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HomeMy WebLinkAboutTR-9961A Glenn Goldsmith,President � 'oF SOUryO 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 h Telephone(631) 765-1892 Greg Williams �� Fax(631) 765-6641 �'y��UNTY,Nct� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE - - - ------ --- -- # 1854C Date: August 30,2021 THIS CERTIFIES that the as-built deck which extends 18' 2" northerly off of the house and is 34' 2" wide. On the north side of the deck there is an 18' wide step/staircase which is two steps, __— three-risers to-grade.-On-the_west-sid_e_of-thesleckth-e:re is a 4' =6"wide staircase, 2 steps and 3 risers to grade. The deck is topped with brown trex decking and white PVC railings. At 870 Inlet Lane, Greenport Suffolk County Tax Map#1000-43.-2-8.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 14, 2021 pursuant to which Trustees Administrative Permit#9961A Dated August 18, 2021,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the as-built deck which extends 18' 2"northerly off of the house and is 34' 2" wide. On the north side of the deck there is an 18' wide step/staircase which is two steps,three risers to grade. On the west side of the deck there is a 4' - 6"wide staircase, 2 steps and 3 risers to grade. The deck is topped with,brown trex decking and white PVC railings. The certificate is issued to Patrick DiLollo owner of the aforesaid oil property. 'X- t�� Authorized Signature Glenn Goldsmith,President �Qf SO(/ry Town Hall Annex A. Nicholas Krupski,Vice President ,`O ��� 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 o�y�DUNTV,�� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPECTED BY: V/- �' C . 275 Ch. 111 INSPECTION SCHEDULE Pre-construction;haybale line%silt boom/silt curtain 1st day of construction '/ constructed Project complete, compliance inspection COMMENTS: CERTIFICATE OF COMPLIANCE: Glenn Goldsmith, President �QF S0 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 Telephone(631) 765-1892 Greg Williams �� �� Fax(631) 765-6641 cOUNT`I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD SOUTHOLD TOWN BOARD OF TRUSTEES YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE ACTIVITIES CHECKED OFF BELOW INSPECTION SCHEDULE Pre-construction-;-hay-bale line/silt boom/silt curtain 1St day of construction- % constructed When,project complete, call for compliance inspection; Glenn Goldsmith,President Vv*Of SOUJyO Town Hall Annex A. Nicholas Krupski,Vice President ,`O l0 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 �yI NV I BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9961A Date of Receipt of Application: July 14, 2021 Applicant: Patrick DiLollo SCTM#: 1000-43-2-8.1 Project Location: 870 Inlet Lane, Greenport Date of�Resolution/lssuance: August 18, 2021 Date of Expiration: August 18, 2023 Reviewed by: John M. Bredemeyer, III, Trustee Project Description: As-built deck which extends 18' 2" northerly-off of the house and is 34'2"wide. On the north side of the.deck there is an 18'wide step/staircase which is -two steps, three risers to grade."On:the west side of the deck•there.is a.4' - 6" wide staircase, 2 steps and 3 risers,to grade:Tho-deck is topped with brown''-trex decking,and white PVC railings. 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 survey prepared by Scalice Land Surveying, received on July 14, 2021, and stamped approved on August 18, 2021. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. _t�7 b�" Glenn Goldsmith, President Board of Trustees 0 �y, CL® � 2N�V1 YW vW -k 0u� SYMBOL LEGEND r---� z a <Q� �T 0 MONUMENT FNDJ 1A. 1 O o I.P. I.B. END ® 0 I.P. /I.B. SET SPOT ELEVATIONS UTILITY POLE }— GUY WIRE ' g 3 0 UTILITY POLE W/LIGHT L1 w 0 LIGHT POLE �I � .. ■ .7 t✓ y�i w�i SIGN lam✓ rr*d O a' FIRE HYDRANT ° jQ O - PVC FENCE (PVC) -i- STOCKADE FENCE STK -X- CHAIN LINK FENCE(CLF) r-- o -"- WIRE FENCE TAX LOT 26.1 ® MANHOLE "A"-INLET I 200-19' B/11 � P a "B"-INLET t45't ���� r .► ® YARD INLET I gRiCK WOOD Rg.WA}L LL YARD INLET ' n WAU '(10") r �� + r •— y v� oon I 405 50 1 WALL t 2dt ,,. r o a W Z A/C UNIT I WAIL 1"`' 2.63' .� .� +'-"�"A,L 'HOOD RET. G17 c "'w s WOOD RET.WALL ® ELECTRIC METER I D� �r 5���tW ALL—3„ 3 BEARINGS SHOWN HEREON ARE BASED nn`` o�o p GAS METER I WALL q ON USER 12702 PAGE 888 W o (I4•) 0.2ft oy J w� a �` ® WATER METER I B7171.4' I C fGAS VALVE { j 1WATER VALVE I oTEST HOLE I { 8'71 z 1 FLCAnNG 0OW xo s w o TREEI { ' _. I a I 'Fo Q SHRUB I /" I 3` BOLLARD i /i /,,Y 1 1E7 . 61.0# WOOD r� N z ® WETLAND FLAG O '7 D.C. DEPRESSED CURB I Op m/1 STORY' tL J V FE. FENCE I .-FRAME / 1 WOm �' f f"I < w {.O, PROPANE() DEN RESICE I DEC< f 4 N76o 20 33 'T W MAS. MASONRY I TANK'S 0 /870 1 (26') r� Lo ^4 PLAT. PLATFORM I 6.62 W.W. WINDOW WELL I 1 ' 4.4' j �- ' 1 i o Q3 B/W BAY WINDOW I 11.8' R/OI 227 S13009,50"X50"II • - \ Q o< C/E CELLAR ENTRANCE I 14,2 , y C) Ey z G o 1 < 0/H OVERHANG ,- 55.5± 22./4 'T r5y �� I t_7 L 1 <o Ln R/0 ROOF OVER f { .. �_ i L` s r (`' � W m CAN = ic CANT. CANTILEVER jS78°0035EP0-& `7.27. 52.71; 24.0. r� 44 w x DEE_-O L, tNe - "'.."�... 1-30' 4 _ P < I PARCEL III - I • - W� .!�' H P.O.B. 2 •DRIVEWAY, / m ^ z a o �mWN O p SIIo w t 1 v p 1 L I TAX LOT 6.1 °� j O -1 oao r,, I nt N 4 a� a, 1N CD 0 I t o p AR� O Q Q 0 o Z 2� w C?� cg rc 1 m cPo I— O Q ~ i Y rn �wx� 1 ti .�1p7, prj o o w o I 1 , �4T O LI1yLy, O d- "j >W- 1 �y �Dj �QRy�*0 � LLJ � UI C4 > I w000Eo , �l�� A mop 8U 0 Z w p s b o { 1 AREA iC )�A Lxlr� m f- •• u��i 7� ^ ACU V �Z TAX LOT 7 IY o 0 Nto�o PAA W 0w Z� I i S00046'56"E z -r Z w l= ` PARCEL w LLJ P.D.B. N87°05 32.56 Q- w D w 250.00' — —` a U) N s y OZ W o \ ————————————— O F= LL_ L- z ;uv _____----- ---------------- V) O O O `.1 6 ------- ----------- --_---- _ U 2N p EDGE Of PAVEMENT ,, --`-- �� WOOD BORDER LjJ Z rc°d F'JE MANI�ANSET A VENUE > Q o o U z p 0 GRAPHIC SCALE NAL' —' L� �a&a (VAR. WIDE) � > I'- ?:06H 30 0 15 30 o 0 0 srw ( IN FEET ) LOT AREA =w- 1 inch = 30 ft. 49,975± S.F. 1.15± AC. COO W a N; 2x 1 �y �� FR Glenn Golc ith, President SOS ' TowrFHall Annex A. Nicltoias Krupski, Vice-President ��� Gym 54375 Route 25 John M. Bredemeyer, III o "` P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams y'f9p� �0 Telephone (631) 1892 (631) 765 6641 Fax BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: �!� �J�. Completed in field b : N Y i+ PATRICK DI LOLLO requests an Administrative Permit for an as-built deck which extends 18' 2" northerly off of the house and is 34' 2" wide. On the north side of the deck there is an 18' wide step/staircase which is two steps, three risers to grade. On the west side of the deck there is a 4' - 6" wide staircase, 2 steps and 3 risers to grade. The deck is topped with brown trex decking and white PVC railings. Located: 870 Inlet Lane, Greenport. SCTM#: 1000-43-2-8.1 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK=� 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 o Hearing Card Posted: Y / N Ch. 275 Ch. 1111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Surveys 5,years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: Rfo*J✓ -Pa A407" /IV LL ✓vim fl1)T be) x Pj/ e_ I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: _A�J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other E ' o � c� Eq ECL E� Ec[ ILINEOEDEGKAND - - - - - - - - - - - STAIRS ABOVE a - - - - - - - - - - - 3-2x10 BM O � I II I � � I 4 x 4 P.T. P05T5 P. I 3-2x10 BM v n - - O 10" 0 GONG. FILLED �j w } N 3-2x10 BM "50NO TUBE PIER, TYP. O Z tL _d) I m N p 3-2x10 BM iI w ry !I x DEGKING ED — [):f J in l m x l l O Z O 0 a - —`t' I •O � l` 0 w li � •— w � II II L7 2x6 ledger II LINE OF HOUSE — II I I I � it I CL Z7 4'-6" Z 0 0 z Q 0 � z o J _ � LL- A FRq JUL 14 2021 rt�,��N6gus�cl DATE 06-18-2021 SCALE 1/4"= 1'_0„ FOUNDATION 5� DWN BY � CHECKED )OB No. sTq No. 01 ABgA �F 2 � Rg REV. No. DATE DESCRIPTION DWG. No. U � ON 54'-2" C cz In N G > � kn 8'-O" HIGH RAIL ' d U W 0 - . i Q a_ J W w �-- I x 6 COMFOSIT DECKING iv �cn t~ Z ALL FRAMING MEMBERS ARE c_ W ry PRESSURE TREATED j �O Z +- — 0 O 0 a- 0 0 w LINE OF HOU5E % -- �t J Y w W_jvo �EPE D ARCh,� u L JUL 7 4 20 � NgRusC� ' DATE 06-18-2021 21 �o� ,i SCALE 1/4"= 1'-0'• Tow n ~' � DWN BY DEG< PLAN �� `' CHECKED JOB No. . 014 C� ATF c 9 REV. No. DATE DESCRIPTION DWG. No. Q�� Legend 2018 Deck & Shower? Write a description for your map. lw, a 1 q' Iq n Y 74, a 1kP t, :1 Y os.' fAta�tr No�� eS'Css�i� �I rte. k { . M.................. ....._..:a:::::::3sr,e,�t• w a t a .70 rrd�Y -14� z ,III Iii 4 K 1 J r � _ . jJf lop tit. 64_11(p i i ii 1r, 'G _AlA.. A. _ t ' �W ^r 0 e t \y 't .m. FAC:*:!r NotiT14 a# / J{ / V V1 "`•�,;.. - " ... � _-.- _ � moi- - -r _'" � _ Ilk ai — ' a' m o_ DiSalvo, Diane From: Patrick DiLollo <pjdilollo@gmail.com> Sent: Wednesday,July 28, 2021 8:30 AM To: DiSalvo, Diane Cc: 870 Inlet Subject: 870 Inlet Ln Greenport Hello, As per your request,the as built deck permit I am applying for extends 18' 2" northerly off of the house and is 34' 2" wide. On the north side of the deck there is an 18'wide step/staircase which is two steps,three risers to grade. On the west side of the deck there is a 4' -6"wide staircase, 2 steps and 3 risers to grade.The deck is topped with brown trex decking and white PVC railings. Patrick DiLollo ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i Glenn Goldsmith,President ®f S®(�j� - Town Hall Annex A.Nicholas Krupski,Vice President ems'® �� 54375 Route 25P.O.Box 1179 John M.Bredemeyer III Southold,New York 11971 Michael J.Domino Telephone(631) 765-1892 Greg Williams �Q 6631 765-6641 rpU E C t�- 0 V E BOARD OF TOWN TRUSTEE . JUL 14 208 TOWN OF SOUTHOLD This Section For Office Use Only Boar or'-j, ­- es Coastal Erosion Permit Application Wetland Permit Application 1( Administrative Permit ; Amendment/Transfer/Extension K Received Application: ?•�`���. Received Fee: $ ZW,0V 11D- (U ---- =Completed Application: 7.Z.2-1 Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: ,C oordination:(date sent): . LWRP Consistency Assessment Form Sent: _CAC Referral Sent: Date of Inspection: Receipt of CAC Report: _- Technical Review: —Public Hearing Held:_ •Z Resolution:— Owner(s) - Owner(s)Legal Name of Property(as shown on Deed): _- Mailing Address: 2_4 —TLc- Njtc_ Lpc j r yf k'j'e,j 0� Phone Number: Suffolk County Tax Map Number: 1000 -,__ � v-1 Property Location:- S-'�D e--r (-nt (If necessary,provide LILCO Pole#, distance to cross streets,and location) AGENT(If applicable): t ANA ® - Mailing Address: -- Phone Number:_ _ -- Email: Board of Trustees Application �1 GENERAL DATA Land Area(in square feet): Area Zoning: �' 4/0 Previous use of property: Intended use of property: -- Covenants and Restrictions on property? Yes No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes 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 No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes �No - z Does the structure(s) on property have a valid Certificate of Occupancy? Yes No Prior permits/approvals for site improvements: Agency Date M 60 r et�K Z-zoLft ov (2-- L019 321a D2 `os 'Soo No prior permits/approvals for site improvements. Hasanpermit/approval ever been revoked or suspended by a governmental agency? No Yes Y If yes,provide explanation: Project Description(use attachments if necessary): 6 wi l� - C,�k�n�`►�,,. oPr�eet-� Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Area of wetlands on lot: square feet Percent coverage of lot: 0/0- Closest distance between nearest existing structure and upland edge of wetlands: 575.5 feet Closest distance between nearest proposed structure and upland edge of wetlands: feet Does the project involve excavation or filling? -_ No ---Yes If yes,how much material will be excavated? A)& cubic yards How much material will be filled?_ N `� cubic yards Depth of which material will be removed or deposited: 6 feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: Statement of the effect, if any,on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): 01✓ 617.20 Appendix B Short Environmental Assessment Form Instructionsfor_Umnletin� Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part I. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part I-Project and Sponsor Information kt- Name of Action or Project: Project Location(describe,and attach a location map): (cj Lij 1jY1�. of o.t� A-' Brief Description of Proposed Action; Name � /li of Applicant or Sponsor: Telephone: r!6_ 4 _ ?ZZ A4r- d" -rcv'(i cq-1a v E-Mail:. �.`�ocv- Address: City/PO: - - — = State: Zip Code: ev 1.Does the proposed action only involy the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? 0If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that may be affected in the municipality and proceed to Part 2. If no,continue to question 2. - 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: = - 3.a:Total"acreage of the site of the proposed action? acres - b.Total acreage to be physically disturbed? _acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor'? �. acres 4. Check all land uses that occur on,adjoining and near the proposed action. _ Urban ❑Rural(non-agriculture) []Industrial ❑Commercial Residential(suburban) ❑Forest ❑Agriculture (,'Aquatic J]Other(specify): ❑Parkland Page 1 of 4 5. Is"the proposed'action", - NO YES N/A a.A permitted use under the zoning regulations? 1— b.Consistent with the adopted comprehensive plan? ❑ LJ 6. Is the proposed action consistent with the predominant character of the existing built or natural _NA_ _YES J landscape? 7. Is the s'►te 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? - o,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: 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? W FJ 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 YE wetlands or other waterbodies regulated by a federal,state or local agency? a 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: 14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: El Shoreline [I Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban Rluburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO_ YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100 year flood plain? NO-- YES. 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO DYES F b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: NO ❑YES Page 2 of 4 18.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: _ 19.14as the site of the proposed action or an adjoining property been the location of an active or closed NO .AES 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:__ - I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATETO THE BEST OF MY KNOWLEDGE f Applicant/sponsornarne: _+ P �� -:.-- �-C�- Date:—04 'Signature: ��`—1 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 1. Will the proposed action create a material conflict with an adopted land'use plan or zoning regulations? a 2. Will the proposed action result in a change in the use or intensity of use of land? T 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate (� F1reasonably available energy conservation or renewable energy opportunities? L�1 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? u 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? 01 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. F] 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 4 Page 4 of 4 Board of Trustees Application AFFIDAVIT BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED 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. a ure of perty Owner rvSignature of Property Owner SWORN TO BEFORE ME THIS. -----/C)-74( DAY OF_ Lc-_l _,20Z/ LISA GIOIA NOTARY PUBLIC-STATE OF NEW YORK ` No.01G16126405 Qualified in Nassau County My commle®iail INgim 09.024 Notary Public APPLICANUAGENUREPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM •The Town of Southold's Code of Ethics prohibits corifikts of interest orithe partof town'afficers and erriploveos°Tfie pu=oose of this form is to-provide information which can alert`the town of-s6p! lk onflicts�of inierest and allow ittflFtake,yuhatever.action is r essary t6 avoid,samie " YOUR NAME:_ - L �o ._ _Oar rU aC (Last name,first name,ipiddle 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 = X ` Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map :_ Planning Other (If"Other,name the activity.) __ Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee " of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(whets 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 day of 200_ Print Name ' 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 asto its significant__ _ _ .beneficial and adverse effects upon the coastalarea(which includes all-of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency ; review law. Thus,_each answer-must be explained in detail, listing both supporting and non- .supporting facts. If an action cannot be certified as consistent with the- 1-WRP policy standards and conditions,It shallnot.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#-c 45v_y_ -,01--,90 lid 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:'-I: 4Z`i T,1cz J(w Gr e- O_.' tom_ Site acreage: Present land use: Present zoning classification:,-, 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: (b) Mailing address: a i�„ L � 5 w e— (c) Telephone number:Area Code (d) Application number,if any: Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes F1No D61 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 E] No V6 Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWnRP Section III—Policies Pages 3 through 6 for evaluation criteria U_ Yes D No O Not 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 0 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 Pages S through 16 for evaluation criteria Yes No u Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria EJ Yes No EZfNot 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. F-1-' o ,� Yes No 1, `"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 E] No Not Applicable Attach additional sheets if necessary T 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. t Yes 0 No 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 191 Not Applicable Attach additional sheets if necessary WORKING COAST PCw-wCIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III•—Policies; Pages 47 through 56 for evaluation criteria. ❑.Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. No Yes ❑ 2 Not Applicable : Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. � j F Yes ❑ No u 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. .0 Yes ❑1 No Not Applicable PREPARED BYE-cc1,Ecat - �����y TITLE ��h _ == DATE a 2 OFFICE LOCATION: MAILING ADDRESS: Town Hall Annex " � "� �� �^� � �A P.O. Box 1179 54375 State Route 25 ° y Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 Telephone: 631 765-1938 n 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, AICP LWRP Coordinator Date: August 9, 2021 Re: LWRP Coastal Consistency Review for PATRICK DI LOLLO SCTM# 1000-43-2-8.1 PATRICK DI LOLLO requests an Administrative Permit for an as-built deck which extends 18' 2" northerly off of the house and is 34' 2" wide. On the north side of the deck there is an 18' wide step/staircase which is two steps, three risers to grade. On the west side of the deck there is a 4' - 6" wide staircase, 2 steps and 3 risers to grade. The deck is topped with brown trex decking and white PVC railings. Located: 870 Inlet Lane, Greenport. SCTM#: 1000-43-2-8.1 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 INCONSISTENT with Policy Standards and therefore is INCONSISTENT with the LWRP. Policy 6. Protect and restore the quality and function of the Town of Southold ecosystem 6.3 Protect and restore tidal and freshwater wetlands. A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction I. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions The structure was constructed without obtaining a Wetlands Permit. 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 B� 17 `aha"gad a�►•®Ei3ea,a,®®er9®®®©oiTr��im����soo� Wpig n R x 4 urA JUL 14 2021 �= Southold Town Board, of Trustees INLET LANE PRNATE ROAD (49 5' WIDE) — -----------------------,o; n e� ----------------- _ 205.00' - i lift I � N I IaI 1 s;i ' I I $ p 1 41 I I4 I~ I 1 I 1 6`�g9 �xs�•Or•� mer � 1 c - y2Y I 1 3 »s,gg• Iw; 1 1 g9 ea+'wo 1• I I �b 60 4'rol acl $ 1� e 9 N c 1 I � Rop .,� 1 $1� AT C��NARA�O'�FAC io�; s GULL POND h7cq opON 1 1 S,as 1 ,ql 9� SHEET 3 SURVEY OF PROPERTY SUFFOLK TAX MAP N0. �pF NEry SITUATE 1000-043.00-02 00-008.007 SCALICE r VILLAGE OF GREENPORT � �-. 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