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Home My WebLink AboutTR-96470 Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 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-construcfioh,,ki y bele line%silt"boom/silt curtain 1St day of construction % constructed When project complete, call for compliance inspection; BOARD OF SOUTHOLD TOWN TRUSTEES SOOUTHOLD, NEW YORK i I PERMIT NO. 9647 DATE: FEBRUARY 12, 2020 i' ISSUED TO: RICHARD & PERRI PARLINI PROPERTY ADDRESS: 4585 PEOUASH AVENUE, CUTCHOGUE SCTM# 1000-137-4-5.2 AUTHORIZATION Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on February 12, 2020, and in consideration of application fee in the sum of $250.00 paid by Richard & Perri Parlini and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit for the existing two-story dwelling (1,238.8sq.ft. footprint); on seaward side of dwelling remove existing open wood deck and steps (482.Osq.ft.) and replace with proposed 324.1sq.ft. open deck and proposed 178.4sq.ft. screened covered porch; and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling; and as depicted on the site ! plan prepared by Mark Schwartz & Associates, received on February 10, 2020 and stamped ! approved on February 12, 2020. ' 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 12th day of February, 2020 i i � t tlll�+ � TERMS AND CONDITIONS The Permittee Richard & Perri Parlini, residing at 4585 Pequash Avenue, Cutchogue, New York as part of the consideration for the issuance of the Permit does understand and prescribe to the following: 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 24 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 at a later date. 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. 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. That there will be no unreasonable interference with navigation as a result of the work - herein authorized. 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. 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. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. 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. 10. 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. Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams February 19, 2020 Michael Kimack P.O. Box 1047 Southold, NY 11971 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: RICHARD & PERRI PARLINI 4585 PEQUASH AVENUE, CUTCHOGUE SCTM# 1000-137-4-5.2 Dear Mr. Kimack: Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax (631) 765-6641 The Board of Town Trustees took the following action during its regular meeting held on Wednesday, February 12, 2020 regarding the above matter: WHEREAS, Michael Kimack on behalf of RICHARD & PERRI PARLINI 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 January 2, 2020, and WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator issued a recommendation that the proposal to construct a 178.4sq.ft. screened covered porch; and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling be found Consistent with the Local Waterfront Revitalization Program policy standards, and, WHEREAS, the LWRP Coordinator recommended that the proposed action 'is recommended as Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered the Local Waterfront Revitalization Program Policy 6.3, to the greatest extent possible through the imposition of the following Best Management Practice requirements: the issuance of a permit for the structures; and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on February 12, 2020, 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, WHEREAS, the structure 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 of the Southold Town Code, and, RESOLVED, that the Board of Trustees APPROVES the application of RICHARD & PERRI PARLINI for the existing two-story dwelling (1,238.8sq.ft. footprint); on seaward side of dwelling remove existing open wood deck and steps (482.Osq.ft.) and replace with proposed 324.1 sq.ft. open deck and proposed 178.4sq.ft. screened covered porch; and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling; and as depicted on the site plan prepared by Mark Schwartz & Associates, received on February 10, 2020 and stamped approved on February 12, 2020. Permit to construct and complete project will expire two 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, XZ' Glenn Goldsmith ident Michael J. Domino, ,.ice -'resident John M. Bredemeyer III A. Nicholas Krupski Greg Williams BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 Date/Time: Completed in field by: N4- Michael Kimack on behalf of RICHARD & PERRI PARLINI requests a Wetland Permit for the existing two-story dwelling (1,238.8sq.ft. footprint); on seaward side of dwelling remove existing open wood deck and steps (482.0sq.ft.) and replace with proposed 324.1 sq.ft. open deck and proposed 178.4sq.ft. screened covered porch; and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling. Located: 4585 Pequash Avenue, Cutchogue. SCTM# 1000-137-4-5.2 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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 Setback Waiver Required Ch. 275 Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre -Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non -Jurisdiction Surveys 5 years: Y/N ' Wetland Line by: Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: C.E.H.A. Line Present were: �/ J. Bredemeyer _,,"M. Domino G. Goldsmith ✓ N. Krupski -/G. Williams Other SITE DATA: SCTM # 1000-137-04-5.2 DESCRIPTION: AREA LOT COVERAGE: EXCAVATE: FILL: PROPERTY: 11159.1 SQ. FT. 0.256 acres - ESTIMATED AREA OF 2500 SQ. FT. - - GROUND DISTURBANCE: EXISTING HOUSE: 1238.8 SQ. FT. 11.1 % EXISTING WEST PORCH: 42.0 SQ. FT. 0.4% - EXISTING EAST DECK: 482.0 SQ. FT. [TO REMOVE] 1 CU. YD. 1 CU. YD. PROPOSED EAST DECK: 324.1 SQ. FT. 2.9% 5 CU. YD. 2 CU. YD. EUGENE g o PROPOSED SCREENED PORCH: 178.4 SQ, FT. 1.6% 3 CU. YD. 1 CU. YD. LL CREEK 101' PROPOSED OUTDOOR SHOWER: 30.2 SQ. FT. 0.3% 2 CU. YD. 1 CU. YD. / PROPOSED DRYWELLS: 6'dia., 3'deep 5 CU. YD. 2 CU. YD. u — — — — HW (2.941) — — —3 TOTAL: 1813.5 SQ. FT. 16.3% 16 CU. YD. 7 CU. YD. 0 O• - - _ _ - / DELAP. R.R. O TIE RET. MEETS & BOUNDS BY: PETER GROBEN, LAND SURVEYOR SURVEY DATE: 11/9/2019 - _---- \i \ � 1 7, I 1 111 ►U II [1 0 / DEMOLISH EXISTING 324.1 SQ.ECK I RE -CONSTRUCT NEW 324.1 SQ. FT. D CK AND 178.4 SQ. FT. SCREENED -IN PORCH HAY BALE OR SILT FENCING A // /7 gp IN SAME LOCATION LIMITS OF CLEARING TO BE NO PROPTHANOSED ROM STORM WATER MANAGEMENT DETAILS PROPOSED WORK AS � _ � � EXI G DECK INDICATED ON SITE PLAN CO )t IC'RETE / ------ _ 'TO E REMOVED L -� - N.T.S. hYlASHOUTI 1 \ NEW ROOFAREA 258SO FT / / , • ki AT 700% WATER RUNOFF: 44 CU FT /TOP 19.8' 11.7'\ PROPOSED PROVIDE B' DIA. X T DEEP DRYWELL / SOIL I / .. m :SCREENED CAPACITV'565 CU FT. 6X3 o DW ) •, • PROPOSED . . PORCH . N EXISTING GUTTER, DOWNSPOUT \ / DECK O UNDERGROUND DRAINAGE • • ITTFR -STANDARD / PROPOSED �, Ilr/fll/J� NOTrs: W / OUTDOO Tri S1' y 1). EXECUTION: �• ! / SHOWER �� A) DO NOT BEGIN INSTALLATION UNTIL SUBSTRATES HAVE BEEN PROPERLY PREPARED. 2). PREPARATION: L ( EXISTING DOWN GUTTER / A). CLEAN SURFACE THOROUGHLY PRIOR TO INSTALLATION Q • . • - B). PREPARE SURFACES USING METHODS RECOMMENDED BY THE MANUFACTURE FOR Ir `� EXISTING STY. HOUSE UNDERGROUND ACHIEVING THE BEST RESULTS FOR THE SUBSTRATE UNDER THE PROJECT CONDITIONS. DRAINAGE C). PAINT CONCEALED METAL SURFACES AND SURFACES IN CONTACT WITH DISSIMILAR METALS WITH PROTEC 1VE BACKING PAINT. ^z (. O 3 7.5' 7.0' _ 3. TNSTAUATLDN: 0A). A). PERFORM WORK IN ACCORDANCE WITH CDA HANDBOOK AND THE DRAWINGS. Lu / - TO BE PITCHED TOWARDS LEADER 1° TO 2" FOR EVERY 40' OF RUN. / 1 O 2). SHEET METAL JOIN LENGTHS WITH WATERTIGHT JOINTS. 7 0'29 5, a). COPPER / LEAD: FLASH AND SOLDER GUTTERS TO DOWNSPOUTS AND Q/ / N _ I , ^ \ B). ALUMINUM: NUMB AND CAULK WITH A BUTYL SEALANT SLIP JOINT CONNECTMAS. PLANFER�9- - - Y1) Q /7 BRI K M "T"CONNECITON WATERTIGFIT. W LK I 9' OV 3). CONNECT DOWNSPOUTS TO STORM SEWER SYSTEM AS INDICATED. SEAL DRY WELLS TO BE 10' MIN. 4). PROTECTION: EXISTING GUTTER. DOWNSPOUT J \ UNDERGROUND DRAINAGE AWAY FROM HOUSE A). PROTECT INSTALLED PRODUCTS UNTIL COMPLETION OF PROJECT. L J \ EXISTING B). 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THEREFORE, THEY ARE y;{ NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION ell 10.38 \ � C�r,•, 9 OF FENCES, ADDITIONAL STRUCTURES OR ANY OTHER IMPROVEMENT. \ �7 [ies •' r g 787 1 TYBG UNAUTHORIZED ALTERATIONS OR ADDITIONS TO THIS SURVEY ISAVIOLATION OF N, SECTION 7209 3UBDIVISON 20 OF THE NEW YORK STATE EDUCATION LAW. COPIES \ C" ��1�- 9.925t i OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR10.92 T/POA. Q f EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BEA VALID TRUE COPY. �- �/ i_ I r LAND S Y ��1�50869 10.46BOW JAN 2 2 CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM � � � t i� P.O. �®% ��'l 11961 THE SURVEY IS PREPARED, AND ON THEIR BEHALF TO THE TITLE COMPANY, GOY- \ 11.06'T�h 9w f�i1 lG { 631.849.4750 ERNMENT AGENCY AND LENDING INSTITUTION LISTED HEREON. CERTIFICATIONS \ ?� . ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS \ \ "'cs • 11.82 \PPC/, s t57 J. '- . 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COPIES II II �I 9` l , :c 9.92 '! ; / \ 1 WS INKED SEAS. OR 1 \ �___.• } TRUE COPY. I � I `'' 10 4e �; /;,; ( �� a� _ y- 8 G _ : c. 5086) 'E PERSON FOS? WHOM � ��.`, � \11.06 -:JvS:= r,; , ; ; P.O. BOX � �3��; � 3f 11961 TITLE COMPANY, GOV- 'a '\ t 831.840.4750 ON. CERTIFICATIONS UOSEQUENT 0M/VERS i ` u� •., \i� 11.62 '='j = - SCALE: 1 m2a' IP. ANY SURFACE, SUB- IND/ UE IND/ OPS77RUCTUP.ES 12.0? SCTM 1000 -137 - 04 - 05,2 Parlini Residence Write a description for your map. 416 &AM OFFICE LOCATION: Town Hall Annex 54375 State Route 25 (cor. Main Rd. & Youngs Ave.) Southold, NY 11971 MAILING ADDRESS: P.O. Box 1179 Southold, NY 11971 Telephone: 631 765-1938 Fax: 631 765-3136 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From. Mark Terry, AICP LWRP Coordinator Date. February 6, 2020 Re: LWRP Coastal Consistency Review RICHARD & PERRI PARLINI SCTM# 1000-137-4-5.2' Michael Kimack on behalf of RICHARD & PERRI PARLINI requests a Wetland Permit for the existing two- story dwelling (1,238.8sq.ft. footprint); on seaward side of dwelling remove existing open wood deck and steps (482.0sq.ft.) and replace with proposed 324.1sq.ft. open deck and proposed 178.4sq.ft. screened covered porch, and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling. Located: 4585 Pequash Avenue, Cutchogue SCTM# 1000-137-4-5.2 The proposed action is'recommended as INCONSISTENT with policy 6.3 below and the LWRP. Policy, 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 theirjurisdiction 1. Comply with Trustee regulations and recommendations as -set forth in Trustee permit conditions. According to Town records, the 324.1 sq. ft. deck proposed to be re -constructed is an unpermitted, as -built structure. No permits were found. The proposal to construct a 78.4 sq. ft. screened covered porch and 30.2 sq. ft. outdoor shower on northerly side of dwelling is recommended as CONSISTENT. Drainage for the outdoor shower should be verified. The adequacy of storm water controls and the prevention of surface runoff to the waterbody should also be verified. In the event the action is approved, a vegetated, non -turf buffer is recommended to be installed landward of the W topographical contour to further Policy 6. Native and salt tolerant vegetation is recommended. 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 • t _ ��9gUFFQt„�-fid �� GS Peter Young, Chairman H Lauren Standish, Secretary u,. Conservation Advisory Council' Town of Southold Town Hall, 53095 Main Rd. P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1889 Fax (631) 765-1823 At the meeting of the Southold -Town Conservation Advisory Council held Wed., February 5, 2020 the following recommendation was made: Moved by Caroline Burghardt, seconded by James Abbott, it was RESOLVED to SUPPORT the application of RICHARD & PERRI PARLINI to remove existing wood deck and steps; replace with proposed open deck and proposed covered, screened porch; construct outdoor shower on northerly side of existing dwelling, including a two-story dwelling. Located: 4585 Pequash Ave., Cutchogue. SCTM#137-4-5.2 Inspected by: James Abbott, Caroline Burghardt The CAC Supports the application and recommends the installation of gutters, leaders and drywells to contain the roof run-off. Vote of Council: Ayes: All Motion Carried Michael J. Domino;" :sident John M_ Bredemey�r;,:Il, Vice -President Glenn Goldsmith A Nicholas Krupski Greg Williams Town Hall Annex 54375 Route 25 P.O_ Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax (631) 765-6641 SOCITtfOLD TOWN BOARD OTRUS _ES TO: SOUTHOLD TOWN BUILDING DEPARTMENT ` JAN - 3 2020 RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS S CTM#: Property Owner Name: Date Sent to Bldg. Dept: PueLINi 1.3-2-0 The Office of the Board of Trustees is forwarding the above referenced application for - verification of the Building Department's permitting requirements stated below: YES NO —Z COMMENTS: Will the proposed project require a Building Permit? Will the proposed project require a variance determination from the Zoning Board of Appeals? Will any part of this application be considered a Demolition as described under Town Code? Michael J. Domino, President John M., Bredemeyer III, Vice -President Glenn Goldsmith A. Nicholas Krupski Greg Williams OR1 G1A1146 S Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, New York 11971 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Fiff-,at—cu.: j( This Section For Office Use Only Coastal Erosion Permit Application Wetland Permit Application Administrative Permit 4Amendment/Transfer/Extension Received Application: 1 1.2-20 Received Fee: $ 2--0,00 Completed Application: I.3eZU Incomplete: SEQRA Classification: Type I Type II Lead Agency Determination Date: Coordination: (date sent): _74_LWRP Consistency Assessment Form Sent: _ CAC Referral Sent:/.;Z-zo Date of Inspection: Z•S. Receipt of CAC Report: Technical Review: Public Hearing Held: Z, 12—M Resolution: Unlisted ).31.20 Negative Dec. JA N � 2 2020 Positive Dec. Owner(s) Legal Name of Property (as shown on Deed): f?/ el,JARD f _ SS 91 94RI � I Mailing Address: 110-45 11 ROAD ARE 45—P, , AORL�Sr /-11 L 13 %(l. Y Phone Number: Suffolk County Tax Map Number: 1000- Property 000-Property Location: 45i? 5 PXQ UASR .411E. (If necessary, provide LILCO Pole #, distance to cross streets, and location) AGENT (If applicable): lel I q -1A 2 E � � 4 WYA ele- Mailing Address: O 8 0 X `09*1 % , S0 U72V Q 90 . MY, 1/ �! I0 Phone Number: -5-116 6:!!�74 - 6801 GO 1 3 Board of Trustees Applx.cation GENERAL DATA Land Area (in square feet): Area Zoning:-- R-40 Previous use of property: _ ' . R,E, 64011- y Intended use of property: 9,691 %)4/1/V A L ONE _,eA1114 y Covenants and Restrictions on property? Yes DC No If "Yes", please provide a copy. Will this project require a Building Permit as per Town Code? )e 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 No If "Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? _Yes No r jClSyyJl%(7 ,o Does the structure (s) on property have a valid Certificate of Occupancy? _Yes No Prior permits/approvals for site improvements: Ageny Date 96 6/.zb�� 9 79 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):,Q,66OI/� aClSl,/iL�G opt/ WOW ,C/- J. ,QZv44 C,5 W1 7-1-1 PA000.SW 6,PzSN VAPAD 41169 Pde*P65.EO Sc'� i� 6x'ORc11`0 78:4 .S)rf CoNST,1Uc7 Board of Trustees Applikiaeion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose, of the proposed operations:. 46 CC;. ZZC/S;T/11�& O.R_AiV GJ C/G ��PD C 0/y2/oN O�MN dMClc 5_-_CRf4r_N 4D -%N aR 1A11 0 / r OM S -1-10,C- 77 Area of wetlands on lot: O Percent coverage of lot: Q % square feet Closest distance between nearest existing structure and upland edge of wetlands: 6S feet Closest distance between nearest proposed structure and upland edge of wetlands:-- feet Does the project involve excavation or filling? X No ,Yes If yes, how much material will be excavated? ��.5e, . cubic yards How much material will be filled? cubic yards y Depth of which material will be removed or deposited:'_ ,� feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: A.4aeM0 �, AI L�4 Hog 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): dI. Cad-Tr2UCT/1001 7714Z416Pr lW CLli1/,A—E 70.JWF_ I_1WH (�/ ME !9/S7",4A1 Q5 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part 1 - Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding, are subject to public review, and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item, please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency; attach additional pages as necessary to supplement any item. Part 1 - Project and Sponsor Information Name of Action or Project: P4 Z AF Project Location (describe, and attach a location map):. 4 ® (z4rj� AV4 cam( �cNOG Brief Description of Proposed Action: U� ®� (X o�',E/v W �P�i'9D1/E �XIST��(/G CSL z4 R4PI.� w� ��Pos/��P /� Pa f a s uc ?9OPas�P vvrpoae J"// QuU� 13d, z Sr) p N NOR IAE OF lam ,��y CG �YG I —F_. Name of Applicant or Sponsor: Telephone: 9_ 6907 Address; �+ P ®- X 10-4-7 City/PO: State: Zip Code: 1. Does the proposed action only involve the legislative adoption of a plan, local law, ordinance, NO I YES administrative rule, or regulation? If Yes, attach a narrative description of the intent of the proposed action and the environmental resources that 9-7 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: AlY.2,90C, TOCOM 3.a. Total acreage of the site of the proposed action? Q, 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 0 � 5k project sponsor? acres 4. Check all land uses that occur on, adjoining and near the proposed action. E] Urban E:1 Rural (non -agriculture) ❑ Industrial ❑ Commercial 'Residential (suburban) ❑Forest ❑Agriculture El Aquatic ❑Other(specify):� ._ ❑Parkland rage 1 of 4 U 05r - 5. is the proposed action, a. A permitted use under the zoning regulations? b. Consistent with the adopted comprehensive plan? NO YES N/A ❑ ❑ X 1 ❑ ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? _ NO , ❑ YES 7. Is the site of the proposed action located in, or does it adjoin, a state listed Critical Environmental Area? If Yes, identify: NO YES ❑ _ _ _ . _ 8. a. Will the proposed action result in a substantial increase in traffic above present levels? 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? NO YES ❑ ❑ 9. Does the proposed action meet or exceed the state energy code requirements? If the proposed action will exceed requirements, describe design features technologies: NO YES 21 E]AII10. Will the proposed action connect to an existing public/private water supply? If No, describe method for providing potable water: A11.4 NO YES 0 11. Will the proposed action connect to existing wastewater utilities? If No, describe method for providing wastewater treatment. /V/,g-j'�'j NO YES INO ❑ 12. a. Does the site contain a structure that is listed on either the State or National Register of Historic YES Places? 771 Elb. Is the proposed action located in an archeological sensitive area? ❑ 21 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 fedei al, state or local agency? b. Would the proposed action physically alter, or encroach into, any existing wetland or waterbody?j ❑ If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres: 11�� Id 14.ntify the typical habitat types that occur on, or are likely to be found on the project site. Check all that apply: Shoreline El Forest ❑Agri cultural/grassland s ❑Early mid-successional ❑ Wetland ❑ Urban bezuburban 15 Does the site of the proposed action contain any species of animal, or associated habitats, listed by the State or Federal government as threatened or endangered? NO YES ❑ 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? If Yes, a. Will storm water discharges flow to adjacent properties? NO [—JYES b. Will storm water discharges be directed to established conveyance systems (runoff and storm drains)? If Yes, briefly describe: ❑NO D<YES 'INO YES ❑ < Page 2 of 4 18 Does the proposed action include construction or other activities that result in the impoundment of water or other liquids (e.g. retention pond, waste lagoon, dam)? If Yes, explain purpose and size: �„ ____„ � _�—_�_ _. NO YES-, ❑ 19. Has the site of the proposed action or an adjoining property been the location of an active or closed solid waste management facility? NO YES impact If Yes, describe: _.._ _ - N T ❑ may 20. Has the site of the proposed action or an adjoining property been the subject of remediation (ongoing or completed) for hazardous waste? If Yes,describe: NO YES �( ❑ ❑ regulations? I AFFIRM THAT THE, INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Date. Date. W12®/ Signature: _.. � � �"�W" 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?" Page 3 of 4 No, or Moderate small to large impact impact may may occur occur 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ® ❑ regulations? 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? t E 1:14. 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 infrastructure for affect existing mass transit, biking or walkway? G. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. W i I I the proposed action impact existing: a 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, mm ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources (e.g., wetlands, j -f lU! ❑ waterbodies, groundwater, air quality, flora and fauna)? Page 3 of 4 Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part Z 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 -tern, 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. Town of Southold - Board of Trustees Name of Lead Agency Gfei)n r Print or T • Name f sponsible Officer in Lead Agency ignature of Responsible Officer in Lead Agency 2 is 1, Zo2C? Date President Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRIiVT Page 4 of 4 No, or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential -for erosion, flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3 - Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part Z 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 -tern, 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. Town of Southold - Board of Trustees Name of Lead Agency Gfei)n r Print or T • Name f sponsible Officer in Lead Agency ignature of Responsible Officer in Lead Agency 2 is 1, Zo2C? Date President Title of Responsible Officer Signature of Preparer (if different from Responsible Officer) PRIiVT Page 4 of 4 - Board of Trusteesiacati.on APP' AFEI- AVIT �APS��P 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 SOUTHOI,D AND' THE BOARD, OF TRUSTEES HARMLESS AND F AND CLAIMS ARISING UNDER OR BY VIRTUE E O FSAIDPERMIT(S), IFAMAGES GRANTED. IN COMPLETING THIS APPLICATION, TRIJSTEES, 'THEIR AGENT(S) OR REPRESENTATIVES', INCLUDING TBY HE THE CONSERVATION ADVISORY COUNCIL, TO ENTER INSPECT THE PREMISES IN CONJUNCTION WITH THIS OAPPLICATION, MY PROPERTY � O INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIAJNCE WITH ANY CONDITION OF ANY OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES H E OF THE PERMIT, DURING THE t r Property Owner ^ - Signature of Property Owner ` aICN �D FARI-W1 SWORN TO BEFORE ME THIS DAY OFcew, . 20 1 5 ANTHONY FABRIZIO SIMON Notary PUb�IC - NotaryPublic -State ofNew York NO. 0 1 516 3 5 995 5 Qualified in New York County My Commission Expires Jun 12, 2021 Board of Trustees App,;iaati.o>n AUTHORIZATION (Where the applicant is not the owner) owners of the property identified as SCTM# 1400-- - r" in the town of New York, hereby authorizes M! y'_ZL-A• KfVACL<:_� 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. Property Owner's Signature Rl c, Ii4 RD M e.11..V1 Property Owner's Signature P4A7,491 AWA7ZA I SWORN TO BEFORE ME; THIS --C) _ PAY OF Cen,l�� 20 j ji Notary Public LANTHONYFABRIZIO SIMON ic -State of NewYork01SI6359955 in New York County on Expires Jun 12, 2021 .4FPLICANT/AGENT/REPRE-SENTATIV E TRANSACTIONAL .DISCLOSURLi FOJM necessary to avoid came. YOUR -NAME: _ _ —eA& .A1 e / _ (Last name, first name, 4piddle 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 �– a Change Chan of Zone — Coastal Erosion Approval of plat _ Mooring Exemption from plat or official map y_ Planning Other — (If "Othe(', name the activity.) Do you personally (orthrough your company, spouse, sibling, parent, or child) have a relationship with any offccr or employee of the Town oh Southold? "Relationship" includes by blood, marriage, or business interest `Business interest" means a business, including a partnership, to which the town officer or employee has even a partial ownership of (or employment by) , corporation in which the town offtceroremployee 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 applicattt/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 share.,; of the corporate stock ofthe applicant (when the applicant is a corporation); 13) 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 tlais,_ o? J 1da oerv`2p Signature Print Name Form TS ]_--AEEQW/ ---------- APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL :DISCLOSIRE FORM necessary to avoid same. YOURDAME: _%__ R /AI / 91C[MAP (Last name, first name,jtiddle 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 Variance Change of Zone Approval of plat _ Exemption from plat or official map Other (If "Other', name the activity,) Building Tnistee Coastal Erosion Mooring Planning =` Do you personally (or through yow 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 ha;, 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 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 relationship between yourself (the applicant/agent/represen:ative) and the town officer or employee, Either check the appropriate line A) through D) end/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 S% of the shaves of the corporate stock of the applicant (when the applicant Js a corporation); 13) the legal or beneficial owner of any interest in a non -corporate entity (when the applicant is not tt corpora ion); G) an officer, director, partnt:r, or employee of the applicant; or D) the actual applicant. DESCRIPTION OF RELATIONSHIP Form TS I Submitte day of 1�l-CtQ3p Signature Print Name?�? p,Q APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURF, FORM necessary to avoid same. YOUR NAME: �lI f'I� C/C H` qd° (Last name, first name, rpiddle 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 Variance Change of Zone Approval of plat Exemption from plat or official map Other (If "Other', name the activity.) Building Trustee Coastal Erosion Mooring Planning Do you personally (or through your company, spouse, sibling,,parent, or child) have a relationship with any officer or employ -cc, 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,employce 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 y 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 owrier of greater than 5% of the shares of the corporate stock of the applicant (when the applicant is a` corporation); 13) the legal or beneficial owner of any interest in a,non-corporate entity (wheat 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 Z8 day o 20� Signature Print Name . L Form TS I Glenn Goldsmith, President Michael J. Domino, Vice -President John M. Bredemeyer III A. Nicholas Krupski Greg Williams G` BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of RICHARD & PERRI PARLINI COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE I, gjCj/4& 4 ezIAC/L , residing at /dba P d•909 /047 - SOUTh�dl1�. N Y // Q7/ being duly sworn, depose and say: That on the,-?/ day of jWN(JARy, 2009, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, February 12, 2020. Dated: �-I�worn to before me this IVT day ofrA. 20C'�O . Notary Public (signature) CONNIE D. BUNCH Notary Public, State of New York No. 01BU6185050- Qualified in Suffolk County Commission Expires April 14, 2t� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD In the Matter of the Application of RICHARD & PERRI PARLINI COUNTY OF SUFFOLK STATE OF NEW YORK AFFIDAVIT OF POSTING Town Hall Annex 54375 Route 25 P.O. Box 1179 Southold, NY 11971 Telephone (631) 765-1892 Fax(631)765-6641 THIS FORM IS TO BE COMPLETED AFTER POSTING REMAINS IN PLACE FOR AT LEAST SEVENDAYS PRIOR TO THE PUBLIC HEARING DATE I, gjCj/4& 4 ezIAC/L , residing at /dba P d•909 /047 - SOUTh�dl1�. N Y // Q7/ being duly sworn, depose and say: That on the,-?/ day of jWN(JARy, 2009, I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hearing. Date of hearing noted thereon to be held Wednesday, February 12, 2020. Dated: �-I�worn to before me this IVT day ofrA. 20C'�O . Notary Public (signature) CONNIE D. BUNCH Notary Public, State of New York No. 01BU6185050- Qualified in Suffolk County Commission Expires April 14, 2t� PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: 1-5 / 3-- 3 -� f1v-3-3 STATE OF NEW YORK COUNTY OF SUFFOLK residing at being duly sworn, deposes and says that on the day of , 20____, 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 there 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 that said Notices were mailed to each of said persons by CERTIFIED MA1L/RETURN RECEIPT. Sworn to before me this _ Day of , 20 Notary Public CO . `° CUTH�GPE, r j i 1=1U" f 4 M Certified Mall as CO $ $3.55 M Extra Services & Fees ElReturn Recei t (checkboa; ad, ❑ Return Receipt (elecptronic) 0 $ 0 ❑ Certiflpd Mail gestdcted Delivery $, r3 ❑Adult Signature Required ❑Adult Signature Rashicted Delivery $ - p Postage Ir $ C3 Total Posta e M 9 and eea $ sib .95 CO Sent To O $treefariCA�At� pOBo>xAfo.�"" m �. Only Cc o ��c $ Certified Mall Fee $3.55 v 0971 CO R7 Extra Services &Fees (checkbox, add fee p�pr�d02 ata) �r i El Return Receipt (hardcopy) $ . iJ' J N ! ra ❑ Return Receipt (electronic) $ Post i 17f1 7i� a t 0 ❑ Certified Mali Restricted Delivery $ +C li .� 0 ❑Adult Signature Required $ []Adult Signature Restricted Delivery$ P�� b 0 Postage 1--3 Total Postage andees 731 M $ 106.95 �S 43 Sent To ' A' r -q ___1�a'4N--Y1 fa',4 3 $treetandA t o. r x Crt} Slate, 7(p+4°D /V'I/- M. P. im CERTIFIEDo. ECEIPT cO .. , r%- �o NOMMIROM. 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PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS Name: Address: "I cVAX-1 '" O'VMIZG 47 H®M10NZ;yY786 //0 -3-.32 C7X//- /!t�•�tJPTON ,yQFcx e'V&r rRusT STATE OF NEW YORK COUNTY OF SUFFOLK 9s M/pW00,0 !l9�S� C UT' E OG 1/'6/ /V,>' .S',765 5-7-1a roe cuT��o 'z/ �v•y 4 6?3- PAVV4-71/ A,/e C.v TOlao&ve, N- y // 93s - H/.tf A..0/.N,4 .;e _ iesiciing at //9T / being duly sworn, deposes and says that on the 9P7- day 0f _ 09442MY , 20Q, 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 there 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 SQrITHOLD , that said Notices were mailed to each of said persons by CERTIFIED MAIL/RETURN RECEIPT. Sworn to before me this ) d 44, Day of F.tbr I t rV 20c).t) Notary Public CONNIE D. BUNCH Notary Public, State of New York No.olBU6185050 (Qualified in Suffolk County commission Expires April 14, 2 Qi4D NUTILL CSF HtAKING NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property. OWNER(S) OF RECORD: RICHARD &PERI PARLINI SUBJECT OF PUBLIC HEARING: For a Wetland Permit for the existing two-story dwelling (1,238.8sq.ft. footprint); on seaward side of dwelling remove existing open wood deck and steps (482.Osq.ft.) and replace with proposed 324.1 sq.ft. open deck and proposed 178.4sq.ft. screened covered porch; and construct a proposed 30.2sq.ft. outdoor shower on northerly side of dwelling. Located: 4585 Pequash Avenue, Cutchogue. sCTIVI## 1000-137-4-5.2 TIME & DATE OF PUBLIC HEARING: Wednesday, February 12, 2020 — 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 for inspection prior 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 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# z 3 % The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board ❑ Building Dept. ❑ Board of Trustees 0 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: o M- a 000010 R4C& 9 JTZ S 482, D R4R44 C,- W1 P Pas -'0v OPEN O& CX 1524. 1 -7 U CT Location of action: 4!�5 Q UASV AVO CUMi��%. Site acreage: o, Present land use: R4VAJ,QV rZAL ONE AA/ ,14 Y Present zoning classification: R— _4 Q 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: !V W)FAXAMAN r � (b) Mailing address: -45- :Z/ ROAa ,LX ?7: ,�5--R (c) Telephone number: Area Code ( } (d) Application number, if any: 17 Will the action be directly undertaken, require funding, or approval by a state or federal agency? Yes ❑ No X 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 n No n 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 ❑ NoX Not Applicable .96acy Z ZVOr- AIM4 W- SLS BR0N7-C7- 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 awl RF CP4 r'F/) Ix LIC1-Gr- Z & ®wEVAI& 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 S through 16 for evaluation criteria Q Yes ❑ No-12"'�N" Not AutDlicable 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 1-1ro No 1u Not A plicable 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 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 JK Not Applicable POUCY I NOrtl&SZ, ZO 7VI-F MOZEcT Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVW Section III — Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No IXI Not Applicable POUCy ig Ivor 4M. Ta 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. ❑ YeF-1 No ® Not .applicable Attach additional sheets if necessary WORDING COAST POLICIES Policy 10. Protect Southold's water -dependent uses and promote siting of new water -dependent uses in suitable locations. See LWRP Section III — Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No 0 Not A 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 X Not 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 F] No J/`J 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 ,ill Not Applicable PREPARED BY_.____R A .1C//LACe TITLE _A( 9 7' DATEI&4�7