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HomeMy WebLinkAboutTR-9318A V �OS�FFO(�co Michael J. Domino, President Town Hall Annex c�o Gyp John M. Bredemeyer, III, Vice-President �o 54375 Route 25 Glenn Goldsmith n y P.O. Box 1179 A Nicholas KrupskiWSouthold, NY 11971 Greg Williamso! , �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 When project complete, call for compliance inspection; ��OF S®Ur�O Town Hall Annex Michael J.Domino, President �® l0 er III,Vice-President 54375 Route 25 John M.Bredeme Y P.O. Box 1179 Glenn Goldsmith T = Southold,New York 11971 A.Nicholas Krupski COQ Telephone (631) 765-1892 Greg Williams `OU '� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9318A Date of Receipt of Application: August 22, 2018 Applicant: Charles & Brenda Grimes SCTM#: 1000-86-2-12.6 Project Location: 4145 Wells Road, Peconic Date of ResolutioniIssuance: October 17, 2018 Date of Expiration: October 17, 2020 Reviewed by: Board of Trustees Project Description: Install an on-grade 13'x23'x17' (350sq.ft.) bluestone patio in 6" concrete base to prevent shifting; install drains leading to drywells to facilitate proper rain water drainage; install a 5'-8' diameter fire pit on top of the patio and add stepping stones from patio to the front of the home. 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 project plan prepared by Brenda Grimes, received on August 22, 2018 and stamped approved on October 17, 2018. Special Conditions: None. 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 CO WATER " MATER 14100 ,•3 S � r DW �D DW ( S CONCO. -OR Ch Ile DWI DWI IUG ;. 00 <,0 "". �.�.. . !. .. M.,. . PROPAN W ► N �F .... .. TANK ��► APPROVE a o� ����' � �� . =BOAS OF iP\USTEE r. Y; TOWF SO�I�Tf� )LD DATE ®cTop,�� i7 °NF 'D `w '��. �� 7 ►f �` L ti ` - "" 11 H AUG 22 2018 Scot`told john t Boartl aT Tnttees ._ 1 Michael J. Domino, Presii J o�pstfFot BOG ` y Town Hall Annex John M. Bredemeyer III,Vice-Presiaent ¢�� y 54375 Route 25 Glenn Goldsmith o P.O.Box 1179 zM A.Nicholas Krupski Southold,NY 11971 Greg Williams ® p! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: Completed in field by: CHARLES & BRENDA GRIMES,request an Administrative Permit to install an on-grade 13'x23'x17' (350sq.ft.) bluestone patio in 6" concrete base to prevent shifting; install drains leading to drywells to facilitate proper rain water drainage; install a 5'-8' diameter fire pit on top of the patio and add stepping stones from patio to the front of the home. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setback Waiver Required I 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other iJ 5 .......................... ...u. .. I . !...........0 ...W.r.. ...m���......u�....u.��... ................... m......................... ........ ...... ........ ........W..W...r....... ....�...u........ ......u...� ..... ;, AUG 2 2c ��I o V FM USE �n� eu EX7 5VgaV1CWNECn0 ,S'CDHS Ref No. R10-17-0030 S��'�o�a�o�F SURVEY OF PROPERTY Y "'S DRO SI PPER END TOTAL AREA TO TIE UNE T PECONIC VER ORPLUG�SUABLG ; Board of Tru;tees _a_ J c4�T� 7v0F / AREA sq. >t TOWN OF SO UTHOLD 3 UPLAND = 28,297 sq.ft. a m WETLAND 10,298 sq.ft. �VFL®Lj COUNTY A . Y . PROPOSED UPLAND 1000-86-0 2-12.6 a SEWER PIPE m o < LOT COVERAGE SCALE1�-4®' a 3 �a n�,y O� 3744/28,297 = 13.2 9 a 30•EIBOW /500. `bcE of F<e 0-4 O 13.2 9 PROPOSED COVERAGE JANUARY 14, 2015 4AI FEB. 16, 2016 (SITE PLAN) APRIL 7, 2016 (REVISIONS) s q� Fo rp�� MAY 24, 2016 (REVISIONS) 60'WYE `• � �pFp e4/C 3 JUNE 9, 2016 REVISIONS TEST HOLE DATA q 4v ( ��lc� c) McDON 10 GEOSCIENCE NSA. 'T A R , 28 2016 /REVISIONS) \ 70/15/15 � OG� 19 7�Si //y fr® OCTfi v, (n a O.5 DARK BROWN LOAM OL �1�P�� G1 L O�7r NOV 04, 2016 (REVISIONS) P� � ���� �R „� �L � ZLT FEBRUARY 7, 2017 (REVISIONS) PALE BROWN SILT ML off �P � .13� 4 FEBRUARY 15, 2017 (REVISIONS) 5 t �' �b�� �Dw�� R s�zOc�y��� 0 8s MARCH 6, 2017 (REVISIONS) �J `�' / KgRe ST Amory Fay PALE BROWN RNE TO MEDIUM SAND SP AC DRAIN i� FOp MARCH 16, 2017 (REVISIONS) Ql1NTs O ,� 2,o, m ��i DWI O " MARCH 28, 2017 (REVISIONS) s.s' 1� y�PFF o "�' Qom \� ' Qm'mAPRIL 30, 2018 (FINAL) s co . s, JUNE 5, 2018 (SCDHS COMMENTS) WATER IN PALE BROWN RNE TO MEDIUM SAND SP 0. 0 ,�0. C%9 p �0 �•�-� WATERF j,�,e�3 AUGUST 22, 2018 (CONC. PAD LOC.) j a rss �s �PqC \�A�X METER -w a` 13 1 0320. "a NO 7E: WA7ER ENCOUNTERED 6.6'BELOW SURFACE D WI / LANDWARD LIMIT OF 77DAL WETLANDS AS DETERMINED ' �v1 \ / rsa• a ro BY SUFFOLK ENVIRONMENTAL CONSUL77NG, INC. i _ ti d0 >a. ro 4. 3P ON SEPTEMBER 24, 2015 �pH p� G�� ; 1, s WFT�Nasw<< 0. NJ BEFnc LOCATION /W 4 W '®' NOTE.• A 4 FOOT ACCESS PATH PERMITTED THROUGHs2 �' v , 1 THE 30 FOOT NON-TURF BUFFER FOR PURPOSES _ �� �W) �<v� CO 4' 62 OF SHORELINE ACCESS. �� "`�Z o ow% �� V V \o 3T 20.5 59.5' o ZD _.-_ PROPAN ? �� TANK ,� " �� DGj 28' 46' 50' AukBUF �� o O J� L �. t of y2F � �: L0345' 27.5' KEYZpN� NDs FFR h lb L04 48' 33.5' F A = STAKE N7 1Z L jrrI, , ® = MONUMENT .'5711W nfU7VE ' FT Z} m !�-, Ita rl �% ;_• C 0 = TEST HOLE \'.� vi m = WET LANDS FLAG yZ MHµ, \ CER CHARLES W. GRIMES �s Z 2 IFIED TO. \ �\ n L 3�' �- E INE r K2o BRENDA GRIMES } AUG 2018 F S940238s WFG NATIONAL TITLE INSURANCE COMPANY ELEVA77ONS AND CONTOUR LINES ARE REFERENCED FROM NAVD 88 W FLOOD ZONES FROM FIRM 36103CO162H _.- 1' ` ' Southold Town ,� _ --?—' The location of public water, wells and cesspools shown hereon are o�f Boar ai Trustees from field observations and or from data obtained from others. FLEXIBLE SUPPORT RING SEPTIC SYSTEM DETAIL CONNECTOR AT PVC/CI JOINT \�, I AM FAMILIAR WITH THE STANDARDS FOR APPROVAL AND --"�� � F.F. EL. 11.0' NOT TO SCALE CONSTRUC77ON OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOREAN EL. 8'EAN OUT SINGLE FAMILY RESIDENCES AND WILL ABIDE BY IHE CONDITIONS \ FINEL. 8'ISHED GRADE `p y� t SET FORTH THEREIN AND ON THE PERMIT TO CONSTRUCT. P4^ 1e IN. MASONARY CHIMNEYS MASONARY CHIMNEY 7 t INV.EL 67f/N. 1'MIN. LOT ®s REFER TO "MINOR SUBDIVISION PLAT KNOWN AS RICHMOND CREEK FARMS" AREA= 38,595 SQ. FT. 75, INV.EL' 12 s 2 MAX � TO BE A PORTION OF 7HE PREMISES CONVEYED TO THE GRANTOR TO TIE LINE HOUSE TRA 6.5" 6 10 INV EL. ®®®®�s HEREIN BY DEED DATED NOVEMBER 25, 1997, RECORDED IN THE SUFFOLK COUNTY 61 111 ®®®� 3.0' CLERKS OFFICE ON DECEMBER 9, 1997 IN LIBER 11866 CP 74Z / 4 P FOOT MINIMUM PIPER FOOT 1 5.6' ®®� MINIMUM MINIMUM PITCH M ANY ALTERATION OR ADDITION TO THIS SURVEY 1S A VIOLATION MINA"DIA. PIPE $4" MINA' DIA. PIPE 2, PEC &R RS, P.C. OF SECTION 7209OF 7HE NEW YORK STATE EDUCATION LAW. 2' min' (6) 2 feet deep gallies (631) 765-5 20 FAX (631) 765-1797 a EXCEPT AS PER SEC77ON 7209-SUBDIVISION 2. ALL CER77FICA77ONS _WATER EL=0.7'P,D, BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF a SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON SOUTHOLD, MY 11971 15-225 ..�.m .�.r..�.�.��..��r..����..r...���.�.�a�.�u� �.ua�a�....�..��r..�.. .�...�.r.�.rr��..�..� r �... ...�ur..u �.un�����.�w.r�uti..�..mr.�.�.r.��..�.mur..a�u��...�... ��ru���..�.a.�u�h.��.....�.��......�.�b...... r.�m.���. .u ..a .,u.....�.........����.�...�..�.......�...r��.......�u�u�y.�.....�u..ru��...�..��....��.r.........r.�.�....�....u��... r�...��..ati.....�� ��r���a� • R ♦+ O&A iY 7* . a r r [ � j s } •�� .4w ; , A V— -i b 001 Of AT •"• n 'kr7 I a ! r • y y YA r !'.., 5'• •, + e e ��•c f� 4 �}i,(�+R �' s .y .� ) • � •.tet_ ,., ,�� .. t ' _ � � iP~t .µ • "• �� t �t- :�� Jen+'." f " ri+��1 * nt ,1''.� . . ' '�i •m '1� ,. - t _ „Mr fit's • :f `t -� ♦ .� yf : - i ,a�w:-. it' s -(...- •. .% r � t n " A I - - 1 � .,li:r �. y.i.':.u• _..y, r'� •i :i1 ri ._ .� lei•'' '"":i---Z-4 jly�, 1 . i tu%r• il', ��/i rJ• '1 •'ti�!]j�r """"�:`:t Ir 1' - Jj-�-_�w`1✓-'��_ r;�:i--�'s+�`'r�,r 1� .�„;�G'r+.�•--••��:a tj!.'��. ��Y `•i' i .•..•`\�1��� .,5�jC-'-. } °' �` 'G {(� '37%V`' ,±�,•.�.' r _,ti•.���6 -rill �;t _`�.� �'7=^"__ _'- •, "� 6:-'- r� . {�.�aj,p•• �==�.`.-'.,•�lE_�-.+iK`.L'a���CY'• jl- sC-3 _ � - .�.=L�.• .it13�,=7•�.=4 •^�� �•-,�1 y-� �� �r-lam'"^i: .:s-.;�, 1, is"T: .aT.A•.:c i?.^�."_^:'_'.�:'•7'..^�„ ,s r11� r "_!r.. iE.^^.9r_•::•i•a waTEC:l. .�_nC•si.c---.:r:.ya.r*�r•=t.r^r,•)r^.:m.rg.^..^J'_^u :^a`.tc" :-' v.a.r:V - f� �''b •'1 � ii.C��i 1 �'t BOARD OF ISOUTHOLD ' "OWN TRUSTEES 4R u5j SO•f THOLD NEW YORIK 3 PERMIT NO. 8805 DATE: MAY 18, 2016 �! �� €:r E.G.STEIN I - .�'.•�'•��' ISSUER TO: FAMILY TRUST c/o I�r�VSI�EIl'ELSTEIN�:LIBSY GOLDSTEIN 1 PROPIRTY ADDRESS: 4145 WELLS ROS,PECONIC � - - - t��C rtdY SCTTAV 1000-86-2-12.6 1 = � . . �z A HORIZAT�� t . �• UT � `� •-�rt ,�� Pursuant to the provisions of Chapter 275 of the Town Code of the To«•rt of Southold and in MQ accordance ith the Resolution of the Board of Trustees adopted at the meeting held on May 18.2016,and in � � 1-1 consideration of application fee in the sum of$250.00 paid by E-G. Stein-Family Trust c/o David Edelstein& 91 Libby Goldstein and subject to die Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: xa Wetland Pettit to construct a 37'x50' (1,850sq.ft.) two-story dwelling with a F t &I 241x24' 576s .ft. attached ar e-and a 12'x62' 895s• .ft. attached deck;install a septic system on landward side of dwelling; connect to public water; install a 1,890sq.ft i3 gravel driveway; and install a system of drywells to contain,stormwater runoff;with r the condition to establish and perpetually maintain a 30'wide non-turf buffer along the landward edge of wetlands with a 4 wide access path through same for shorelineFy access; any activity-to remove invasive species in said buffer area will require the # issuanceofaermit• and as depicted on the survey prepared by Peconic Surveyors, q a P.C.,last dated.Tune 9,2016, and stamped approved on July 3,2016. -p { r,s 1N WITNESS urIiEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of die said Boards f this date. 01 tIFFt�E i .J ij 1 _ �•• �� --_cam' i;�(;.+�"��:�v.:�/2.r,:r,."3:-..�r..�.:'-.��n..,.-..._.mi-i.•"'.^a..'Ae 5::,>=...3.��","=-mT..T®�i.'..:C'..:":..L:S.�:„�••�:c�.x".�,'.c�..^,..^'.0-...u.'.-r••-.•.«�,.;+.a•.:rs,_..,,...;,.ru,•.-F,^ �1 k; -eE`�.� h� � `.. n-..rr^ •s_- G.?^'-„._l�.L.�.�Cy rJti J -•:,�z'.T•�r �` 71M1`r+c-*` - _:1 7 ....Y4•ter �F' �•�c'S .. �+FLii[n��in -.wr-3"�-R>:t \`Y=<s'�� �• ., f h� ilu�'=�� �� F � �� •;� i. �.�'�..C�y�Y ;•nr -iy-�� � �,r��}� �;�-t�' p,;�,�,��.:r.'`.':”"'-�.-1'-�i��r�Y`2 -!:' i,,.•�r;f`• ���;; Y�'i'rti'' - .Cr•��:kffd'.'�." �w�L!i7i 1�2i�• _' =(f.rr,!•f��;`F'.�f� �.:,_�+r'J�• .� !•.'• .a«. r,.•�::r Wit;+ t .m� �=.=>. :...L•:::f••. 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Box 1179 54375 State Route 25 Southold,NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 �pQ Tel 631 765-1938 Q Fax: 631765-3136 �'y�oUfVTV,Nct� LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: .October 16, 2018 Re: Local Waterfront Coastal Consistency Review for CHARLES & BRENDA GRIMES SCTM# 1000-86-2-12.6 CHARLES & BRENDA GRIMES request an Administrative Permit to install an on-grade 13'x23'x17' (350sq.ft.) bluestone patio in 6" concrete base to prevent shifting; install drains leading to drywells to facilitate proper rain water drainage; install a 5'-8' diameter fire pit on top of the patio and add stepping stones from patio to the front of the home. Located: 4145 Wells Road, Peconic. SCTM# 1000-86-2-12.6 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. 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 Y Charles W. Grimes 4145 Wells Road Peconic, NY 11958 October 4,2018 Damon A. Hagan, Esq. Assistant Town Attorney 2 Town of Southold D EC E � �sf�] E Town Hall Annex 54375 Route=25 PO Box 1179 OCT - 4 2018 Southold, NY 11971-0959 Southold Town Re: Pending Permit Applications Board of Trustees Dear Damon: Please be advised that we are withdrawing the"Patio" portion of the Wetlands Dock Permit application that is on file. Based uponthe advice of the Trustees,we filed a separate Administrative Permit application for the"Patio"so as not to get that hung up with the more complicated "Dock" portion of the Wetlands Dock. Permit application. Accordingly,we,currently have two permit applications pending on file: 1. Wetlands Permit application for a'Dock; I Administrative Permit application for a Patio. Let me know if you need additional information regarding either pending permit application. Sinc ely Charles W.Grimes Michael J.Domino,President Town Hall Annex John M. Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Charles J.Sanders N Southold,New York 11971 Glenn Goldsmith G,'�cO ® Telephone(631) 765-1892 A.Nicholas Krupski l/�i+o� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only s Coastal Erosion Permit Application Wetland Permit Application Administrative Permit Amendment/Transfer/Extension FIA Received Application:Received Fee: W,®®Completed Application:' _ +A / 2 2 2d� Incomplete:. SEQRA Classification: Type I_ Type R UnlistedSontho!d To.vn Lead Agency Determination: -Board a , steres____ LCoordination:(date sent):- V LWRP Consistency Assessment Form Sent: f 111 CAC Referral Sent. Date of Inspection: Receipt of CAC Report: ---- Technical Review: Public Hearing Held:- D c 1 7t _ Resolution: s Legal Name of Property Owner(s): Charles,& Brenda Grimes Mailing Address:- 3501 Bonita Bay Blvd,Bonita Springs, Florida 34134 Phone Number: 239-777-4185 _ Suffolk County Tax Map Number: 1000- 86-02-12.6 Property Location: 4145 Wells Ropd, Peconic, New York 11958 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable):. N/A Mailing Address: Phone Number: Board of Trustees Application GENERAL DATA Land Area(in square feet):- 38,595 Sq Ft/.89 Acres Area Zoning: Previous use of property: 3 Intended use of property: Residential Covenants and Restrictions on property? X Yes No If"Yes",please provide a copy. i see attachment A adjacent to this page f Will this project require a Building Permit as per Town Code? Yes X No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No r Prior permits/approvals for site improvements: k Agency Date e Southold Board of Trustees 5/16 ammended 4/17 Southold Building Dept 7/17 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?_?S_No Yes If yes,provide explanation: Project Description(use attachments if necessary):. See attached project plan for further details To install on grade 13x23x17 bluestone patio, in 6"concrete base to prevent shifting. Install drains leading to ftwells to facilitate pamper rain water drainage To install firepit on top of the patio and add stepping stones from patio to the front of the home. Total approximate square feet equals 350 Board of `Lrusta®s Application WETLAND/'TRUS'TEE LANDS APPLICATION DATA Purpose of the proposed operations: To enjoy our property Area of wetlands on lot: 10,298 square feet Percent coverage of lot: 27 % Closest distance between nearest existing structure and upland edge of wetlands: 75ft feet Closest distance between nearest proposed structure and upland edge of wetlands; 61 feet feet Does the project involve excavation or filling? X Into X Yes If yes,how much material will be excavated? 6.5 cubic yards Flow much material will be filled? 6.5 cubic yards Depth of which material will be removed or deposited: 1/2 Foot feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Wheel barrel No heavy equipment will be used Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): No effect 61 Z20 Appentlix B Short Environmental Assessment Form IngtructiouS for Gonipletina 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 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information r Bluestone patio and firepit Name of Action or Project: Patio and Firepit 'Project Location(describe,and attach a location map): 4145 Wells Road, Peconic New York, 11958 Brief Description of Proposed Action: Remove dead trees, dead branches and debri in the non turf buffer. Remove invasive species t in the non turf buffer such as oriental bittersweet, English Ivy, Proclain berry, Honeysuckle vine, Japanese wisteria, winter creeper, kudzu vine and poison ivy. Prune healthy trees to facilitate new growth. SEE THE ATTACHED PROJECT PLAN FOR PHOTOS z Name of Applicant or Sponsor: Telephone: 239.777.4185 239-777-4185 Charles and Brenda'Grimes E-Mail: bgrimes@gandb.com Address: - t 3501 Bonita Bay Blvd City/PO: State: Zip Code: Bonita Springs Florida 34134 1.Does the proposed action only involve the legislative adoption of a plan,local'law,ordinance, NO ;-YES- administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ` a may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: DEC _ _ 3.a.Total acreage of the site of the proposed action? .89 acres b.Total acreage to be physically disturbed? •_00.8 -acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 38,595 sq ft .89 acres 4. Check all land uses that occur on,adjoining and near the proposed action.- []Urban ction.❑Urban El Rural(non-agriculture) ❑Industrial []Commercial Residential(suburban) ❑forest ❑Agriculture ❑Aquatic []Other(specify): ❑Parkland Page 1 of 4 � v S. Is the proposed action, - NO YES N/A a.A permitted use under the zoning regulations? .❑ ❑- ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ ❑ -�_7. Is the site of the proposed action located in,or does.it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation service(s)available at or near the site of the proposed action? ❑ ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ ❑ 9:Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ N/A 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: a ❑ 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? ❑ X 13.a.Does any portion of the site of the proposed action,or lands adjoining die proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: El Shoreline E3 Forest I&Agricultural/grasslands Early mid-successional El Wetland ❑Urban ❑Suburban IS.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 _ x 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ®NO []YES ❑ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES French drains will be erty 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: El I 19.Has the site of the proposed action or an adjoining property been the location of an active or closed "NO_ YES solid waste management facility? If Yes,describe: ❑X 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES ; completed)for hazardous waste? If Yes,describe: Fx] El I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE rr Applicant/sponsorname: *V _ & \I Dal,--- Signature: ate:Signature• Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the,following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" 4 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? El Z. 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 ❑ El 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 ❑ El 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, Elwaterbodies,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 X❑ i problems? H. W-M 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 r 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. , fi y x P 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. EICheck 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 Date President ' 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) - PRINK Page 4 of 4 A..PPLICANT/AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM -The Town of Southbld's Code of Ethics.prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide inrorination ivhich can alert the town ofpossibie conflicts of intcres_and•alldFv'it td take whatever action is, neceistiry td avoid same. YOUR NAME; Charles and Brenda Grimes 3 `(Last name,-first name,.ipiddle 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.) - F Tax grievance Building ; Variance Trustee X Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally,(or thlrougli your company,spouse,sibling„pare»t,;or child)have-a relationship with-ally officer or employee of,the'rdwri ot'Soutlibld? "Rcludonship"includes by.blood,marriage,or business interest:".Business into-rest mearis;i busiiii s, including a partnership,in which the townofliccr'dkemploycc alas eyes a partial owncrship of(or"employment by,)a corporation in.wliidi tliatown,ofticur or employee owns more than S%of laic shnres; 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 r Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation, ' . B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION Of RELATIONSHIP Submitted this �} of Signature Print Name-- Form TS 1 4 APPLICANT/AGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics.prohibits conflicts of interest orf tile part of town officers and-employees.The purpose of a this,form is to'provide inrorination whish can alert the town of possible conflicts of interest and alloiv'it to take whatever action'is, f .necessniy to Avoid same. YOUR NAME: Charles and Brenda Grimes_ r (Last risme,first name,'riddle initial,unless you are applying'in the name of someone else or other entity,such as a company.If so,indicate the other person's or company''s name.) NAME OF APPLICATION: (Check all that apply.) ' Tax grievance Building "variance Trustee x- + Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map _ Planning Other (If"Other',name the activity.) Do-you pe"rso"nally(or through;your company;spouse,sibling;,paren_t,,or child)have_a relationship with miy officer or employee of thc'rowir of_Soirthold? ".Rclittionship"includes•by.blood;naarripge,or business iii crest."Busin�s4ntcrest"mems a'business, including a partnership,in which the toivn officer or crii}iloyce has Owl a partial oivncrsliip_of(or,cnt'ployment by,)'a cor!}omfion then ; irrwhich iowofficer'or cmploy&e-owns-more than,5%of the shares: YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold . Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check r 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 m e of If LLL 20th, ignature __ a' Print re ' Gnmes Fot m TS I Board of Trustees Application AFFIDAVIT lgepj _.P6421gu _ --------BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMT IT(S) ANIS THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO 'rHE BEST OF HISMER KNOWLEDGE AND BELIEF, AND THAT ALL WORK.WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUS'T'EES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES ANIS 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 TRUS ES DURING THE TERM OF THE PERMIT. _.re o' roperty Owner SWORN TO BEFORE ME THIS DAY OF _ -� , 20�a '""` STACIE KESSLER �SY COMMISSION#FF975928 %.""Ile EXPMES:March 28,2020 �� Notary Public Beard of Trustees Application AFFIDAVIT !a�---_._.—._BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SIZE 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'T'OWN OF SOU IIOLD ANIS TIRE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING TINDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES,THEIN AGENT(S) OR REPRESENTATIVES, INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICA'T'ION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE.BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDI'T'ION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TVSRING THE TERM OF THE PERMIT. T Signature of P SWORN TO BEFORE METHIS 2- 1 DAY OF �tlj' .S —) 20 / 9 `°`"P% STACK KESSLER MY COMMISSION#FF975928 '$�d"7 EXPIRES:March 28,2020 Notary Public {�m 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 i 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 Mon-the coastal-aica f-Whkeh includes all of'Soiithold 6Ngg. 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 answer•must be eaiilained in detail, listing both supporting-and non- supbdrti ig-facts~. If an action cannot be certified as consistent with the LWRP policy standards and conditions,;it-shall not be undertalcen: 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. f B. DESCRIPTION OF SITE AND PROPOSED ACTION ` SCTM# 1000-86 = 02 12.6 PROJECT NAME Patio and Firepit The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees LX I 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) FJ (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit, approval,license,certification: ❑ Nature and extent of action: See attached project plan for further details. To install n grade 13x23x17 bluestone patio in 6"of concre e to prevent shifting. ns a renc rains which ea o drywells to allow for proper drainage. Install firepit on top of patio and install stepping stones set in gravel leading to front of house. Location of action: 4145 Wells road Peconic Site acreage: 38,595 square feet .89 Acres Present land use: residential - - f Present zoning classification: 2., If an application for the proposed action has been filed with the Town of Southold agency, the following E information shall be provided: (a) Name of applicant: Charles and Brenda Grimes 3 (b) Mailing address: 3501 Bonita Bay Blvd Bonita Springs Florida 34134 (c) Telephone number: Area Code( ) 239-777-4185 e (d) Application number,if any: 1 Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes 0 No❑ If yes,which state or federal agency? DEC C. Evaluate the project to the following policies by analyzing how the project will further support or, not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space,makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ,❑ No ❑ Not Applicable Policy 1 is not applicable given that the project does not involve development, preservation of open space` mfastructure use of coastal location and adverse effects on development. Space is already open. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria •❑ Yes ❑ No x❑ Not Applicable Policy 2 is not applicable in that the proposed project plan does not impact any potential historic and or archaeological resources or in the surrounding areas Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See f LWRP Section III—Policies Pages 6 through 7 for evaluation criteria t Yes ❑ No 0 Not Applicable This project does not effect the scenic resources of the Town Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria :❑ Yes ❑ No F] Not Applicable The project plan will comply with policy 4 in that it will ensure that rain water is captured by drains-which lead to drywells. Accordingly there will be no erosion_ due to flooding as a result of this-project. o eavy equipment will be used. 4A There wi a nolog-s- of human lite and or s ruc ures_. - 4.2 e buffer and wetlands will be pro ec a no impact on public land. 4.4" no impact on costal. 4.5 no public funds used. 4.6 no public funds-used. Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 12 Not Applicable Project is not applicable to policy 5 in that it will have no impact on the water quality supply within the surrounding area nor the Town o -SouthoFd. 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. ❑ ❑ I X1 Yes No Not Applicable Policy number 6 is not applicablein the project will not impact the Town of Southold's ecosystem coastal fish and wildlife habitat and the wetlands. Attach additional sheets if necessary t 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 0 No E] Not Applicable The project will not have any impact on air quality and therefore policy number 7 is not applicable 4 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 1:1 No 0 Not Applicable The project does not involve disposal or transportation of solid waste, hazerdous waste, toxic pollutants petroleum pro ucts etc. As such, policy number 8 is not appica e. 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. +--- Yez] No❑x Not Applicable Policy 9 is not applicable. Project relates to a private residential property. Attach'additional sheets if necessary i P I WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III--Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No [3 Not Applicable Policy 10 is not applicable as the project does not effect water dependent uses. 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 0 Not Applicable Policy 11 is not applicable in that it does not involve any form of marine resource managment ie., commericial " fishenes,recreational fisfieries, aquaculfure a c. - { 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❑x Not Applicable Policy 12 is not applicable in that the project does not involve agricultureal of lands (i.e.the converson of farmland, the establishment and or maintencance of new coastal agricutlural production etc. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes ❑ No 0 Not Applicable Policy 13 is not applicable in that the proposal does not involve the conservation of energy resources on a commercial eve -and/or the- promo ion o alternative energy sources, proper maintenance of tuelstorage facilities and 1 or the e rac ion of rn ral extr-a-etion. - - C� �m l 1� PREPARED BY �L� TITLE DATE I