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HomeMy WebLinkAboutTR-9830A Glenn Goldsmith, President q so Town Hall Annex A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski 3 Southold, New York 11971 Liz Gillooly Elizabeth Peeples Telephone(631) 765-1892 Fax(631) 765-6641 c®UNTi,� ta,1Go� EI`1adLd BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD r-i fmr ovr o)" DATE OF INSPECTION: i3 INSPECTED BY: ,-"Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain Y. 1St dot-ef.,�e t u c i r� Qrr#F Ptfi 440LTE % constructed Project complete, compliance inspection COMMENTS: Wd4u 44'2� 6k anew ��yc a mut .✓a ,�Ctnretci�41,E .h'u /aw.",/ 4004 CERTIFICATE OF COMPLIANCE: �' Glenn Goldsmith,President �QF SU(/� 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 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 COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-constructidn,"hay bald,line/silt boom/silt curtain �( - BSc CVT 6Fv=P �►►LM5 . % constructed When project complete, call for compliance inspection; Glenn Goldsmith,President *QF SU!/� Town 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 G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9830A -Date of Receipt of Application: February 19, 2021 Applicant: Richard & Scheherazade Madigan SCTM#:.1000-27-4=9.6 Project Location: 856 Narrow River Road, Orient Date of Resolution/Issuance: March 18, 2021 Date of,Expiration: March 18, 2023 Reviewed by: John M.-Bredemeyer, Trustee . Project Description: Maintain existing managed lawn up to the landward,edge of the existing berm with no use:of chefnical/inorganic fertilizer;-for a Ten (10) Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to no less than 12" in height by hand, as,needed; on berm running along the westerly side of property and up to the,seaward side of existing berm and to cut and maintain Phragmites to maintain access along 4' path to Orient Harbor. 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 Patricia Moore, received on March 17, 2021, and stamped approved on March 18, 2021. § 275-5 Permit procedures. (i) Cutting of common reed (Phragmites australis) to within 12 inches of the soil surface landward of the wetland boundary. This does not include mowing to ground level. Special Conditions: Do not disturb native vegetation during the hand cutting of Common Reed (Phragmites.australis), including but not limited to; Eastern Red Cedar (Juniperus virginiana), Northern Bayberry (Myrica pensylvanica), Marsh Elder (Iva frutescens), and Groundsel Bush (Baccharis halimfolia). The approved operations must be commenced within two (2) years from the date of the resolution. The permittee is required to provide the Trustees with before 2 and after photos of the area within this time period before any further maintenance is conducted. 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 J MADIGAN 1000-27-04-9.6 E C E � U E P. {BAR 17 2021 Project description Southold Town Boa!I of Trustees Maintain existing managed lawn up to the top of the landward edge of the existing berm and no use of chemical/inorganic fertilizer. See Drawing below Cut and maintain phragmites on berm running along the westerly side of Madigan property to 12" height, cut and maintain phragmites up to the seaward side of existing berm shown on Nathan Taft Corwin III survey last dated August 11, 2014 and highlighted in yellow. Cut and maintain phragmites to maintain access along 4' path to Orient Harbor. 10-year maintenance permit. fl � d . C ..y'1 rn "JL-) ��� ;ED BY L AR® OF ITEES WN ®F SHOLD Aiecc+ 1 Y D V E SURVEY OF PROPERTY SITUATE r ORIENT TOWN OF SOUTHOLD MAR 17 2021 SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-27-04-9.6 SCALE 1"=40' Southold Town JUNE 21 2014 Board of Trustees AMUSE 11.2014 ADO SPAT ELEVATION AREA = 125.452 ■Q. ff. 2.600 ac. CERTM D TO- FIRST AMERICAN TITLE INSURANCE COMPANY • a�j JPMORGAN CHASE BANK, N.A. ,�� •'. s g RICHARD MADIGAN a.-0 �y $, SCHEHERAZADE MADIGAN c LT&.F- +Y\Np \ EUEKISTIS ARE REFER ERENCEDs ARE TO N. THUS19@ DATUM rOL RySd{Mt .�•• as= Z.TH15 POOPEDTY IS IN FLOOD ZONE AE(EL O) �� S FLOOD ZORE INFORMATION TAKEN FROM: FLOOO ZINURANEFCOO EtEY 1pN5 EDATE ODEIT C.O.H O Cis yl� +4i APPROVED BY BOARD OF I RUSTEES Vk� ® TOWN OF SOUTHOLD DATE � �\ h�2ct�- 16, — Nk'y7a• •� C �°f �\ \ _ � c LOTO/ z + �o C 13' X ee .L C. LI • .O �3. \ ,b U •AF \ NY' .b � j n � •b s 1.01 / 4 yoRK of q 'N 0� �;�,. W leK UwL4..va YVi[��ww Sr,*e�um Qp So,YtIN�. a Nathan Taft Corwin III s[cRal T2p a M[KN m+x sr,TE CK9 oF ,®gl� Land Surveyor �Fa SW sNR.NRT O[ wm MOt•CR N.,9ML W S--To SloNay J.MW11R .L.S. aIA� �R OII I�4 N 911MY JaaMR A ky L.S. Na �a fro l,Ire Surv�a-Subdmamf- 51.P1wr- w4uc Lapin Term.cFeriusTp°fi9�IOAaTNitTwfWe1E. PHONE(951)727-4090 ER1•(677)737-1727 TNL 11n1CNCE-.--T M MATS L1`Fifi"S LOUIFO IF IIF9AL ADDRESS •YO/lN[AS[NCMTS lM OECO9O,IF 1506 Ibin Roal P.O.BR1 16 • MOT SHORN AOC NOT OO•RARTCED. Jomefporl,Ile.YorY 1196] lmM1Ar1,IIA NOT 119.1 SURVEY OF PROPERTY 15) �n SITUATE 11 EV ORIENT TOWN OF SOUTHOLD i SUFFOLK COUNTY, NEW YORK MAR 1 7 2021 S.C. TAX No. 1000-27-04-9.6 SCALE 1"=40' JUNE 2, 2014 AUGUST 11,2014 ADO SPOT EIEVATION Southold Town Board of Trustees____j AREA = 125.452 39. H. .. 2.890 cc. ��► CLRTfFJ6D TOr FIRST AMERICAN TITLE INSURANCE COMPANY JPMORGAN CHASE BANK, N.A. RICHARD�.�' � •-. ',.y SCN HER ZADIE AMADIGAN • Ylw,� NOTES: L I.ELEVATIONSMI5f� 7UY NLE(MA &' TIONS ANE SHOWN 7HUM rpm V.^ `\•^ 2.THIS FPAOPENTY IS OI F1,000 LO.FE AE(EL A) a _ J FL000 ZONE INF'OM1YTgH TAKEN FROW,- ' . Y FLOOD im nNLS- `iwk'En=ELYVAm,a OfrL LAMESUE M0 D $ >IL a S. r ;ts �d r.�f'� yOK� o^ • �� N 4'av + LOTO] •` �� a - A G �V� ■ rte , ozp� •L� t`.AN �J el� •AA r r * .AI 0 MEIF rola ! f ! f f � r � J 4 0� + ,•� '� P.nA�■ .,H we N� 'A4�..Ni Foi AOF.HIVE.N Nathan Taft Corwin III ��7�v nIf 110 faM1.rn,s Land Surveyor Y mNUY�ll9 11.lSOM wAl OF SUa.�.or T.l J.i�0 J,LS. M P[Ia�I.,s MO!i18 SNlEM !b Pt in m u°fCm*<.+wNlul ara.r.n ml.su,..r,-sYnal7r.,,.- M.Plvn- c�lAn IA7o,rt >a ,p0 PHONE(871)727-2090 Fa.(631)727-1727 Ntsw.[aauarn•6..f mf nwW ]. Tel[/T�9�i[wCf p 9800 Of WAYS OmGES L IEO AFNNUNG ADDRESS NpT'YNNP Y[�P,N{TGU1�IiYIEfO. ..W.NLA 47 Yat 119P.O. .bINNp1Mm I6 Tal,11917 • - l.t MADIGAN 1000-27-04-9.6 ® � i'[;; `' MAR 1 7 2021 -3 Project description Southold Town Ht�Pr1 of Trustees Maintain existing managed lawn up to the top of the landward edge of the existing berm and no use of chemical/inorganic fertilizer. See Drawing below Cut and maintain phragmites on berm running along the westerly side of Madigan property to 12" height, cut and maintain phragmites up to the seaward side of existing berm shown on Nathan Taft Corwin III survey last dated August 11, 2014 and highlighted in yellow. Cut and maintain phragmites to maintain access along 4' path to Orient Harbor. 10-year maintenance permit. i Z N t ND%\I A-" 5� /ate Glenn Goldsmith," ISi " t 'of Fol, Town Hall Annex A. Nicholas Ki , _`ki,`vf6e-President ,�� Gym" 54375 Route 25 John M. Bredemeyer, III o ` P.O. Box 1179 Ze Michael J. Domino o Southold, NY 11971 Greg Williams O! Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD / Date/Time: 26 21 2 J Completed in field by: J, C U Q r i Patricia C. Moore on behalf of RICHARD & SCHEHERAZADE MADIGAN requests an Administrative Permit for a Ten (10) Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to no less than 12" in height by hand, as needed; and to clear a 4' path where Phragmites encroach on catwalk. Located: 856 Narrow River Road, Orient. SCTM#: 1000-27-4-9.6 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� Setbac'k 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 aring 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: 0!&/,-G �� n/e cJ �)/e v �G- v 42d�� �J ei r' 4C_ kelvi 4-z S624 4vz''�-A) /J I have read & acknowledged the foregoing Trustees comments: Agent/Owner: a 4 ZIZ Z Present were: ,a. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other SURVEY OF PROPERTY SITUATE ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-27-04-9 .6 SCALE 1 "=40' JUNE 2, 2014 AUGUST 11, 2014 ADD SPOT ELEVATION AREA = 125,452 sq. ft. 2.880 ac. 1 a > v DOGE . F0„N� M°N. CERTIFIED TO: `0N FIRST AMERICAN TITLE INSURANCE COMPANY JPMORGAN CHASE BANK, N.A. ea 5° ArO s RICHARD MADIGAN va`R o ti oo SCHEHERAZADE MADIGAN olrolo o c� %-SL WEU- 1'1. 1111 sr6,\ o, �� 51Eps f] SSoo NOTES: 1. ELEVATIONS ARE REFERENCED TO N.A.V.D. 1988 DATUM D �— ��•p6 EXISTING ELEVATIONS ARE SHOWN THUS:JU F.FL- FlRST FLOOR r SERE G.FL- GARAGE FLOOR FEB J 2021 1ELL EA \. 2. THIS PROPERTY IS IN FLOOD ZONE AE (EL. 6) FLOOD ZONE INFORMATION TAKEN FROM: 01 FLOOD INSURANCE RATE MAP No. 36103CO068H ZONE AE: BASE FLOOD ELEVATIONS DETERMINED �-- - ees .00; 11b o \ a O_ x oP� O\ O,� v� LIN O \\ ` O, H n 1` CKE 1A,1 , 01 sz� �okP A. �� 4 01 011NF' O as Z OT 6 S)4ory ' O, �0° O, 1 \ o � r+ O tel °Pg� oad �G dN Oyu, 9 0 LOT 1O 00 °x lop O //A X42 ao 0 • � �pM0 65 AAp C5 � ._ bio Q� •.p.v m lir X A2. 0 oT x o P ° '_4j 000,06- 'D ° STONE DRIVEWAY ,D'. x o"SES o > oA��' �el. y s ° _11 o // 0 X A y0 1pGE d ,L5 0 2.1 X ��Q a�O sc��6Vsrys ,-4.2 Ao�7S`F° x XIS O Zti o 1�2,:J X�m1-3 S 2 00 0 PS R X2_8 �' P \\ X$.$ \ N x'14 \ \may X X-4.9 X \ -Al 31 \ 6'. m a W� o �s � O x 0 D L la G --I . 5 r015 r / � m / � o / i m 0 6 k 1 Nti/, Eby 0 Jim N101F STATE OF NEW YORK fWni` ary/ r syOR nO'i /pb` FvtiF =/ �ary � /ryOi ti iy S6. PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR TITLE SURVEYS AS ESTABLISHED BY THE L.I.A.L.S. AND APPROVED AND ADOPTED 0� FOR SUCH USE BY-THE-NEW YORK STATE LAND TITLE ASSOC I TI6N, N. N.Y.S. Lic. No. 50467 UNAUTHORIZED ALTERATION OR ADDITION Nathan a t h an T of t Corwin I I I TO THIS SURVEY IS A VIOLATION OF `w SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. L.S. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno L.S. IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND Title Surveys - Subdivisions - Site Plans - Construction Layout LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- PHONE (631)727-2090 FOX (631)727-1727 TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamespo rt, New York 11947 Jamesport, New York 11947 ArcGIS Web Map 1000 Peters Nsok Rd s 310 Narrow Riva Rd 1 �- k. F.N4 - ti0 P'aars Ned 856 Narrow R—Rd 1792 Pe1ws Neck Rd February 12.2021 1:1.000 Parcel Data o 0.01 0.02 0.04 mi Address Labels o 002 004 0.07 km Wee 4aoaum3w br Am(I;cs - -� __ ..,,. _� a ... n- � ,.�R y �' 1 �.`. 1 � e I T p �.y 1p �����'�,M, ��"'r+� �t_.°f!` � ; ,.,.�, re� ? 'it}�'w'1� �s'• "�t►.•o.'1g t ., ... '� ,�„� �'r� 'max, ,.,"`r �;� ns ;'_ ,•,.w,c., '>- �4 `+' - ' - 4W �•.A 'r« NO i' 1 ' AIr y ! l T _--_— z _— ---_ _—�—UNE _ $ FON nL NO. SEE SEC.NO. OlB1l 22 O TOWN-' $� SAA B'BNc) N 1 22 9.5A(c) MA 5 b 6 OA i, ,2, .owc w V i , ,(\ 210 IM mp _ O \ U w 2. 1IMA .7AO) .21 Sr w - 0 2-7 I.M » 23 t.A .! M l�A 1iA ♦ 70.M .� UA �a 1,116 n \ \ iOf r ewe OF NEWYORK \ t y ® \ 'a.. a \6�� \ b'! TOM of soumolm \\ 7.7ft) 52 t..µe _ wiatu w- \ ,\M1.t•\ \ 2UA(c) a.ca 373. az'AAW . - 27A \ '\ p Cb, e lle.OFNEWTOral M.D.eO 5 e C) - SEESEc.NO.— am am No.at �... . OR/ENT,y- --" �. - -- _-• ——a— ——^—— w NoncE COUNTY OF SUFFOLK © e 01• a SOMMOLD seclart NO —zz— 4 a+) O2 --•-- ^^-'- --M-- .w^=E.««<c K,�,,,�..KE� Real Property Tax Service Agency r °a , wA°E 027 -- w. vw e•wr•non or.� .... :.• m m A .. .,.... .. -y.trN v.:: OFFICE LOCATION:' w �, 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 r M � �. .� 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 RICHARD & SCHEHERAZADE MADIGAN SCTM # 1000-27-4-9.6 Patricia C. Moore on behalf of RICHARD & SCHEHERAZADE MADfGAN requests-an Administrative Permit for a Ten (10) Year Maintenance Permit to hand-cut Common Reed (Phragmites australis) to no less than 12" in height by hand, as needed; and to clear a 4' path where Phragmites encroach on catwalk. Located: 856 Narrow River Road, Orient. SCTM#: 1000- 27-4-9.6 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 'UV solf�•� Town Hall Annex Michael J.Domino,Vice-President ` ,��y ��'� 54375 Route 25 P.O.Box 1179 ` John M.Bredemeyer IIIIDSouthold,New York 11971 A.Nicholas Krupski u9 Telephone(631) 765-1892 GregWilliams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application ® -ea-v ma-(V\�CA Wetland Permit Application ' ,Administrative Permit -Com- � � S - �c_Amendment/Transfer/Extension V Received Application:_ 2�1Q•2� Received Fee: $ IN,®0 Completed Application: 2.z&7-1 Incomplete:;. SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _/Coordination:(date sent): {�/7 LWRP Consistency Assessment Form Sent: _ U CAC Referral Sent: Date of Inspection: FEB 19 2Qj Receipt of CAC Report: Technical Review: :VtPublic Hearing Held: Southold Town Resolution: Board of Trustees -- Owner(s)Legal Name of Property(as shown on Deed): &JA C GI C' ► V I CQa lCQa� �Z 0`15 -S� ,q n -/-� � � Ml- ca�r1 Mailing Address: uV • ,C: L-Z D012 Phone Number: _ 31 - 77 39 _0 9�(y Suffolk County Tax Map Number: 1000 - Q.7 Property Location: 5 Ncurr6 W \11C1 P_C)0(� (r 1 (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT(If applicable): R4f(_C'e_6'__ C ffloort Mailing Address: S �0 2.0 M 01 ky) �_`�.6 ( c�0-W410-1 dl W 11 OW Phone Number: 6 31 ^ '� (y f_ -I �Jo Board of Trustees Appli< ion GENERAL DATA Land Area(in square feet): 2 5- -1, S1 mo- Area Zoning: 9L- 2 d o Previous use of property: '-'-uf UC Intended use of property: �5ckm C Covenants and Restrictions on property? Yes - X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes X No If"Yes", be advised this application will be reviewed by the Building Dept. prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes , X No If"Yes", please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X No Does the structure (s) on property have a valid Certificate of Occupancy? x Yes No Prior permits/approvals for site improvements: Agency Date 4- [ acLm 6AOoc) 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): -To vin 0�gaqnvks-o, Utc� Li mhAw(c 0,amch) Board of Trustees Appli( ion WETLANDITRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: (a l VD k OA �n�l�rc ny(Izs Area of wetlands on lot: ®400C> square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: Q feet Closest distance between nearest proposed structure and upland edge of wetlands: . d feet Does the project involve excavation or filling? x -No Yes If yes, how much material will be excavated? &)A cubic yards How much material will be filled?_ 6 cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: _�/C1'1� 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): Board of Trustees Appli< -ion AUTHORIZATION (Where the applicant is not the owner) I/We, E owners of the property identified as SCTM# 1000- ;17- j in the town of C?>C''t i t, ( C1 New York,hereby authorizes { t �Y t C.t CL• 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. B 0 Property O ignature Property Owner's Sign&e SWORN TO BEFORE ME THIS DAY OF 20 a of y Public BETSY A. PERKINS Notary Public, State of New York No. 01 PE6130636 Qualified in Suffolk Coun Commission Expires July 18,&& CONSENT TO INSPECT Richard Madigan and Scheherazade F.Madigan,as owner of premises 856 NDiver ient(sctm: 1000-27-4-9.6)do hereby authorize and c n n the Southold Tow Trustees to inspect our property. )%L,- (owner's signature) Y (owner's signature) APPLICANT/AGENT/REPRESENTATIW TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics pn,hihits conflicts of interest on then►rt of town officers and emniovece rhe piirnc„e of thi:form is-to nroN ide intiinnntion%%hick can alert the'towll of conflict,(if interea and allo%v'it to take whatever action is _iie.ces,ary to avoid cnme. t r G c !l ►'7d►�- YOUR NAME: I AC-4�r�,� l i!�t l��i;`� %=i =1 i ,�r� �,� .i l G ctu a-0, (Last name,first`n tme,ipihdle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance _ Building Variance Trustee _ Change of Zone Coastal Erosion a._.. Approval of plat _ _ Mooring 4. 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 /L_.._ If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling, parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Subm' of ZOQL Sign;rtuie Print Name Form TS I 61 Z20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 1 -Project and Sponsor Information Name of Action or Project: SGVr- raZ cicu M_ (a I a4^ Project Location(describe,and attach a location map): R008 0QCKr Brief Description of Proposed Action; l O©d " 0-7 - '-i C/ Name of Applicant or S -nponsor: Telephone: f 7 7 I(_' -k 5 - r V`fid 1 , C�A.Vl E-Mail; Address: A65-W City/PO: State: Zip Code: N l y M` L op _: 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that Rf 0 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? 3 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 Residential(suburban) ❑Forest ❑Agriculture El Aquatic []Other(specify): _ ❑Parkland Page 1 of 4 S. Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ 21 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: _ ❑ L"J 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? ff ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? F7f ❑ 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: - Rl� ❑ 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 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 1 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? ❑ Iff 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: Er Li :JJ_ kA AJ O&S vat L&, ✓b Q cd—und is c L"a S iii CAS IUP �vDQC�PS 14. Identify 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/grasslands El 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? ❑ I6.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 nori-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? 10 DYES ❑ ❑ b.Will storm water discharges be directed to established conveyance systems(runoff storm drains)? If Yes,briefly describe: io . 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: E . ❑ 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO- _ YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: F1 I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spon name: _ Date: Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the rfollowing 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? ❑ F] 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 F1 El of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or a affect existing infrastructure for mass transit,biking or walkway? _ 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ Eli problems? 11. W ill 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. aCheck 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. aCheck 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 Town of Southold LWRP CONSISTENCY_ASSESSMENT FORM A. INSTRUCTIONS L, All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A prop_ osed_action will .be evaluated as to its sim_i_ficant_ 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- ,su -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 PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital ❑ 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: �� M 0V�mrpVA kA cvyd Location of action: A10 X'rrVA Ok A^ C2d r �c P Site acreage: 3 C-- Present _Present land use: H A�U , &I - Pr,01 h G-� C�Oct C1 A n!(�JI(c Present zoning classification: L 2 l7 U _ - - 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: 12 t r t(qrut6 cl ��eherc z—C AA rid k A allyl (b) Mailing address: 5—<,-- w -. Tic (c) Telephone number: Area Code (D9 (d) Application number,if any: - ! )/A _ Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No❑ If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED-COAST-POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location, and minimizes adverse effects of development. See LBVItP Section III—Policies; Page 2 for evaluation criteria. ` l Yes ❑ No ❑ Not Applicable to y-rpgmI�r-5 A}eA" CkINP yftZ- d.wA q bJVI — 10 %Huta C4&AI-ri -Q�— hVC(aWAICn Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LNVRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No E rxot Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No ❑ Not Applicable A -S a (3Y1 Crtj- M AIA Al bb-y' Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No u Not 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 through21for evaluation criteria El YesE] No 1 Not 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. Yes No N___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�ZNot Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LVVRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑ Yes ❑ No ►_ Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. ❑ YeZ1 No u Not Applicable Attach additional sheets if necessary WORKING COAST POL.._1ES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LVVRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No E/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 LVVRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ No U Not Applicable Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LVVRP Section III—Policies; Pages 62 through 65 forevaluation criteria. 1:1 Yes ElNo U Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LVVRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑ Yes •❑ No Not Applicable PREPARED BY-- TITLE - DATE �„��� PATRICIA C. MOORE Attorney at Law 51020 Main Road Southold,New York 11971 Tel: (631) 765-4330 Fax: (631) 765-4643 Betsy Perkins Paralegal Julia Spanburgh Julia Schade February 19, 2021 Board of Town Trustees Town of Southold ® ,- C1117 2 U PO Box 1179 Southold,NY 11971 SEB 19 RE: 856 Narrow River Road, Orient(M� Soar igan7c2701 0 w Southold Ton SCTM: 1000-27-4-9.6 , of Trustees Dear Board members: With reference to the above, enclosed please find an Administrative Permit application to the Southold Town Board of Trustees and a check in the amount of$100.00 made payable to the Town of Southold. Thank you. Very truly yours., la�k� C Patricia C. Moore v PCM/jms