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HomeMy WebLinkAboutAntunovich, Richard & Anne (2) Glenn Goldsmith,President \OF SUU�� Town Hall Annex Nicholas Krupski,Vice President ��V� ��� 54375 Route 25 P.O. Box 1179 Eric Sepenoski J Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Joseph Finora Q Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD April 14, 2026 Ural Talgat RA, RLA 436 7th Street Greenport, NY 11944 RE: RICHARD &ANNE ANTUNOVICH 1845 EAST GILLETTE DRIVE, EAST MARION SCTM# 1000-38-4-26 Dear Mr. Talgat: . The Southold Town Board of Trustees reviewed the site plan prepared by Ural Talgat, last dated March 12, 2026 and determined that the proposed construction of a 14' x 32' swimming pool is out of the 100 foot Wetland jurisdictional area under Chapter 275 of the Town Wetland Code. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary, or within 100' landward from the edge of vegetated wetlands, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. This determination is not a determination from any other agency. Sincerely, Glenn Goldsmi , President ,LLYL7�- Glenn Goldsmith,President �QSUGFU(�-`D Town Hall Annex A.Nicholas Krupski,Vice President ��� Gy,��j 54375 Route 25 Eric.Sepenoski y a P.O.Box 1179 Liz Gillooly P" Southold,NY 11971 Joseph Finora y,�0 �p� ' Telephone(631)765-1892 1 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NON-JURISDICTION INSPECTION DATE OF INSPECTION: INSPECTED BY: Z- Ch. 275 Ch. 111 COMMENTS: PROPOSED BETA I N I N6 0� NALL 50" H 16H AT NATURAL 6RADE PROPOSED �.� 'p 5N I MM I NG �� r,� O PROPOSED POOL POOL (445 sO % p„ EG2U I PMENT _ Ci � 0 \�'\p„ -�o NOW OR FORMERLY if) �, < DWELLIN �- 41x5' DRYNELL GARDINERS BAY COMPANY POOL FENCE 0 tu USES P C WATER FOR POOL F-NOL05URE 60 0 N Tanzi Vito FOR FOOL HT AT NATURAL F Trieu-Tanzi Le BACS26°36'30" E GRADE 00.00' +8.5 8.� PROPOSED BETA I N I N6 o +I I .O I I .O+ NALL 30 HIGH AT UJ o PROPOSED � NATURAL GRADE P w SWIMMING POOL AGGEcTURE W � � I � �� I � STRUGTWRE 14' x 32' - SETBACK A v ACCESSORY 0 (() Q ? 5TRUGTURE } � SETBACKor- Q POOL FENCE 0 ENCLOSURE 60" HT AT NATURAL gate +11 .0 +11 .0 GiRADE : EX 15,TI NG T FLOOR :EXISTING.:.: .. IOR DECK or .,. . : :. 2:. .L .R; POOL FENCE FOOL FENCEXI , ': ENCLOSURE 60" R:ES.�DEN HT AT NATURAL Cleaves ENOL05URE 60" HT 105 sf GRA,DE 15op Point PRINCIPAL s ;: 1-... � •'4' . STRUCTURE - gate SIDE YARD +12.0 10' Road SETBACK 66 sf : PRINCIPAL. 5TRUGTURF- DWELLING . .. :. . : . 51 DE YARD xfST1.NG* SETBACK USES PUBLIC WATER DWELLING NIF CYNTHIA WOLF USES PUBLIC WATER :/ TkCDV/F DAVID WOLF N F Pappas Ath,anasios EXISTING DRIVENAY / P� I:-GA:R: GAR4GE:::.. N/F Papyas Frideriki -r'-7ARAGr---_F:FL, •I.Ij' LOT COVERAGE TABLE W SITE AREA TOTAL: 10,000 sf tu w !Y o 5TRUCTURE5 EXISTING PERGENTA6E PROPOSED PERGENTA6E K0 EX 15T I NG FIRST FLOOR O Q v RESIDENCE: 1,450 sf 14.8 90 1,450 sf 14.50 EXTERIOR COVERED 0 � � FIRST FLOOR DECK: 105 sf 1.05 % 105 sf 1.05910 N I TERRACE I C) < N COVERED TERRACE: 66 sf 0.66 90 66 sf 0.66 %, o 5NIMMIN6 POOL: O sf 0 % 448 sf 4.45 % J co 0 Q TOTAL 1,651 sf 16.51 90 2,Oaa sf 20.�a 9b Z IL 0 ��O ii +lo.� C15+ ANrU77.00' 100.00' N26036'30"W V SITE SCTM # 1000-38.-4-26 PROPERTY: 1845 East Gillette Dr ADDRESS East Marion NY 11939 pavement edge OWNER: Anne Antunovich Richard A Antunovich 86 Inlet View Path East Moriches, NY 11940 EastGillette Drive SITE: 10,000 sf_ 0.229 ac _ ZONING: R-40 Residential SURVEYOR: Paul Barylski Land Surveying Patchogue, New York License # 050782 DWELLING MAR 1 7 2026 DATED 10/ 2 / 2025 USES PUBLIC WATER ELEVATIONS ARE REFERENCED Southold Town TO N.A.V.D. 1988 DATUM N/F Buskard Donald A Board oiTrustees PLAkr"'M" SCALE: 1 "=10'-0" INOT T H E 16'a Im Am " OTUPMOOVICHx N E 'n EAST MARION, NEW YORK DATE: 3-12-2026 TA URAL TALGAT ' ARCHITECT 436 7th STREET TRUSTEES APPLICATION 3-12-2026 4" �© GREENPORT, NEWYORK11944 �. �� ��� (631)477-8963 r i &ARA&E \ TWO DE K STORY HOUSE ORIENT HARBOR \ EDGE OF WETLANDS BY URAL TALGAT RLA OCTOBER 25, 2025 \ �0 POOL HIGH WATER LINE BY URAL TALGAT RLA OCTOBER 25, 2025 NEA I I SWIMMING I POOL DECK PROJECT PROPERTY RESIDENCE RESIDENCE DE K RESIDENCE Cleaves Point I \ I I I Road EXISTING \ BULKHEAD \ RESIDENCE East Gillette Drive \ DECK DECK Cleaves I I I RESIDENCE Point \ RESIDENCE DECK Road DECK \ VAR 1 7 2026 \ \ — — — — — — — — � SoutiioidTown Board of Trustees A'% EAST MARION, NEW YORK DATE: 3-12-2026 `A 9T' URAL TALGAT KH C)" RE) PILAImm" I Ap" H 0 mm"k m m OA ARCHITECT SCALE. 1 =30 0 �o �- 436 7th STREET =� 20 � GREENPORT, NEW YORK 11944 Nzzh TRUSTEES APPLICATION - F (631)477-8963 .:. �:: •vich — #1, view looking October A' u aw Antun ' � �•4r: Y. • looking South — October 2• 2025, • • am _ ._..?brae.► � ��' �_� - - --- - ri > •'4rf O Antunovich —#3, view looking Southwest — October 29, 202 �rrf� r tl U E no MAR 1 7 20 �y es r _ y Antunovich —#4, view looking Southwest— October 29, 2025, 9:46 am k ♦ f1'� f ■■ Lu ILL 01 ,' loss -- Ak i d y L� Antunovich —#5, view looking West— October 29, 2025, 9: LIAR 7 2026 s I- Antunovich —#6, view looking Nothwest — October 29, 2025, 9:46 am lu •vich —#7, view looking Northwest— October 29, 2025, • • ■ 16 LI ::s .* f•� yam- '•�� y�:... Antun « �y •vich — #8, view looking October 29, 2025, • • . SURVEY OF: \ PROPERTY LOCATED AT EAST MARION LOT 82 AS SHOWN ON MAP OF MARION MANOR FILED: MARCH 18. 1958: FILE No. 2038 LOT BI SET TOWN OF SOUTHOLD SPIKE SUFFOLK COUNTY. NEW YORK rE S.C.T.M. u 1000-38-4-26 SCALE: 1-=20' 0,op a NOTE: THE EXISTENCE OF RIGHT OF WAYS. � WETLANDS ANO/OR EASEMENTS OF RECORD IF ANY. NOT SHOWN ARE NOT GUARANTEED. \ LPI O LP2 Ja6e O t AC SET UNITS .�. SPIKE LP3 / GRAVEL GAS ' DRIVEWAY Fy® yy6 ON / W/B.B.C. A 9 N C.P. 29' G 9. C/D Z 'C4 00 C'!pA^P 2 s. OI/A s0 WATER /� yy0 y�0 SPIKEEt3oardt 1 / I026 METER .B. ��R yt a N ya°y��` ���rA G� f \ NOTE:WATER SERVICE AND OO O 0 yy6 Oy t hold Town `� �� 5 SEPTIC SYSTEM LOCATION of TrusteesBY OTHERS. B.OH.REF.No. .� S SEPTIC LOCATION Y� Z�j A B. °c S 6;p0 p0 F I/A 35 28 OB 43 32 'o LOT 83 LPl 23.5 55.5 � S� LP2 27.5 52.5 y'A RE-BAR LP3 40.5 53 FOUND SURVEYED BY: UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION PAUL BARYL SKI LAND SURVEYING OF SEC T(ON 7299 OF THE NEW YM STATE EOLLSTTION LAIC .� PATCHOGUE. NY. COPIES OF THIS SURVEY NAP NOT BEARIND THE LAND SLRVETURS WED -� OR EMBOSSED RANTEES SEALSHAHF�n NOT CONSI0EREDTED +ETO BE A MID TRUE COPY. of a Oo V. �?I PHONE 631-•�294-6985 THE PERSON FOR NHON THE SIRYEY IS PREPARED.AND ON HIS BEHALF TD SYZE IY �' FAX 631-62!-31 B 6 THE TITLECOHPANY.DDYENMERTAL AGENCY AND LENDING INSTITUTION a�" .H+r; S� PAULBARYL SKI o YAHOO.COM LISTED HEREON AND TO THE AS'SIONEES OF THE LENDING INSTITBTDN. 00 GUARANTEES Ui CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL • ; * \ C5 1 NOVEMBER 12. 2024 INSTITUTIONS OR SIBS O ENT DINERS •' Y SFy -" �o FApV 12-27-2024: FOUNDATION LOCATION SepCANO Surd G1' 9-5-2025: FINAL SURVEY 6045-FINAL 10-2-2025: RELOCATE DRIVEWAY. Ural Talgat RA, RLA Architect and Landscape Architect 436 7th Street Greenport NY, 11944 ® ECE VE March 31, 2026 MAA 17 2026 Board of Town Trustees Town of Southold Southold Town Board of Trustees Town Hall, 53095 Main Road P.O. Box 728 Southold New York 11971 Re: Antunovich Residence New Pool 1845 East Gillette Dr. East Marion, NY 11939 SCTM# 1000-38-4-26 Dear Trustees: Enclosed please find two Site Plan drawings, two overall neighborhood plan drawings, Trustees Application and a check for $50, for the property referenced above. The proposed construction is greater than 100 feet from the edge of wetlands; we are therefore requesting a letter of non jurisdiction from the Board of Trustees. If you have any questions, please do not hesitate to call us. Sincerely, Ural Talgat ho�aoe soup, Town of Southold P.O. Box 1179 0 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY Date: 02/05/2026 No: 46840 THIS CERTIFIES that the building Location of Property: 1845 E Gillette Dr East Marion.NY 11939 Sec/Block/Lot: 3 8.-4-26 Conforms substantially to the Application for Building Permit heretofore, filed in this office dated: Pursuant to which Building Permit No. and dated: Was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: nd Single family dwelling with unfinished basement, red front Z�BA#7877side firstadated and floor decks, rear entry stoop and attached garage as applied ed for per 2/15/2024. The certificate is issued to: Richard Antunovich,Anne Antunovich Of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL: R 24- 2/3/2026 0 5 ELECTRICAL CERTIFICATE: 51274 08/ PLUMBERS CERTIFICATION: Brad Piecuch 08/08/2025 ® � ��� nn E 0 Auth zed Signat MAR 1 7 2026 Southold Town Board of Trustees Glenn Goldsmith,President � '��, F so&Ttf Town Hall Annex A.Nicholas Krupski,Vice President { � C 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly G Telephone(631) 765-1892 Elizabeth Peeples �y� Fax(631) 765-6641 COUNly , BOARD OF TOWN TRUSTEES MAR 1 7 2026 TOWN OF SOUTHOLD This Section For Office Use Only Southold Town :F. Coastal Erosion Permit Application Board of Trustees Wetland Permit Application Administrative Permit —Amendment/Transfer/Extension Received Application: Received Fee: $ Completed Application: Incomplete: 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): Richard A.Antunovich&Anne Antunovich Mailing Address: 86 Inlet View Path, East Moriches, NY 11940 Phone Number: 631-495-3231 Suffolk County Tax Map Number: 1000 - 38-04-26 Property Location: 1845 East Gillette Drive, East Marion, NY 77 Feet North of Cleaves Point Road (If necessary, provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Ural Talgat Mailing Address: 436 7th Street, Greenport, NY 11944 Phone Number: 631-477-8963 Email: arga7380@gmail.com Board of Trustees Applia :)n GENERAL DATA Land Area(in square feet): 10,000 sf Area Zoning: R-40 Previous use of property: Residence - Single Family Intended use of property: Residence_Single Family Covenants and Restrictions on property? Yes _E_No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? ZYes _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 No If"Yes", please provide copy of decision. his project r,eqp=q 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 F-1_No Prior permits/approvals for site improvements: Agency Date Southold Building Department BR#45270 As Built 10/1/20,#51274 10/10/24 Southold ZBA #1229 2/27/69,#7877 2120/24, No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? I I No_n Yes If yes, provide explanation: _ Project Description(use attachments if necessary): New Swimming Pool and retaining walls New Swimming Pool: 14'x32', 448 sq ft., New retaining walls 139 If. 6"-8"thk x 30" high Board of Trustees Applic, on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: New Swimming Pool and retaining walls New Swimming Pool: 14'x32', 448 sq ft., New retaining walls 139 If. 6"-8" thk x 30" high Area of wetlands on lot: 0.00 square feet Percent coverage of lot: 0.00 Closest distance between nearest existing structure and upland edge of wetlands: 174.5 feet Closest distance between nearest proposed structure and upland edge of wetlands: 1 57•8 feet Does the project involve excavation or filling? ❑ No Yes If yes, how much material will be excavated? 99.0 cubic yards How much material will be filled?. 99•0 cubic yards Depth of which material will be removed or deposited: 6.0 feet Proposed slope throughout the area of operations: 0% Manner in which material will be removed or deposited: Bobcat and Backhoe 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): none 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part l -Project and Sponsor Information Name of Action or Project: New Swimming Pool at the Antunovich Residence Project Location(describe,and attach a location map): 1845 East Gillette, East Marion, NY Brief Description of Proposed Action: New Swimming Pool and retaining walls New Swimming Pool: 14'x32', 448 sq ft., New retaining walls 139 If. 6"-8" thk x 30" high Name of Applicant or Sponsor: Telephone:631-495-3231 Richard A. Antunovich & Anne Antunovich E-Mail: arga7380@gmail.com Address: 86 Inlet View Path City/PO: State: Zip Code: East Moriches NY 11940 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 F ❑ 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: ElSouthold Town Building Permit, Southold Town ZBA 3.a.Total acreage of the site of the proposed action? 0.23 acres b.Total acreage to be physically disturbed? 0_057 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0•23 acres 4. Che 11 land us at occur on,adjoining anlL4ar the proposed action. Urban ✓ Rural(non-agriculture) LJ Industrial OCommercial Residential(suburban) Forest [:]Agriculture ❑Aquatic ❑Other(specify): Parkland Page I of 4 SEE DEC APPLICATION FOR REST OF THE FORM 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ✓ b.Consistent with the adopted comprehensive plan? fl 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 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: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ W1 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: _ ❑ Pol 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 tf�groject site. Check all that apply: Shoreline Forest U Early mid-successional Wetland Urban �Agricultural/grasslands 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 storm water discharge,either from point or non-point sources? PNZO Iq If Yes, . ❑ a. Will storm water discharges flow to adjacent properties? ❑NO OYES b.Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes,briefly describe: t7NO YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon, dam)? If Yes,explain purpose and size: R] ❑ 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: _ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor me: Ural Talgat Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible forthe completion of Part 2. Answer all ofthe,following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning El ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ i. 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)? S. Will the proposed action result in an adverse change in the existing level of traffic or ❑ El affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate . ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. W ill the proposed action impact existing: ❑ ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ ❑ 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ ❑ problems? 11. Will the proposed:action create a hazard to environmental resources or human health? ,❑ Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration, irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this boa if you have determined,based on'the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. 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) PRINT Page 4 of 4 Board of Trustees Applic ion AFFIDAVIT Richard A. Antunovich and Anne Antunovich 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. J ignature of Property Owner nature of Property Owner Richard A. Antunovich Anne Antunovich SWORN TO BEFORE ME THIS DAY OF ` C�Y� ,.20 2 C Notary Public LauronM MotUcsl� Nagy Public,State of NewYol0 No.OIMC6342308 oualifled In Suffolk County ConunhWon Expina May A 2020 Board of Trustees Applic - ion AUTHORIZATION (Where the applicant is not the owner) I/We, Richard A.Antunovich and Anne Antunovich owners of the property identified as SCTM# 1000-38-04-26 in the town of Southold , New York, hereby authorizes Ural Talgat to act as my agent and handle all necessary work involved with the application process for permit(s) from the Southold Town Board of Trustees for this property. f Property Owner's Signature ropdty wner's Signatur Richard A. Antunovich Anne Antunovich SWORN TO BEFORE ME THIS DAY OF � /�u� , 20 2 Notary Public Lauren M Mclt7ssick Notary Public,State of New Vb* Nm 01MCB342308 Qualified In Suffolk County Commission Expires May 23,20 2Pj APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the partof town officers and,employees.lovees The nuroose 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: Talgat, Ural (Last name,first name,4iiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee ✓ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other',name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,.marriage,or business interest`Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than.5%of the shares. YES NO Fv� _ 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): f2A)the owner of greater than S%o of the shares of the corporate stock of the applicant L2 (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� � 20 26 Signature Print Name UralTalgat m Fonn TS 1 61 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town ofSouthold's Code of Ethics prohibits conflicts of interest on the cart of town-officers and employees.The puroose 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. YOURNAME: Antunovich, Richard A. (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.) Tax grievance Building Variance Trustee ✓ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally(or through your company,spouse;sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest'means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES F1 NO W 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): _aA)the owner of greater than 5%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); ]::[Q an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this. da f e2v%_ 2022.6 Signature (�l Print Name Richard A.Antunovic Form TS I " APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town°ofSouthold'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: AntunOvich, Anne (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.) Tax grievance Building Variance Trustee ✓ Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (If"Other",name the activity.) Do you personally°(or through your company,spouse;sibling,parent,or child)have a relationship with any officer or employee. of the Town of Southold? "Relationship"includes-by blood,marriage,or business interest."Business interest'means a business, including a partnership,,in which the town officer or employee has even partial ownership of(or employment by)a corporation in which the town officer or employee owns more than.5%of.the shares. YES NO Fy 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): _nA)the owner of greater than 5%of the shares of the corporate stock of the applictuit Q (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 p_day of 202 Signatur f _ Print me neAfifunovich Fonn TS 1 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 siiificant beneficial,and adverse effect&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# 38 _ 04 26 PROJECT NAME Antunovich Residence 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) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: New Swimming Pool and retaining walls New Swimming Pool: 14'x32',448 sq ft., New retaining walls 139 If. 6"-8"thk x 30"high Location of action: 1845 East Gillette Drive, East Marion, NY Site acreage: 0.23 Acres Present land use: Residental 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: Riechard A.Antunovich and Anne Antunovich (b) Mailing address: 86 Inlet View Path,East Moriches, NY 11940 r (c) Telephone number: (631)4953231 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No If yes, which state or federal agency? 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 LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No Not Applicable There are no historic or archeological structures on property. 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 Pool structure is in keeping in style and scale of neighboring structures. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No 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. 1-1Yes —]No Not Applicable No development will take place in the"protected"or"natural indigenous environment'. 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 0 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. ❑ Ye❑ No R1 Not Applicable No public land involved. Littoral access unimpeded. Attach additional sheets if necessary 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 ❑✓ 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 RI 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 0 Not Applicable There are no agricultural lands on site. 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 W/1 Not Applicable PREPARED BY Ural Talgat TITLE Architect DATE 3/31/2026