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HomeMy WebLinkAboutTR-10870A Town Hall Annex (j� So✓f�� 54375 Route 25 Glenn Goldsmith, President �� ®� P.O. Box 1179 Vice President °`® Southold, New York 11971 A. Nicholas Krupski, � Eric Sepenoski Telephone (631) 765-1892 Liz Gillooly Fax (631). 765-6641 Elizabeth Peeples �o �COUNTI,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRE D TO CONTACT THE OFFICE OF THE BO RDOCHECKED OFF 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES B E,OWN INSPECTION SCHEDULE _ Pre-construction, hay bale line/silt boom/silt curtain 151 day of construction '/2 constructed When project complete, call for compliance inspection; Glenn Goldsmith, President QF S®UJ� Town Hall Annex A. Nicholas Krupski,Vice President �O� ��� 'P.O. Route 25 P.O. Box 1179 Eric Sepenoski J J Southold, New York 11971 Liz Gillooly Q Telephone(631) 765-1892 Elizabeth Peeples • y0 Fax(631) 765-6641 0,4UNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10870A Date of Receipt of Application: October 30, 2025 Applicant: The Cox/Carlson Living Trust U/A Dated May 9, 2013 SCTM#: 1000-54-5-2 Project Location: 2250 North Sea Drive, Southold Date of Resolution/Issuance: November 12, 2025 Date of Expiration: ,November 12, 2028 Reviewed by: Board of Trustees Project Description: Replace existing deck (±1,742 sq.ft.) in-place/in-kind with steps. 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 site plan prepared by Nick Marks drafting, received on October 30, 2025, and stamped approved on November 12, 2025. 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. Glenn Goldsmith, President Board of Trustees V 7 1/2", 7-9' 47-5- 19'-7' iJ11; OCT 3 0 Soufliald Town oar(i E3 of Trustoes z 11 S 360 59' 30" W 96.61' Z 0) z N O (y) cy) 0 u- DECK < uj W CO Li— Q t.,Ku Lij liy Lu cy) 51'-3 1/2" 13 cy) Z *,0 BOARD OF ) PZUSTEES @) TOWN OF SOUTHOLD ry DATES n cp cl) c� DECK b 17-0" EXISTING DWELLING DECK 00 C6 eq PROPOSED bo bo REBUILT DECK 20.V 113 C14 L 29.8' 17.9' 513 — 1-STORY uj FRAME z b DWELLING CN =1 3.01 < 39.V �2 23.2' 10.0, NICK MARKS F ui rl Z 0 ..............).; 0 0 (y) C) 0 0 cl) 0 LO F71 _17 129.92' z PROJECT DETAILS: N 390 24' 00" E ev'l 100.00, DECK n z _D ao NORTH SEA DR. O < 01 N- 8'-4 1/2" 34'-U' 01 4--1 1 16-0" 3'-8" n u LU LJ_ 7l'-3 1/2" PLOT PLAN < n (/) If SCALE: 1 201-011 > n DECK PLAN 0 SCALE: 1 /411 1 1-0 1, Q UJI O v) 3: O DECK COMPLIANCE NOTE: O EXISTING DWELLING PROPOSED DECK IS IN COMPLIANCE WITH THE 2020 RESIDENTIAL CODE OF NEW YORK STATE SECTION R507 AND DECK LATERAL ATTACHMENT AS PER FIGURE R507.2.3 (2). PROVIDE 36"HIGH DRAWN FOR: HANDRAIL WITH MIN.OF DECK FOOTING SIZES SHALL COMPLY WITH TABLE R507.3.1 200#LATERAL LOAD AND KATHERYNE NOT TO ALLOW A 4"DIA. SPHERE TO PENETRATE, RAILING TO BE SELECTED BY CARLSON TTEE& OWNER-TABLE R301.5 SHELBY COX 7TEE d MII 2250 NORTH SEA DR. OUTHOLD, NY STM: 1000-54-05-2 PTL WOOD TREADS AND RISERS SHEET: AL:SE T 'X4 TL 24'.X1 9`PTL'REAM YPICALA" VP. ............... WOOD POST. '41 TIDERUNNER ENGINEERING & DESIGN, P.C. GRADE .1 r 7 RIDGEWOOD ST. 1 -7 BAYS HORE, NY 7006 FRONT ELEV. PHONE: 631-839-4824 ssl SCALE: 1 /4 11 1 1-011 TYPICAL 36"DEEP MIN. DATE: 10.01 .25 P.CONC.PIER FOOTING m L 0 z 20* 29.8' 17.9 F7 Lc 0 12992' 0 71'-3 1/2" i 1 i 1 2'-8" 47-5" '-7 1/7L 19'-7" )! '! 0 C T 3 CI 20' 0.. 7._8" 7._8„ 7-8" T 8" T-OA 7-8" 6'-10 1 6'-10 1/2" 7- IC IcSt vdrl t -- - - - - - - - - - - - - - - - — — — — — — — — — — — - - - - - - - - - - - - - - --- BoardOf-I rustel?s �- - - o ` 1 z (2) 2X 1OPTLT GIRDER (2) 2 X 10 PTL (2)2 X 10 PTL GIRDER 4 X 4 PTL POST ATOP 14"DIAMETER GIRDER CONCRETE SONO TUBE FOOTING 1 I z O fn WITH MIN.DEPTH OF 36"BELOW (2)2 X 10 PTL (2)2 X 10 PTL U Gnn GRADE(TYPICAL) GIRDER GIRDER N i O ,^ o N N lJ N U, O N N � d I z �GH ry F_ o a I 0 �O w O I a, HANDRAIL WITHWITH MIN.VIDE 36" OF Q M AND 1"X 6"TREX DECKING 00 @) 2NOT TO ALLOWA D4'D A TYP• LLB 0 x 2 X 8 LEDGER 0- I SPHERE TO PENETRATE, 12'-2 1/2" u— < r— N BOARD W/2'LAG 51'-3 1/2" X I RAILING TO BE SELECTED BY b � ('7 CV I OWNER-TABLE R301.5 ih 2 X 8 PTL FJ @ M W Z �O STAGGERED (2)2 X 0 PTL 16"O.C. �' J RDER I TYP• Q I r r v 1. j2�X10PTL � 1 � % GIRDER � ` ` �—(2)2 X 1 O r PTL z 0 2 X 8 12 LEDGER ^^ N 8-0 v BOARD W/2'LAG L..1 BOLTS @ 30"O.C. N I SIMPSON DECK TENSION TIES U I MODEL#DTTI Z-KT U w 0 4 @ 16"O.C. U Oa = Lu 10 I O N _ I cn GRADE O O J d co 00 X 4 X 04 I 4 X 4 PTL POST ATOP 14" N I DIAMETER CONCRETE SONO EXISTING DWELLING TUBE FOOTING WITH MIN.DEPTH � 2)2 X 0 PTL_ /' I OF 36"BELOW GRADE G DER L� ` (TYPICAL) N I SECTION A - A Z 1.(212 X 10 PTL �� L CN N GIRDER L N N SCALE: 1 /4" = 1 '-0" o I �--- I- - - ° - - - - �j W o o ° ;0 I o -- - - - -I o � @ I o CL 00 00 x - - - -a 04 I —� )2 2 10 PTL `� I b I— (-C®J � IRDER \® I DECKING SIMPSON HEI TIE Q M r N I EACH FLOOR JOIST PROVIDE SIMPSON CCQ — — — 0!64U `(2 2 X 1 O L � CAP TO ATTACH POST TO GIRDER(— —` J I TOP PTL FLOOR GIRDER NICK MARKS - - - --I W O - - - - -I JOISSaI&IOC. t TO 4 X 4 PTL WOOD POST WITH (2)2 X 10 PTL GIRDER BOLTED — — MIN,(2(1IT X 9'GALVANIZED 2 X 8 LEDGER THRU BOLTS WITH WASHERS&NUTS SIMPSON CC44 POST CAP -0" 00 X 5'-8" -0" 4 BOARD W/2'LAG — — — — 1? _ + 1 ON 12 <n BOLTS @ 16"O.C. I I o0 1 — — — TAPER _ 1 � STAGGERED � o I I � PTL 4 X 4 WOOD POST _� (2) 2 X 10 PTL - SIMPSON ABAZ POST-TO-BASE \ \ 12'-21/2" U 39'-l" GIRDER I ANCHCRBO SITHMIN.YeDIAM. \ (2) 2 x 10 P PROJECT DETAILS: GIRDER Lu O r \ 4 X 4 PTL POST ATOP 14"DIAMETER o � o (2)2 X 10 PTL \� �l —` ® — — — • ' '' \ ~ T \ POURED CONCRETE FOOTING PIER CONCRETE SONO TUBE FOOTING iv 0- C� GIRDER `r \ 1 WITH MIN.DEPTH OF 36"BELOW 00 — — — MIN.14"0 AND 36"BELOW GRADE 6-. \ GRADE(TYPICAL) X �-- - - - - - -- - - - - - - - - - - /7 \ co 04 (2)2 X 10 PTL (2)2 X 10 PTL / \ \ GIRDER GIRDER ` •• O \ / \ .• ' . ry - - - - - - - - - - - - - - - - - - - - - - - - PORCH POST/DECK CONNECTION � U � Q � � r N boo. 8'-3 1/2" 8'-31/2" 8'-3 1/2" 8'-3 1/2'. PROVIDE ADEQUATE O FLASHING BEHIND LEDGER 4'-4" 8'-4 1/2" 34'-0" 4'-1 1" 16'-0" 3'-8" PROVIDE SIMPSON TECO f f t JOIST HANGERS(TYP.( W O r 71'-3 1/2" z _ 1X6WOOD DECIONG O 2 X 8 PTL FLOOR JOISTS®16"O.C. O 2 X 8 PTL LEDGER BOARD DECK FRAMING PLAN BOLTED TO DWELLING WITH Z A ' MIN.Yi'DIAM.X 6'LONG GALV.LAG SCREWS®16"O.C. STAGGERED AS PER TABLE R507.2.3 n SCALE: 1 /4" 1 '-0" HOLD-DOWN DEVICE MIN.760US- I CAPACITY AT 4 LOCATIONS,EVENLY , DISTRIBUTED ALONG DECK AND ONE WITHIN 24"OF EACH END OF THE LEDGER,HOLD-DOWN DEVICES SHALL FULLY ENGAGE DECK JOIST PER .'•..' HOLD-DOWN MANUFACTURER. ' •. '• FULLY THREADED B'DIA.LAG DRAWN FOR: SCREW PREDRILLED W/MIN.3" PENETRATION TO CENTER OF •', " TOP PLATE,STUDS,OR HEADER KATHERYNE CA RLSON TTEE& CC44 CBS6SIMPSON SHELBY COX TTEE SIMPSON POST SIMPSON POST CAP (TYPICAL) BASE (TYPICAL) PORCH/DECK TO HOUSE CONNECTION 2250 NORTH SEA DR. ® STANDOFF SATISFIES SOUTHOLD, NY SATISFIES ® SIDE OVER ® CODE STM: 1000-54-05-2 REQUIREMENTS ® SEAL: SHEET: TIDERUNNER �t ,�� aE ENGINEERING & DESIGN, P.C. P 7 RIDGEWOOD ST. a POST CAP POST BASE BAYSHORE, NY ?� 77006 PHONE: 631-839-4824 �'�'�oFEssioNP�'�, DATE: 10.01 .25 S TRUSTEES OU . HOLD . ivo. 10$'�OA Issued T Date Addressa�,50 �lor►4, Sep D�*Je. � Soul'1�o�1 THIS NOTICE MUST BE DISPLAYED, DURING CONSTRUCTION TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL: 765.1892 G Glenn Goldsmith,President �� CO �- Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski y ,� � P.O.Box 1179 Liz Gillooly �y Southold,NY 11971 Elizabeth Peeples- � ' y Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time:I I It l 5 Completed in field by: ai7,Gl &o L, Qet.bl-Z THE COX/CARLSON LIVING TRUST U/A DATED MAY 9, 2013 requests an Administrative Permit to replace existing deck (±1,742 sq.ft.) in-place/in-kind with steps. Located: 2250 North Sea Drive, Southold. SCTM# 1000-54-5-2 Type of area to be impacted:. Saltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: Chapt. 275 Chapt. 111 other Typp of Application: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: S�rntek�w�rdl. i n kiv�d I a n Tq,Gt reb�ac a wwh'� Present Were: G. Goldsmith N. Kru ski E. Sepenoski L. Gillooly 7E. Peeples SURVEY. OF PROPERTY DESCRIBED PROPERTY SITUATE SOUTHOLD, TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. TAX MAP NO.: 1000-054-05-02 LOT AREA: 18,622.41 S.F. (0.428 ACRES) DATE SURVEYED:OCT. 17, 2022 ADD DECK SETBACKS:SEPT.30,2025 0 30 60 Feet SCALE: 1 INCH= 30 FEET �p Jp V G� O ,:..._..... p V j- 00 / 1� OG O � •"va1, GAR. t� i O UNDER ' 1 STORY /......._...._...._ i FRAME O♦♦j _.5.5x7.2 SHED / 30 RESIDENCE A,C.UNIT s #k2250 ^q z �O� SHEDOORSHOWER pGF y, E O / o G� O M a O.� v OY -CONC.COVER S2. 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'� 1. �i ? :ra' ,77 .E ,emu 1 ' �,.., ..nt-. t.!.. a ! :. :'n'.srlr'>.�flI .I t ! I r,Ft -r i;:!.t'I,.n•,a'.' :'.. •'� F¢' p da.S$ a, ftJ'�141A 3�,. Y�_:, .Ya"hi� �' ..... 3m,L4;.` iA..:� '- �} fix': "� �§ $�„�' "/.": .l.. l:i l .I- F.a.l ' .„ ,,,aa�.tr.E. Ot i. J ..,..t.c-I x: ,:cr.L, t. _....r_ .` ra....,..,,•;:n-:::!..,nnl•u>na.-,.:.n:..-c:!,=>:.rlsx r,:nu ,h_....,v.,r!.I Frtt,.:: •o ''.a•� �r I��{,�,"�� ��. � s" Sbril7�IrR'�+�y��y ''�. 9"��,ky�£3 '..�._.1:- "� '� � L I I r. � l< - L t �r >r I i i r�.!.:nr;,sx.::::..:.-.I-.':..r. :;::I<.,ra N ` .�' ...ay;r �...§".... -•- nv r F. c' I xt I r r +. - I- N OPTORILINE.NET Jamie Francis From: Nick Marks <nick@nkmdrafting.com> Sent: Thursday, October 30, 2025 10:11 AM To: Jamie Francis Cc: Andrew Malguarnera Subject: Southold WIN f _ .i► Los U ®IM �. 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J= y r ea•e } f s r � \�� Try,, t•i v f os'" ee P! z�•r r > .a0f e,'` ar ssJs bi 1` 1 a yr=.�.. y r •fix 3 � ��;a rr- r' y a ,ti,, }y r o r r '�, y r-V `" � a ,• 4 r, Pes e i y q - rp" 44eore.aiSEE r 4f 4 •» '•� • . •' — ••" ... COUNTYNonce OF SUFFOLK© O ..- - - _ :�N..v.. R.P)Property Tax SP,A-Agency +*sw*a.,euEal v .. O!I J'7 OFFICE LOCATION: �OF SO(/rho! 1NAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd.&Youngs Ave.) G Southold,NY 11971 p Telephone:631 766-1938 Y , . LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD Glen ' ith s� .`.R..'d���::, . . ... ... r�'° oldsm President . Town,of Southold Board of,Trustees Cc: Honorable Lori Hulse Attorney-, From: Heather Lanza, AICP, Planning Director Date: November 10, 2025 Re: LWRP Coastal Consistency Review THE COX/CARLSON LIVING TRUST U/A DATED MAY 9, 2013, SCTM#.1000-54-5-2 This applicatiohIs for an Administrative Permit to replace existing deck (±1,742 Jsq..ft.') in-place/in-kind�with steps. 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 policies of the LWRP as follows: The plan includes actions which are consistent with the "Administrative Permit" requirements of Chapter 275-2 A. of the Wetlands Law of the Town of Southold. 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. 2 Glenn Goldsmith,President Town Hall Annex •9 54375 Route 25 A.Nicholas Krupski,Vice President "4z P.O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD OCT 3 O 2025 This Section For Office Use Only Southold Town Coastal Erosion Permit Application Board of Trustees Wetland Permit Application Administrative Permit _ Amendment/Transfer/Extension Received Application: Received Fee: $ Completed Application: Incomplete: m SEQRA Classification: Type I__ Type II Unlisted Negative Dec. Positive Dec.. Lead Agency Determination Date: __Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report:— __Technical Review: Public Hearing Held: Resolution: Owner(s) Legal Name of Property (as shown on Deed): Katheryne Carlson TTEE & Shelby Cox TTEE Mailing Address: 2250 North Sea Drive, Southold Phone Number: 408-202-3672 Suffolk County Tax Map Number: 1000 - 54-5-2 Property Location: 2250 North Sea Drive, Southold (If necessary,provide LILCO Pole 4, distance to cross streets, and location) AGENT(If applicable):Andrew Malguarnera Mailing Address:713 Main Street, Port Jefferson, NY 11777 Phone Number: 631-732-0010 Email:andrew@brkexp.com v , Board of Trustees Applica,&xvn GENERAL-DATA Land Area(in square feet): 18,622.41 sf Area Zoning:R-40 Previous use of property: residential Intended use of property: residential Covenants and Restrictions on property? —ayes __Z__No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Ems, ,Yes _nNo 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 _Z_No If"Yes", please provide copy of decision. is project 7�ry demolition as per Town Code or as determined by the Building Dept.? is o Does the structure(s) on property have a valid Certificate of Occupancy? Yes_D_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?-a No Yes If yes, provide explanation: Project Description(use attachments if necessary): proposed wrap around wood deck 1792sf f'C ISCIh P {� h de CS�r�P J�1P.) Board of Trustees Applicai�,-,_. I WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: C co al a(4 Area of wetlands on lot: square feet Percent coverage of lot: (/ % Closest distance between nearest existing structure and upland edge of wetlands: d feet Closest distance between nearest proposed structure and upland edge of wetlands: 0 _feet Does the project involve excavation or filling? 0 No 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: (ply feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Oj 1h 97 3 tV/erlh 47 A4 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): ��C 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 an Sponsor Information Ir4a lso Name of Action or Proj ct: North Sea Drive Project Location(describe,and attach a location map): 2250 North Sea Drive, Southold, NY Brief Description of Proposed Action: proposed wrap around wood deck Name of Applicant or Sponsor: Telephone:631-732-0010 Andrew Maiguarnera, agent for owner E-Mail:andrew@brkexp.com Address: 713 Main Street City/PO: State: Zip Code: Port Jefferson NY 11777 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 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: ❑ building permit 3.a.Total acreage of the site of the proposed action? 0.428 acres b.Total acreage to be physically disturbed? acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or.project sponsor? acres 4. Che I land us at occur on,adjoining an ar the propqsp4 action. Urban Rural(non-agriculture) Industrial Commercial ❑✓Residential(suburban) Forest ❑Agriculture Aquatic QOther(specify): Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? nVE1 R, 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 I 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: ❑ El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: _ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? ✓ b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ✓ 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. ntify the typic bitat types that oc n,or are likely to be found on t1Mroject site. Check all that apply: Shoreline Forest Agricultural/grasslands Early mid-successional ✓ Wetland Urban Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ✓ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create stone water discharge,either from point or non-point sources? NO If Yes, ❑ ❑ a.Will storm water discharges flow to adjacent properties? ONO DYES ✓ b.Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes,briefly describe: rJNO �'ES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon, dam)? If Yes,explain purpose and size: _. ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: . ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: drew Mal uarn ra, went �ate;10/30/25 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ ❑ regulations. 2. Will the proposed action result in a change in the use or intensity of use of land? ® ❑ l 3. Will the proposed action impair the character or quality of the existing community? n 4. Will the proposed action have an impact on the environmental characteristics that caused the o ❑ establishment of a Critical Environmental Area(CEA)? S. Will the proposed action result in an adverse change in the existing level of traffic or ® ❑ affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate © ❑ reasonably available energy.conservation or renewable energy opportunities? ?. Will the proposed action impact existing: ® ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ S. Will the proposed action impair the character or quality of important historic,archaeological, © ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ( ❑ waterbodies,groundwater,air quality,flora and fauna)? LJ Page 3 of 4 No,or Moderate ' small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? D ! Part 3-Determination of significance. The head Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered",moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined.that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. QCheck this box ifvou 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 tread 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 of different from Responsible Officer) PRINT Page 4 of 4 �-'3oard of Trustees Appli.aa`"�1n AFFIDAVIT BEING DULY SWORN DEPOSES AND AfMFI THAT HE/SHE IS THE APPLICANT FORT E 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. S ?o'fProperty Owner Signature of Property Owner SWORN TO BEFORE ME THIS A )AY OF ,20 NOTARY PUBLIC,STATE OF NLVV YOX Rgt.kislnitlon No,OiFR6912394 N Public �'w—dified in Sti olk County ':ard of Trustees ApplicatS AUTHORIZATION (Where the applicant is not the owner) I/We, , owners of the property identified as SCTM# 1000-, JN in the town of New York hereby authorizes to act as my agent ent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. i P op %wn is Signature Property Owner's Signature SWORN TO BEFORE ME THIS . DAY OF , 20 _X7 kA- 4'tp y ublic F �A�ANCIS NOTARYPtltiLlC,S'TAi'E,0F NE`V PORK tration No.OiFR6 1239alified iu Su'f_CoutIlyj s.s', , res July 06,2029 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics,prohibits conflicts of interest on the part oftown officers and employees.The purpose of this form is to provide information which.can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: nj ftlo --jur (L st name,first name,middle initia,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"Others,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest'means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES _E NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): _EA)the owner of greater than S%of the shares of the corporate stock of the applicant _n (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this day of welO&7 Signature PrintNa ., h.'I Fonn TS I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should,review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its sipiificant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of-Trustees Office,the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 54 _5 -2 PROJECT NAME 2250 North Sea Drive, The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. Z Board of Trustees ❑ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation, land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: ❑� Nature and extent of action: proposed wrap around wood deck Location of action: Site acreage: Present land use: residential Present zoning classification: R-40 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Andrew Malguarnera (b) Mailing address: 713 Main Street, Port Jefferson, NY _11777 (c) Telephone number: 631-732-0010 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No Fv-,] If yes, which state or federal agency? 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 Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LNVRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No❑✓ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize floss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No MNot Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section In —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No ONot Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ Yes ❑No F Not Applicable Attach additional sheets if necessary Policy 7. Protect and 'improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes No❑✓ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No ❑✓ 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.❑ YeO No O Not Applicable Attach additional sheets if necessary Y WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See I.WRP Section M—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No Z Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. ❑Yes ❑ No❑� Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No Not Applicable PREPARED BY Andrew Malguarnera TITLE agent for owner DATE 10/30/25