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HomeMy WebLinkAboutTR-9793A Glenn Goldsmith,President �QF SO&P Town Hall Annex 25, A.Nicholas Krupski,Vice President ,`O ��� 5 Route P..O.O. Box 11799 John M.Bredemeyer III Southold, New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams % �� Fax(631) 765-6641 o�yCOUlm-,N`- BOARD OF-TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9793A Date of Receipt of Application: December 9, 2020 Applicant:-Irene Markotsis SCTM#: 1000-78-5-12 Project Location: 6540 Main Bayview, Southold -Date of-Resolution/Issuance: January 20, 2021 Date of Expiration: January 20, 2023 Reviewed by: Michael J. Domino Project Description: Install a 40"x 54" automatic generator on a concrete pad. 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 project plan prepared by Sean O'Neill received on December 9, 2020 and stamped approved on January 20, 2021. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any,other agency. Glenn Goldsmith, President Board of Trustees Glenn Goldsmith, President �QF SO!/r,�, Town Hall Annex A.Nicholas Krupski,Vice President ,`O� - ��� 54375 Route 25 -John M. Bredemeyer IIIP.O. Box 1179 Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES " TOWN OF SOUTHOLD 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 i're-cofttruEticsr�;,>lijrbale Jine%`silt brborrt/silt curtail =st. gy o construction; Y2 constructed i K Whenlprojeet,Qomplete, ca11 f&compliance,inspection; AIN 5,9.0 41 EC E WE z '?OAD AA(-,4,_,W OA, FL DEC - 9 2o2o S59-01,00.e Flo I 160Southold——Tow-u—. . wn 00, Soqrri of Tri,ci ees c� 40 SUR VE A TO WA SUFF0 CU 100 z 0 '0/'00. AP,,PROVED BY 160,00, 'BOARD OF IRUSTEES V/o/p 8), 1 TOWN OF SOUTHOLD ®ANTE 3A*il"4 20 zo?-1 AREA 28,657 sq.ft ANY,AL TWA 770/4 OR ADDITION TO TM SURVEY IS A VIOLATION OF SECTION 7209 OF THE'NEW YORK STATE EDUCATION LAW, EXCEPT AS M SECTION 7209-SUMWSAW 2. ALL CERTFICATAM NSTEOJV A89 VALID FOR TI#S MAP AND-COfW.1 7MACOF OKY IF CHM0 M ll M SEp SEAL OF THE MMEYOR ADVITIONALLY'TO COMPLY WITH SAID LAW THE TERM ®ALTERED OY' V 12 MJSr RE LMM BY ANY AND ALL SURVEYORS UT -17MS A COPY Glenn Goldsmith, F` 'ident OSUEFUL��oG % Town Hall Annex Michael J. Domino 54375 Route 25, John M. Bredemeyer III o ='` P.O. Box 1179 A. Nicholas Krupski o Southold, NY 11971 Greg Williams y AV®t Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: a I )AV VD Completed infield by: ff Sean O'Neill on behalf of IRENE MARKOTSIS requests an Administrative Permit to install a 40"x 54" automatic generator on a concrete pad. Located: 6540 Main Bayview, Southold. SCTM#: 1000-78.- 5-12 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: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other S, 59.E V - s59•p�'Cf p„ ' 160 . IK $kn. :: C SUR VE 2¢ i el q h �► f TOW!�Aj i v Q47" �, Y 4r f - SU Z ��YC� ;RO'� a. 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) g d Southold, NY 11971 Telephone: 631 765-1938 � � � U 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: January 19, 2021 Re: LWRP Coastal Consistency Review for IRENE MARKOTSIS SCTM# 1000-78.-5-12 Sean O'Neill on behalf of IRENE MARKOTSIS requests an Administrative Permit to install a 40"x 54" automatic generator on a concrete pad. Located: 6540 Main Bayview, Southold. SCTM#: 1000-78.-5-12 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 action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. It is recommended that the generator is located to avoid floods. 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 Glenn Goldsmith,President SOF SO(/TTown Hall Annex Michael J.Domino,Vice-President ,`O� ��� 54375 Route 25 P.O.Box 1179 Y John M.Bredeme III er k Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 COU BOARD OF TOWN TRUSTEES - TOWN OF SOUTHOLD TO: SOUTHOL-D TOWN BUILDING DEPARTMENT RE: VERIFICATION OF BUILDING DEPARTMENT PERMIT REQUIREMENTS SUM //[A14KOT&&S Pri perty Owner 1�arme: _ 13 . :c ve Date'Serit`td'Bl dept: t3- M3 ; .. The Office of the Board of Trustees is forwarding the above referenced application for verification of the Building De-yN„artment{s perMittin requirements stated below: YES NO 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 consid_e_red,=a„Demolition as described under Town Code? - COMMENTS: 3 � S ature of Re iewe-r Date Glenn Goldsmith,PresidentSO Town Hall Annex SO Michael J.Domino,Vice-President 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III X11% Southold,New York 11971 A.Nicholas Krupski Telephone(631)765-1892 Greg Williams Fax(631)765-6641 coon�rl BOARD OF TOWN TRUSTEES TOWN Or SOUTHOLD This Section For Office Use Only F__ Coastal Erosion Permit Application Wetland Permit Application —NefAdministrative Permit DEC 2020 /Received mendment/1'ransfer/Extension Application: I Ztt?-ZO eceived Fee:$ 10-0.OV Received Application:. Incomplete: —SEQRA Classification: Type I_ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent); LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: —Receipt of CAC Report: Technical Review: 'Public Hearing Held: li",L24 Resolution: Owner(s)Legal Name of Property(as shown on Deed): 1,el Mailing Address:, X191-liz—ew�U/_ AX to ,5 Phone Number: /a,?Z— 7&V�_C2(P i cAcle4 Hilo lid Suffolk County Tax Map Number: 1000- z_l'n Property Location: :z L., Yzeal_ Id (If necessary,provide LILCO Pole#,distance to cross streets,and location) AGENT(If applicable): A�(/ Mailing Address: B. 0 .Y Phone Number: L Board of Trustees Application ®®GENERAL DATA Land Area(in square feet): 6 y Area Zoning: 774 �_71-IAIOIP I a "Previous use of property: t,Pa��c� Intended use of property: ✓ �l/�� Covenants and Restrictions on property? ___Yes I e 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 L I 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 9� No Does the structure(s)on property have a valid Certificate of Occupancy? 1/ Yes No Prior permits/approvals for site improvements: Agency Date _No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? To Yes If yes,provide explanation: Project Description(use attachments if necessary): o u otoJ9 -ern Gf Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: / as square feet Percent coverage of lot:_'70 _% Closest distance between nearest existing structure and upland edge of wetlands: 26_feet Closest distance between nearest proposed structure and upland edge of wetlands:4fQ_feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? 1VV A4 cubic yards How much material will be filled.? IVOIV 4iC cubic yards Depth of which material will be removed or deposited: 0 feet Proposed slope throughout the area of operations: 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): 61220 Appendix B Sliort Environmental Assessment Form Instructidits,fbf Corng[ptin Part l-Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 1 based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part l-Project and Sponsor Information Name of Action or Project: Project Location(describe,and attach a loc n"tiiap): Al 30W /��,✓ Brief Description of Propo ed Action: Name of Applicant or Sponsor; �y Telephone Address: City/PO: State: Zip Code: r/ 1 115F-71 I Does the proposed action only involve the legislative adoption of a plan,local law,o dinance, NO YES administrative rule,or regulation? F]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 pertiit 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 0 Rural(non-agriculture) ❑Industrial ❑Commercial (residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 I 5. Is the proposed action, NO YES NIA 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? 1 ❑ 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: WT n 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES b.Are public transportation smice(s)available at or near the site of the proposed action? Lni ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑ 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: M-7 I 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method,fur providing wastewater treatment: I�i ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? M F]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? ( `j b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? uuPul 0 If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: LSI (—I 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all thatapply: ❑Shoreline ❑Forest [IAgricultural/grasslands ❑Early mid-successional ❑Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? 0 16.Is the project site located in the 100 year flood plain? NU 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 nYES \❑ b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO F]YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: ❑ 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: Ek ❑ 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: EZ EJ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE I � Applicant/sponsor name: �f� Date: Signature:, Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur ; 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? 10 1 (�I 3. Will the proposed action impair the character or quality of the existing community? ( L❑_ 4. Will the proposed action have an impact on the environmental characteristics that caused the � a establishment of a Critical Environmental Area(CEA)7 5. Will the proposed action result in an adverse change in the existing level of traffic or ® D affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate (V reasonably available energy conservation or renewable energy opportunities? t t 7. Will the proposed action impact existing: a.public/private water supplies? !�f b.public I private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, 1�1 architectural or aesthetic resources? �[ 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, [ [� waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? 11. Wil I the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur ,or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid orreduce 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. N EJCheck 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. 0 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 Application AFFIDAVIT 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 WORD 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. Sign e of Propert caner ignat e of Property Owner SWORN TO BEFORE ME THIS DAY OF IDO-d/-�bt, ,20 � f 4�n�� No Public EpUBLIC, L1ARD0 OF NEW YORK BL6337529 lk CoufitY Board of Trustees Application AUTHORIZATION (Where the applicant is not the owner) I/We, /� _ �/' �/7�/r , owners of the property identified as SCTM# 1000- �0 — s ' ® in the town of New York,hereby authorizes 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. r roperty O er's ignature Property Owner's Signature SWORN TO BEFORE ME THIS , ti/ DAY OF ��%�`" .20 1kot ry I lubfi-c FRANK J BLANGIARDO NOTARY PUBLIC,STATE OF NEW YORK Registration No,02BL6337529 Qualified in 5uftl C t� a �,� my Commission Expires; APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of thald's"Code of Ethics Prohibit."conflicts of interest e pan or-town itffteers and e tloees.The u s f this form is to provide inforination w ich can Wort t 'town ofsslblesomtlictsi of interest and allow it to take whatevernctio •s nese ml^i„tti avoid'snme. fu�`!/'C OJ��e�% . YOURNAME: 1 (Last name,fast name,Viddle 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 Etosion 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 appiiept (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 RELATIONS14 Submitted this _ day of 20010 Sigria*cr , Print Name Vq Wz- qr Form TS I ®,%PF3� Pf S l3lla�d��®� No.023L133375-20 E'if3•02/23/2'f 00 "04,4 GC�'r` OFNe 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, listingboth supporting and non- suyyortinoo 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 GGtr�•d ca 4�S The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1, Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Location of action: /0 S�� �'�!� �+� d/®�G�/ (r'u Site,acreage: t (O 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: %e�� (b) Mailing address: �c4,Z 4- , I (c) Telephone number:Area Code( 4 (d) Application number,if any: 1i)l!`T Will the action be directly undertaken,f 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 KNotApplicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policie ages 3 through 6 for evaluation criteria ❑ Yes'❑ No KNot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section Ill—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No eNot 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 Paggs S through 16 for evaluation criteria ❑ Yes ❑ No 13"'Nt Applicable Attach additional sheets if necessary Policy S. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria F-1Yes ❑ No rNot 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. ❑ ❑ D1 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 ONot Applicable A 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 RrNot 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. ❑ Yen No bo Not Applicable Attach additional sheets if necessary i WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies;Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No,❑-Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters.See LWRP Section III—Policies;Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies;Pages 62 through 65 for(evaluation criteria. ❑Yes ❑ No[? Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No Not Applicable r PREPARED BY TITLE_ 21� _ __DATE