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TR-10995
Glenn Goldsmith,President O�Q��FFQ Town Hall Annex A.Nicholas Krupski,Vice President '�� GyJ, 54375 Route 25 Eric Sepenoskio = P.O. Box 1179 Liz Gillooly r'y Southold,NY 11971 Joseph Finora 'f'� p�_, ` Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st day of construction % constructed Project complete, compliance inspection .+ ,(.,.. ._ �:.-. j�•.. ...- . r. a", -_.._ ._ ..to,._ •. 'ask._ _ 1 �`'�.4.,�- - •eTie�o r `:c_. _. of 4 eor � -.. ,eVo oe��°s• t sf •qJe a fee >6'r [. aea r'rr t3 t °eofi neo p!p114f �fllYy V 1� 0 � Y 4� f0l Q 1f. f d� 4 11 if A BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD,NEW YORK �$ DATE: DULY 15 2026 PERMIT NO. 10995 ° :e�afd � � Ilei�al... :• ' 14 ISSUED TO: JOHN M. MILLER LIFETIME QTIP TRUST s PROPERTY ADDRESS: 1132 BRIDGE LANE, CUTCHOGUE ��,�9 r �� �y~'' a�• x SCTM# 1000-118-1-18.4 <' AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in r accordance with the Resolution of the Board of Trustees adopted at the meeting held on July 15,2026, and in �. �1. t consideration of application fee in the sum of$1,250.00 paid by JOHN M MILLER LIFETIME QTIP TRUST and subject to the Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees [ Z5 authorizes and permits the following: ' 3 Wetland Permit to construct a dock attached to bulkhead consisting of a 31x14' hinged 'fo,0r ramp to a 6'x20' floating dock secured by two 10" diameter piles situated in an "L" -i configuration; construct a 16' 3' swimming pool (southwest corner to be eleva x3 ted up to 18" above existing grade); remove portion of existing stone patio as needed and q install 6' wide paver stones; construct a 596sq.ft. masonry pool patio; and install a pool -> I drywell and pool enclosure fencing; establish and perpetually maintain a 10' non-turf 111fe buffer along the bulkhead and wetland boundary; and as depicted on the site plan prepared by Kenneth M. Woychuk Land Surveying PLLC, received on July 31, 2026, r J and stamped approved on August 2, 2026 and the site plan prepared by En- Consultants, received on August 5,2026 and stamped approved on August 5, 2026. 4 3 0 IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, ' and these presents to be subscribed by a majority of the said Board as of the day and year written above. � aidef ` �ul•FQC� � .e 4e1e1me! coo A i� e,4;/er � j /elelAl ;t r rtl` f crcnmu.rer.�W,T�'rYr� i,;iY%;rZ Qi.Fn:T,.h.>T;tTrhin:7Y.:Sr7.lu';ra'v�',?.m'/ry lrr�3tirr,+r;:2C7F rr xiiF�rr7"'fn"�"rYr35i"7'2'�:r`ri.�,r•v.fii�r`fYn7i;��n;,��i��e"+iiY�i:;G:t�xir" Yr'd�"LY'Ifi'�r''r.u'�7ni.r,,o �� ,�_ •. �±, .,o//4 bllee. .� :.[, ° I 1\i bf II t• sa 44 11 ! a.;r elellePy .a0r44 lelal.. ' %a. a/r/4•Ile a ,�, ..;:::•ten.. ,'' •:.�'�•::5:AtPe ..;•. 'k <Saoe Pset•..• et?� d°�P ,,/' .,gfp�,:,. _••!t.e♦ e. �`� °:S$:P TERMS AND CONDITIONS The Permittee JOHN M. MILLER LIFETIME QTIP TRUST, 1132 Bridge Lane, Cutchogue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto,to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 36 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board prior to expiration. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved,to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. A permit issued for work not including a demolition as per the definition in the Town Code, but subsequent to issuance,the work results in a demolition,the permit is voided and a new application must be submitted. 6. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 7. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 8. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees,the work shall cause unreasonable obstruction to free navigation,the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 9. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety(90)calendar days of issuance of this permit. 10. That the said Board will be notified by the Permittee of the completion of the work authorized. 11. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 12. No right to trespass or interfere with riparian rights. This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. V" E N - CONSULTANTS � °`° 5uffdk Canty Nagstrom 1319 NORTH SEA RD, HorseClTo�e Map#45 i SOUTHAMPTON, NY 11968 4 9 '" 2000' 631-253-6360 �y Site(Access via 5u6jed PROP. 3'x14' RAMP I N/�+ yo property) PROP. 6'x2O' FLOAT ���� ?h'E SECURED BY (2) 10" PILES "e .�'E STK TA O _+18' ����,p METo e / Wu femetrt � WUNNEWETA e , , ; ;; Fo ©OA STK. po POND ` ,-';' • ;� EDGE of LA WIDTH > 400' / N1V co �+ P OP. 1 YtG T!q f1TED ON URF IFFER s�s%�i jj PROP. 10' NON—TURF F&18 j �o Pano L.P. PIN �1�� H SAND...• ±55' ZONEAE �� co \4 Bye RD Tip E. S . 01t�N"'0F SOUTHOLD PATIO 19"OAK �poti` /18R'OA 10 ST9Vf \ / / / / 4"OAK ZONE 0.2N ' .• / i CHANCE NUAL FLOM STONE WALK O STK , MgSO4; Y9p SF / Q 35"OAK 0 2 STY FRAME N6` +{�'' DWELLING E XE C AN Fl� 9.frl DRAIN O ASPHALT \ DRIVEWAY AUG — 5 20— STK. STONE B / Southold Town WB ► :` Board of Trtastees I. Pupae Prhete,mralmarcw bast da uw / 2. Plan based sraal Rii bl Kanelh R WajdA \ sio w.v. I.ad 5JV944 RX,last dated ApH 1,2026 \ \��� �w"LL / 5. tlabm;AM-0'-0" _ k. Plan ad ams&w dlai are x6niatt III ZavE fifte r na4re ad ae tlFalded A to eswbh K*A � c�Alf 6CAW,sage,ad basic mi*ucum detab for e Rmw to saw M as or YbAW for "or amirucUm PPOi POCK FOP M11K QTIP TU51" O's for c`mtr"`a 20' 20' SOP JOHN M.Mll Ll k ON WUNNMTA 5. Pro)ec%.10 0d16-1 15.4 POND, CUTCHOi 5UFFOi COUNTY, NY 5L1MNo.1000-II&I-18,4 1" = 40' WA I OF 2, 5-28-26, 8-4-26 5�210N THPU MOP05N) LOCK FPUP05W POCK 55 +18 >G i1 MHW 2'-6" MI.W 0'-0" �X.6P*t � = 10' nn ��] (2) 10" PU5 R c EPdE LAUG5 2026 Southold Town '< hoard of Trustees E N - CONSULTANTS ROPO5�19 POCK FR I.KIM QTIP VU5f 1319 NORTH SEA RD, F0k JOHN M, MI. k ON WUNNMfA SOUTHAMPTON, W 11968 POW CU1'CHOCA4 5UFFOLK CO,, NY 631-283-6360 IPACZ 2 OF 2, 5-28-26 S.C.T.M. DISTRICT: 1000 SECTION: 1 8 LOCK: LOT:# 1 1 18.4 , `� DEPTH SOUNDINGS 61 40,00„ TIDAL WETLAND BOUNDARY AS DELINEATED BY APPROVED B DATUM MLW0.0 EN-CONSULTANTS 10-15-2025 •_BOARD Or 1 RUSTEES � LANDWARD LIMIT OF NYSDEC ARTICLE 25 JURISDICTION EQUALS THE 16' ELEVATION CONTOUR 36 1 SHOWN ON A SURVEY PREPARED BY JOSEPH INGEGNO LS DATED DECEMBER 28 2000 'GOWN OF SOUTHOLD 37s x��—x STK. / PURSUANT TO TIDAL WETLANDS LETTER F NON-JURISDICTION#1- 38- 2 82 0 � 11 pp XXX ` 0 47 0 9 /00 01, DATED FEB.26, 2002 DATE /� X XXXXXXX X ELEC.®``�/ g 1.3S STK. & XXXX%XXXX METER � s� LAND N/F OF T<N45 X X�oXXXX �,`���eo 101' `s�7\�° KATHERINE PERRETTA C 0 <X X X J J� F 19"OAK s')� MEAN HIGH WATER ALONG BULKHEAD OQ'0\' `�\V �/ XXXXXXXXXX�y F�� %9F�9(4, EQUALS TIDAL WETLAND BOUNDARY 3,0° Q OQJ�00FF X X X X ' O ���OP�J�\ �Q x F / X X X Y Q p EDGE OF LAWN 9r A s AS DETERMINED BY EN-CONSULTANTS,10-15-2025 N�� Q� P�p��' ��5 ca RELOCATE ��SI�,� 16"OAK STONE L.P. �d ABOVE GROUND 'QCcF cry I +78' PATIO) GAS LP TANK PIN \r c�NcF 05`1� SAND 4 ZONE AE � I "' o EX. STONE PATIO 01 (EL 6) 23'fOAK DECK �...............h� �k 6 / I STK. ......:.:...........:.........:...... (fBR WHERE NEEDED E�2 i 19"OAK STK. 19"OAK ti°�j .... 2� GATE �+ BRICK 18"OAK ,\ `` ...;..: .�:.. .............. h \ ��p�� PATIO Q / /.:'... .•..:.... .. ; ✓��, :::::::::: P� S\O°....... i 2.... 00 �c�..'.'......... / 24"OAK ZONEX0.2% �/ .' tc p; ;`PROP. 6� .'.'.'.'......:..:.:.:':':':'.' \+ WIDE.'.......... /F� fie' .... .... .... / CHANCE ANNUAL FLOOD I D•'� ��6' :�:Pq�ER w o �.' cQ @ S TQ 4\1 ...::�...'.'..'.'. Q .':'.'::':':':':'.'.'.'.'.'.'.'....NES:':'::':':.:' .: ......:.'..'.'. 1 �'�' �� 6 / :.::Gy .'' T STK./ STK:.... 4 ® �. ':':::':':':':'. ` Q k .�°`.. ..................... . r - STK; � o .:':':': :.'... STONE WALK O ........... PROP: V POOL FENCE j° 1 3' �, \��� STK. n 2 STY FRAME / L� \ DWELLING#1132 .:.:.:.:.:.:.:.:.:. .:.:.. :� ................. / �5�, A,Q ............... �8, / r GRAVEL \�� cO�op \11 AFRcOI ° \ / ��`l• �, DRIVEWAY �� )�7 .,NFiQ 6�'33, '°�r'p ............'.'.'.'.'.'.'.'.'.'...............:.:.:':':':':'........86, . + / �Fo 35"OAK \ 8`,� To q \ 1 �2 :........::.:.:.:.:.:.:.:.:......100, ........:......:.:.:.:.:..:...:.....:...' f ZONE X 0.2%CHANCE ANNUAL FLOOD � �,9 <��1}% .:.:.:.:' �o DRAIN � �� GEN.--_- ASPHALT + DRIVEWAY LAND N/F OF /V \ F 1 S�o O o- �01 p STp NF 044 � \ COVERED ALAN CARDINALE G� STOOPSTONE PILLAR BELL. BLOCK CURB Wq \ °�Nj S (( / STK. ` ` — — — SJc SOPS =sue M ` F/ GEN. — — 1Is\ STONE CURB— ' ZONE AE NE� `� GE CONC. EN RLOS URE� (EL 6) j�I � � Z41VE 17/ STEPS WFTCgN S°� 0 N 7645' "50 W 100.77' D OUNDA _--- � \ \ \ RIVFwAY ST ONF wA�C PNN�P�F�°°� � ''--�-•�-_._..A_ �r It (/ IV 64 1 p \ S 45. 2 p,v p ti°NEB �o�No� i JUL 3 �' Soufiiold Town TIDAL WETLAND BOUNDARY AS DELINEATED BY \ J�Ko SO '' BoardafTrbW-11 EN CONSULTANTS 10-15-2025 ` o, --- NYS DEC ADJACENT AREA MEAN HIGH WATER -- -- _ , — ` FEMA MAP#36103C0502H 2p1'23' EFFECTIVE 0 TOWN BUILDABLE LAND (LOT AREA BETWEEN ELEV 14&WETLAND BOUNDARY) � THE WATER SUPPLY, WELLS, ORYWELLS AND AND C CESSPSSP OOL LOT AREA 45,108 S.F. LOT AREA 24,640 S.F. LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. GARAGE: 658 S.F. AREA:48 955.04 S Feet or 1 .12 ACRES ELEVATION DATUM: _ NAVD88______________ EXISTING DWELLING: 3,124 S.F. PORTION OF ASPHALT DRIVEWAY: 922 S.F. q• UNAUTHORIZED ALTERA71ON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY DECKS, PATIO, STOOP: 830 S.F. PORTION OF CONC.WALK/STEPS. 150 S.F. MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN GARAGE: 658 S.F. BRICK PATIO: 298 S.F. ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. f PORTION OF PROP. POOL& PATIO. 8 S.F. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE 4,612 S.F. or 10.2% o NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS 2,036 S.F. or 8.3�0 AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY PROP. POOL& PATIO : 1124 S.F. o SURVEY OF:DESCRIBED PROPERTY OF N�Wti CERTIFIED TO: SARAH EHRENSON MILLER; . 5,736 S.F. or 12.770 MAP OF: P �N .M._ wo y 0 Al FILED: �� G REVISED 07-23-26 SITUATED AT:NASSAU POINT x a REVISED 07-12-26 TOWN OF:SOUTHOLD ° REVISED 06-08-26 SUFFOLK COUNTY, NEW YORK 2 �- J� KENNETH M WOYCHUK LAND SURVEYING, PLLC REVISED 06-04-26 0 0 582'w� Professional Land Surveying and Design P.O. Box 153 Aquebogue, New York 11931 REVISED 04-01 -26 FILE #225-234 SCALE:1 "=20' DATE:JAN. 13, 2026 '.� PHONE (631)298-1588 FAX (631) 298-1588 N.Y.S. LISC. NO. 050882 _ _._ --------- SO Glenn Goldsmith, President " r4fTown Hall Annex 54375 Route 25 Nicholas Krupski,Vice President y P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Joseph Finora Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD August 26, 2026 En-Consultants 1319 North Sea Road Southampton, NY 11968 RE JOHN M. MILLER LIFETIME QTIP TRUST 1132 BRIDGE LANE, CUTCHOGUE SCTM# 1000-118-1-18.4 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, July 15, 2026 regarding the above matter: WHEREAS, En-Consultants on behalf of JOHN M. MILLERLIFETIME QTIP TRUST applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated June 5, 2026, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 6.3 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: when visiting the property, the Trustees determined that the property does not have a bank; and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on July 15, 2026, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, 2 WHEREAS, the project complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees APPROVE the application of JOHN M. MILLER LIFETIME QTIP TRUST to construct a dock attached to bulkhead consisting of a 3'x14' hinged ramp to a 6'x20' floating dock secured by two 10" diameter piles situated in an "L" configuration; construct a 16'x33' swimming pool (southwest corner to be elevated up to 18" above existing grade); remove portion of existing stone patio as needed and install 6' wide paver stones; construct a 596sq.ft. masonry pool patio; and install a pool drywell and pool enclosure fencing; establish and perpetually maintain a 10' non-turf buffer along the bulkhead and wetland boundary; and as depicted on the site plan prepared by Kenneth M. Woychuk Land Surveying PLLC, received on July 31, 2026, and stamped approved on August 2, 2026 and the site plan prepared by En- Consultants, received on August 5, 2026 and stamped approved on August 5, 2026. Permit to construct and complete project will expire three years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of$50.00 per inspection. (See attached schedule.) Fees: $ 50.00 Very truly yours, Glenn Goldsmith President, Board of Trustees SOUTH O, LD TRUSTEES Na. 10995 So{�n M. M:IIt� Issued To e*"Me QT3: p -rct&rr Date. �_b . Address. 1131 Sr Lane, c t ,Tcv,oqu� THIS. NOTICE MUST BE DISPLAYED DURING CONSTRUCTION .TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765.1892 �F� At EN-CONSULTANTS July 27, 2026 Glenn Goldsmith, Chairman Board of Trustees Town of Southold P.O. Box 1179 "' Southold,NY 11971 � JUL 3 1 2026 Re: Miller Lifetime QTIP Trust, 1132 Bridge Lane, Cutchogue Southold Town Dear Mr. Goldsmith: Board of Trustees Pursuant to the conditions of permit issuance adopted by the Board during the July 15, 2026,public hearing on the above referenced application, please find enclosed three (3) copies of a site plan prepared by Kenneth M. Woychuk Land Surveying PLLC, last dated July 12, 2026,which has been revised to depict a 10-foot wide non-turf buffer along the landward edge of the existing bulkhead, and a 10-foot wide vegetated non-turf buffer along the landward edge of the vegetated tidal wetlands boundary and in place of the existing lawn area situated east of the bulkhead: Although I trust the Town Wetlands Permit can now be issued in accordance with these revised plans,please let me know if you have any questions or require anything further, Resp ct lly yours, Robert E. Herrmann Coastal Management Specialist Enclosures 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting S.C.T.M. DISTRICT: 000 SECTION: LOCK: LOT:# 1 118 1 18 .4 � I DEPTH SOUNDINGS PROP. 3'X 14•' RAMP 40,00" 61 TIDAL WETLAND BOUNDARY AS DELINEATED BY E PROP.. f'x 2 0' FLOAT DATUM MLW 0.0 EN-CONSULTANTS 10-15-2025�6, �'1� _ x i LANDWARD LIMIT OF NYSDEC ARTICLE 25 JURISDICTION EQUALS THE 16' ELEVATION CONTOUR SECURED BY (2 10" PILES sTK.�' �`� �36 �-• 1 x--•� STK. ! SHOWN ON A SURVEY PREPARED BY JOSEPH INGEGNO LS, DATED DECEMBER 28,2000 3.Ts STK.?'° �� 110.0 PURSUANT TO TIDAL WETLANDS LETTER OF NON-JURISDICTION#1-4738-02982/00001, DATED FEB.26,2002 STK.� ��, /.��.� It STK.®� 2� ±18 Y / / XX X XXx x ELEC.®\/ 1.3S STK. \ S �Ft X x x x �O METER k & LAND N/F OF 11 ,L STK. FF x x x x \\� O . TW4 STK. F�� / XxXxXxXxx ����¢ �o �o/, s�>\�o KATHERINE PERRETTA x x x ��J�F cF 19"OAK s�, MEAN HIGH WATERALONG BULKHEAD p0��`�` �p`� / xXXXXXxxx�\\ \/ F�4�, Gy,, C9 EQUALS TIDAL WETLAND BOUNDARY °o oQ•��� / "x"oQ m_oQ�`��� / N EDGE OF LAWN ���rgr�QA \� s, AS DETERMINED BY EN-CONSULTANTS,10-15-2025 Q� / Q� p`��' ��5 RELOCATE \OSTi�1,�R 16 AKA' +78' ,/ STONPATIO GAS LPOVE TANK ROUND PIN ��FFNCF o��� SAND Q ZONE AE / ' \/ .:.:.:.:.:.:.:.:3... . EX. STONE PATIO \ �..............� (off (EL 6) / OAK ' ' STK. DECK (TBR WHERE NEEDED ..::......:.:.:.......:..:.. ........ .6�: S So { :. ........... ....... 19"OAK 19"OAK k/ STK<11, .: �° 'vF�,�l< o,, GATE BRICK �d F�°°% 18"OAK \ . :::::::::::::::.. �' h PATIO Q / �/. sa::.:.:.:.:.:.:.:.:.:.:.:.:::::.:.: ::. .... ..... 24"OAK ZONE X 0.2% �/ . q pl PROP. 6' \+ pF� gF ................. / CHANCE ANNUAL FLOOD '�6'• :PAVER WIDE w ��`� _ :.:.:.:.: :`...::. / . o,`OgQ` v� .::::::.:.:.:.:.......STONES:::::::::::;: :: a,� . ........................ STK. STK;........... 4 O <v %. h .:................ .:....... q �. .. ..................•.. ':.:... y �x �. �, .. ...... ........... ......��:.:.:::.:::::.:::: /� STK: o STONE WALK ���, PROP POOL FENCE `K � \ Q j° 13 9/ STK. h \ ��\�\� 2 STY FRAME:':::::::::'2�8-... h CD f DWELLING#1132 Opp / GRAVEL \0p co, 0'01 \� FRcO �. DRIVEWAY a TO N� 6,I, :: ::: :: ::.....:...:..... .....:.8 + fit' 33� �'t®� .....::. s... \ Foc 35"OAK ,x� T0� AD �• p0 .:.:.:.:.:.:.:.:.:.:.:.:. .:.:.:.:.:.:.:.:.:.:.:. .:.:.:.:.:.:.:.:...: ZONE X 0.2%CHANCE ANNUAL FLOOD <cl \ �0����C�� 0` � i .................. o DRAIN G, qT�O GEN. `�� ASPHALT / ILAND N/F OFF k� ` ® NdF �- �� eqy.. .: - DRIVEWAY - 0 0; 40�10 �NF WA�� \ I, ALAN CARDINALE STONE j s9° ST COVERED STOOP / PILLAR BELG. BLOCK CURB \ \ �� \ STONEW egy � ACC ' SO G. STK. GEN. pp, c� � — ____ ____ ____ '�GE � c� RA"' AC STONE CURB �3`10 ZONE AE NEpO' ` CONC. EN LOSU� (EL 6) j6' � �� I \ 1 STEPS _ �--- / �N IVEl7 SO N 76°45'50" W 1 OU.77' / FPP��M D OUNDq y \ �- 62 GRAV C d W.V. o �- ` \ %6WAY S TONE W �F�oo JV 64° � S 45 �Q2°I°cNPN � lJ 1 3S r0'� 20'40„ T(:Aa °i JUL 15 2026 TIDAL WETLAND BOUNDARY AS DELINEATED BY uo Southold Town EN-CONSULTANTS 10-15-2025 \ Board o`rTrUSteo NYS DEC ADJACENT AREA [MEAN HIGH WATER — — _ FEMA MAP#36103CO502H 201.23f EFFECTIVE 09/25/2009 TOWN BUILDABLE LAND (LOT AREA BETWEEN ELEV 14&WETLAND BOUNDARY) �' THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOT AREA 45,108 S.F. LOT AREA 24,640 S.F. LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS. GARAGE: 658 S.F. AREA:48,955.04 Sq. Feet or 1 .12 ACRES ELEVATION DATUM. _ NAVD88____________^_ EXISTING DWELLING: 3,124 S.F. PORTION OF ASPHALT DRIVEWAY: 922 S.F. DECKS, PATIO, STOOP: 83O S.F. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SEC71ON 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY PORTION OF CONC. WALK/STEPS: 150 S.F. MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN GARAGE:658 S.F. BRICK PATIO: 298 S.F. ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 77TLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. PORTION OF PROP. POOL& PATIO: 8 S.F. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM 7HE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE 4,612 S.F. or 10.2% o NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS EASEMENTS PROP. POOL& PATIO : 1124 S.F. 2,036 S.F. or 8.3/o AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF:DESCRIBED PROPERTY OF Nc:W CERTIFIED TO: SARAH EHRENSON MILLER; 5,736 S.F. or 12.7% MAP OF: AY,, NM kko)__ FILED: S SITUATED AT:NASSAU POINT REVISED 07-12-26 rowN oF:SOUTHOLD ° REVISED 06-08-26 ) '� w KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK 'GS 05USg2 Professional Land Surveying and Design REVISED 06-04-26t �,�! P.O. Box 153 Aquebogue, New York 11931 REVISED 04- 01 —26 FILE #225-234 SCALE:1 "=20' DATE:JAN. 13, 2026 N.Y.S. LISC. NO. 050882 PHONE (631)298-1588 FAX (631) 298-1588 Glenn Goldsmith,President �O�QS�FFO(k�oGy . r' Town Hall Annex A.Nicholas Krupski,Vice President < 54375 Route 25 0 Eric Sepenoski W ,z P.O.Box 1179 Liz Gillooly �y • o�� Southold,NY 11971 Joseph Finora l �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: Completed in field by: En-Consultants on behalf of JOHN M. MILLER LIFETIME QTIP TRUST requests a Wetland Permit to construct a dock attached to bulkhead consisting of a 3'x14' hinged ramp to a 6'x20' floating dock secured by two 10" diameter piles situated in an "L" configuration; construct a 16'x33' swimming pool (southwest corner to be elevated up to 18" above existing grade); remove portion of existing stone patio as needed and install 6' wide paver stones; construct a 596sq.ft. masonry pool patio; and install a pool drywell and pool enclosure fencing. Located: 1132 Bridge Lane, Cutchogue. SCTM# 1000- 118-1-18.4 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 Type of Application: Ved Wetland Coastal Erosion Amendment Administrative Emergency Pr7Yesmissionb Violation Notice of.Hearing card posted on property: No Not Applicable Info needed/Modifications/Conditions/Etc.: gees S•4 Pa►l Qg�•l - �pc��✓ — tk,t K +-Aa,t lUP Present Were: y G. Goldsmith N. Kr�pski E. Sepenoski L. Gillooly J. Finora S.C.T.M.# DISTRICT: 1000 SECTION: 118 BLOCK: 1 LOT: 18.4 1 40 00 I TIDAL WETLAND BOUNDARY AS DELINEATED BY I`�---:._.-. -(, �. DEPTH SOUNDINGS " �� ; ' EN-CONSULTANTS 1015 2025 _ � DATUM MLW 0.0 36 - r " `� 1 „ r" /t � JUN 5 2026 � . 3.TS x,. x STK.i 1 " S J ,' 1x'�[ J110 ; Se.dtwi,;toa,�n �O e � it x`�x-..L 00 I �.nJ�!ni�5 �- �. ELEC: METEM ' ) 1 / 1.3'S 1, STK. x ;r /19 OAK/ f �;�� s�p , LAND N/F OF KATHERINE PERRETTA MEAN HIGH WATER ALONG BULKHEAD PG �b� / ! OO gyp\ EQUALS TIDAL WETLAND BOUNDARY EDGE OF LAWN AS DETERMINED BY EN CONSULTANTS,1015 2025 6 �� ;� STONE L.P. `vim PIN \ F +78' /� /i PATIO :::?� , GAS I 3 \ o�j�� SAND '�°j�20NE AE %� d ,/ "' o EX. STONE PATIO i h' i (p� ��__'' 1 (EL 6) OAK �; DECK . ...............:.:.::... (TBR WHERE NEEDED o _10 j 19"OAIf, // \ 2 .• :. F�l,� 1 ��`__ ?so GATE�+ BRICK �� 19 OAK ��000/�/ 18'OAK ' %� 1 / ! : --1 PATIO i ;� .::a.r 2 _ ?.. PROP• + ��_ . • -,•= r \G�s�..::•:�::�:.. / 4"OAK ZONE ro.2% � ; � ;% �'o' 6'W1D ........ .. \ CHANCE AN UAL FLOOD �� 1 i �'�� `�6' pq�ER E........w. �`` i ;,.f.........�;: / STONES s ` .✓ / l I I Q 4 �• . ::::::::::::::... �,•-`°�� tp .:. � :.:.::..:.:.:.... ` /I� \a I �Q o��c' ..................... STONE WALK O ........... PF)OP. -'POOL F�=NCE `R....... 1 \ 13' hti STK. its :::::: tio. ... *::.��2 STY FRAME::-:-*-,: \� DWELLING#1132::::............. �o:: �, / f- / GRAVEL �� ``., �A .C'QRQA`�.� pFRG�.. j 0O 1 . - \ DRIVEWAY \ •� IQ .R/V�C 6� A ` q Fp 35 OAK �, x ` TQ �zs;. r ZONE X 0.2%CHANCE ANNUAL FLOOD I `l�`� �FF ,� `\\ C��} DRAIN '� (� '�_T� �'`.� diJ� �°' ASPHALT \f / \ F� G EIS .......... � xr� ® �� \ Y DRIVEWAY \�r / LAND N/F OF 1\rs9 f; F o O °40'10�� ��ALL \ \ --- � COVERED ALAN CARDINALE W \ `� - ti �ct' � ., STOOP ,. \ STONE gELG.BLOCK CURB PILLAR \-'�,�\ 11 ` ' ' TON- 'v '�- � STK. r71 , STEPS - --- NK / D �-� �' '�, STONE CC$ _�.. _ RASH ZONE AE HE --- - ' ---��� T� `.� - �01QC/ �EN LOSURE _ L (EL6) ,STEPS ---- __f`i / N� , -'"" '�, _ WE '� - _ '`\ �--,._•-�0 .w-1V 76�4�' � -off" W rC60.77 ,,- NND ` 42. W.V. - I ----r- 62, �� GRAVE _.:„"-�..\ — _= o \ � \ L�RIVEW Y STONEW P A ALL - --_ � oEPNNo TIDAL WETLAND BOUNDARY AS DELINEATED BY EN-CONSULTANTS 10-15-2025 FEMA MAP#36103CO502H NYSDEC ADJACENT AREA MEAN HIGH WATER 241 23 - 009 TOWN BUILDABLE LAND (LOT AREA BETWEEN ELEV 14&WETLAND BOUNDARY) �\\` j r EFFECTIVE 0S AND CESSPOOL ' J THE WATER SUPPLY, WELLS, DRYWELL S AND CESSPOOL LOT AREA 45,108 S.F. LOT AREA 25,450 S.F. L___ � _� LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS AND OR DATA OBTAINED FROM OTHERS. GARAGE:658 S.F. AREA:48 955.04 S Feet or 1.12 ACRES ELEVA77ON DATUM: ___ NAVD8$____Y_—___r_ EXISTING DWELLING: 3,124 S.F. � q• PORTION OF ASPHALT DRIVEWAY:922 S.F. UNAUTHORIZED AL7ERA770N OR ADDITION TO 7H/S SURVEY IS A VIOLATION OF SEC77ON 7209 OF 7HE NEW YORK STATE EDUCATION LAW. COPIES OF 7H/S SURVEY DECKS, PATIO, STOOP: 830 S.F. PORTION OF CONC.WALK/STEPS: 150 S.F. MAP NOT BEARING 7HE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN GARAGE:658 S.F. BRICK PATIO: 298 S.F. ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO 7HE 717LE COMPANY, GOVERNMENTAL AGENCY AND LENDING JIVS77TU77ON LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS71TU770N, GUARANTEES ARE NOT TRANSFERABLE. 2 028 S.F. or 8.0% 7HE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 7HE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, AD0177ONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS 4,612 S.F. or 10.2% AND/OR SUBSURFACE SMUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE 77ME OF SURVEY PROP. POOL& PATIO : ,736 S.F. SURVEY OF:DESCRIBED PROPERTY of New y CERTIFIED TO: SARAH EHRENSON MILLER; 5,736 S.F. or 12.7% MAP OF: �Q��,N "' wow o� FILED: SITUATED AT:NASSAU POINT ; a r � TOWN OF:SOUTHOLD ° - 4, KENNETH M WOYCHUK LAND SURVEYING, PLLC SUFFOLK COUNTY, NEW YORK s osossF �, Professional Land Surveying and Design REVISED 06-04-26 ;i' " ,� J P.O. Box 153 Aquebogue, New York 11931 REVISED 04-01 -26 FILE #225-234 SCALE:1 "=20' DATE:JAN. 13, 2026 ."`�'I PHONE (631)298-1588 FAX (631) 298-1588 N.Y.S LISC. NO. 050882 E N - CONSULTANTS 91 LOOP) ow o 1319 NORTH SEA RD. Horseshoe %ffdk Carty Nag5trom SOUTHAMPTON, NY 11968 Cove lIp 2000' ti %x9T 631-283-6360 9�� , PROP. 3'x14' RAMP N Site(Access via subect PROP. 6'x20' FLOAT SECURED BY (2) 10" PILES ,ys �� I l property) / HM ' STK. TT9 ga' •/� I 4y�y s / ELEC x` x MET 8 WUNNEWETA " / 19"OA STK. / (D Wit meta POND �,�i a tilt (WIDTH > 400') E°�OF LAIfWI / lbd A ©16 % PION GAS PIN \Q Ln�oon SAND ZONE AE OAK co �+ t��"o sr �� 33i, PICK 19"OAK poti 18�OA rry Bq� GATE ATIOp\ a / 4"OAK CHANCE NUAL MOD \+•• •• \ JUN 5 2026 p SroNE WALK O So Old Town k 4,70 Sg � d of TnTstees / A S,o 35"OAK \� gjIO 2 STY FRAME �6 9` DWELLING p*\14. DRAIN DRIVEWAY G 1 \ 20NE K 0.$%CHANCE ANNUAL FLOOD 9 ASPHALT ip4 ® � / •.� \ STK. STONE a / DGE / NAM: I, pl/ptl3e:Pltlate,rceramercid beat dockage E _ 2. Pbm based arvq prWed by KwA M.Wa*tk \ stDyr WAu W.V. I"5zvqPq FUZ,last dated Ap9 I,2026 5. PAW:A0-0'-0" 4. Plat aid awAm diwm ae sdmlatk h refire ad are mmkj A to esta A peteet '•\ :oYr a der . IDoat aL snipe,ad basic m bwt&detail for MIlly wmdm plrpeses ad are rot IlfAded to serve as or 26.4 tte for ergtleerllq or mrebidw PROP05W POCK FOP I.KIM QT 1RU5f 035fereertslrucbertpipases 20' 20' FOR JOHN M,MII. M ON WUMMM y, Prgec .A 01 6rldgelate,Cutdtoge; S POND, CVCHOCU�, 5UFFOLK COUNTY, NY CiM No.I000a1&I-18,4 1" = 40' PACE I OF 2, 5-28-26 ZC110N THFU PPOP05�12 POCK ROP05�P L90CK 6' �I.OAT pm' x MM 2'-6" } l� MM 0'-011 JUN 5 2026 t�?t i - EX.G�� , Southold TovJn--- , f 10, Board of Trustees (2) 10" PUS E N - CONSULTANTS 1319 NORTH SEA RD, SOUTHAMPTON, NY 11968 631-283-6360 PPOP05W t70CK FOP 1.KIW OT VU5f FOP JOHN M. MII. P ON WUNWWA POMP, CVCH06U�, 5UPFOLK CO,, NY FMG 2 OF 2, 5-28-26 JOHN M. MILLER LIFETIME OTIP TRUST, 1132 BRIDGr, uANE, CUTCHOGUE h tr v� r e J w Figure 1. Looking west at existing bulkhead and location of proposed ramp and floating dock. k' e� ;n t .P 1� s z H _ Figure 2. Looking northeast at existing bulkhead and location of proposed ramp and floating dock;and at adjacent dock to north. 'fir ,. -✓ � . •��- ._ �` may[ Y S- -•Y- �` fff ",� •� ��M., ice. '�1" a" y� '� .i �ti F 1• YV[ .- �r 0&BT ,T 03 01.010 ,o23ae N MATCH SEE 9EC 111 LINE pP1 P s 36 r O ti PoM TOWN OF -- ll ", 9.1. 1 T \b`Y 24M.) * 0 g i 14! r ` ,b ,a b si �y v ^w'^•""� _ "" '" "^' — —' -- --^-- Nonce COUNTY OF SUFFOLK © x °t aouTNan SECTION NO (z,) � Real Property Tax Service Agency r wan GnYrAN.MMC,NT„aw 118 p rd r�� -...,.D wtw Nmw,tu ,.. —_— a.",. --.-- e.w,..--w-- r"u'.,�+._✓� C w A i twn xo PROPERTY MAP OFFICE LOCATION: fifMAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees Cc: Honorable Lori Hulse, Attorney From: Heather Lanza, AICP, Planning Director LWRP Coordinator Date: July 13, 2026 Re: LWRP Coastal Consistency Review John M. Miller Lifetime QTIP Trust, SCTM #1000-118.-1-18.4 This application is to construct a dock attached to bulkhead consisting of a 3'x14' hinged ramp to a 6'x20' floating dock secured by two 10" diameter piles situated in an "L" configuration; construct a 16'x33' swimming pool (southwest corner to be elevated up to 18" above existing grade); remove portion of existing stone patio as needed and install 6' wide paver stones; construct a 596 sq. ft. masonry pool patio; and install a pool drywell and pool enclosure fencing. 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 INCONSISTENT with the policies of the LWRP as follows: Policy 6. Protect and restore the quality and function of the Town of Southold's ecosystem. 6.3. Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction. The proposed pool is inconsistent with Policy 6.3A because it does not comply with Town Code Chapter §275-3(D)(1)(a)[5] that states the setback at the top of the bank slope for a swimming pool and related structures: 60 feet. The proposed ramp and dock attached to the existing bulkhead is consistent with Policy 6.3A because it complies with the Town Code associated with the regulations below: Town Code Chapter§275-11 Construction and operation standards C. In water. The following standards are required for all in-water operations (2): Docks. (a) Standards for residential and commercial docks; general rules. (b) Dock locations and lengths (c) Regulations for the placement and configuration of docking facilities. [1]Residential docks. 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 `��F SO(/r� Town Hall Annex A.Nicholas Krupski,Vice President ,`Oy` d 54375 Route 25 P.O.Box 1179 Eric S'epenoski Southold,New York 11971 Liz Gillooly cn ae Elizabeth Peeples � � �' Telephone(631) 765-1892 ,, Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only- e E (G` E0E Coastal Erosion Permit Application ciDO Wetland Permit Application j Administrative Permit ° FUN 2026 Amendment/Transfer/Extensioin Received Application: o Received Fee: $ W Southold Town Completed Application: o Board of Trustees Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): —FLWRP Consistency Assessment Form Sent: 612� CAC Referral Sent:--� _Date of Inspection: /I x IoZ�P Receipt of CAC Report: r Technical Review: Public Hearing Held: / o Resolution: Name of Applicant John M.Miller Lifetime QTIP Trust c/o Ruth Metcalf,Trustee&Sarah Ehrenson Miller,Trustees Address 1132 Bridge Lane,Cutchogue,NY 11935 Phone Number: 631 682-2595 Suffolk County Tax Map Number: 1000 - 118- 1 - 18.4 Property Location:1132 Bridge Lane,Cutchogue,NY 11935 (property is located on north side of Bridge Lane,+/-363'south of Bayberry Road) (provide LILCO Pole #, distance to cross streets, and location) AGENT: En-Consultants (If applicable) Address: 1319 North Sea Road,Southampton,NY 11968 Phone:631-283-6360 coj SW `i r/a-ee Board of Trustees Applic' `13ri GENERAL DATA Land Area(in square feet): 48,955 sf Area Zoning: R-40 Previous use of property: Residential,single-family dwelling Intended use of property: Same,with dock and swimming pool Covenants and Restrictions: Yes X No If"Yes", please provide copy. Will this project require a Building Permit as per Town Code? X Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by Building Dept. Yes X No Does the structure(s)on property have a valid Certificate of Occupancy X Yes No Prior permits/approvals for site improvements: Agency Date Southold Trustees#5606 August 23,2002 Southold Trustees Tree Removal Letters September 8,2020&May 14,2022 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? . X No Yes If yes, provide explanation: Project Description(use attachments if necessary): Construct a dock attached to bulkhead,consisting of a 3'x 14'hinged ramp and 6'x 20'float,secured by(2) 10"-diameter piles,as depicted on the project plan prepared by En-Consultants,dated May 28,2026;and construct a 16'x 33'swimming pool(southwest corner to be elevated up to 18"above existing grade),remove portion of existing stone patio as needed,install 6'wide paver stones, construct a 596 sf masonry pool patio,and install a pool drywell and pool-enclosure fencing;all as depicted on the survey/site plan by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 4,2026. and of Trustees Applicatii WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: To provide a small dock for private,noncommerical boat dockage;and a recreational accessory swimming pool appurtenant to existing dwelling. Area of wetlands on lot: +/-3,847 square feet Percent coverage of lot: +/-7.86 Closest distance between nearest existing structure and upland edge of wetlands: +/- 17 feet accessory garage Closest distance between nearest proposed structure and upland edge of wetlands: +/-78 feet swimming pool Does the project involve excavation or filling? No X Yes as required for proposed swimming pool If yes, how much material will be excavated? < 150 cubic yards How much material will be filled? N/A cubic yards Depth of which material will be removed or deposited: N/A feet Proposed slope throughout the area of operations: N/A Manner in which material will be removed or deposited: N/A 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): --SEE ATTACHED ADDENDUM-- JOHN M. MILLER LIFETIME QTIP TRUST 1132 BRIDGE LANE CUTCHOGUE,NY SCTM#1000-118-1-18.4 STATEMENT OF EFFECT One of the project elements is a small dock,which will be fully compliant with the construction and operation standards set forth for docks in Section 275-11(C)(2)of the Town Code. Specifically,with no dock located to the southwest,there is no established pier line for the dock to align with,but the float will be oriented parallel with the bulkhead and extend into the water waterway only 18 feet,a fraction of the 400-ft wide waterway and significantly less than the adjacent dock to the northeast,which based on aerial imagery extends roughly 45 feet seaward of the bulkhead.The dock is also positioned in the center of the property, and the float would rest in 30 to 36 inches of water depth at mean low water. Given the minimal scope of the dock, including the absence of a pile-supported catwalk in the waterway, it will have no adverse impacts on water quality,nor the quality and function of the surrounding tidal wetland ecosystem; and it will in no way interfere with navigation or impede public access or use of the Wunneweta Pond, consistent with the standards for permit issuance set forth in Section 275-12 of the Town Code,and with the goals of LWRP Policies 5, 6,and 9. The other project element is a swimming pool with surrounding patio to be located immediately seaward of the existing dwelling's covered porch.The pool and patio are modestly designed and positioned well above the groundwater table within the highly elevated(EL 16)and predominantly flat area adjacent to the dwelling, in part to minimize the vertical exposure of the waterside of the pool,primarily its southwest corner,to approximately 18 inches.The pool is also set back nearly 80 feet from wetlands (50%more than the required 60-foot setback),and a drywell is proposed to contain pool backwash.The pool will thus be well protected from potential flooding and erosion risks;will have no adverse impacts on water quality; and will cause no physical loss,degradation,or functional loss of ecological components,or otherwise impair the quality or function of the surrounding tidal wetland ecosystem, consistent with the goals of LWRP Policies 5 and 6, and with the standards for permit issuance set forth in Section 275-12 of the Town Code. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I-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 I-Project and Sponsor Information Name of Action or Project: Miller Bulkhead and Pool Project Location(describe,and attach a location map): 1132 Bridge Kane,Cutchogue,Town of Southold, SCTM it1000-118-1-18.4;property is located on north side of Bridge Lane,+/-363'south of Bayberry Road Brief Description of Proposed Action: Construct a dock attached to bulkhead,consisting of a Y x 14'hinged ramp and 6'x 20'float,secured by(2) 10"-diameter piles,as depicted on the project plan prepared by En-Consultants,dated May 28,2026;and construct a 16'x 33'swimming pool(southwest corner to be elevated up to 18"above existing grade),remove portion of existing stone patio as needed,install 6'wide paver stones, construct a 596 sf masonry pool patio,and install a pool drywell and pool-enclosure fencing,all as depicted on the survey/site plan by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 4,2026. Name of Applicant or Sponsor: Telephone: 631-682-2595 John M.Miller Lifetime QTIP Trust E-Mail: sarahfehrenson@gmail.com Address:c/o Ruth Metcalf and Sarah Ehrenson Miller,Trustees 1132 Bridge Lane City/PO: State: Zip Code: Cutchogue New York 11935 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. X 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: NYSDEC,USACE,NYSDOS X 3.a.Total acreage of the site of the proposed action? 1.12 acres b.Total acreage to be physically disturbed? +/-5,000 sf c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 1.12 acres 4.Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial ®Residential(suburban) ❑Forest ❑Agriculture ®Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5.Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? X b. Consistent with the adopted comprehensive plan? X 6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 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: Name: Peconic Bay and Environs,Reason:Protect public health,water,vegetation& scenic beauty,Agency: Suffolk County, ate:7-12-88 X 8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES X b.Are public transportation service(s)available at or near the site of the proposed action? X c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 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: N/A 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: N/A 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 X 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? X 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: The proposed X dock will encroach upon approximately 156 sf of Wunneweta Pond seaward of MHW. 14.Identify the.typical habitat types that occur on,or are likely to be found on the project site. Check all that apply. ® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ® Wetland ❑Urban ®Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? X 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? 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❑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: X 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: X I AFFIRM THAT THE INF I MATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name; Herrmann,Coastal Management Specialist Date: June 4,2026 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 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 L Will the proposed action create a material conflict with an adopted land use plan or zoning regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur 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 I Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts.Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude.Also consider the potential for short-term,long-term and cumulative impacts. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. ❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Name of Lead Agency Date Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer) Page 4 of 4 �I Raphael z Vineyards Ri rnond Creek �t�y 0 958 LA S t>o Bedell N 90 L Cellars o' a Pugliese vineyards ® PS 4A � EAST � CUTCHOGUE �' , HOG NECK BAYS 9 hl' <9 90 Peconic Bay MBE 1. F Winery P s ro At olH�gDD PL y F EET U °9 o o b Hayvater Hog Cove 9 NA AU Neck. a T % & � 5uffjk Canty Nagstrom Horseshoe Map 445 tie Marsh Pt CNtdtobue Cove ox x o° 1" _2000, 5V`., Harbor o g 9 51te(Access via subject , property) 9 x OXES ONLY Oy S:�i9x9 d. k Lee RD ` Wu teweta s`t GEDRGF D �� P0i � } g Old CDYO FANNWG RD YC .' f Latomr Pors LJ 4 g NEW SUFFOLK 15 Nassau Pt i LITTLE PECONIC BAY 037 f x .tt :..dam. ... .. t :�3 and of Trustees Applicat: AFFIDAVIT Ruth Metcalf, Trustee, John M. Miller Lifetime QTIP Trust BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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. N/A Signature of Property Owner Signature of Property Owner Ruth Metcalf,Trustee,John M. Miller Lifetime QTIP Trust SWORN TO BEFORE ME THIS ° DAY OF 20 2(e Notary Public IAN NICIiOLSON NOTARY PUBLIC STATE OF NEW YORK SUFFOLK-COUNTY LIC.#01 N10014962' COMM.EXP.10/20/20 a'f' and of Trustees Applicat: AFFIDAVIT Sarah Ehrenson Miller,Trustee,John M.Miller Lifetime QTIP Trust BEING DULY SWORN __. DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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. pku (2 1 N/A Signature of Property Own //yy , 4klupu" Signature of Property Owner Sarah Ehrenson Miller,Trustee,John . il�llfe� SWORN TO BEFORE ME THIS DAY OF M&v7 `\ CATHERINE MARGARET WARD Notary Public-State of New York NO.OIWA0038041 Qualified in Suffolk County My Commission Expires Jun 3, 2029 Notary Public p and of Trustees Applicat AUTHORIZATION (Where the applicant is not the owner) I/We, Ruth Metcalf Trustee John M. Miller Lifetime QTIP Trust owners of the property identified as SCTM# 1000-_1000-118-1-1.8.4 in the town of Southold New York,hereby authorizes En-Consultants 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. N/A Property Owner's Signature Property Owner's Signature Ruth Metcalf,Trustee,John M.Miller Lifetime QTIP Trust SWORN TO BEFORE ME THIS . DAY OF P��rc 2Q9,G Notary Public IAN NICHOLSON NOTARY PUBLIC STATE OF NEW YORK SUFFOLK COUNTY LIC.#01 N1001 4962 COMM,EXP. 10/26/20 ar�' and of Trustees Applicat AUTHORIZATION (Where the applicant is not the owner) I/We, Sarah Ehrenson Miller, Trustee, John M. Miller Lifetime QTIP Trust owners of the property identified as SCTM# 1000-. 1000-118-1-18.4 in the town of Southold New York,hereby authorizes En-Consultants 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. 1,4aA&h - &A,, 11 ./A Property Owner's Signature *ie6rUidhZXruV""jOwner's Signature Sarah Ehrenson Miller,Trustee,John M SWORN TO BEFORE ME THIS I DAY OF a�� 20. ZC.� CATHERINE MARGARET WARD � Notary Public-State of New York.. NO.O1 WA0038041 Qualified in Suffolk county My Commission Expires Jun 3,2029 Notary Public APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM -The Town of Southold's Code of E` is pmbibits confl[as of intercA on the part°of Town officers and employees The purpose of this form is to provide information which can alert the town of o c ible conflicts of interest and allow it to take whatever action is necessary to avoid same. Ruth Metcalf,Trustee YOURNAME: John M.Miller Lifetime QTIP Trust (Last name,first name,jtiddle initial,unless you are applying int e"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 persomlly'(or through your,company,spouse,sibling,parent,or child)have a.relationship'with any officer or employee ofthe Town of Southold? "Relationship"includes by*blood;marriage,or busines„s'interest."Business interesf'means a busiiress, 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 56/4ofthe shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicantlagent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. df The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): E_A)the owner of greater than 3%of thc°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(wliemthe 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. OV;L-day of 111e,4 20 a--Le Signature Print Name Ruth Metcalf, Trustee Form TS 1 John M. Miller Lifetime QTIP Trust IAN NICHOLSON :.:(-)TAFFY PUBLIC STATE OF NEW YORK SUFFOLK COUNTY �, LIC.#01 NI0014962 CIOMM.EXP.10/26/20 a�- APPLICANTIAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The pumose of this form is to-provide information which can alert the town of possible conflicts of inntemg and allow it to take whatever action is necessary to avoid same. Sarah Ehrenson Miller,Trustee YOURNAME. John M.Miller Lifetime QTIP Trust (Last name,first name,.griddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee 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 through your company,spouse,sibling,parent;-or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than,5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): _aA)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 thi day o r�G 20 Signature —k Print Name Sarah Ehrenson Miller, Trustee Fonn IS 1 John M. Miller Lifetime QTIP Trust TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Henmnann, -Robert E (Last name,first name,middle 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 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 X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person_ Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater 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 pfficer;director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 4o �. f June 2026 Signature Print Name emnann Form TS 1 i NOTICE TO ADJACENT PROPERTYOVvR� - f : BOARD OF TRUSTEES TOWN OF SOUTHOLD z' In the matter of applicant: 30r John M.Miller Lifetime QTIP Trust SCTM#1000-118-1-18.4 YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a dock attached to bulkhead,consisting of a 3'x 14'hinged ramp and 6'x 20'float,secured by (2) 10"-diameter piles,as depicted on the project plan prepared by En-Consultants,dated May 28,2026; and construct a 16'x 33'swimming pool(southwest corner to be elevated up to 18"above existing grade), remove portion of existing stone patio as needed, install 6'wide paver stones,construct a 596 sf masonry pool patio,and install a pool drywell and pool-enclosure fencing,all as depicted on the survey/site plan by Kenneth M. Woychuk Land Surveying,PLLC,last dated June 4,2026. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1132 Bridge Lane,Cutchogue 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: DATE: Wed.July 15,2026 @ 5:30pm;Town Hall Meeting Rm,53095 Main Rd,Southold You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. John M.Miller Lifetime QTIP Trust PROPERTY OWNERS NAME: c/o Ruth Metcalf&Sarah Ehrenson Miller,Trustees MAILING ADDRESS: 1132 Bridge Lane PHONE #: Cutchogue,NY 11935 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road, Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: #1000-118-1-9 PO Box 561 Jeanne&Alan Cardinale,Jr. Mattituck,NY 11952 #1000-118-1-18.3Ϩ-118-2-7 439 E 51 st Street,Apt.6B Katherine Perretta New York,NY 10022 #1000-118-1-11 P.O.Box 1179 Town of Southold Southold,NY 11971 #1000-118-2-11.4 750 Abom Lane Jennifer Burrell,Jonathan Perry,Dr.Jonathan Perry Cutchogue,NY 11935 #1000-118-2-16.1 & 19 1175 Bridge Lane 1175 Bridge LLC Cutchogue,NY 11935 , 1iCt91Gt3�OVINI STATE OF NEW YORK COUNTY OF SUFFOLK Robert E.Herrmann doing business at En-Consultants 1319 North Sea Road Southampton,NY 11968 , being duly sworn, deposes and says that on the 1st day of July ,20 26 , deponent mailed a true copy of the Notice set forth in the Board of Trustees Application, directed to each of the above named persons at the addresses set opposite their respective names; that the addresses set opposite the names of said persons are the address of said persons as shown on the current assessment roll of the Town of Southold; that said Notices were mailed at the United States Post Office at Southampton , that said Notices were ailed to each of said persons by (certified)(regieoe mail. i Robert E. Herrmann Coastal Managment Specialist Sworn to �P-f re me this 1 day of ,20 26 KIM H. STEPHENS _ Notary Public-State of New York _..._ No.0nSuffokCo 5015931 Qualified in Suffolk G�ounty My Commission Ezplres August 02,20 A M is F F I A L p- Certified Mail Fee Certified Mail Fee U1 $ Lr) $ Extra Services&Fees(check box,add fee as appropriate) C3 Extra Services&Fees(check box,add lee as ap—propriate) ❑Return Receipt(hardoopy) Return Receipt(hardeopy) $ C:3 E3 Return Receipt(electronic) $ Postmark C3 ❑Return Receipt(electronic) $ t E]Certified Mail Restricted Delivery $ Here ❑E]Certified Mail Restricted Delivery $ P H osema rk re 171- FlAdult Signature Required $ P- ru rU []Adult Signature Required []Adult Signature Restricted Delivery$ U-1 F]Adult Signature Restricted Delivery$ Postage Postage C3 $ rq Total I rq Total Po C3 $ C3 $ Sent Jeanne&Alan Cardinale,Jr Ir Sent To Katherine Perretta 1:0 Nj6i PO Box 561 CO 439 E 5 1" Street,Apt. 6B I Ln Mattituck,NY 11952 ....... New York,NY 10022 17- Ad CD Lr A Mille= .111 11 M r-1 F rr 1 '01", 1 01", 0 U Z" 1 19 1- 11.11, 1, r%- Certified Mail Fee r%- Certified Mail Fee Ill $ Ln $ r3 Extra Services&Fees(check box,add fee as appropriate) Extra Services&Fees(check box,add fee as appropriate) El Return Receipt(hardeopy) $ El Return Receipt(hardeopy) $ 0 Return Receipt(electronic) $ Postmark El Return Receipt(electronic) $ Postmark C3 C3 ❑Certified Mail Restricted Delivery $ Here r- 0 Certified Mall Restricted Delivery $ Here I,-- rU R Adult Signature Required $ rU ❑Adult Signature Required to []Adult Signature Restricted Delivery$ U-1 ❑Adult Signature Restricted Delivery$ Postage E3 Postage $ C3 rq $ Total P( Total F Jennifer Burrell C3 $Sent To Town of Southold $Sent T Jonathan Perry CO ��TFii6i� PO Box 1179 .......... CO sFF66E Dr. Jonathan Perry ........... Ln ........ Southold,NY 11971 ....... 111 750 Abom Lane ........... city,st� 'CIII Cutchogue,NY 11935 a- E3 F"lo 17— M � rzIf 'A I" 131- p- Certified Mail Fee 0 Extra Services&Fees(check box,add fee as appropriate) ❑Return Receipt(hardcopy) $ E]Return Receipt(electronic) $ Postmark, C3 E]Certifled Mail Restricted Delivery $ r Here rU DAdult Signature Required $ []Adult Signature Restricted Delivery$ Postage C3 $ rilli Total P CO $ a- Sent Tc 1175 Bridge LLC cc Nj6fi 1175 Bridge Lane .......11 Ln Er Cutchogue,NY 11935 ........... NOTICE TO ADJACENT PROPERTY OWNER. BOARD OF TRUSTEES TOWN OF SOUTHOLD J In the matter of applicant: SCTM#1000-118-1-18.4 John M.Miller Lifetime QTIP Trust YOU ARE HEREBY GIVEN NOTICE: 1. That it is the intention of the undersigned to request a Permit from the Board of Trustees to: Construct a dock attached to bulkhead,consisting of a 3'x 14'hinged ramp and 6'x 20'float, secured by (2) 10"-diameter piles,as depicted on the project plan prepared by En-Consultants,dated May 28,2026; and construct a 16'x 33'swimming pool(southwest corner to be elevated up to 18"above existing grade), remove portion of existing stone patio as needed,install 6'wide paver stones,construct a 596 sf masonry pool patio,and install a pool drywell and pool-enclosure fencing,all as depicted on the survey/site plan by Kenneth M. Woychuk Land Surveying,PLLC,last dated June 4,2026. 2. That the property which is the subject of Environmental Review is located adjacent to your property and is described as follows: 1132 Bridge Lane,Cutchogue 3. That the project which is subject to Environmental Review under Chapters 96,111 and/or 275 of the Town Code is open to public comment on: "Note updated meeting location DATE: Wed.July 15,2026 @ 5:30pm;Peconic Community Center, 1170 Peconic Ln,Peconic You may contact the Trustees Office at 765-1892 or in writing. The above-referenced proposal is under review of the Board of Trustees of the Town of Southold and does not reference any other agency that might have to review same proposal. John M.Miller Lifetime QTIP Trust PROPERTY OWNERS NAME: c/o Ruth Metcalf&Sarah Ehrenson Miller,Trustees MAILING ADDRESS: 1132 Bridge Lane PHONE #: Cutchogue,NY 11935 AGENT: En-Consultants MAILING ADDRESS: 1319 North Sea Road, Southampton,NY 11968 PHONE #: 631-283-6360 Enc: Copy of sketch or plan showing proposal for your convenience. M Complete items 1,2,and 3. A. Signal f 0 Print ❑ e your name and address on the reverse X �, �/"`µ"�� A9 so that we can return the card to you. dressas N Attach this card to the back of the mailpiece, BrRecalved by(h''n ed Name G. Dat of D livery or on the front if space permits. 1. Article Addressed to: D. Is delivery address differ t from item 1? ❑Ye If YES,enter delivery a dress below: ❑No 1175;Bridge LLC 1175 Bridge Lane S. Service Type ❑Priority Mail Expresse ❑Adult Signature ❑Registered MaIITM Cutchogue,NY 11935 p Adult Signature Restricted Delivery 13 Reggistered Mall Restricted rtitfed WHO (very El Certified Mail Restricted Delivery ❑Signature Confirmation'" C1 Collect on Delivery ❑Signature Confirmation 2' 9589 0710 5270 4057 9137 09 _Slivery Restricted Delivery Restricted Delivery over � ) evicted Delivery PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt i )7 i ✓'` COMPLETE • - S SECTION DELIVERY NIA.items 1,2,and 3. A. Signature 8 Print your name and address on the reverse X 13 Agent so that we can return the card to you. o� '�`� �+ ❑Addressee 8 Attach this card to the back of the mailpiece, @;Received by(Pri ed Ame) C.Date of Delivery or on the front if space permits. ' 1. Article Addressed to: D. Is delivery address qfferent rem item 1? U Yes If YES,enter delivery addre s below: p No Jennifer'Burrell Jonathan Perry Dr. Jonathan Perry 3. Service Type 0 Priority Mail Expresso 750 Aborn Lane ❑Adult signature a Registered MauTM f]Adult Signature Restricted Delivery ❑Re istered Mail Resir., Cutchogue NY 11935 erunedMa110 DeNery e ❑Certified Mail Restricted Delivery o Signature Confirmation- 0 Collect on Delivery 0 Signature Confirmation 2 n r , n,,,„,ti rrx��r dmm o�n,lna/ahAn ❑Collect on Delivery Restricted Delivery Restricted Delivery 9589 0710 5270 4057 9136 93 1 Restricted o91ivery PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt Glenn Goldsmith, President o��SUffU(kc ,. Town[-fall Annex A. Nicholas Krupski, Vice President ;. 54375 Route 25 Eric Sepenoski d 'd P.O. Box 1 179 Liz Gillooly o 1 Southold, NY 11971 .Joseph Finora ':; �j Q� ' • p� �� .;• "['elephone(631)765-1892 ;r:;... Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD 9 #x HOARD OF TRUSTEES: TOWN OF SOUTHOLD l U. --------------------------------------------------------------- In the Matter of the Application of J u, JOHN M. MILLER LIFETIME OTIP TRUST i rc;br,l ........ COUNTY OF SUFFOLK oar�;t„ �r3t<tr _a -,_ STATE OF NEW YORK AFFIDAVIT OF POSTING DO NOT COMPLETE THIS FORM UNTIL THE POSTING HAS REMAINED INPLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DA TE— COMPLETE THIS FORM ON EIGHTH DA Y OR LATER I, Robert E. Herrmann ,residing at/dba En-Consultants 1319 North Sea Road, Southampton, NY 11968 being duly sworn, depose and say: That on the 7th day of July , 2026 , I personally posted the property known as 1132 Bridge Lane, Cutchogue; SCTM #1000-118-1-18.4 by placing the Board of Trustees official noticing poster where it can easily be seen from the street, and that I have checked to be sure the noticing poster has remained in place for a full seven days immediately preceding the date of the public hearing. Date of hearing noted thereon to be held Wcdnesday,July 15,2026. Dated: (signature) Sworn to before me this 15thday of July 2026 =,Se EPHENS TM Ntate of New York j c - 5015931 r ffolk County Notary Public _ My s August 02,209 , NUTILL Uim HtAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Peconic Community Center Auditorium, 1170 Peconic Lane, Peconic, New York, concerning this property. OWNER(S) OF RECORD: JOHN M. MILLER LIFETIME QTIP TRUST SUBJECT OF PUBLIC HEARING: For a Wetland Permit to construct a dock attached to bulkhead consisting of a 3'x14' hinged ramp to a 6'x20' floating dock secured by two 10" diameter piles situated in an "L" configuration; construct a 16'x33' swimming pool (southwest corner to be elevated up to 18" above existing grade); remove portion of existing stone patio as needed and install 6' wide paver stones; construct a 596sq.ft. masonry pool patio; and install a pool drywell and pool enclosure fencing. Located: 1132 Bridge Lane., Cutchogue. SCTM# 1000-118-1-18.4 TIME & DATE OF PUBLIC HEARING: Wednesday, July 15, 2026 — at or about 5:30P.M. If you have an interest in this project, you are invited to view the Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee Office until to the day of the hearing during normal business days between the hours of 8 a.m. and 4 p.m. BOARD OF TRUSTEES *TOWN OF SOUTHOLD * (631) 765-1892 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS l. 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 si nificant beneficial and adverse effects upon the coastal area (which includes all of Southold Town] 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# 118 - 1 _ 18.4 PROJECT NAME John M.Miller Lifetime QTIP Trust The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 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: Construct a dock attached to bulkhead,consisting of a 3'x 14'hinged ramp and 6'x 20'float,secured by(2) 10"-diameter piles,as depicted on the project plan prepared by En-Consultants,dated May 28,2026;and construct a 16'x 33'swimming pool(southwest corner to be elevated up to 18"above existing grade),remove portion of existing stone patio as needed,install 6'wide paver stones, construct a 596 sf masonry pool patio,and install a pool drywell and pool-enclosure fencing,all as depicted on the survey/site plan by Kenneth M.Woychuk Land Surveying,PLLC,last dated June 4,2026. r i Location of action: 1132 Bridge Lane,Cutchogue Site acreage: 1.12 acres Present land use: Residential,single-family dwelling 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: John M.Miller Lifetime QTIP Trust (b) Mailing address: c/o Ruth Metcalf&Sara Ehrenson Miller,Trustees 1132 Bridge Lane,Cutchogue,NY 11935 (c) Telephone number: Area Code 631-682-2595 (d) Application number, if any: 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? NYSDEC,USACE,NYSDOS 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 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 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 --SEE ATTACHED ADDENDUM-- 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 ❑ Not Applicable --SEE ATTACHED ADDENDUM-- 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 ❑ Not Applicable --SEE ATTACHED ADDENDUM-- 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. ® Yes ❑ No❑ Not Applicable --SEE ATTACHED ADDENDUM-- Attach additional sheets if necessary WORKING COAST POLICIES LWRP CONSISTENCY ASSESSMENT FORM ADDENDUM FOR JOHN M. MILLER LIFETIME QTIP TRUST 1132 BRIDGE LANE CUTCHOGUE,NY SCTM#1000-118-1-18.4 POLICIES 5.6& 9 One of the project elements is a small dock,which will be fully compliant with the construction and operation standards set forth for docks in Section 275-11(C)(2)of the Town Code. Specifically,with no dock located to the southwest,there is no established pier line for the dock to align with,but the float will be oriented parallel with the bulkhead and extend into the water waterway only 18 feet,a fraction of the 400-ft wide waterway and significantly less than the adjacent dock to the northeast,which based on aerial imagery extends roughly 45 feet seaward of the bulkhead.The dock is also positioned in the center of the property,and the float would rest in 30 to 36 inches of water depth at mean low water. Given the minimal scope of the dock, including the absence of a pile-supported catwalk in the waterway, it will have no adverse impacts on water quality,nor the quality and function of the surrounding tidal wetland ecosystem; and it will in no way interfere with navigation or impede public access or uAe of the Wunneweta Pond,- consistent with the standards for permit issuance set forth in Section 275-12 of the Town Code,and with the goals of LWRP Policies 5, 6, and 9. The other project element is a swimming pool with surrounding patio to be located immediately seaward of the existing dwelling's covered porch.The pool and patio are modestly designed and positioned well above the groundwater table within the highly elevated(EL 16)and predominantly flat area adjacent to the dwelling, in part to minimize the vertical exposure of the waterside of the pool,primarily its southwest corner,to approximately 18 inches.The pool is also set back nearly 80 feet from wetlands (50%more than the required 60-foot setback),and a drywell is proposed to contain pool backwash.The pool will thus be well protected from potential flooding and erosion risks;will have no adverse impacts on water quality; and will cause no physical loss, degradation,or functional loss of ecological components, or otherwise impair the quality or function of the surrounding tidal wetland ecosystem, consistent with the goals of LWRP Policies 5 and 6, and with the standards for permit issuance set forth in Section 275-12 of the Town Code. Policy 10. Protect Southold's water-dependent uses and promote siti'_,, cif 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 ® 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 BY4�_,���,TLECoastal Management Specialist DATE 6/4/2026 Robert E. He ann Amended on 811105 (lZm* Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION. S.CT.iN.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A 1000 118 1 18.4 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN iITs rURT Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No a.What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off (include Total Area of all Parcels located within (S.F,/Acres))1.12 Generated by a Two(2")Inch Rainfall on Site? X Elthe Scope of work for Proposed Construction) (This item will include all run-off created by site b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed Site improvements and the permanent creation of construction activity? (S.F./Acres) impervious surfaces.) 2 Does the Site Plan and Survey Show All Proposed ❑ PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location?This item shall include all proposed Grade Changes-and Construct a dock attached to bulkhead,consisting of a 3'x 14' Slopes Controlling Surface Water Flow, hinged ramp an 6'x 20'float,secured by(2) 10"- iameter piles, 3 Does the Site Plan and/or Survey describe the erosion F as depicted on the project plan prepared by En-Consultants, and sediment control practices that will be used to dated May 28,2026;and construct a 16'x 33'swimming pool control site erosion and storm water discharger.This (southwest comer to be elevated up to 18"above existing grade), Item must be maintained throughout the Entire remove portion of existing stone patio as needed,-install 6'wide Construction Period. 4 Will this Project Require an Land e to Natur or ❑ paver stones,construct a 596 sf masonry pool patio,an instal a l Y Excavation where ere is a change to a Natura pool drywell and pool-enclosure fencing,all as depicted on the Existing Grade involving more than 200 Cubic Yards survey site plan by Kenneth M. Woyc uk Land Surveying, of Material within any Parcel? PLLC,last dated June 4,2026. 5 Will this Application Require Land Disturbing Activities ❑ Encompassing an Area in Excess of Five Thousand (5,000 S.F.)Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the Site?Is this Project within the Trustees jurisdiction General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one(1)or more acres:including disturbances of less than one acre that 7Will there be Site preparation on Existing Grade Slopes Elare part of a larger common plan that will ultimately disturb one or more acres of lands; which Exceed Fifteen(15)feet of Vertical Rise to Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance? the DEC has determined that a SPDES permit is required for storm water discharges, p (SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit O Will Driveways,Parking Areas or other impervious for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X 1.The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way? submitted to the Department prior to the commencement of construction activity. 2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ❑ required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder compliance with the terms and conditions of this permit. In addition,the SWPPP shall Areal(this item will NOT hrclnde the installation of Driveway Aprons.) potential sources of pollution which may reasonably be expected to affect the quality of storm water discharges. NOTE:If Any Answer to Questions One through Nine is Answered with a Check Mark 3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.&1 Acre in area, component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit. that is knowledgeable in the principles and practices of Storm Water Management. (NOTE:A Check Mark(X)and/or Answer for each Question is Required for a Completed Application). STATE OF NEW YORK, Suffolk COUNTY OF -Suffolk ----------------------- SS That I, Robert Herrmann Na-me of individual sig nin g Nova m ent) -;-being duty sworn,deposes and says that he/she is the applicant for Permit, And that he/she is the Agent - ---------------------------- ---------------------------------------------------------------------------- (Owner,Contractor,Agent,Corporate Officer,etc. Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to make and file this application;that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed.in the manners set forth in the application filed herewith. Sworn to before me this; 4th &ay ,__June ,2026 - ------------------------ I c ------- - -------- - -- KIM H. STEPHENS atnreo pp t) FORM - 06 10 p4mary Public- wale or New T No.OIST5015931 Qualified in Suffolk County 51 My Commission Expires August 02,20_ �F� At EN-CONSULTANTS June 4,2026 JUN - 5 2026 Town of Southold Board of Trustees `• Southold lown 54375 Main Road Board of Trustees Post Office Box 1179 Southold,New York 11971 Re: John M.Miller Lifetime QTIP Trust 1132 Bridge Lane,Cutchogue SCTM#1000-118-1-18.4 Dear Board of Trustees: In regard to the above referenced property, enclosed are the following for the Board of Trustees review: 1. Four(4)Wetland Permit Applications including: a) Authorization&Disclosure Forms; b) Short Environmental Assessment Form; c) LWRP Consistency Assessment Form. 2. Project plan prepared by En-Consultants, dated May 28,2026. 3. Survey prepared by Kenneth M. Woychuk Land Surveying,PLLC, last dated June 4,2026. 4. Three(3)sets of Photographs. 5. Application fee of$1250.00. I hope this information shall allow you to process our permit request. Should any additional information be required,please do not hesitate to contact our office. Sinc ely, Robert E.Herrmann Coastal Management Specialist /khs Enc. r� 1319 North Sea Road Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com environmental consulting