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HomeMy WebLinkAboutTR-9827A Glenn Goldsmith, President *QF SU(/rTown Hall Annex A.Nicholas Krupski,Vice President ,`OOl0 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold, New York 11971 Michael J. Domino N Ar G Q Telephone(631) 765-1892 Greg Williams X3 Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: Alts/-1 INSPEC D`BY: Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale-line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection COMMENTS:. 1//I� �f � tel'► yYl��� �' � P 0/Z_ )�f�� CERTIFICATE OF COMPLIANCE: �! •���I Glenn Goldsmith,PresidentoOF 80!/j�ol Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 P.O. Box 1179 John M.Bredemeyer III Southold,New York 11971 Michael J. Domino G Q Telephone(631) 765-1892 Greg Williams '0 �� Fax(631) 765-6641 �ycOUNT`I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 4.18660. - ;Date: October 15, 2021 ,THIS CERTIFIES;:that•the-replacemerit/ekterision`of existin "fg ence..120' aril 80'"on'either side of hdii§&,iis'ing either PVC'or wood; ,<;rA;t 2,15'"Tarpon Drive,.Greenport, -Sid Taz 1VIap#1000'53 Conforms to the application for a•Trustees Permit'heretofore'filed in this' ; office Dated February 9, 2021 pursuant to which Trustees Administrative Permit#9827A Dated March 18,2021,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the replacement/extension of existing fence 120' and 80' on either side of house using either PVC or wood. The certificate is issued to George& Stavroula Protonentis owners of the aforesaid pr perty. 141.4— 4"- — Authorized Signature Glenn Goldsmith,President �QF SU(/lTown Hall Annex A. Nicholas Krupski,Vice President ,`O �W A. Route 25 P.O. Box 1179 John M.Bredemeyer III 4 Southold,New York 11971 Michael J.Domino G Telephone(631) 765-1892 Greg Williams Fax(631)"765-6641 'BOARD'OF TOWN TRUSTEES TOWMOYSOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES 'YOUARE REQUIRED TO CQNTACT'THE'OPFICE 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 ` % constructed X When project complete, call for compliance inspection; Glenn Goldsmith,President *QF so. Town Hall Annex A. Nicholas Krupski,Vice President ,`O� ��� 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III J�t J�t Southold,New York 11971 Michael J.Domino G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 cou�m,��' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD -Permit No.: 9827A Date of Receipt of Application: February 9, 2021 Applicant: George & Stavroula Protonentis SCTM#: 1000-53-5-3 Project Location: 215 Tarpon Drive, Greenport Date of Resolution/Issuance: March 18, 2021 Date of Expiration: March 18, 2023 Reviewed by: John M. Bredemeyer, III, Trustee Project Description: Replace/extend existing fence 120' and 80' on either side of house using either PVC or wood. 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 George Protonentis, received on February 9, 2021 and stamped approved on March 18, 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. 1�k Glenn Goldsmith, President Board of Trustees S.0 TAR NAp 61D OiSi 1000 SFCG 53 LOT 3 FtiE IF PRO UT N(LIMW476 -taR 2 7 �_ A10 Of olio If t-3 < �U N/P SASE APPROVED E Y 12aao' BOARD ® I RUSTEES TOWN OF • OUTHOLD WE. DAI E m�.R �g�2ozl d .ate ' - V �m°• t9' � b aaa �� nl d 7-SJr IRAllr t719f OeAtcx • a c.u.r � SGC rl t 3J' H2Y �Vu NOTE: a- aa- r \1,SF•- o The too do¢hod, 50%etpon¢,on is � peo'n or*iluitrated by den' n 9 Purpose and have not Cern In¢toliod. t } T NIW .tar 12000 ♦69' ra0' TARPON ®R (509) Amended 3/08/2006 septte offsets roNnad. CO H.W.J. ALL RICNIS RESERVED. Atnooded 2/02/2008 to tlorffy onpansion pwo. Sspttc oMseto,iota Ileo by dltWl=1 pro 1997\9B-720 d \FINALdv PRQECL• =v.,.tom.t«.� .aa n.�h w r.a mc a a ra aoua oa c re eaea u FIATAL LOCATION q'- d m. FOR IAT 40 . i+:ea'ao ana+r>Q,ea a as data r o.azef w e a an w won M/O SOUTHOLD SHORES «7r "O a"'eb le`tea°J "�""�a.►o.r.,r w acay w oo a.oaera csc.a SWATE AT: SOUTHOLD. NY W aN P!N.In w�e7 0.LAh1 b(aW Fw .alb J lata.vb i�¢�0 DATE: OCTOBER 2005 SCALE t'd30' Comm OYLY TO W p°lY i Qa 0 G S/R1EY DAiBllerch 7 ? 5 AWA 21.00 $O.FT FLO HAP NO.WS3 DATE PUB 8/2411963 FW BOWS 4EUaf z DATA DSC 1997\9B-7?_ r FTID.SZ97/05 IRO.0016T RRAL 141].T MS Dy "WLUANo. W85 HAW= EDD JAEGM Am Pit{L JAECER 0 q,Y$UC:N0.094148 P LAND`� DSD ORAttft flA0 OtD rat m mono[lot is urst CM=nm obaa E LJ t�� \y/t�/7 12 6rti W taDet E .t)ea5i o.i us¢[b FEB ® 9 2021 Southold Town Board of Trustees Glenn Goldsmith, `sident �OSUFFQ(�Co Town Hall Annex A. Nicholas KruNs,�i, Vice President „ ��,, 54375 Route 25 John M. Bredemeyer, III y P.O. Box 1179 Michael J. Domino Southold, NY 11971 Greg Williams �y O� Telephone (631) 765-1892 X01 �a Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �:r �,d S Completed in field by: GEORGE & STAVROULA PROTONENTIS request an Administrative Permit to replace/extend existing fence 120' and 80' on either side of house using either PVC or wood. Located: 215 Tarpon Drive, Southold. SCTM#: 100-53-5-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=4 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_z 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/comment /standards: I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: /J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other X6 IM NAP D4 DIST.MM SECr.53 Lor 3 AGE Ma PRO,fjCi MIXAM9476 MR 2 7 (' ' - Alo of 000 s .4/r SAGE T 30' 12Qoo' n Ealf d' \ tRr£ .or Q +fair a kz? ap War tzr ( q 7-SrrIRDS am V n.t —� �I pe LM I ff 1jr ® r vRrAw tevrr NOTE: r �_ sr ry• The two Oaohoo. 50%expansion �� �— o peo'e ora Aluitrated for deaign purpose C>a at o' O and hava not boon Inatallad 1 X15000' b t 6 �— �� i i, \\ . z'I NB3 •mY 120.001 TARPON ®RFVE (5a) Amended 3/00/2006 septic offaata mi w. © H-W.J. ALL RICHIS RESERVEO. An"*ori 2/02/2006 to Oorffy orpmdan poria Septic Offtift0i rater Ifna by oppllaarttL1ro 7!197\98-720 d \FiDtALdK e tw•rn.'.wr r.r nee+.n .+wr..r rsw.,m..a Re.wn ten, PROUT: eYmatau■m■..t.t..tRa.u..y V w+.n+b r■, R\ataauea w P q e■-b FINAL LOCATION a"70°'1O�'R a,+..wte'anrr.+ tsMp■eawvt en„•■.m.ea,b>y mfpe�d as FOR LOT 40 °e•s• ebswntw....,v.■rray b e.oar t mu w.neao.a o■.. M/O SOTITHOLD SHORES •�!(tM«'■>a■t+t V.of.7 tti,tR'hteW.bn1 V�a►,t,sf W OI s1 M,■.Rbs R w fn;11�,. p SiIIATE AT: SOUTFifJLO. NY "'•�'�^b�v..■o......eww Pvt.e-e" GATE OCTOBER 2005 SCAIE 1'e,30' CE 7WO any TO Q' O SURVEY DAIS Iler hr—7-TINiS -AWA.27.000 SOFT, FM MAP NO. M DATE FM 8/20f1963 FMD GM 02R1J DATA DSC 1997\98-720 RiD.V07[QS _ UND.OW. FMAL 10111/20 5 a , No 0wo9s (W HAM" W JAE� A M F.Q IYWA1f L�AEC✓:A#q.YS UC N0.Amin P CAND`� ORAM RAO OtQ m t.et aamre ysriret ta■ats nmr ease ste necc man acs treats..aa.0 D) -L-U FEB ® 9 2021 Southold Town Board of Trustees t 1,� r �� •f � #�,�,ter..- ,�,x ...♦-,,� • _ / I • / H,J�iq' , 'L+ -. ; 1�, 1•, h f � r�+ war i l���IJ�•S •• r, .�: �'' ,� 1 �: `. � ~ 7i1 � �} i't J +aJ ,�(�+► � � f t,Jam, • .� �fi' � . (fill, t r ' t y N. .i 1 _ J � �_� 1 �F. t I�k a ��4} ,� 1 �t�t'j�t d �.y +r.�fgr"4•'��>: 1°'t" a k:ry � �, ��. ►Aq C+r�`6• -.`faA 12F,fiLfli�� y +='t� �4`i 4•i a f�. } y I - r •- '.' Ir - s � /k ` JY - ... 1 X11, � 3gr S! _�.. "'. •f W .=.�1 R �x - r �f. e y�fj t♦ 7. i\� J.✓. js{;J Z 1 UNK IT W- 17 `e d a j ' r t � •'� n t �-� gra ��ati:. w - -- SEC NO al5'-u SEC.N0.016: UNE O "TCH S• T rORPG-NO. ' t.Tµcl sEE SEG NO. �• O, /• 70'M,OF p 0cs•saoc IP t. FOR PARCEL . f j / 4a SEE SEC-NO.NO LtA �O SO � / � `1 62 1.4 WM OF SOUMOW a I fwcdToM OF r- v 31A c) I sourHo O /• / �,_.• COUNtY OF SUFFOLK ar O t1 +< • rn Nq ,� Z. 12 19] 1• 1• --. f�f `;� �� !�//' TOM/� O• � � 'O 2 Ls� SOUrIgID d•i•e£'" P o sT, 1 1 .7µ.1 O • "l o ... TOMMOFSOLMOIO R 3`�' `•." `y � t..oR�awKM p .I!�!•�: �, y .---�. TWIN OF SoUYHOD ' Wx�pwllrY '. N ryr �aES CREEK P ( O . \P C s ' a 1]AQ q y'6 - E E`,s s♦a`, �q l� v b ,; a/. ♦ P P PP P.! P _ R4p q 4 P P - q - s•Wq I �q ♦ "A{ A14 St1 S 1 .F ¢ ,•'� t t P rfoxN�w,00 os ��S'� fq � sf€� +t / •P '1c ya 4a yy yg JSt 4fe q, �'f,� 1,44 -xa q f as if d °'4'e y ty�a •d 4.7, y ,♦ �'o•.pkv' 11 O5 a w 9 0µ.1 - "y`4 y M TAA t -- I 'x'M(/ 1y -~ TAA R $ � ;�' •°' T2KPcL 6 p sem-NNo- --Z- 9 2 Y .•;a 06rL/-0%9 ----- ------ WTd1 xm1R 7 • j - ��. — — IME _ TARPpN s e - i E sEc.No-on s,E s,c.No.w •8„ pFt b eff SEC.NO.ow _ - SECTION NO a towxaF SOIrrNOLO NorrcE COUNTY OF SUFFOLK © e a, al Property v '""'w°F 53 Tax Sery ce A mz ,.�. �. .:.,.. -- ro+.w• „"�rxu. Real it n .NYt1"at 9 M R envy .,..1. —. -`.,..,r"r: (21) _,.r O .:.s..u. —�-- ...„e..r• —'xT-- rte.. �• F xs*xicr„o 1000 PROPERTY MAP "rvr� pox am� �` ax rawrrru xmww+m � OFFICE LOCATION: "�� �� Y MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 " Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 ; Telephone: 631 765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: March 12, 2021 Re: LWRP Coastal Consistency Review for GEORGE & STAVROULA PROTONENTIS SCTM #1000-53-5-3 GEORGE & STAVROULA PROTONENTIS request an Administrative Permit to replace/extend existing fence 120' and 80' on either side of house using either PVC or wood. Located: 215 Tarpon Drive, Southold. SCTM#: 1000-53-5-3 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 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 Glenn Goldsmith,President IVO S®(/l° Town Hall Annex �d Michael J.Domino,Vice-President ,�O 'lQ' 54375 Route 25P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 A"Nicholas Krupski G Telephone(631)765-1892 Greg Williams i® Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application �� E C E Q Wetland Permit Application D Administrative Permit Amendment/Transfer/Extension FEB — 9 2021 Received Application: . 2.4-21 Received Fee:$ '00,0 – Southold Town Completed Application:_ '12ZI Board of Trustees 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: 3T6—1t I Receipt of CAC Report: Technical Review: Public Hearing Held: I$ 2l Resolution: Owner(s)Legal Name of Property(as shown on Deed): G'" Protvyl e 7H-- g.S- vra Pha fo1►en�7J Mailing Address: 2 ro 1 `76 A s16--ed f g ro o k is, a / Z Phone Number: I" R2 - a 9 S/ py rv►C 9 / 7- 7 // - 3 � 3 Y Cel/ Suffolk County Tax Map Number: 1000- 53 - 5 - 3 Property Location: 2 Tct /-�I r 1 V c �o y `r/ /4AZ,Y 7/ (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Re:. Fence Replacement/Extended Project Location: 215 Tarpon Drive, Southold SCl'I #53-5-3 Applicant: George & "Stavroula Protonentis Project Description: To, replace/extend an existing fence To replace/extend existing fence at 215 Tarpon Drive in Southold with either wood or PVC. Thedimensions are 120 feet left side and 80 feet on,right side -of house When facing house in from front on Tarpon Drive. Materials types that considering-using is either PVC or- wood. ID ECE0VC FEB 12 2021 Southold Town Board of Trustees Board of Trustees Applic Lon GENERAL DATA Land Area(in square feet): Area Zoning: 1 C .5 _I.d en ®- Previous use of property: r e S , 8 e n i(o Intended use of property: reS_ i e A A %, a, 1 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 /No If"Yes",please provide copy of decision. Will this project requ. any demolition as per Town Code or as determined by the Building Dept.? Yes V No Does the structure( ) on property shave a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date No prior permits/approvals for site improvements. Has any permitlapproval ever been revoked or suspended by a governmental agency? �/No Yes If yes,provide explanation: Project Description(use attachments if necessary): - Q, C 0 � � S Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: („__� C -P a n A. ...... d WU I 0 al A Area,of wetlands on lot: square feet Percent coverage of-lot: Closest distance between nearest existing structure and upland,edge,of wetlands:, feet Closest distance between nearest proposed structure and upland edge of wetlands: feet, Does the project involve excavation or Pilling? V' Na 'Yes If yes,how much material will be excavated? cubic yards How muph material will be filled? cubic yards 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: Staterbent 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), UU 61Z20 Appendix B Sltort Environmental Assess`nent 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 I -Project and Sponsor Information -TIt-e n exsiin �cn ce Name of Action or Project: y n/ mer) ® ST ( n ' -e®)Cc Project Lodation(describe,and attach a location map): car unnv e S� n ) a N d `� 71 Brief Description of Prop ed Action: �o r C F Lace, 0�n ex on our Fr(3Prt 1 ,e-P4- 8'0 ���- r i qh ��,��. X20 -C-4- �J +- / W en i o o k c n M- �i out s e, P /0'C I e- W (3 Name of Applican or Sponsor: Telephone: S t-0.\/r0a l� �rv47-�n(.1,)hS E-Mail: 21 ( p1• G� Address: City/PO: State: Zip Code: ® d y- 112'o 1.Does the proposed a tion 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 ElF 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 R610soidential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 • ti 5. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ 12/ b.Consistent with the adopted comprehensive plan? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO ES landscape? 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: � ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO - YES b.Are public transportation service(s)available at or near the site of the proposed action? Liz M c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 07 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: I—I 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO - YES Places? ❑ b.Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: Lld 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: El Shoreline ❑Forest ❑Agricultural/grasslands Early mid-successional Ea/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? ❑ 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 ES If Yes, a.Will stone water discharges flow to adjacent properties? NO YES ❑ b.Will storm water discharges be directed to established conveyance systems(runo nd storm drains)? If Yes,briefly describe: O 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: LJ ❑ 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: I ❑ 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/spo or name: x'11 Date: 2 / 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 regulations? ❑ 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ 3. Will the proposed action impair the character or quality of the existing community? ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate [01reasonably 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? ❑ S. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 � � I 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 1:1problems? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this 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) PRINT7 Page 4 of 4 Board of Trustees Applic, ion AFFIDAVIT (9 CV Gq e 0- Pru /-v 17 ���i f' 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. Signature of Property Owner Signature of Pro erty Owner SWORN TO BEFORE ME THIS A - DAY OF J�—�c 4A GEORGE L.DIACUMAiKOS Notary Public,State of New york No ary Pu lie Ys-01D16085902 Qualified in Kings Counq Commission Expires January 13, 3 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 ---"--tsrop�s�d�ctit�t�r�snb�t`�o-tli�`��s�;'cit'S23ut3t�tilcl`�Vat�r�ronf�orz�z�t"enc"-;y Review,Lat^v. Tl-iis assessment is intended to supplement other.irtformation 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 �orouosed, action, will be evaluated as'to its sisrni6cant beneficial and ad erse ef#ects anon the coastal area Cwhiclt meludes all of Southold Town). 3: If any question in Section C on this form is answered "yes, or no then then proposed'action will affect the achievement of the LWRP policy,standards,and.conditions contained in the consistency review law: Thaws,-each aumver must be explained in detail, listing botlu suduorting, and.don-. i supporting facts. If an action cannot`be certified as consistent with the L'WRP 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 Is website.(southoldtown.northfork.net),the Board of Trusteeg Office, the Planning Department,all local libraries,and the Town Clerk's office. B. DESCRIPTION OP'S1'F,AND PROPOSED ACTION` SCTM# t ROJE0 CT NAME1 ` I orpo n rt v, r' 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 appropriateiesponse): (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: r i t e r Location of action: i Site acreage: _ r Present land use: P-e S 1 U&t- ] Co Presezonmg classificaoff.---- 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: lfh VfOt� 3 � � (b) Mailing.address; -S)ly "- f �N. (c) Telephone number:Area Code( q S-/ -7 Vf 7 (d) Application number,if any: —Ao..... Will the action be dir y undertaken,require funding;or approval'by a state or federal agency? Yes ❑ N6-ET"" nto -_ If yes,which state or federal agency? �C. EVdluate,66 project to.the following policies by analyzing ho*the project will further support`or' not support the policies. Provide all proposed Jest Management Practices that will further each policy. Iricobiplete answers will require that the form be returned-for eompletidii. DEVELOPED COAST POLICY Policy'l. F'bsier a pattern of development in the Town of Southold that enhances community characte § preserves open space,makes efficient use of infrastructure'makes beneficial use of a coastal location,and minimizes adverse,effects of development. SeeLWRP Section III-Policies; Page 2 for evaluation criteria. ❑Yes ❑ No 12 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 b for evaluation criteria ❑ Yes 1-1 No I-1�lot Applicable Attach additional sheets if necessary `PbIfcy. Enhance- rees through-0-ur thol�jst � LWRP Section 111—Polic' s Pages 6 through 7-for evaluation criteria ❑ YesE] No Not Applicable I I: Attach additional sheets if necessary NATURAL, COAST POLICIES Policy, 4. -I Iinianize`loss ofjife, stmetures, and natural resources from flooding Anderosion,See L Section III Policies Pa'gK8 through,l6 for evaluation.criteria Yes No Not Applicable � i Attach additional sheets if necessary { Policy 5. Protect and improyeWater quality and supply in the Town of Southold. See,L Sedflo21111- - Policies Pages 16 throuQ 1 for evaluation criteria Yes 0 No rNot Applicable F 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 111—Policies; Pages 22 through 32 for evaluatio riteria. Yes No Not Applicable Attach additional sheets if necessary -- Policy--7.--Protect--and-improve air quality in the-T-ow n-of-Southold:See-L- : Seetion-SII---Policies--- I'aees 32 through 34 for ev uation criteria. F] Yes ONO Not Applicable k Attach additional sheets"if necessary i Policy S, Minimize env' nmerntal degradation in Town of Southold from solid waste and, hazardous substances and wastes See LNV12P Section IH,_Policies;Pages 34 through M for evaluatloA critenria, i �--� - Yes ice} No,--' o Not Applicable 3 PUBLIC CAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the.To wnouthold. See L Section III_Policies,Pages 38 through 46 for evaluation criteria. Ye� No pplicable Attach.additional sheets if necessary WORDING COAST POLICIES Policy 10. Protect Southo .'s water-dependent uses and promote siting of new water-dependent uses in suitable locations. See Section III Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes F1No . Not Applicable 4 Y f Attach additional sheet's ifnecessa.ry Policy 11: Promote su ainable use of living marine resources in Long Island Sound, the Pecoiiic Estuary and 'Town tiva rs.-See L'4�6TRP Section III-Pelicies;Wages 57 through 62 for evaluation criteria. ❑Yes ❑ No, Not Applicably ` Attach_additional'sheets if necessary r Po ey 12. Protect agric al lands in the Town 4 Southold. See Z.VVRP,Section III -Policies;Pages 62 through 65 for evalu 'on criteria. ❑Yes ❑ No NotApplicable i Attach additional sheets if necessary Policy 13. Promote/appriate use and development of energy and mineral resources. See LWRP Section III-Policiesthrough 6S'for evaluation criteria. ❑ Yes ❑ No Not.Applicable PREPARED BY ' `—�- 'TITLE UV DATE-q)-71bl 26176th Street Brooklyn, NY 11209 February 2, 2021 Town Hall Annex P.O. Box 1179 Southold, New York 11971 Re: Fence Replacement Project Location: 215 Tarpon Drive,Southold SCTM#53-5-3 Applicant: George&Stavroula Protonentis Project Description:To replace/extend an existing fence The existing fence rotten and fell. We would like to replace/extend existing fence at 215 Tarpon Drive in Southold with either wood or PVC. Attached please find the necessary paperwork and a check for$100.00 payable to Town of Southold. If you have any questions please call me at 917-741-3634. Sincerely, George&Stavroula Protonentis =� E FEB _ 9 2021 Southold Town Board of Trustees