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HomeMy WebLinkAboutTR-9535A i �SUFF01 Michael J. Domino, President opo �o� Town Hall Annex John M. Bredemeyer, III, Vice-President '� y1 54375 Route 25 Glenn Goldsmith r N P.O. Box 1179 A Nicholas Krupski �y` Southold, NY 11971 Greg Williams ��1 , �ta°fr Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1St day of construction 1/2 constructed �i When project complete, call for compliance inspection; Michael J.Domino,President �'OF S�Ujy Town Hall Annex John M.Bredemeyer III,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith, 1 [ Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams ; Fax(631) 765-6641 ao BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9535A Date of Receipt of Application: August 5, 2019 Applicant: Robert & Patricia Elliott SCTM#: 1000-110-7-11.1 Project Location: 275 West Road, Cutchogue -Date of Resolution/Issuance: September 18, 2019 Date of Expiration: September 18, 2021 Reviewed by: A. Nicholas Krupski, Trustee Project Description: Install approximately 60' of 6' high privacy fence at east property line extending from existing fence toward the bluff. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by David Bruce Mann, Architect received on August 5, 2019 and stamped approved on September 18, 2019. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees GENERAL NOIES Site Data I PLL Irklt 91tLL W_10 11 IAK Pa[£,IWD RniRAN+£ hLtMiY.R[f[ROQS 51N9A�D5,T hC r¢e M SIA"BIAr¢m cmL n¢PaWAna coon.mt N'"Iil 11MANAS.IIIA+" pronerty Address ".1 notta¢WmM ua M ail%w TNA as w wruwts Am mOm T Ui0 M-.I AY Cn-Ta um NAW AwRwNs ix AW°NNMf Aix M Loc.ulaR°Pwtt ALL aaRma mecoo[s ua x N ulY DrNm vo+o AJrLmrat[s IA nmro[s a ` /( `�.� / \ AaruNs xAMva.uASNCIxN ora ut �' 275 West Road,CuLehogue,Town of Pmtc1 i �°¢mupwxa sx u¢WI+TRACIW s m[w au aD r, _ /- '\N• atncA¢s a PraRA,a AN NE 01"Tlmn a A 14&Wul+ t'VI,Q-J / Southold,Suffolk County,New York 11935 uL aauaD P TS,AWD PA•..Rs a _.'_'S MV rax E 001TI / / \A ,\t— x M ca+IRAcw you e[Lq,T¢i arnn M sWn a YArx S C Tax No 1000-110-07-11.1 I M C sT,D rR SHALL vRaN 1-is A KDAM.1 MABIIIY ItPP ,A pAWa WSLWAai">ID➢IS AS I¢Sat BT INC it% r uWatmwrY ua/W o-M AAD sou a Pasvaruat rm WrJzma Y DFPARNCN wo�APRNAoNo fm Aj P9�oxmrcMADta°f1zi[s m �y i' G h tN°51Psy /- ° Lot Area s D¢wmAcrR w°+ucomurxW a M A IK s+uL APar Am tt�S�` - Cl.� 8fi•0 t 6 °XDs p SF d`tcstdenc" / d S\\ I\ trh 0 400 ACRES =20,925 SF _x 1oR III— T o-wtOYGs"SPICImNS ua srYwrs V f_ ��n,SON ibv cl E.osb�\(Cn 19`t \n to rjs y e it C,o,Aca sou As"N,yT AAD M(W ruwn stn u¢ 5��+Qv /' be arAu' sola d A taY�` bcdcpO - y nrsmc srt s+nnas M crm+n:1W stw as Nm WxsY Nt 1 nb Y O =>rz� .av"Mas K'A"+Da w .6 a raa W / 4 O10 tsn4�YCL16y P <� ncc � � jos h `\ \ r� ExistingGa1 Story Frame Ilovse r N A arar+nal oR asrwna PPLFCI A.nLrNsws AAo / / "edxe 4 w do \ dcyw° ty'+ and Garage Coverage = 1,342 SF Wlolxx+s saYN A"[APaAavw=es at aY rmaN uusl nx Am \ rv° sed toll \ �i Existing 2 Story(louse am 1mx wsar.cW m. W-i:a+-M sou IR:rzAar¢ ln° 4A,o n� � Psts ac l. -� \ g Y Acnu rwmm MlA a mr,M,wv urA1.xe.N Is.sits, e / cam'c old ( Coverage = 1,150 SF CO EUS vWU.c.KAs,'Ewam Al W D¢DW To.qW u+D AOQ+XEU I\\ a F,os It &I a1LLS Ki IrUen1,IN.9T.. .1 I.—I Fa SOVe en j = 52 1 `- Existing Lot Coverage 2500 SF PR-c°mAlcrmx a ua=AR-i D¢YAxx sww a WRUNo As vs1Y a4P i t7 � cctbv ° o,Iev g g r My raa[".Tut W�¢°mwtes Y,., rico y10Dov a nvo sto 9 cott'+S° - `cotrdt'L' IooC qty 9 M C9111F1C,R 5ND I Uy at-R 0YN aUi(AAD 91w f90YM i = w mu[Nvas aorRLo rn+oM:YULs tPtlnaAxr.rAremru,ne) \ ,ri nsC9 a44vOvs oty 4coPp5eebeavooiri '/- \ 2tAd Sa deck 7j \ `• 119% li+om+sm n'+[w''N' »�iouoi'ucu A a ire.w rer,Aw 5 N Yt ° ea'ry ova SF d'sC e / ;n 40 S ` ".o QECK� Z .s nntsArorcpestoSO-ss \ oiV11 1— ° wis' /' Preciously approved It NE Imo IIA oW1xYLctx.surrD ao'AAI rl rmAeu_ tom°a AetotYL -- "ty as ``-' 2)0 \ proposed 1 Story Frame ALL Otxm Max.11MM a aaa¢D-o couPas NE We \ ev,sunS a /. p{c`n°vca Y J Y C '` \ Ilovse and Garage Addition )�(` 1 Coverage = 1,927 5 SF 12 MC CnaIR;C a1Pn PROnCI Na T PAvEA Ct rm M 9i[ an um AOAAxa+a PRoPmra,Buaoxa,n.:TAr�PAWMcurz smnuxz h° / �' aP4to a 1 story E�.cU S�OR -toy° suras_n w.oslx wz u-+A s Jrm mxoWawrs ArnW IN[ _ ose 2 O g Att+a aaRAlcArs Lamm M aeAanc- txt ewtRulm s+Nt / rvo4 vinaow w ah K Ctn Ay p PRMaF w t¢aSSARY rz 0I!ARY 1,A S.a.a RALS 8MItI S, 'q bay\ -' 5 � /� � � M ID ADE.at PRoax1 ALL Aa P—W .'S.Aro M-NC �� �S� ce°T� `r 22 'LI y approved m°A Pm9nt Rum r r¢cIs;AP-,i[uN+MT PRorzctla Arm A A stoop 1'i 32''p• � Faost'U /-/ \ Total Proposed Lot Coverage = 2,585 5 SF Aarss o avwic s¢�yA�Ienm siuL a1 ffia E \' cv 5 0 2 / rm At"vuaNAw oR DwN¢(¢strias rrrol IWwrwaao Ams toIooC°` r 28 8087. M s¢rW M mnAi¢x a M",:r:r a\ \ �` 5� / `":n Y O'Ct�A�O pOF. ;c' bo°h s� r 10 , ,n °C opt 5 Zia = 12 39. A t EAtS SNALI a N[FY aJ[RY J?aSsid NTD UNWSMICTCD Ar I11'SL c.0 AAT Awem swu K to¢ to A Pan a ' cD S�' `� y5 breksw /- \ precious) approved /' t 5 \ m 11 J N s\ y ve Is 0.—AFT SMAC a"ro- r Lf oR ataco I:1 "sty 6n , •o /' Proposed Coverage of Is RCmaa9W+�Ato oils£A-r 11.uTeu ru�w.c ire>�rNIIpi++c �.,1,e\ /'/// 27 2 Yr°v'Invcd story � 225 � Y, 2 story frame addition ItI u K ao.rct M sa s K LRT OASI AN Aa \ \Ctn.>s'"` - 92 _ 2q° a4P cat n /' Y+rtA Axo runs sro¢O W AA:P I Y r 30t,AN ALL A— \` 9 0 \ / / �, taros ie 550 1y, k8' Cacc oC 3 5 /- to existing 2 story frame ISM PP�OIU[I:1 "i) + cmJlAi¢`siIIvuiuAAAtt m 2 �' .rAWv// ' 4 aStaT' N! 20gl vesbaY /' house = 375 Sf r�AQ QUR U w MAi 9+Mt DIM W W A BROOM SA71 � \ o�snn6`// � r ,.�.( c Cnv "o �C ovev) •SF aaa no•• eY � c�ntc v've /- IA ALL[tm o rN AR¢AaSV LL a MATED,GFAALD, eke Qatag sty sul°4 d°\ IA°Ra1m w Pamrp W—I 1E AN w.—Ws / _�� V 4 262 vtevto.ca bock I chs co-' v�tn` / TotaPrevl usly approved RmolWnm+ms o / Total Proposed Lot Coverage =2,9805 SF IBic.,��uiai¢ac°oimA1-m DrL�I¢�*+c oAYrnAYao u cnnJv+,�v+csM \ 1/� nn4 land ZT2 4vo4°Ita've cn�loc 2�%9 etbI Jl /`/ = IA9. m alae LwiswL nevi saL a mwanr asraPro RLPARm �p c uo/a RLPLAac to M—:¢1AWW.a M AltOIUT Arm \ \ nnact� s�yvnn can \y �x st�C oNaa Ar xo Ami+au coir ro,K oA•¢R cs ))) ,a o uxuss omS a mivoia m APrraRct wD ARoarzcrs r t JaYc` CaSLliANi£WQINA,C"U"c t VNUACIUR[I ANa 1DSO aFR[RWi+DK£9W1 NAW NC R�I.tl-W ra TNC DSCOWRi / PaaNa,N"A"Ll R[YOYA, ' 'IL U W°W9NC U PERS@+S 10 /- mIS 1,U5 Winlns N NIY rOVY Ai M PROLCI 91C IM MnLO[£ sn n t(patio ID Asa" A�sW PRtdlCl£Pnm¢rnAutm / Ba¢NYL(PW)am PNN!CFAIANT_DR ANY OMR(DAC AADs1NAz5 DR susA AI[ a oo 0 A\T NASA 0,SE a Ixcaxlmm at scrim,tv W IIP al suAL 'Aa KNI Ae¢a+mT ua REAMr M wan-oanllas AN tn[umertcT m¢nu�v+vro+rw uuwtii vrlTMx;;mIlmCU 0AU1gtx�5 wait�M R[uas�pu"air¢aw-—i"crca_TeAM sett Almy y I IAL Lac.orAte+c NPARMIN,NCNP ut—soon tD Nttalm[ I—a Att msAac uoDAanNRa utAn¢z Arm NaarmL \ PRDrtclax r A SAYE s Axa tts It,sx PROaNFCs 4� /- iI Ms[m stAi As ARt I o'RRAR EA eRaax"a M '\ ARMrzCf Aro sou ray a Lm rw crNm aAox wprctz a Oma/. \ /' vRUaALS,CR P[RimNS M➢rO-W fi55&C(rICwY APPROWO BY M 4�^ ARnartcr IT Is+\aAt°+a M uv rca AAT P[Rsa wn[s r� ,/ AUG AMR LAAI'o`R1 ra I+rL�wrA'"TK oT c c­T'S ttiNcnsm-N9a aullur°'t""A0� �ketbnct 2019 last cotu¢Yls Aar Mtro¢D sr ISM STATES ctv»xan uK \ t\ ILS` 5� oCskone n44hcab) /' p1 Za gage .AvAt°t' Southold Town Road df rostees APPROVED BY \ \ BOARD OF TRUSTEES \ etTOWN,.OF SOUTHOLD �y°�.A �lj�sk t � "OW � \ ,�,� •Q 1�1 R�� �O� DATE burr I 5SLED FOR ZONING REVIEW 07/2?/201. number Issued for date l\ 7 PRINT RECORD David Bruce Mann,Architect 122Fd(255th Succi New YDll,NY1003 Tel(212)6LM6ilb Fax(2I2)61aL913 EUJOTT RESIDENCE Sale PROPOSED SITE PLAN NOTES INFORMATION FOR THIS PLOT PLAN WAS TAKEN FROM A SURVEY PREPARED BY CU275INO�ROAD AS NOIEC NATHAN TART CORWIN III LAND SURVEYOR JAMFSPORT NEW YORK DATED DECEMBER Scale 1" = 30' 22 1998 AND CERTIFIED TO FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK, NORTH NORTH FORK BANK,ROBERTJ•TAPP,AND NICIIOLAS RT 11 1Y sh- PROPOSED FENCE SPF-1 C. 000FQ(K Michael J. Domino, Presid DEQ COG Town Hall Annex John M. Bredemeyer III,Vice-Presiaent �� y� 543,175 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski 0 Southold,NY 11971 ` Greg Williams Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD v Date/Time: � d 7/1 Completed in field by: ��✓ /`✓'PS� Douglas McGahan on behalf of ROBERT & PATRICIA ELLIOTT requests an Administrative Permit to install approximately 60' of 6' high privacy fence at east property line extending from existing fence toward the bluff. Located: 275 West Road, Cutchogue. SCTM#: 1000-110-7-11.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=q Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency. Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: rc fw_A o r &w Nit- e4vi ove K fl/t/R-7 Cjf I�r��� �✓� _�iuv4vte Z 77c,✓. I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith �N. Krupski G. Williams Other \GENERAL NOTES Site Data\ \ 1. ALL WORK SHALL CONFORM TO ALL LAWS, RULES, AND REGULATIONS, INCLUDING REFERENCES STANDARDS, OF THE NEW YORK STATE BUILDING CODE, FIRE PREVENTION CODE, FIRE DEPARTMENT REGULATIONS, UTILITY Property Address COMPANY REQUIREMENTS, AND THE BEST TRADE PRACTICES. ALL MATERIALS \ AND EQUIPMENT USED IN THE PROJECT SHALL CONFORM TO, AND HAVE APPROVALS IN ACCORDANCE WITH THE LOCAL MUNICIPALITY, ALL REFERENCE Q1 SUBCODES, AND WITH ANY OTHER PUBLIC AUTHORITIES OR AGENCIES OR 2U\ • / \ O 275 West Road, Cutchogue, Town Of AGENCIES HAVING JURISDICTION OVER THE PROJECT. -� / \ O Southold, Suffolk County, New York. 11935 2. BEFORE COMMENCING WORK, THE CONTRACTOR SHALL FILE ALL REQUIRED CERTIFICATES OF INSURANCE WITH THE DEPARTMENT OF BUILDINGS, OBTAIN Ln ALL REQUIRED PERMITS, AND PAY ALL FEES REQUIRED BY GOVERNING NEW ''/ v� \ S.C. Tax No. 1000-110-07-11.1 YORK AGENCIES. 3. THE CONTRACTOR SHALL BE LICENSED WITHIN THE COUNTY OF WORK. v� \ 4. THE CONTRACTOR SHALL PROVIDE WORKMEN'S COMPENSATION, LIABILITY, Q. AND PROPERTY DAMAGE INSURANCES TO LIMITS AS REQUIRED BY THE LOCAL MUNICIPALITY AND /OR OWNER, AND SHALL BE RESPONSIBLE FOR OBTAINING AND PAYING FOR ANY AND ALL PERMITS REQUIRED BY THE LOCAL BUILDING Svo� G DEPARTMENT AND ARRANGING FOR ALL REQUIRED NOTIFICATIONS, TESTINGS, I�v• s1 11 �1V0 e / y \ Lot Area 5.SPTHE CONTRACTOR UPON ECTIONS, AND LCOMPLETION OF THE WORK, SHALL APPLY AND �� tiS. � � ON�11 exl�b ST �A�e ide�'ce " 0.480 ACRES = 20,925 SF ARRANGE FOR DEPARTMENT OF BUILDINGS INSPECTIONS AND SIGN-OFFS - lON 0 4 G el X1Sb�' e0 1 20 I�TeS \ REQUIRED. Q� f_ �� + NI s �t1Ce� ' pOC�e � n 11�11� be&V00 / y+ WN 6. THE CONTRACTOR SHALL VISIT THE SITE AND BECOME FAMILIAR WITH THE �' G 1C " \ Q EXISTING SITE CONDITIONS. THE CONTRACTOR SHALL CHECK AND VERIFY ALL EXISTING CONDITIONS AND DIMENSIONS IN THE FIELD PRIOR TO COMMENCING �TppOsea ecce Xis •e>> \ , Existing 1 Story Frame House - WORK, AND SHALL REPORT ANY DISCREPANCIES BETWEEN DRAWINGS AND FIELD /� ���� uppl pden / ' dTy� \ and Garage Coverage - 1,342 SF CONDITIONS TO THE ARCHITECT. 1ptS ANO �' ` \ 7. IN A RENOVATION OR RESTORATION PROJECT, ALL DIMENSIONS AND �" Oxed (S1O ALOIGNTIONS WHH EXIOSTWINGARE CONDPTIONSIMAITHEE AS ALL NEW CONTRACTOR SORK HALLMUST DE DETERMINE ALIGN \ '�� O pSet`j Bey St StO�Y Ck �� \ Existing 2 Story House ACTUAL FINISHED DETAILS OF CONSTRUCTION RELATING TO HEIGHTS, SIZES, \ �Ce / C�� i 0&a \ \ Coverage - 1,158 SF ETC. BASED ON FIELD MEASUREMENTS, ALL IN ORDER TO JOIN AND ALIGN NEW �Y+1S f ems/ NO \ ` 60 TO EXISTING WORK. \ QeCj C 8. MINOR DETAILS NOT USUALLY SHOWN OR SPECIFIED, BUT NECESSARY FOR \ NOUs�y wov StoTY 1152 e / ��' Ce>>2s Ce pve� o \ 00 Existing Lot Coverage = 2500 SF PROPER CONSTRUCTION OF ANY PART OF THE WORK SHALL BE INCLUDED AS IF THEY WERE INDICATED ON THE DRAWINGS. i r� 2►Te`� �Te d 00 Cokv% e��T'(� To°f O \ O 9. THE CONTRACTOR SHALL LAY OUT HIS OWN WORK, AND SHALL PROVIDE Tpxed OSe oo O�7 ALL DIMENSIONS REQUIRED FOR OTHER TRADES (PLUMBING, ELECTRICAL, ETC.) \' � S1 wov �pTy 1�T°� ee VedT , / �` sa deck �T \ � 10. PLUMBING AND ELECTRICAL WORK SHALL BE PERFORMED BY PERSONS \ t9 ex�pU y 2pd S S�+ �ZT e i �O 5 AN \ LICENSED IN THEIR TRADES, WHO SHALL ARRANGE FOR AND OBTAIN �T OSed Oxe ?►T2Lg / O \ Z INSPECTIONS AND REQUIRED SIGN-OFFS. \ pf V'co'�210, d�UO'� `�� e Wl ' /� / , $g \ Previously approved REQUIRED CID CTONTRACTOR PERFORM SHALL LALL OFD AL CUTTORK ING, PATCHING, AND REPAIRING AS THE DRAWINGS, AND \ fT 'e Stogy'fT / / Sly `-A 2� ` \ proposed 1 Story Frame ALL OTHER WORK THAT MAY BE REQUIRED TO COMPLETE THE JOB. jS� 1 �Ta¢�''e �/ � � I'TeU �-1� C 1'" \ \ House and Garage Addition 12. THE CONTRACTOR SHALL PROTECT AND BE RESPONSIBLE FOR THE SITE eX e fid ' / i TOxed OTY �rXTst• O�l °� ` Coverage = 1 427.5 SF AND ADJOINING PROPERTIES, BUILDING STRUCTURES, PAVEMENTS, SIDEWALKS, >>O�S i �17� Sed1 St v e11 cL O10 fop \ g STREETS, CURBS, LANDSCAPING, UTILITIES, AND IMPROVEMENTS WITHIN THE i T91) w to Cl 1 AREA OF OPERATIONS UNDER THE CONTRACT. THE CONTRACTOR SHALL / p �d0 `P. f1'(v• Q$ \ PROVIDE ALL NECESSARY TEMPORARY CLOSURES, GUARD RAILS, BARRICADES, !`Z u�yr 1SC ETC., TO ADEQUATELY PROTECT ALL WORKMEN, OCCUPANTS, AND THE PUBLIC \ 2s� �2lCe eX O ' 22• , ^�� ^�� t• \ Previously approved FROM POSSIBLE INJURY. IF NECESSARY, TEMPORARY PROTECTION AND A y c- /� i Te'P 'St p 5�5 3.2 3 0 I �,x�s / " \ Y PP CHAIN LINK FENCE SHALL BE CONSTRUCTED TO PREVENT UNAUTHORIZED \\ \ ^`s 39 �7 �� r- wsov ly �eT �+ O d�`NeU 60 2 /" ' \ Total Proposed Lot Coverage = 2,585.5 SF ACCESS TO THE PROJECT SITE. THE CONTRACTOR SHALL BE RESPONSIBLE ) O FOR ANY VANDALISM OR DAMAGE RESULTING FROM UNAUTHORIZED ACCESS TOTHE 7� \ 5�0� G1��t' T°pl SAO°p `n 12.3% 13. AITE LL EXXIIRSTHE SHALLRBEION KEPTFTHE READILLY PROJECT. CCESSIBLE AND UNOBSTRUCTED AT w0\ \ Q° 2� c� COXT �Gv c� b Ck O \ TOo, Ove00'9 / o ALL TIMES. y \ \ C9 LU CFC cv 6' 'o AL p \ 14. ALL PIPING AND WIRING SHALL BE REMOVED TO A POINT OF /�" . �j �T�.�' 6 r �• ` Previously approved CONCEALMENT AND SHALL BE PROPERLY CAPPED OR PLUGGED. �� \ \ Z �/ ' �� 21 2 p�Sh ���� 5 \ ^� /" Proposed Coverage of 15. CONTRACTOR SHALL PROVIDE FOR THE LEGAL REMOVAL AND DISPOSITION �" \ / 2�• jeVT CL2. `c9. P g OF RUBBISH AND DEBRIS, AND FOR THE GENERAL CLEANING FOR THE FOR THE Acle\ / / pxet0'(y \ 7-• < 2 storyframe addition DURATION OF THE PROJECT. THE SITE SHALL BE LEFT DAILY WITH ALL \C1r• g•2 24. 2CQ�T ed2$ n pf MATERIALS AND TOOLS STORED IN AN ORDERLY FASHION, WITH ALL AREAS 2c� Q�\ / / +'� Tp,�OS �e 55 18� f�Ce 3,5 / - to existing 2 story frame BROOM SWEPT. NO ACCUMULATION OF DIRT OR DEBRIS SHALL BE PERMITTED. / / GJ• p fT� ' 1 UPON PROJECT COMPLETION, THE CONTRACTOR SHALL LEAVE THE PREMISES \ 'N�tex/ �pOc� O'n Cl xeTbay house = 375 Sf FREE AND CLEAR OF ALL RUBBISH AND DEBRIS, AND IN A BROOM SWEPT �� ' / VeT d1b ble xe CONDITION. \ ex,s'eve, / �, image���• 1y T°Of °stopp S� ad ' ney ``9• c��' ao`v ab° / 16. ALL EXPOSED FINISHED SURFACES SHALL BE TREATED, CLEANED, et / g 26 2 �Te�ovsd uTick I cr''�' .��' / Previously approved VACUUMED, OR POLISHED IN ACCORDANCE WITH MANUFACTURER'S \ \ / fl. pxe / Total Proposed Lot Coverage = 2,960.5 SF RECOMMENDATIONS. _ OPERATION17. ROFNCE THE OCONTRACTOR,AMAGE ESULTING WCLUDWGIRECTLY DAMAGEOTOI LAWNS, PLANTINGS,Y FROM E \ �'SUS / 11d 22 2 P°p°sed e Cel OCP- �' X �'T bay I / " / OR OTHER LANDSCAPE ITEMS, SHALL BE PROMPTLY RESTORED, REPAIRED, \ CXR eE00 StoT� fT e 2• �lexe - 14% AND/OR REPLACED TO THE COMPLETE SATISFACTION OF THE ARCHITECT AND 6? \ \ V Cha ;lie aT�0P G�� dpNN 1 -sv* C OWNER AT NO ADDITIONAL COST TO THE OWNER. \ teT �� Td tN1� v CA 19. UNLESS OTHERWISE PROVIDED, THE ARCHITECT AND ARCHITECT'S — \ CONSULTANTS, INCLUDING EQUIPMENT MANUFACTURERS AND THEIR / REPRESENTATIVES, SHALL HAVE NO RESPONSIBILITY FOR THE DISCOVERY, PRESENCE, HANDLING, REMOVAL, DISPOSAL OF, OR EXPOSURE OF PERSONS TO HAZARDOUS MATERIALS IN ANY FORM AT THE PROJECT SITE. THIS INCLUDES, BUT IS NOT LIMITED TO: ASBESTOS, ASBESTOS PRODUCTS, POLYCHLORINATED BIPHENYL (PCB), LEAD PAINT CONTAMINANTS, OR ANY OTHER TOXIC SUBSTANCES OR CONTAMINATE. SHOULD ANY HAZARDOUS MATERIAL BE \ / ENCOUNTERED OR SUSPECTED, THE CONTRACTOR SHALL CEASE WORK \ ' IMMEDIATELY AND REVIEW THE PROJECT CONDITIONS WITH THE ARCHITECT AND 41 / OWNER PRIOR TO PROCEEDING WITH ANY WORK OF THE CONTRACT. \ / 20. EXCAVATION FOR UTILITY PIPING OR FOUNDATIONS SHALL BE THE RESPONSIBILITY OF THE GENERAL CONTRACTOR. CONTRACTOR SHALL NOTIFY THE LOCAL BUILDING DEPARTMENT AND/OR UTILITY COMPANY TO DETERMINE LOCATIONS OF ANY EXISTING UNDERGROUND UTILITIES, AND PROVIDE PROTECTION FOR SAME DURING EXCAVATION PROCEDURES. O \ \ 21. THESE DRAWINGS AS ARTICLES OF SERVICE ARE PROPERTY OF THE ARCHITECT AND SHALL NOT BE USED FOR OTHER BUILDINGS, PROJECTS, OR PROPOSALS, OR PORTIONS THEREOF UNLESS SPECIFICALLY APPROVED BY THE ARCHITECT. IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS \ 0 ACTING UNDER THE DOCUMENT IN DIRECTION ANY WAY. THE INFORMATIONFCONCEPTS,THE IIDEASTO ALTER ST AND ESIGNCONTAINEDIN THESE DOCUMENTS ARE PROTECTED BY UNITED STATES COPYRIGHT LAWS. Ot Stp�e cl �VC l' �d�e 1pt 504 l,��Tpxed \3n5 \ / , \ , / '_7 S� lsl0 ti� O T>>nel \ e AUG 5 2019 by 4, _/1\- ISSUED FOR ZONING REVIEW 07/23/2019 \ \ number issued for date PRINT RECORD David Bruce Mann, Architect 122 East 55th Street New York,NY 10022 \ / / Tel(212)644-6416 Fax(212)644-6913 Client Date ELLIO'IT RESIDENCE Scale PROPOSED SITE PLAN NOTES: INFORMATION FOR THIS PLOT PLAN WAS TAKEN FROM A SURVEY PREPARED BY 275 WEST ROAD AS NOTED CUTCHOGUE NY 11935 Scale 1" = 30' NATHAN TAFT CORWIN III LAND SURVEYOR JAMESPORI NEW YORK DATED DECEMBER Drawn By 22 1998 AND CERTIFIED TO FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK, NORTH NORTH FORK BANK, ROBERT J. TAPP,AND NICHOLAS ELLIS. Title Sheet PROPOSED FENCE SPF-1 k 1_,, .,ry�� �.�♦♦ � , Igo• / ''�e ,� ,gyp ti tz �� i .y 1 i l it }• ,�a y� -'Y'��k^Y �� ' \br Y..•:. } .t I.e' ti "S'tt ski ' \Vi �h %,�• .r. p�`=y/ 4• 1 Y'4� "`"r 'i� 1j � •i�r �, ��.,"I`` '�7' i"� 14\ •_` 1� � I a !?f T'Y }.,�, °�-S { 'j x,12 f r � � � •, s3�,�I�e4' .r !in"+ f S iR a �`1 yy� I l Yr • , k' �v N , ' 111r '�' •Y IJ t OFFICE LOCATION: S®Ury®� MAILING ADDRESS: Town Hall Annex ® P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) c� Southold, NY 11971 ® �®� Telephone: 631765-1938 um, LOCAL LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: September 16, 2019 Re: LWRP Coastal Consistency Review for ROBERT & PATRICIA ELLIOTT SCTM# 1000-110-7-11.1 Douglas McGahan on behalf of ROBERT & PATRICIA ELLIOTT requests an Administrative Permit to install approximately 60' of 6' high privacy fence at east property line extending from existing fence toward the bluff. Located: 275 West Road, Cutchogue. SCTM#: 1000-110-7-11.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Michael J. Domino,President so yo Town Hall Annex John M.Bredemeyer III,Vice-President �O lQ 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold, New York 11971 A. Nicholas Krupski �p� Telephone(631) 765-1892 Greg Williamsl Fax(631) 765-6641 Comm BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only n 11 Fff Coastal Erosion Permit Application Q E E , Wetland Permit Application Administrative Permit AUG 5 2019 Amendment/Transfer/Extension Received Application: Received Fee: $ 100.00 Southold Torrn , Completed Application: •( B rd of rustees Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination: sent): 'LWRP Consistency Assessment Eorm Sent: �- CAC Referral Sent: ✓ Date of Inspection: q ll Receipt of CAC Report: Technical Review: Public Hearing Held: Resolution: Owner(s) Legal Name of Property (as shown on Deed): Egg D (I lel\C-(A Mailing Address: (6v Q51' 13 R-9 S^rex-el ��-N' A ' 9 - NA)i 2 S Phone Number: 5116 ST 2- - l`� Suffolk County Tax Map Number: 1000 - -110— Property 110--Property Location: (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): V'&j&LJK1 h,C-C.AA4 A-f-J Mailing Address: Y3-a (02 �_ y� Q!q 3 S Phone Number: ? q q5 Board of Trustees Apply' tion GENERAL DATA Land Area(in square feet): Area Zoning: g.qu Previous use of property: Sk 11 C Intended use of property: /-�laC�i.JC.� Covenants and Restrictions on property? Yes ✓ No If"Yes", please provide a copy. / Will this project require a Building Permit as per Town Code? Yes /--No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes r/ No If"Yes", please provide copy of decision. Will this project require 3' demolition as per Town Code or as determined by the Building Dept.? Yes 1 No Does the structure (s) on property have a valid Certificate of Occupancy? ' Yes No Prior permits/approvals for site improvements: Agency Date TV-1-53TU675 A X3( 5 T-,�- (3 �b Z3 ^ • 201 -4 No prior permits/approvals for site improvements. / Has any permit/approval ever been revoked or suspended by a governmental agency? �No Yes If yes, provide explanation: Project Description (use attachments if necessary): t Board of Trustees Appli tion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: T5 E�J Va NtAy"e' rgg - UJB 1 IE5 �ST eM6- � CUkAi Area of wetlands on lot: square feet Percent coverage of lot: 0 _% Closest distance between nearest existing structure and upland edge of wetlands: 2 3 feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? !� No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: ''"S�f Manner in which material will be removed or deposited: 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): 617.20 Appendix B Short Environmental Assessment Form Instructions for CompletinI4 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 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 I -Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a location map): ?;TS- WQ--K- Brief Description of Proposed Action: Name of Applicant or Sponsor: Telephone: I-SLLA­5 (Vt. E-Mail: d N1i aN p Address: C P 'd 3bx 6Z City/PO: ' State: Zip Code: I.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: / ❑ 3.a.Total acreage of the site of the proposed action? acres b.Total acreage to be physically disturbed? © acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial EfrResidential(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? ❑ ❑ b_Consistent with the adopted comprehensive plan? ❑ ❑ ❑ 6_ Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ Er 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: Ef ❑ 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? Er ❑ 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: 2 El 10. Will the proposed action connect to an existing public/private water supply? NO YES If No;describe method for providing potable water: ❑ IT 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: rte}' ❑ 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? F1 FT_ 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_ Iify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply_ Shoreline E]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 JES 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? NO YES If Yes, ^ ❑ a.Will storm water discharges flow to adjacent properties? ❑NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: 19. Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsornDate: 1�( 4 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning 11regulations? 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 El 1:1affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ El available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage 1:1 E]problems? 11. Will the proposed action create a hazard to environmental resources or human health? F] El 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. E] 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. 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 Appli ion AFFIDAVIT tZo��V ''Mv-t.CjA , - ULCf GTI— 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. AASignature of Property Owner ignature of Property Owner r SWORN TO BEFORE ME THIS DAY OF , 20 kA Notary Public BONNIE].©OROSKI 44otary Public,State Of New York No.01D06095328,Suffolk� u ty Term Expires July_,7,20 _ r , Board of Trustees Appl: tion AUTHORIZATION (Where the applicant is not the owner) I/We, P a fk ew-0-f f owners of the property identified as SCTM# 1000- 1�o \\A in the town of t-- L\-kV G& ,New York, hereby authorizes L' 3LK S M'LEAA-&) 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. J , Property Owner's Signature Property Owner's Signature SWORN TO BEFORE ME THIS J DAY OF J , 20 Notary PiWic ti BONNIEJ.DOROSKI Notary Public,State Of New York No. O1D06095328, Suffolk IVY Term Expires July 7,20 APPLICANT/AGENT/REPRESENTATIVE TRANSAC'T'IONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and em to ees.The PuVsc 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 (Last name,first n e,-middle initial,unless you are applyin&ifte name of —someone else�r9ther 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 _' Trustee Variance Coastal Erosion Change of Zone Mooring Approval of plat Planning Exemption from plat or official map Other (if-Others,name the activity.) Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood, rgarriage,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 5hares. Voll0 YES NO - Ifyou 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 relafionship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Dated: Signature Print Name PX&L'. Form TS 1 Y APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE,FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The puroose of this form is to provide information which can alert the town of ppssible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: IaP 1kt-�5 ' (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 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): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this of N' "r-200 Signature Print Name ()OUUM Nk fC Form TS l f I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and 'explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions, it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department.-all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# PROJECT NAME 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 El 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: CaJ P,rt,�x� G r1� Location of action: (.-ate lg- Site acreage: Present land use: Present zoning classification: 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: (c) Telephone number: Area Code (d) Application number, if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? 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 Z"N'ot 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 Gfor evaluation criteria ❑ ;Yes ❑ No I J 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 gNot 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 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 thrMot ugh 21 for evaluation criteria Yes 1:1 No 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. ❑ ❑ - - -Y-es - -No -1 Applicable - - Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No U 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 U Not Applicable Attach additional sheets if necessary - WORI(ING COAST PO" IES_ 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 �� 1:1No U Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in theTown of Southold. See LWR_P 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 allot Applicable PREPARED BY TITLE DATES