)� �`� �` 3"f8'd31V/�V lON 301/�2l3S Sd9. 0 @IOZ-bo xinJ."VN' N3HaN3WV 7VN3N39y �) (!)WUNaCiGa!1T30S3S 9 @ OZ O 'O 0 05 '�1 / \ 31Va SNOISVA321 d0 aWOOM J / y / \ (99bi) UVC I.ILISN3Q MO-1 TdI1N3QIS3?J = 1'JI?1LSIQ 35f1 9LNaA • SUOIsIAaZI 40 pJOJGZj (@@bU WfLLVa'/l'1fN = W(LLVa 1V711213/1 • @IOZ'LO'934 a321Vd32)d dVH / b \ •ON IVH SV 99bl'OG•1435 NO UNnOV W10499 d0>'aG lO 3H1 LIOZ'90'/SON a313'IdHOJ AaAlaM C T31d \ d0 301440 3H1 NI a3'11d..SNOZRIOH 3(1'19 d0 dVH..-NOISVUQSM s 'd3?J`d Y ld bf�dBS No 532j'�`d gLIZ'I 99GG 101 10 13018 •bL.a01i3Bs 0001 131mLa Clopq xv1 Rjuno0 \ '29S = . a3,ol x•v1a,@(ZJ \ `41`44 X115 ;aANnG INN9d 9NIC II(19 / o Id-I \ II.lo,� MON 'FlunoV �I1044n5 ploglnoS 40 uMol oluo"Cj 10 ILSNOZIZIOH an-iG =iO civHn '9 lO'T oo�o ���, \•\'�� � s ej rr 4 \ N /� � L — ✓ R4 0� \ S7 vi IVNOISS34O2!d d0 NOIIVIOOSSd 4350 \ �S-5I+J -ma OQV GAaAlaM CW I'dOd MVIl Sa ¢O?,3Hlt ,37NVCWO'>W NI a321Vd321d SVM A3.AN(*G \ '•1`�/I� -1-I i N V H.LV N o r Ol J.d1121 0 A33NgH 3M• J4 l�� \ \'� ' \ AVMA121a \ J \ 810Z 6 — n r :, 0 �� 3NII N3VH13S \ o !, \ E)NIOlU18 lVdION18d � a3.9�•416,@ \� '� '\ tt_• Q41 \ 301na3s 2131b'M -t ! a3sodaad `u; 21V11NVS i GA Nb J. o n I • ': ['=.: t"" \ \ \ a35adaad '' �6 YO UJI S \ Aho o \ \ 2{ 1 . $o N \• / ti a \\ \ �� y bimbo ° o °� ('v'M'S•d•S OOt9N5N7 �o s \\ P� 10 SITI3a1 a3so \ 1910 d3'G3.@ I / J a 39fi LN3HINIVcIaC HIIY3H � \ so� -- \\ \ X•via,@(Z) a> y sadOH5 2100am H1IM I O -10 6 \ ® 35nOH-tood Q39OJO�tW \ `o A o of \ \ -10 �o zi\ L o. 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DISTANCES SHOWN EON FROM ERTY LINES TO ExisnNG ARE FOR A SPECIFIC PURPOSE AND ARE OT TO BE USED TO ABLISH PROPERTY LINES OR FOR C11ON OF IES OF EARING THE LAND SURVEYOR'S KED SEAL OR ED SEAL ALL NOT BE SIDERED TO BE A VALID (L INDICATED OHEREON SHALL.RUN ONLYOI OOTHEOPERSON"OR WHOM THE SURVEYFIS PREPARED AND ON HIS BEHALF O THE TITLE¶COMPANY,GOVERNMENTAL AGENCY AND LENDINGINSTITUTIONTUTION LISTED HEREON.AND O STRUCTURES ASSIGNEES OF THE LEND(G(INSTITUTION NCERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OFENCES. SUBSEQUENT OWNERS THIS THE LOCATION OF SWELLS(W).SEPTIC TANKS(ST)&INCESSPOO S(CP)uSHHOWN HEREON�ARE FROM FIELD NOBSERVATIONS AND OR DATA OBTAINED FROM FROM OTHERS. (2)8'DIA.x 10'ED \ f� 400 Ostrander Avenue,Riverhead,New York 11901 / tel.681.72'1.2303 fax.631.129.0144 admin®youngengineering.com goy \ 01\ +coward A.Young,Land Surveyor / )Ik Thomas G.Holpert,Professional Engineer QJ� Douglas E.Adams,Professional Engineer f (� o� Robert G.Tost,Architect \\ >� ce�� ` HEALTH DEPARTMENT USE pas pas tK 140Q 01 �n S N SITE DATA AREA = 12118 ACRES OR 53,0441 50. FT. $ 5MVIV151ON-"MAP OF BLUE HORIZONS"FILED IN THE OFFICE Or- THE FTHE CLERK OF SUFFOLK COUNTY ON SEPT.30,1485 AS MAP NO. ooi 1 9994. V • VERTICAL DATUM = NAY.DATUM(1988) •ZONING USE DISTRICT = RESIDENTIAL LOA DENSITY I ACRE(R-40) �.S d RESORT RESIDENTIAL(RR) 3 \ �o GAS SERVICE NOT AVAILABLE o 68055 FLOOR AREA <kco SURVEYOR'S CERTIFICATION BASEMENT FLOOR = 1,508 SQ.FT. 8' FIRST FLOOR = 1,7179 50.FT. ewe+ewe ---------- SECOND ------"SECOND FLOOR = 1_55 50.FT. AE HEREBY CERTIFY TO J O NATHAN R LA' THAT 6ARASE = 576 5Q.FT. SURVEY 5 PREPARED IN ACCORDANCE '04,E-CODE-op". ' PRACTICE FOR LAND SURVEYS ADOPTED THE NEVA,Y.'QRKISTP� POOL HOUSE = 221 50.FT. ASSOCIATION OF PROFESSIONAL LAND ORSt C \ ! ' (J 1• a J U L9 2018 1 HOWARD W.YOUNG,N.Y.S.L. .45893 '••,.``"L , �_' �;,'�F \ �$> --�--- ! SURVEY FOR g�.4? , JONATHAN iBELL a \ \ \ LOT 6, "MAP OF BLUE HORIZONS" \ \ at Peconic, Town of Southold \ Suffolk County, New York \ EIUILVINS PERMIT SURVEY \�-196. County Tax Map DlstFmt 1000 Section'14 Block OI Lot 3556 000, \ FIELD SURVEY COMPLETED NOV.06,2017 MAP PREPARED FEB.0-7,2018 Record of Revisions RECORD OF REVISIONS DATE �SCD��ICANO,INO,I X01,2018 o GENERAL AMENDMENTS JULY 09.2018 o ,/7 J O /0 C D ) SDO 191,Y 4o a 20 40 80 O a Scale: In = 40 JOB NO.2011-0214 DWS.2015_0061-2017_0214—bp OF 8 O = MONUMENT SET ■= MONUMENT FOUND = STAKE SET = STAKE FOUND r ` J �F ar Michael J.Domino,President �o�� soTown Hall Annex Hplo John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �pQ Telephone(631) 765-1892 Greg Williams OI�•C�f'J Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9291A Date of Receipt of Application: July 9, 2018 Applicant: Jonathan Rebell & Noah Levine SCTM#: 1000-74-1-35.56 Project Location: 4790 Blue Horizon Bluffs, Peconic Date of ResolutionlIssuance: July 18, 2018 Date of Expiration: July 18, 2020 Reviewed by: Board of Trustees Project Description: Remove existing one-story frame cottage (670sq.ft.) and abandon existing water supply and existing sanitary system; to conduct construction activity within 100' from the landward edge of wetlands for the construction of a new 1,779sq.ft. two- story dwelling with a 265sq.ft. screen room, a 435sq.ft. deck with trellis and 50sq.ft. stairs to ground, a 120sq.ft. side porch with 30sq.ft. stairs to ground, a 152sgf.t rear porch with 97sq.ft. stairs to ground; a 576sq.ft. garage; a 232sq.ft. pool house with outdoor shower and 205sq.ft. trellis area; an 800sq.ft. swimming pool; install new water supply well and new sanitary system landward of dwelling; and install gutter to leaders to drywells to contain roof runoff, and in accordance with Chapter 236 of the Town Code— Stormwater Management. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the survey prepared by Young &Young Surveyors, dated July 9, 2018, and stamped approved on August 15, 2018. Special Conditions: (Building envelope falls within 20 feet of Trustee jurisdiction.) Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. . 1 40 Michael J. Domino, President Board of Trustees Michael J. Domino, dent O��SOFFQLk�, Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 Glenn Goldsmith y a P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:� Completed in field by: Young & Young on behalf of JONATHAN REBELL & NOAH LEVINE requests an Administrative Permit to remove existing one-story frame cottage (670sq.ft.) and abandon existing water supply and existing sanitary system; construct new 1,779sq.ft. two-story dwelling with a 265sq.ft. screen room, a 435sq.ft. deck with trellis and 50sq.ft. stairs to ground, a 120sq.ft. side porch with 30sq.ft. stairs to ground, a 152sgf.t rear porch with 97sq.ft. stairs to ground; a 576sq.ft. garage; a 232sq.ft. pool house with outdoor shower and 205sq.ft. trellis area; an 80Qsq.ft. swimming pool; install__new water supply well and new sanitary system landward of dwelling; and install gutter to leaders to drywells to contain roof runoff, and in accordance with Chapter 236 of the Town Code — Stormwater Management. Located: 4790 Blue Horizon Bluffs, Peconic. SCTM# 1000-74-1-35.56 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 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: �e5vktp 60— e4- mp1�'� L�t DG-A6 I have read & acknowledged the foregoing Trustees comments: Agent/Owner: / Present were: 1-/J. Bredemeyer `� M. Domino '/'G. Goldsmith N. Krupski V/G. Williams Other � r i s � r - s _ r n i 4 P r 4 .. 4 _ ;- MAO • 11 X .: .!r .Ji_... .-wy � � A� .�i144•r t .H,� .. up _ PHOTO NO. 1 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:35 PM _ 4 4 ti r t f , � x � y w� r 4., y PHOTO NO. 2 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:36 PM r t!'.' hr s•L .j ' 4 +fit .+r *ArS 11 4 ke r , r .. �. 'a �"r- �+ � � 1 !�'♦ Jf� '��r,,.�. S «_4Rk'.,�r� '� F �r i PHOTO NO. 3 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:38 PM r oF• j 1 r .. 4-4 t � � r _ f . • � + y � 1. , - . A •� _ '11rv�'^. �. X11 PHOTO NO. 4 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:39 PM A R 3 M1 IT -�Ipfflw t ` y It Ik K •i � I r . t• w 's •. PHOTO NO. 5 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:40 PM :}vy F4 , P 1 e Pdr VA 10. wvj �•ems•• „sem�' '';q• ,. �! "s,.—'� a � _ •.� ,�,� - . fit' 1. '1 • y �.+ ! �„ � f � • _ ,,r �� f�� ray` •, ,..- ' Vit. �.� .� J , . J Y 1 PHOTO NO. 6 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:41 PM F..r • Yi..., 1.... �''. ♦ � Cdr. "k. ,. A! Axe ,.` '-•... PHOTO NO. 7 RIVKA SCHOENFELD 800 SALT MARSH LANE AT PECONIC, T/O SOUTHOLD, NY NOVEMBER 11, 2015 1:42 PM 73 2 Na)v,tu A ar.dr 1 1yY►u.. Amu. --5--- i£lA AIM H C [ElX.% t b Mw"l xO..tEOY _ _ _ r ' a.._ .. ^.N: ,�,.wr,,e ,rr�-vm.. � •. .. PROPERTY MAP SEC.I—m ._.-. .. IMTCH _uNE 7 q MATCH �—uNE Yr s, SEC.No I- sec,NO , a.rA + 132 Ic Nom, ?• qo b a p ° N2 ig I O � ig 1 � b I x sSAA(b �'.' I .'ted pg ,® +tIY 141. � Gam. 1�c t TOM OF SOMIIIOED ^ +h I i� bNd 9 a f I� I + " I 6t FOR PCL NO. M &M A SEE SEC.NO. �. I 0!601-0115. I WCIa C,M1NM1 + I _ i M1 1,�\ FOR PCL NO. I, b2 SEE SE No r 6 w oeaotao3., .Zl ; S a." Q 5FOR PCL NO. FOR PCI.NO. F. t w SE cl FOR PCL'M0. Q E SEC.NO. SEE SEG NO. SEE SFC.NO. ° az.6 xa, MATCH— uNE Z2A(c) 065@-0SF —_ 065-Ot-0DB2 — ——— ME I— —_—_�----_-- — �------------- — —__ �Na,ev ME SEG NO.OE6 uN6--- >HBInM6 SEE SEG NO.ONS e � �- ^^ � ------ �u =_�__ __ _ NOTICE COUNTY COUNTY OF SUFFOLK © K 10 01° souTItan SECTION NO —�— (Zt) Z E O _____ N.x __�__ ` , Real Property Tax Service Agency v F µ--- -- -- -- -- p �xwTuxM,RM6....NT„>o W5 6. 074 N �... a r�,z,Na,e,z,n �- —__— owu. --F-- er��--w-- T„-� N P xo 1000 PROPERTYMM OFFICE LOCATION: if �® MAILING ADDRESS: Town Hall Annex `�® x �® P.O. Box 1179 54375 State Route 25 V,. Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) �s Southold,NY 11971Telephone: 631765-1938 , � �� ® P Fax: 631765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, LWRP Coordinator Date: August 7, 2018 Re: LWRP Coastal Consistency Review for JONATHAN REBELL & NOAH LEVINE SCTM# 1000-74-1-35.56 Young &Young on behalf of JONATHAN REBELL & NOAH LEVINE requests an Administrative Permit to remove existing one-story frame cottage (670sq.ft.) and abandon existing water supply and existing sanitary system; construct new 1,779sq.ft. two-story dwelling with a 265sq.ft. screen room, a 435sq.ft. deck with trellis and 50sq.ft. stairs to ground, a 120sq.ft. side porch with 30sq.ft. stairs to ground, a 152sgf.t rear porch with 97sq.ft. stairs to ground; a 576sq.ft. garage; a 232sq.ft. pool house with outdoor shower and 205sq.ft. trellis area; an 800sq.ft. swimming pool; install new water supply well and new sanitary system landward of dwelling; and install gutter to leaders to ,drywells to contain roof runoff, and in accordance with Chapter 236 of the Town Code— Stormwater Management. Located: 4790 Blue Horizon Bluffs, Peconic. SCTM# 1000-74-1-35.56 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP provided the following: 1. Establish a 25' wide vegetated, non-turf buffer landward of the top of bluff that includes existing vegetation. 2. Restrict clearing and-filling within 100' of the bluff due to the severe erosion of the bluff. 3. Require an INNOVATIVE AND ALTERNATIVE ONSITE WASTEWATER TREATMENT SYSTEM to further Policies 5 and 6. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney 3 Cantrell, Elizabeth From: Tom Wolpert <TCW@youngengineering.com> Sent: Tuesday,July 24, 2018 10:04 AM To: Cantrell, Elizabeth Subject: RE:Jonathan Rebell at Peconic, T/O Southold, NY- SCTM No.: 1000-74-01-35.56 Elizabeth, Thank you for the update. Tom Tom Wolpert Young&Young 400 Ostrander Avenue Riverhead,NY 11901 631.727.2303 tcw@youngengineering.com From: Cantrell, Elizabeth [mailto:elizabethc@town.southold.ny.us] Sent:Tuesday,July 24, 2018 10:00 AM To:Tom Wolpert<TCW@youngengineering.com> Subject: RE:Jonathan Rebell at Peconic,T/O Southold, NY-SCTM No.: 1000-74-01-35.56 Good Morning Tom, This application was applied for as an Administrative Permit application. It is currently scheduled for our August 15, 2018 meeting. As it is currently Administrative, it will not have a public hearing so you would not have to attend. If during the review process,the Board determines that this application should for some reason be applied for as a full wetland permit, I will notify you a.s.a.p. Elizabeth From:Tom Wolpert<TCW@youngengineering.com> Sent:Tuesday,July 24, 2018 8:50 AM To:Cantrell, Elizabeth <elizabethc@town.southold.ny.us> Subject:Jonathan Rebell at Peconic,T/O Southold, NY-SCTM No.: 1000-74-01-35.56 Elizabeth, Attached is a copy of the NYSDEC Letter of No Jurisdiction Tidal Wetlands Act dated July 19, 2018,for your review and file. Please advise us if this application has been placed on the Trustees hearing calendar. Thank you for your assistance. Tom 1 Tom Wolpert Young&Young ` 400 Ostrander Avenue Riverhead,NY 11901 631.727.2303 tcw@youngengineenng com 2 New York State Department of Environmental Conservation Division of Environmental Permits, Region I SUNY @ Stony Brook 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631)444-0365 •Fax: (631)444-0360 Website:www y g v LETTER OF NO JURISDICTION TIDAL WETLANDS ACT ((�� July 19, 2018 D 'fie E � V c' - D Jonathan Rebell Noah Levine JUL 44 2018 360 Central Park West Apt 12E New York, NY 10025 Southold Town Board of Truees Re: NYSDEC ID#1-4738-04611100001 Rebell Property 4790 Blue Horizon Bluffs Peconic, NY 11958 Dear Mr. Rebell: Based on the information you submitted,,the Department of Environmental Conservation has determined that the portion of Jhe above referenced property" shown landward of the'Crest of Bluff'as evidenced on the survey prepared by Howard W.Young, last'revised July 09; 2018 is beyond Tidal Wetlands Act(Article 25)jurisdiction. Therefore,in accordance with the current Tidal Wetlands Land Use Regulations(6NYCRR Part 661)no permit is required for project activity proposed landward of the'Crest of Bluff'. B"e'adyised, no construction, sedimentation,'or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above,without a permit. It is your responsibility to.erfsure that all precautions are taken to prevent any sedimentatioh or disturbance within Article 25 jurisdiction which may result from your project. Such precautions"may include•maintaining adequate work area between the jurisdictional boundary.and your project(i.e. a 15'wide.construction area)or erecting a temporary fence, barrier, or hale bay berm. This letter shall remain valid unless site conditions change. Please note that this letter does not relieve yo of the res" ' sibility of.obtdi ing any necessary permits or approvals from other agencies or local mu icipalitie . S' cerel n and 1 epu ministrator cc: Thomas Wolpert NYSDEC-TW File Michael J. Domino, President SOF04 oGy Town Hall Annex John M. Bredemeyer, III, Vice-President _1 54375 Route 25 Glenn Goldsmith y P.O. Box 1179 A Nicholas Krupski • Southold, NY 11971 Greg Williams y��l , �a°! Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES D [ECROVE D'iii TO: SOUTHOLD TOWN BUILDING DEPARTMENT JUL 1 0 2018 RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS BUILDING DEPT. TOWN OF SOUTHOLD SCTM#: Property Owner Name: Date Sent to Bldg. Dept: -74.19 The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building Department's permitting requirements stated below: _ YES NO Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition as described under Town Code? COMMENTS: 54 K4, 44uaj� g ature o Reviewer Date Michael J.Domino,President 10Ol Town Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 < [' P.O.Box 1179 Charles J.Sanders ;; Southold,New York 11971 Glenn GoldsmithO O Telephone(631) 765-1892 A.Nicholas Krupski Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application ✓ _ Administrative Permit rAmendment/Transfer/Extensio Received Application: lEE ; ( c ll-_—.Received Fee: $ /®0,0 / r Completed Application: i ._i Incomplete:, J U L - 9--2018 SEORA Classification:Type I-_ Type H Unlisted Lead Agency Determination: _ Coordination:(date sent): 7�Z7� pD Southold Tuyn- g LWRP Consistency Assessment Form Sent: _ 0 ---_ Boa.d of Tr utees 1 CAC Referral Sent:, Date of inspection: _ o s,778 Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution:- Legal Name of Property Owner(s):. �0O'1 G61Cli)- Re/OCG(_ ®eth 1—e'Wne.. 360 cen4ral PP arts Wesf� �4� E' /2 Mailing Address: M. o _ _ _ - _ __ /DO Phone Number:_ 0(17— Suffolk County Tax Map Number: 1000- 774 — 01 — 3 S, 54? Property Location: . Ri!ah* Of__lwo,V nor* ®i' Middle Road C. R. 4- __ap pr®x._ 0/01 We_s� o_,i° Henvy'-s Lane _a* Penoni r (If necessary,provide LILCO Pole#, distance to cross streets, and location) 4`7 90 73jtWe HOrl"n 04"115e AGENT(If applicable):. Y00r) 4- Youne __ _ Z ornoS _ C. I/I NPeeI-, P.E. Mailing Address: _ ®0 _Oys '�nofier _Avg_,J9 _VC�-eGiGf i NY O _ Phone Number: Board of Trustees Application GENERAL DATA Land Area(in square feet): 590 04-9 S--r Area Zoning: 'RR �Z�SOC�- �iPSigi+e A Previous use of property: 51 We !'M i A I ne, _ Intended use of property: dez)c c.. __ Covenants and Restrictions on property? Yes ✓ -No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? ✓___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 ✓ No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s)on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? No Yes If yes,provide explanation: Project Description(use attachments if necessary): July 9, 2018 ATTACHMENT TO BOARD OF TRUSTEES APPLICATION prepared for Jonathan Rebell & Noah Levine at Peconic, T/O Southold, New York Prosect Description The project consists of removing an existing 1 story frame cottage (670 sf), and abandoning an existing water supply well and existing sanitary system. The project also consists of constructing a new 2 story frame house (1,779 sf), screen room (265 sf), deck with trellis (435 sf) and stairs (50 sf), side porch (120 sf) and stairs (30 sf), rear porch (152 sf) and stairs (97 sf), garage (576 sf), pool house with outdoor shower (232 sf) and trellis area (205 sf), pool (800 sf), new water supply well, new sanitary system, and storm water control structures, ie. LF 1 — (2) 8'dia. by 10' effect. depth leaching pools, LF 2 — (1) 8'dia. by 10' effect. depth leaching pool, and LF 3 — one (1) 8' dia. by 6' effect. depth leaching pool. ,I Hoard of Trustees Application WETLAND/TRUSTEE LANDS APPLICATI®N DATA Purpose of the proposed operations: R6�er_oro A f ac_ -m e + Area of wetlands on lot: 0 square feet Percent coverage of lot: • 3 % 4, 44 4 S'-F , Closest distance between nearest existing structure and upland (-f rnm eXP stills c'o edge of wetlands: feet lb weft erne) Closest distance between nearest proposed structure and upland -fmm Proposed edge of wetlands: $d feet Screen room Does the project involve excavation or filling? No V00 Yes If yes,how much material will be excavated? ® _cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: �j feet Proposed slope throughout the area of operations: X10 Manner in which material will be removed or deposited:; toockh_Q&' wit I be, used f+2 rmot� and dcs,& nna�ria! _ r v�'fi�i;n -+-he-- area of 0Pera ns . 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): .There: wit/ be h® e6jn2f ion the, weHar s and ocl wafers v e. 7"dusn as ct r'esul-�- ' +he _Proposed oDeroe't�7ons- - - 61 Z20 Appendix B Short Environmental Assessment Form Listriictiotis:fai".Cointileiina Part l -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: -- - - - ! -,Ton odhan _ eloe4- -_ Q _ L. evince Project Location(describe,and attach a location map): R� ®-F wayv nom01F Miold/c Road ( t^.R. 4-9) QPPrOk. t °i- a n!t t5 Brief Description of Proposed Action: Re-rerr -►o A ffachrywn* Name of Applicant or Sponsor: Telephone: q 7- 2 01 3— Ton a ,eloel ,f- -Noah_ Lwi n e. -E=Mail: 'r a _- - _ a o m Address: 36 0 l Porvk W e�� A DA. I. - j City/PO: State: i Zip Code: New York I NY _ 1o_®•g 5 1.D"oes the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? - i If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that.! , may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. 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 ora proval: SC D ESS 4#0Pr0 va lNa #r Seuim 5�5>fr�+► .❑ YSDEC __off L .- _ -T_�r'mat -- --_ 3.a.Total acreage of the site of the proposed action? ,. acres b.Total acreage to be physically disturbed? Q,_;� acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 4 acres 4. Check all land uses that occur on,adjoining and near the proposed action.- E]Urban ction.❑Urban [Rural(non-agriculture) ❑Industrial [-]Commercial [residential(suburban) ❑Forest ❑Agriculture ❑Aquatic [jr0ther(specify):, ._Qn S�GYGG. ❑Parkland Page 1 of 4 5. Is the proposed action, ----- _ - - - - — -- ----- -- - - --- NO YES i N/A _ a. A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? ' ❑ ; 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES --landscape?---_ --__ _ ;❑-i, ;� ' 7. Is the site of the p-roposed action located-in,or does if-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 FA ,✓ b.Are public transportation service(s)available at or near the site of the proposed action? � I _. _F-1, c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ! - -- = - - El 9-D6es the pioposed action meet or exceed the state energy code requirements? NO YES' If the proposed action will exceed requirements,describe design features and technologies: - it 10. WiII the proposed action connect to an existing-'pub I ic/private water supply? _YES_ If No,describe method for providing potable water: 11.Will the proposed action connect to existing wastewater utilities? -- "_-_-_- 'jNO YES If No,describe method for providing wastewater treatment:_New =f1/`f or _ 1 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? f❑✓ - ❑_ 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO O YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:, 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ❑Shoreline ❑Forest ❑Agricultural/grasslands El Early mid-successional ❑ Wetland ❑Urban _ ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,Iisted NO YES by the State or Federal government as threatened or endangered? ' - - - D�_ CIL - --- -- ------ 16.Is tl►e project site located in the 100 year flood plain? NO YES " 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? Q NO []YES E P b. Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO ©YES -Mew _dry t&te_Ll -fir -raoi_r_run off', - - - - Page 2 of 4 18--Does. - th�ep-ropos-c-d action-include construction or other activitiesthat 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 I No— YES completed)for hazardous waste? If Yes,describe:- Fv I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY ' KNOWLEDGE `bun©; n Applicant/s a-S- C. W19tD19 Date: ponscy name:, Signature.-,-=c/,,/At2Y -9, T 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 ii impact impact' may may J; occul. occur with-iiiad 11. Will the proposed action create a material conflict opted land use plan or zoning I regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 1-3. Will the proposed action impair the character or quality of the existing community? 14. 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 ❑ affectexistinginfrastructure 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? 110 7. Will the proposed action impAct existing: a.public/private water supplies? FT E]� b.public/private wastewater treatment utilities? ❑ 'El 8. Will the proposed action impair the character or quality of important historic,archaeological, I F] 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)? a, Page 3 of 4 _ . � i No,or Moderate small to large impact impact ma Y may occur occur 10. Will the proposed action resultinan increase in the potential for erosion,flooding or drainage � 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 inPart 2that was answered"moderate»olarge impact may occu/',o,ifthere isuneed mexplain why uparticular ' element oythe proposed action may orwill not result inusignificant adverse imental 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 toavoid orreduce impacts. Part 3should also explain how the lead agency determined that the impact may o,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 xhort-tonn.long-term and � cumulative impacts. i Check this box if you have determined,based on-the inform at�io_n and—an-a"IY41s above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an iF 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. Town of Southold-Board of Trustees Name of Lead Agency Dai-e President i Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signatdre of 1;Ceik6n_�iblei-Officer in-Lead A&ency Signature of Preparer(if differe nt from Responsible Officer) ' � . ' ! | ! ! / ! . / | � Page 4nf4 . Board of Trustees Application AUTHORIZATION (where the applicant is not the owner) I, ,7"on a ,)an Rjbe l( residing at 360 C'x�-n fi- t( PSK U✓P�� (print name of owner of property) (mailing address) A Nom/✓`fU/ft, A1Y do hereby authorize i- Your_q �i/ ��OaY?cZ 5 e. �/�/���� , P C, to apply for permit(s)from the Southold Board of Town Trustees on my behalf. (Owner's signature) Y EKINGAARZYNA KNAP State ofNewYork KN6281650 Suffolk County Expires May 13,2021 1• Board of Trustees Application AFFIDAVIT ,_Cn cr({ )ar, PEe6e!1 BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. I Signature of Property Owner"� SWORN TO BEFORE ME THIS 540 DAY OF :16_15201 KINGA KATARZYNA KNA:2 ]Notory Public-State of New N0.01 KN6281650 (' Qualified in Suffolk Coun ! f My Commission Expires May 1 Notary Public l s APPLICANUAGENTIREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORINT 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 ofWWW'conflicts of interest and allow it to take whatever action is necessary to avoid same, n` f- YOUR NAME: �o�JCX �uI'� f2e b�1' j`'Vt9G1 v1 LQ(),n (Las(name,first name,.griddle 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,spou.s,sibling,parent,or child)have a relationship with any officer or employee of the'17own of Southold? "Itclutionship"includes by blood,marriage,or business interest."Business iniciesi"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or enrploymeni by)a corporation in which the town olT'rcer 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 ofperson employed by die Town of Southold Title br position of that person Describe the relationship between yourself(the applicant/agGnt/representative)and fire 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 11 R Submitted this S qday of J 0® Signature N Print Name .Toncr7/ ,) �n Renhx'11 1 �Q+ k Ut4tl Form TS 1 f 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 -evalbated as-,to.-Its--significant; ''lierieficial aud,adyerse offecis rtpoiitlie.coasfal��rea(whicfi iiielviies•all�of Soutfiold�'Town�;: 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus,:each_ ausivei musf.be explauiecl''ir�_c �tai1�'lis'tln .both,sut�pnrtin�_and_non-, 'sunportifilk1ids Mn-aaction cannot be certified as consistent with the LWRP policy standards-'an conditions,'it-s1iall"iiot 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# /® O O 56 PROJECTNAME ,Lorean 2 11 d Nooth Levine, The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ construction,planning activity,agency regulation,land transaction) ; ❑= Location of action: OF Sr S Load c C-R. 4¢8 nh. nom - t 'c+ollr'c Site acreage: 53. 04-!1 S-F� or 1_i 22 Ot_c-Ks_, _ Present land use: Si rlo,�r: - Mi_w.- t-e.stG1e/_1+i of f Present zoning classification: RR — R,csol Resick/yfj'gr 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? E i Yes 0 No E 1 If yes,which state or federal agency? N YSD EC 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. a ' 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 LMW Section III—Policies; Page 2 for evaluation criteria. ,. a Yes No [:] Not Applicable Rehnoke— ge ' S ;ws" /) We 11 d- San i'E-otry s%alcnn a✓ -ADD o f b lc,r�f Ccns�rt.r,F- a = 2 ry � l+CLsc.. ancf e�la�cd s�,��s a _ nn i_n i ren urn ' d �Crs 6m a,r- zoa IOOV wcr Of HNC,cncsf� of 6ltr f. 1 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 Q Yes No Not Applicable f Attaclii additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes,❑ No ❑ Not Applicable 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 S through 16 for evaluation criteria `® Yes 'E] No ❑ Not Applicable Nvf%L- !{q Polto-e I l Ste. , Attach additional sheets if necessary _— Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section HI —Policies Pages 16 through 21 for evaluation criteria -Z Yes ❑ No ❑Not Applicable mol)SPS. - — - - Attach additional sheets if necessary - -- _ —___ ___.-- - _ _ ------- Policy ___-_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. ®, r-a, h Yes No Not Applicable 40- �D�(te",. 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. Q Yes []'No,'o 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. 0`Yes c .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. ' Y. No Not Applicable Attach additional sheets if necessary , a WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. Q,Yes ,0 No ❑✓ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Pecome Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 0 Yes ,E]. 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 0 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. 0 Yes El N® 2 Not Applicable PREPARED BY - _7' 1 omer5 0. KIOIAW-1- TITLE_ /�} - �Or_ DATE - --- - - ----- - ---- - - - -- 1 YOUNG &YOUNG Telephone (631) 727-2303 400 Ostrander Avenue Facsimile (631) 727-0144 Riverhead,New York 11901 admin@youngengineering.com HOWARD W. YOUNG,Land Surveyor THOMAS C.WOLPERT,Professional Engineer DOUGLAS ADAMS,Professional Engineer ROBERT C. TAST,Architect ROBERT STROMSKI,Architect I July 9, 2018 Town of Southold Board of Trustees Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 `T, RE: Proposed Residence, Garage, Poll House & Pool JONATHAN REBELL & NOAH LEVINE ' lel Lot 6, "Map of Blue Horizons" JUL ® 9 201 at Peconic, T/O Southold, NY SeutheldTorrn (17-0214) Boar, of Trustee-, SCTM No.: 1000-74-01-35.56 Dear Members of the Board: i Enclosed are the following items: 1. application fee —Jonathan E. Rebell check no. 1386 payable to 'Town of pp p Y Southold' in the amount of One Hundred Dollars ($100.00), 2. one (1) original & three (3) copies—Administrative Permit Application and Attachment dated July 9, 2018, 3. one (1) original & three (3) copies—Short Environmental Assessment Form; 4. one (1) original & three (3) copies —Authorization Form, 5. one (1) original & three (3) copies—Affidavit, 6. one (1) original & three (3) copies—Applicant Transactional Disclosure Form, 7. one (1).original & three (3) copies — LWRP Consistency Assessment Form, 8. four (4) color copies— Photograph Nos. 1-7 taken for previous owner, and Planning Engineering Land Snrveying i, Page 2 of 2 July 9, 2018 9. four (4) prints—Building Permit Survey (Sheets 1-3 of 3) last dated July 9, 2018 depicting the existing conditions and proposed improvements. We understand that submission of these documents enables you to commence your review of this application. If you have any questions, please contact us. Very truly yours, Thomas C. Wolpert TCW/cw Encl. cc. Mr. Jonathan Rebell + encl. + 1 print l I I i