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HomeMy WebLinkAboutTR-9540A -A ^ - Michael J.Domino,President �QF SoUTy Town Hall Annex John M.Bredemeyer III,Vice-President Q� ��� 54375 Route 25 P.O.Box 1179 Glenn Goldsmith '' Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9540A Date of Receipt of Application: August 5, 2019 Applicant: Stanley Chase SCTM#: 1000-122-4-26.2 Project Location: 4060 Ole Jule Lane, Mattituck Date of Resolution/Issuance: September 18, 2019 Date of Expiration: September 18,2021 Reviewed by: Glenn Goldsmith, Trustee Project Description: Remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20'from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule,Lane and ending 20''from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. 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 C. Moore, received on August 5, 2019 and stamped approved on September 18, 2019. § 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 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. Glenn Goldsmith, President Town Hall Annex r 54375 Route 25 A. Nicholas Krupski,Vice President 4� P.O. Box 1179 kV John M. Bredemeyer III Southold, New York 11971 Michael J. Domino "� � � yQ Telephone(631) 765-1892 Greg Williams � � ,� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 17, 2021 Michael Monteforte 91 Circle Drive Syosset, NY 11791 RE: 4060 OLE JULE LANE, MATTITUCK SCTM# 1000-122-4-26.2 Dear Mr. Monteforte; The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, June 16, 2021: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer of Administrative Permit#9540A from Stanley Chase to Michael Monteforte, as issued on September 18, 2019. Any other activity within 100' of the wetland boundary requires a permit from this office,. This is not a determination from any other agency. If you have any questions, please contact our office at (631) 765-1892. Sincerely, l ,*V. Glenn Goldsmith, President Board of Trustees GG/dd ' Michael Monteforte 91 Circle Drive Syosset, NY 11791 917-886-8570 June 4th, 2021 Southold Town Board of Trustees 54375 Route 25 Southold, NY 11971 Re:4060 Ole Jule Lane, Mattituck. Permit Transfer Request, Permit#9540A Attention: Board of Town Trustees. This letter is regarding Permit#9540A issued to Stanley Chase (Prior Owner). My name is Michael Monteforte and I am the new owner of 4060 Ole Jule Lane, Mattituck. I would like to request the permit be transferred in my name as the new owner. I give permission to the Board of Trustees to access my property if needed to complete the permit transfer. Please contact me with any questions regarding the enclosed information. Thank you for your time, Michael Monteforte Y� Glenn Goldsr President ��SUFFO(�-� Town Hall Annex A. Nicholas nrupski, Vice-President � - 54375 Route 25 John M. Bredemeyer, III o '` P.O. Box 1179 Ze Michael J. Domino Southold, NY 11971 Greg Williams y ®� Telephone (631) 765-1892 9V '`� Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time:6'/14/Zj 8: Flo Completed in field by: MICHAEL MONTEFORTE requests a Transfer of Administrative Permit #9540A from Stanley Chase to Michael Monteforte, as issued on September 18, 2019. Located: 4060 Ole Jule Lane, Mattituck. SCTM#: 1000-122-4-26.2 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 J Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment V/Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey :5 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 Michael J. Domino, President Town Hall Annex �o �y John M. Bredemeyer, III, Vice-President 54375 Route 25 Glenn Goldsmith r P.O. Box 1179 A Nicholas Krupski y o��` Southold, NY 11971 Greg Williams 10 , ��t.� Telephone (631) 765-1892 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain �( 1 St 0,07rLKG-Or- P006MNt6 % constructed When project complete, call for compliance inspection; IC�fan r� ! ' \\ J � �,/1 s Si AP�eo c s ko Cott,V\1�/ WAN p eC-M J . Q'1_ F-� Michael J.Domino,President SOF SO(/jTown Hall Annex John M.Bredemeyer III,Vice-President 54375 Route 25 O lQ P.O.Box 1179 Glenn Goldsmith l ' Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams 1O �� Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9540A Date of Receipt of Application: August 5, 2019 Applicant: Stanley Chase SCTM#: 1000-122-4-26.2 Project Location: 4060 Ole Jule Lane, Mattituck Date of Resolution/Issuance: September 18, 2019 Date of Expiration: September 18,2021 Reviewed by: Glenn Goldsmith, Trustee Project Description: Remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20' from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. 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 C. Moore, received on August 5, 2019 and stamped approved on September 18, 2019. § 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 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. 1 - If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. Michael J. Domino, President Board of Trustees I I SURVEY OF PROPERTY oOJc�P KRALTs ROAD ^ASITUATE 1� D MATTITUCK TOWN OF SOUTHOLD •• SUFFOLK COUNTY, NEW YORK epj S.C. TAX No. 1000-122-04-26.2 s��cy>P ° e01 �� rk�� �' 1 !j F'�d SCALE 1"=40' �11 JUNE 20, 2007 Jsez Al JULY 19, 2019 UPDATE SURVEY l AUG 5 L11�7 4019 4VI � � �� O AREA = 14,500 sq. ft. �J>�cV, �� c j 0.333 ac. p� ScutnoldToarn ��- go of Trustees n - r S6 a T n °, 5 �� �sGmG �� BOARD OF I RUSTEES 0o TOWN! OF SOUTHOLD vP `49 o �o � r� Iq �o4,rp !� ti� �s °� v DATE i c� 7sF0p �� �q1�. N°pt 90 - h3'� n 'P O , moo!� �.` °co. �y",^ F�O � 'd,�a � -�AFI` � � vto ��• E -�- , 9� �� y�E�• 910 �f PREPAR I T_ INI e� 1t1 SDWD D AN S S 0 °p4�°�° YYY F�0 SUCH EN DIk _G- 11 L `'� spy° 14 CP CP �. vo C7 �o• 0 b = N.Y.S. Lic. No. 50467 A� 1 UNAUTHORIZED ALTERATION TI ADDITION Nathan Taft Corwin III �JY I TO THIS SURVEY IS A VIOIA770N OF SECTION 7209 OF THE NEW YORK STATE COPIES O LAW. Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THED SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. 9 CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isoksen, Jr. LS. ONLY TO THE PERSON FOR WHOM THE SURVEY Joseph A. Ingegno LS. ^ 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 INST— PHONE (631)727-2090 Fax (631)727-1727 TUITION.CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHT OF WAYS OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1566 Main Read P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947 � Michael J. Domino, Presid �Q CO Town Hall Annex ` John M. Bredemeyer III, Vice-&;muent 54375 Route 25 Glenn Goldsmith ro P.O.Box 1179 A.Nicholas Krupski 0 ® Southold,NY 11971 Greg Williams y�o� dap! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ff Date/Time: AI 7 i5 Completed in field by: G. Go)jSmti�'h Patricia C. Moore, Esq., on behalf of STANLEY CHASE requests an Administrative Permit to remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20' from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. Located: 4060 Ole Jule Lane, Mattituck. SCTM#: 1000-122-4-26.2 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 ,/ Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission J 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 ' ,•'- ?wet i y ;• '.;1. qi-\, :,..,'b"� '�'+,. • ,L^i,l 1i}` ;-. •tet • a. •� �-t .. .. - ��'�rt.. , ...� .�..r .eft �l � yk - Ae 1 �. � �. PC , �/.? —97 — `�� Y 'S •� if y . f b )r :i j • � rte"91 .�Y/" i � k•0(" �t.,y ` � � � a y •-���•.;,,�•�`d- �,,jh .gyp. 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Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) rr, Southold, NY 11971 ® �p� Telephone: 631 765-1938 ®lyQutm LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: September 16, 2019 Re:' LWRP Coastal Consistency Review for STANLEY CHASE SCTM# 1000-122-4-26.2 Patricia C. Moore, Esq., on behalf of STANLEY CHASE requests an Administrative Permit to remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20' from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. Located: 4060 Ole Jule Lane, Mattituck. SCTM#: 1000-122-4-26.2 I _ I The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action to install a fence is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. The proposal to clear under bush is recommended as INCONSISTENT. The method, limits of clearing and areas have not been identified. Turbidity erosion controls have not been proposed. The proposal 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand is EXEMPT from LWRP CCR. j I 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 ! 1 I ' I ��►�f S /fiO• _ Town Hall Annex Michael J.Domino,President h0 l0 John M.Bredemeyer III,Vice-President 54375 Route 25 P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski �pQ Telephone(631) 765-1892 Greg Williams OI�C�U Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application v'• Wetland Permit Application Administrative Permit Amendment/Transfer/Extension rRecei'vved eceed Application:Fee: $ 100,00ompleted Application: �1 Incomplete: SEQRA Classification: Type I Type H Unlisted Negative Dec., Positive Dec. Lead Agency Determination Date: Coordination:(date sent): :Z�LWRP Consistency Assessment Form Sent: 7' ED �j �',� E CAC Referral Sent: Date of Inspection: ••11• I LD) Receipt of CAC Report: 5 2019 Technical Review: Public Hearing Held: Tai^rn Resolution: rustees Owner(s) Legal Name of Property (as shown on Deed): AA Mailing Address: / S- 3 re •✓ °� / 7 / 1 Phone Number: Suffolk County Tax Map Number: 1000 - Z 2 Property Location `w �� ' d ,� �e �,. �✓e- � '+' � le // q i (If necessary;provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): FA, a, C. /77co,,,y 65�_�o 7,1 Mailing Address: S- ®2._q M&6 e a f Phone Number: ��� �' Board of Trustees Application { GENERAL DATA i Land Area(in square feet):. E i Area Zoning: ��L, -- -- - - - Previous use of property: Intended use of property: %nLg�, Qi� �\ Z� updec&v >k/ r Covenants and Restrictions on property? Yes __ No o If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes _ 1Vo 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. I Will this project require fy demolition as per Town Code or as determined by the Building Dept.? Yes No Does the structure(s) on property have a valid Certificate of Occupancy? Yes No - I Prior permits/approvals for site improvements: Agency Date i No prior permits/approvals for site improvements. Hasanpermit/approval roval ever been revoked or suspended b a governmental a enc ? No L� Yes Y P pP P Y g g Y If yes,provide explanation:, Project Description(use attachments if necessary): i I i I i Stanley Chase Project Description Propose to remove existing 5' high stockade fence on westerly property line and replace with 4' spruce fence,proposed fence @ 160' linear feet along westerly property line (beginning at Olejule Land and ending @20' from edge of canal) and placement of new 4' spruce fence @160 linear feet along easterly property line (beginning at Olejule Lane and ending @20' from edge of canal). Clearing of underbrush(retain trees); and trimming of phragmites along canal to 12' high with 10 year maintenance permit. Lbyowner- ng conditions: "wood Rack, arbor,boat rack, arbor, lawn and fences" shown on survey placed on owner's property by adjacent owners without permits and without authorization neighbors directed to remove immediately. Board of Trustees Appl _ -tion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /®✓e r o , le. Area of wetlands on lot: Vo square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of.wetlands: C9 ' feet Closest distance between nearest proposed structure a7NOd edge of wetlands: C2 feet Does the project involve excavation or filling? Yes If yes,how much-material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: C� 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): i 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing 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 1 -Project and Sponsor Information Name of Action or Project: / Project Location(describ ,and attach a location ap): 5& C 5a ' 'e Brief Description of Proposed Acti . I Name of Applicant or Sponsor: Sponsor: / Telephone: 4 CG A4 4 f e E-Mail: t o a��/CAjA0 Address: ® n City/PO: State: Zip Code: 77 1.Does tfie proposed action only nvolve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? j If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ +I 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: &r ❑ 3.a.Total acreage of the site of the proposed action? . 99 acres b.Total acreage to be physically disturbed? . 3 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? . 3 9 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial Wkesidential(suburban) El Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page I of 4 5. Is the proposed action, NO YES I N/A a. A permitted use under the zoning regulations? ❑ �j ❑ b_Consistent with the adopted comprehensive plan? El " ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? ❑ RI 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? ❑ 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: El 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: EJ12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO J YES Places? ® F-1b.Is the proposed action located in an archeological sensitive area? ® FI 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? M71 ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional [.] Wetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? N ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ a.Will storm water discharges flow to adjacent properties? D NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: D NO DYES 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: � ❑ i 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: � ❑ 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons nam :�7 Q S 15�? Date: Signature: _ / I 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 El 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 ❑ 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, ❑ 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. 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. I i I �I I i EICheck 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. i 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 I i I i ' I Board. of Tr-urtees� Application AUTHORIZATION- (where UTHORIZATION(where the,applicant is not the owner), � I S'TANLi Y,C NSEE,.as,owner,ofpremises 4060,Ofe Tule.Lane, tMattituck,NY-(sctm: T000-122-4= 26.2,)-resilding at 143 Centre Island Road,,Centre Island,New York&hereby authorize your' attorney,-Patricia G.Moore,to apply for permit(s)and appear before the Southold Board of Town � I 71 .ren my behalf I '—Z� (ownerYs signature) STANLEY C SE ! SWORN TO BEFORE ME THIS ,DAY Or Au 2019 I Notary Public i i PATRICIA C. MORE, II Notary Public, State of New York I Suffolk County -No.4861668 Commission Expires June 18, � j i ! I I I I I ! i ! i r Board of Trustees App'_=�.,ation AFFIDAVIT BEING DULY SWORN DEPOSES AND AFF RMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF 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. Sa ' Signature of Property Owner Signature of Property Owner f SWORN TO BEFORE ME THIS DAY OF 20 Notary Public THERESA M KAITAU Notary PuWft Sta of New York ft 16U148 WggA� Quef iro'Suitolk,Camh� Commisajoh liras'anuery 3I, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM f The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,fust e,itiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other / (If"Other',name the activity.) I 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 shh YES NO v 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. aren or child is check all that apply): The town officer or employee or his or her spouse,sibling,p t, ( pp y): 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 I Submitted this da of tq Signature ' Print Name r Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM i A. INSTRUCTIONS I. 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 si nim beneficial and adverse effects upon the coastal area(which includes all of Southold Towns 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 2- PROJECT PROJECT NAME The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees i 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: J�ef-c" GIe-S-02 00/747 d p . r I Location of action: �� � V k tE"e l 1 V(a� f c]G I Site acreage: ak� ZDr I Present land use: �.c /V,P.e r GrS�/dl c&,, -.r i Present zoning classification: i 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: ((� i (b) Mailing address: (c) Telephone number: Area Code i (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No N 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 i 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. N Yes ❑ No [—] Not Applicable Plf,�C'��f �e� _ !LI l/��ii�• id�17��6'�L/ Gc` C/�C�1'I Q.�t� Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold, See LWRP Section III—Polic'es Pages 3 through 6 for evaluation criteria ElYes 1:1No Not Applicable I I Attach additional sheets if necessary i 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 VfYes ❑ No Not Applicable i I I 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 Pa es 8 through 16 for evaluation criteria ❑ Yes ❑ No Not Applicable i i I Attach additional sheets if necessary i Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No Z Not Applicable I i Attach additional sheets if necessary I 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. 4 - Yes No v�- Applicable Attach additional sheets if necessary i 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 �Nt Applicable I i 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 1:9Not 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. ❑ YeO No U Not Applicable Attach additional sheets if necessary WORKING COAST PG,..CIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations7No WRP Section III—Policies; Pages 47 through 56 for evaluation criteria. F71 Yes F-1Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the PecoMe Estuary and TowFNotApplicable rs. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes 1:1 No ` Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III — Policies; Pages 62 through 65 forevalu tion criteria. ElYes 1:1No Not Applicable i 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 I • I i 1 PREPARED BY C1i0YcGe C����D�`'/-►' TITLE DATE —S `"1 Michael J. Domino, President c%opo coGy,ti Town Hall Annex John M. Bredemeyer, III, Vice-President 54375 Route 25 Glenn Goldsmith c N z P.O. Box 1179 A Nicholas Krupski y , Southold, NY 11971 Greg Williams �ol , ���f�" Telephone (631) 765-1892 -1 Fax (631) 765-6641 SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction, hay bale line/silt boom/silt curtain 1 st C07P10-or- P#06mitP6 % constructed When project complete, call for compliance inspection; Michael J.Domino,President �QF SQUjy Town Hall Annex John M.Bredemeyer III,Vice-President �Q� �1 54375 Route 25 P.O.Box 1179 Glenn Goldsmiths ' Southold,New York 11971 A.Nicholas Krupski G Q Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 ol�COUNTY,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9540A Date of Receipt of Application: August 5, 2019 Applicant: Stanley Chase SCTM#: 1000-122-4-26.2 Project Location: 4060 Ole Jule Lane, Mattituck Date of Resolution/issuance: September 18, 2019 Date of Expiration: September 18,_2021 -0 Reviewed by: Glenn Goldsmith, Trustee Project Description: Remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20'from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. 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 C. Moore, received on August 5, 2019 and stamped approved on September 18, 2019. § 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 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. 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. ?xi'6'4d� " Michael J. Domino, President Board of Trustees �� SURVEY OF PROPERTY oQ�e GAP T TIS SITUATE KRAlJ L ROAD MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK G � °eeP� �e5 �$ r Y S.C. TAX No. 1000-122-04-26.2 �QJeJGy1P � ' SCAdo O` a8, �� r rf I } UNEL 20, 2007 C; I \sem JULY 19, 2019 UPDATE SURVEY AUG 5 2019 ��� a �O AREA = 14,500 sq. ft. �P�� J� 0.333 ac. L°pSnu;noldTown zs`y ( � `e �� F./ �\ �p� T,'Q e� a Df Trustees Y '' 0) O I a• , � '�° /, \� ° 9� 'moo,, Prb� ci � sp,i,t APPROVED BY r- P/bCcf�CKfC.. e011% y W� ,`off 5 � �'�G�G��� BOARD OF r�USTEES ,,,,� �k Lo TOWN OF SOUTHOLD � 9 Vol °`° DATE sef;,jg*AFp- IS, oqq GE 144 0y1P� Y 'N C, e 9 X20 ra�'`goosP), oG�GlG2G7 d�t� rS.uLecC � PREFAB D IN V1D r_ •• INI r� O5E• w� _ct�I19� ep �� STAND;r S S FY L!B0 S�w �7HEW Y D` Yc`�"S�F.I °�G_dl• ^�� ^� " mss' cA4ee ` S �o 67 N.Y.S. Lic. No. 50467 A�f UNAUTHORIZED ALTERATION TI ADORION Nathan Taft Corwin iii TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCAT COPIES LAW. Land Surveyor COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VAUD TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN Successor To: Stanley J. Isaksen, Jr. LS. 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 Iifle Surveys — Subdivisions — Site Plans — Construction Layout LENDING INSTITUTION LISTED HEREON,AND TO THE ASSIGNEES OF THE LENDING INS 1— PHONE (631)727-2090 Fax (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. Jamesport, New York 11947 Jamesport, New York 11947 2 g�FFO(K� Michael J. Domino, Presid' 0�0 e" Town Hall Annex John M. Bredemeyer III,Vice-Pi...uent �� �� - 54375 Route 25 Glenn Goldsmith y P.O.Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams 4' �ap� Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES / TOWN OF SOUTHOLD f Date/Time: �/ 5�iq 7 i5 Completed in field by: Patricia C. Moore, Esq., on behalf of STANLEY CHASE requests an Administrative Permit to remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20' from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed ,(Ph ragmites australis) to 12" in height by hand, as needed. Located: 4060 Ole Jule Lane, Mattituck. SCTM#: 1000-122-4-26.2 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 J 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 Ar ace At �.. • - �a��� �-+sly' ..._ - .. _ _ ;. � y�/ fi 'sem• ! ssr� T ♦ tW'.. -:s. i � � ice'C L _.� " � A J^�{` , s•��� ..'�� . �i7W�'` �Wy� 1 •,fir � '�,. 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O o....... --•_— r..a.--.a,_— o.,.c PaxnoYi rna.d.eo �; w.mr c.nr.w..rn..a.nrnwl o M A acrwct xo 1060 PROPERTY MAP _ ��• P mNb),s,a.na rwaf wr 2,6N1.•,2 a+Nel -- OFFICE LOCATION: ®��®f S® �®� MAILING ADDRESS: Town Hall Annex ® P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) esu Southold, NY 11971 ® a� Telephone: 631 765-1938 Cou Ti LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM To: Michael Domino, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: September 16, 2019 Re:' LWRP Coastal Consistency Review for STANLEY CHASE SCTM# 1000-122-4-26.2 Patricia C. Moore, Esq., on behalf of STANLEY CHASE requests an Administrative Permit to remove existing 5' high stockade fence on westerly property line and replace with 1601f of 4' high spruce fencing, beginning at Ole Jule Lane and ending 20' from edge of canal; and to install 160 If of 4' high spruce fencing along the easterly property line beginning at Ole Jule Lane and ending 20' from edge of canal; clear underbrush while retaining trees; and for a 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand, as needed. Located: 4060 Ole Jule Lane, Mattituck. SCTM#: 1000-122-4-26.2 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action to install a fence is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. The proposal to clear under bush is recommended as INCONSISTENT. The method, limits of clearing and areas have not been identified. Turbidity erosion controls have not been proposed. The proposal 10 year maintenance permit to hand-cut Common Reed (Phragmites australis) to 12" in height by hand is EXEMPT from LWRP CCR. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Michael J.Domino,President � SOUTy� Town Hall Annex John M.Bredemeyer III,Vice-President l0 54375 Route 25 P.O. Box 1179 Glenn Goldsmith CIO� Southold,New York 11971 A.Nicholas Kn,pski � • �p� Telephone (631) 765-1892 Greg Williams ���10DUIdT`I,� ' Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only CW10 _ Coastal Erosion Permit Application _ Wetland Permit Application Administrative Permit r' Received endment/Transfer/Extension eived Application: g'.�'jq Fee: $ 100,0.0 Completed Application: Incomplete: SEQRA Classification: TypeI Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): pq LWRP Consistency Assessment Form Sent: 7/ ! D C, ��' u E CAC Referral Sent: Date of Inspection: •�� Receipt of CAC Report: A11G 2019 Technical Review: =Public Hearing Held: I Southold Town Resolution: B01rd of TrnJqPz Owner(s) Legal Name of Property (as shown on Deed): ,V e Mailing Address: 3 r'2!_ z V "� 7 d Phone Number: Suffolk County Tax Map Number: 1000 - a 2 Property Location: ye e , CJ ,� ✓ �e �.. r✓e � ,'- a /� �� �/ 9� (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): J'a IGZ all C' /?qC70"ry 45r--g Mailing Address: Phone Number: ��� ���' Q Board of Trustees Application GENERAL DATA Land Area(in square feet): Area Zoning: _ q—'(-k c-) Previous use of property: 2t 1J� Intended use of property: %nce., G,(\ak QA0_o"\f� Covenants and Restrictions on property? Yes _ yNo 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 require y demolition as per Town Code or as determined by the Building Dept.? Yes /No Does the structure(s)on property have a valid Certificate of Occupancy? 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 a encY9No L' Yes If yes,provide explanation: Project Description(use attachments if necessary): Stanley Chase Project Description Propose to remove existing 5' high stockade fence on westerly property line and replace with 4' spruce fence,proposed fence @ 160' linear feet along westerly property line (beginning at Olejule Land and ending @20' from edge of canal) and placement of new 4' spruce fence @160 linear feet along easterly property line (beginning at Olejule Lane and ending @20' from edge of canal). Clearing of underbrush(retain trees); and trimming of phragmites along canal to 12' high with 10 year maintenance permit. L ing conditions: "wood Rack, arbor, boat rack, arbor, lawn and fences" shown on survey placed on owner's property by adjacent owners without permits and without authorization ner-neighbors directed to remove immediately. Board of Trustees Appl _ -tion WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: /o ✓e .k ...74- / e2u r a , Area of wetlands on lot: �/D square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: c2, feet i Closest distance between nearest proposed structure andup d edge of wetlands: feet Does the project involve excavation or filling? No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: C� Manner in which material will be removed or deposited: '9V 1pf Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 617.20 Appendix B Short Environmental Assessment Form Instructions for 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 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 34XV4/ClCl c s-z, Name of Action or Project: / Project Location(describ ,and attach a location ap): 54' C 5;arve 'e Brief Description of Proposed Acti : ` G !G�w / Name of Applicant or Sponsor: Telephone: .5r-�G 0ZL 4 // Ce G !� t f e E-Mail: t o �(d��/ '#.0/. G o Address: City/PO: State: Zip Code: S 712- f - a! fi 77 1.Does tfie proposed action onlytfnvolve 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 ❑ LIN �+ 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: ❑ Nr 3.a.Total acreage of the site of the proposed action? . ?19 acres b.Total acreage to be physically disturbed? 3 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? • 3 9 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural (non-agriculture) ❑Industrial [—]Commercial Residential(suburban) El Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? ❑ f jj ❑ b_Consistent with the adopted comprehensive plan? ❑ L®�1 ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES 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? [Y ❑ c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9 ❑ 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: ❑ 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? Ft7l ❑ If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional PP 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? F;U ❑ 16.Is the project site located in the 100 year flood plain? NO Y S 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, ❑ NJ I a.Will storm water discharges flow to adjacent properties? ❑NO DYES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO AYES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO I 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: F-A ❑ 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: n, ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/spons name! 1e 'tet.c S--'7 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 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? r 4. Will the proposed action have an impact on the environmental characteristics that caused the FZ:Z-/` ❑ establishment of a Critical Environmental Area(CEA)? L—;9- 5. Will the proposed action result in an adverse change in the existing level of traffic or FIV ❑ 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, (`� ❑ 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. 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) PRINT Page 4 of 4 AUTHORIZATION- (where UTHORIZATION(where the,applicant is.not the owner), TANLEY,eriAS'E;zs ownersofpremises 4060=OTe.Tule Lane,tMattituck,NY(sum: I000-r22-4w. 26.2"z res%dingat 143 Centre Island Raad,•Centre Island,New Y>ork,do hereby;authorize our attorney,'Patricia C.Moore,to apply for permat(s) and appear before the Southold Board of Town Iri1LgteeS'0 .M' 1a�l�Salf /4j �� (owner"s signature) STANLEY cilAsE SWORN TO BEFORE ME THIS DAY OF AUGUST,2019 Notary Public PATRICIA C. MOORE Notary Public, Stag of New York Suffolk County -No. 4561665 Commission Expires,tune 16, a— / Board of Trustees APP==-- ,ation t� AFFIDAVIT , e-- 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 Property Owner i SWORN TO BEFORE ME THIS DAY OF t/s , 20 Notary Public THERESA M.KATTAU Notary Public Ste of.New York No:016u4020A Qualified iro'Suja k,Counbb Commissjonmoires 1am%ary 3I, APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The pumose of this form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: (Last name,first e,.tpiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other / (If"Other",name the activity.) W e �( OL W �G /_ ft�t a Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town ofSouthold? "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 shar YES NO If you answered"YES complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this da of 20� Signature Print Name ,,✓/e tic Form TS 1 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 To 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# ` z-2- PROJECT 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: Location of action: J`� (PC) O/e j V l e 4T/y` 4 ma�OVCJG Site acreage: fit envt Present land use: AL�� IV"� �yr�,LVrJGt c¢uLrs 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: asc (b) Mailing address: 44 (c) Telephone number: Area Code( ) �� �7 -:2 — /g(jk (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes ❑ No© If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. Yes ❑ No ❑ Not Applicable 161 - / Al ann el- Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Polic'es Pages 3 through 6 for evaluation criteria ❑ Yes 0 No Not Applicable c 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 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 Pa es 8 through 16 for evaluation criteria F-1Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Southold. See LWRP Section IH —Policies Pages 16 through 21 for evaluation criteria F-1Yes ❑ No U 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. ❑ ❑ Y Yes No 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[9/Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. 1:1 Yes ❑ No 1 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. nn 11 WE] No 12/Not APP licable Attach additional sheets if necessary r WORKING COAST P6.,.CIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See WRP Section III—Policies; Pages 47 through 56 for evaluation criteria. F71Yes ❑ 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 Tow7NotApplicable rs. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. 1:1 Yes El No ` 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 PREPARED BY Zee cL. C- OD eO� TITLE DATE �� `�