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HomeMy WebLinkAboutTR-9978A Glenn Goldsmith,President "' � 1 � � Town Hall Annex A. Nicholas Krupski,Vice President �� w" 54375 Route 25 P.O. Box 1179 John M. Bredemeyer III Southold, New York 11971 Michael J.Dominofi Telephone(631) 765-1892 Greg Williams � V Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9978A Date of Receipt of Application: August 9, 2021 Applicant: Kerrie-Ann & Christopher Cohen SCTM#: 1000-56-7-13 Project Location: 195 Albacore Drive, Southold Date of Resolution/Issuance: September 15, 2021 Date of Expiration: September 15, 2023 Reviewed by: John M. Bredemeyer III, Trustee Project Description: For the as-built removal of limbs and trimming of trees; and the as-built removal of five (5) trees. 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 Christopher Cohen, received on August 9, 2021, and stamped approved on September 15, 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.. 411— 441 X__ Glenn Goldsmith, President Board of Trustees f APPROVED BY � X BOARD OF ) RUSTEE S p fl ,� AUG I 9 2MI TEST HOLE No. 1 MST HOLE DUG BY NORTH SHORE WELLDRIUNG ON JUNE 17. 2001) SURVEY EY OF Zo?,� LOT 26Olt �sow� ', arae of w e c"Y SOUTHOLD SHORES nLE no. crass nLED AUOUST 29. 1963 -V e a TEDAT SITUA sm '44CAL CLAY AY ARSHAMOMAQUE O 1' AL AL TOWN OF SOUTHOLD 3 U) 1' SUFFOLK COUNTY, NEW YORK 11 S,0 ilk Ott ,x S.C. TAX No. 1000-56-07-13 X fRi AL TEST HOLES No. 2 & No. 3 SCALE 1 0=400 (y (TEST H043 DUG BY NORTH SHORE WELLDRILLING ON JURE 17, 2001) OCTOBER 6, 1992 „ < d� Aj F% -4 wAL ss 0� , AUL sN+or uku MARCH 14 2 P 0 m h0 � ilk. 01,fl ^ t ub AL EWN SMIDY CLAY 0 RDAREA m 17,476.29 sq. fl. TI ' ilk A 0.401 ac. ° + ® JAZ iYk k� FM 00APSE S" aavnnoMs It TNDIIr e form rmvom w� Imm raw AIL i AL POM "�. ��" ® srrrie 7AK � oris iIGF " :. IL Im"KNUM Is AL . . �. s ''�+ar �. naaal� I�r�oar I1 1651 "AL fi . aoK ri'a + A r�Cw+ w�xw AL AL {.rAt WIMPOr WAU AND rlh •..Ai MW 7D O 7. w 'V#& ML NM 10AM a 140 flitIALman j off AL IPM 2UAL- k aft AL AL Lu — i5 W IL: . �► z r! Qv JJAQQCp CL CL AL �.nr p� 11� ..O .„ Vs mums%"1ro rr '1QI �O 0 mo s v L �,rarr iw' ra .. ,,�� .rte a •rre �•4�1 ��Q y V TEST HDT.R DATA a rsr IL +3T (TEST HOLE DUG AS PER S.C.D.H.S, WE Of WSPECWN 1/27/00) r� � uj = O 0. ! — y' formt L&A i 39W UMM 07 � s FES , N ., SAMw�r e► ro ooNesc aNn yp r-v"q eQ r IN arerow.TEon T� wow Z ? Q Q v c Glenn Golr With, President S1SFFt3ju Town Hall Annex A. Nichu,dm Krupski, Vice-President , 54375 Route 25 John M. Bredemeyer, III N P.O. Box 1179 Ze Michael J. Domino o ^� Southold, NY 11971 Greg Williams Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES ll TOWN OF SOUTHOLD Date/Time: ��3/�-� �0:. Completed in field by: N _ KERRIE-ANN & CHRISTOPHER COHEN request an Administrative Permit for the as-built removal of limbs and trimming of trees; and the as-built removal of five (5) trees. Located: 195 Albacore Drive, Southold. SCTM#: 1000-56-7-13 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 of Hearing Card Posted: Y / N Ch. 275 k"I' Ch. 111 SEQRA Type: 1 II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey <_ 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application co pletene s/ omments/stand r a�ee Xao aAJ!e Y';h y �a ✓.l(F I have read & acknowledged the foregoing Trustees comments: Aeg azt/Owner: 4 AA— 11"IJA Present were: k-J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other nnFFNAL TEST HVLE t& Abu ^�2� 9 2`91 (TEST HOLE DUG BY NORTH SHORE WELL ORILL7JG ON JUNE 17, toot) SLOT 26URVEY � I BROWN SANDY LOANMAP LOT southald Town Southold Town t, aAY SOUTHOLD SHORES Board of Trustees Board of Trustees a RLE 110. 3x33 FILED AkJOUST 24. 163MXVNA SITUATED AT �{•� SOL ARSHAMOMAQUE 1 g� `i`Q� JL �` AL BROWN> �Y TOWN OF SOUTHOLD 3 %b) AL SUFFOLK COUNTY, NEW YORK W t,. S.C. TAX No. 1000-56-07-13 M I X Z cc\_ Fit is '%4c 1.4*�*,,o AL ,Iyl TF'4T HOL•E'� No. 2 No. 3 SCALE 1*=40� N �! k�` )o (TEST HOLES DUG @Y NORTH SHORE WELL DRIUJNG ON JUNE Y7, 2001) MARCH OCT14, OBER BQEORLOt:ATEDBWETLANDS • �s�` sams S%v(LOW SEPTEMBER 12 2000 ADDED MAL WETLANDS ` Q fM&HOO 1— ori F �7h? NOVEMBER 4 12000 REVISED PLOT PLANPp SE 4: t Wit. 4b / s?� • �_• EROWN SANDY CLAY F 4 eQ� AREA rx 17.476.29 sq. 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Main Rd. &Youngs Ave.) Telephone: 631 765-1938 Southold,NY �, www.southoldtownny.gov 4 ..... PLANNING BOARD OFFICE TOWN OF SOUTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: September 14, 2021 Re: LWRP Coastal Consistency Review of KERRIE-ANN & CHRISTOPHER COHEN SCTM# 1000-56-7-13 KERRIE-ANN & CHRISTOPHER COHEN request an Administrative Permit for the as-built removal of limbs and trimming of trees; and the as-built removal of five (5) trees. Located: 195 Albacore Drive, Southold. SCTM#: 1000-56-7-13 The Board approved the construction of the single-family residence in 2001. In 2004 the Board observed clearing and required replanting in the non-disturbance buffer. Submitted materials show that the trees to be removed are not within the non-disturbance buffer. 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 is CONSISTENT with the LWRP policies and therefore CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Glenn Goldsmith, President \Qf SD(/�y Town Hall Annex A. Nicholas Krupski,Vice President ,`O� ��� 54375 Route 25 P.O.Box 1179 John M.Bredemeyer III J [ [ Southold,New York 11971 Michael J. Domino G Q Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application r[ AUG 8 14 --y�Wetland Permit Application ✓ Administrative Permit Amendmeiit/Transfer/Extension24 [ 9 2021Received Application: =g'�• Received Fee: $. 4d Completed Application:_ g•13.2 Southold roWn Incomplete: Board of Trustees SEQRA Classificatiori: Type I Type 11 Unlisted Negative Dec: Positive Dec.- Lead ec.Lead Agency Determination Date: � Xoordination:(date sent): LWRP Consistency•Assessment Form Sent: ECAC Referral Sent - ' - V/ Date of Inspection: Receipt of CAC Report: Technical Review: Public Hearing Held: •/�-� Resolution: Owner(s) Legal Name of Property (as'shown on Deed): C�A4-410- XXAQji- f- rese jq 11 -` (d X- 0; Mailing Address: rVC Phone Number: Suffolk County Tax Map Number: 1000 - ~' i Property Location: �'- (If necessary,provide LILCO Pole#, distance to cross streets, and location) AGENT (If applicable): VOIL4 Mailing Address: I VA ' Phone Number:' Email: Board of Trustees App], ',ation GENERAL DATA Land Area(in square feet): c � Area Zoning: Previous use of property: \ Intended use of property: o l v Covenants and Restrictions on property? Yes Y__N0 If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? YesNo If"Yes",be advised this application will be reviewed by the Building Dep . 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 req ire 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 agency?„ok—No Yes If yes, provide explanation: "' 1 CTrs Alf e.4g /C��* hVkJ tVle�Y 1-ee� 4,J j, A.116( I Project Description (use attachments if necessary): 6u! 0 WJ iite L wv V.1 ., FP ,r Gyo" Y �J VV TZ POW, ® l�Ae I,, "e . '`C� _T_ ' ' Board of Trustees App7" `kation WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Ifar 90) 1$)_ ' ►� J ( R Ap—m-"Wir-i '� 't•tri f � � �=-= � � � U Ar a �I'wetlands on 1 s square feet Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance-between nearest proposed structure and upland edge of wetlands: '*, eet Does the project involve excavation or filling? No Yes If yes, how much material will be excavated? AAA_ cubic yards How much-material will be filled? f cubic yards, J Depth of which material will be removed or deposited: ] " feet Proposed slope throughout the area of operations: / m Manner in which material will be removed or deposited: LyeI k1i i A 0JJ&J 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): A- A /Z% &410 1w , 1 �r � 61 Z20 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: y AV V k X namqo& Project Location( scribe,and attac locati n map). Brief Description of Proposed Action: =R /kJ W fzA�VVWR J4qf /1. C7XA Name of Applicant or Sponsor: Telephone: i ` e E-Mail: Address: _ ® ^, 0 City/P0: tat Zi Code: i q t 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordin 6 e, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that ❑ may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit orpproval: 1 . U � �,l �, 1 I �� El I i a a Total acreage oft e site of the proposed 00A 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? //® r N acres V %F4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial esidential(suburban) ❑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? ❑ ❑ b.Consistent with the adopted comprehensive plan? ❑ ❑ 6. is the proposed action consistent with the predominant character of the existing built or natural NO YE landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? I NO YES If Yes,identify: ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES WE b.Are public transportation service(s)available at or near the site of the proposed action? I ❑ 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: _9 , 10. Will the proposed action connect to an existing public/private water supply? NOYES 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 t reatment: 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 Y wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: X EL 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 ❑Agri cultural/grasslands El Early mid-successional IRkWetland ❑Urban ❑Suburban 15.Does the site of the proposed action contain any,species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ 16.Is the project site located in the 100 year flood plain? NO YES 17.Will the proposed action create storm water discharge,either from point or non-p 'dt sources? NO YES If Yes, iRz a.Will storm water discharges flow to adjacent properties? M NO DYES ❑ ❑ b.Will storm water discharges be directed to established conveyance systemsun and storm drains)? If Yes,briefly describe: O DYES Page 2 of 4 1 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)9 If Yes,explain purpose and size: W'F] 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE N (2 Applicant/spo or e: / / Date: as Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part2. 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 zoningMpll ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? °� f 3. Will the proposed action impair the character or quality of the existing community? �J L❑J 4. Will the proposed action have an impact on the environmental characteristics that caused thej ❑ 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 T�1 reasonably available energy conservation or renewable energy opportunities? u 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? I-1 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, Elwaterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ 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 detennined 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. (e46 I `! tN� xlex�. r � dyA � awl' Al ryet � 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 r Board of Trustees App?lll 1ation AFFIDAVIT �� - - - - - BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL 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 BOAR_ D OF TRUSTEES DURING'THE TERM OF THE PERMIT. natur 'pe wner Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF , 20 _ N tary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. OID1476593 Quaimed In Sullolk County My Commission Expires Aprll 30, 20Z� 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 purpose of this form is to rovide information which can alert the town of ssible conflicts of interest and allow it to take whatever action is neresm to avoid same. - - - -- - YOUR NAME: n (Last na e,first name,ViAdle initial,unt ss 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 '" Tnistee 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�aseven a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of a shares. YES NO Ifyou answered"YES",complete the balance of this fo ,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 applieantlagentt representative)and the town officer or employee.Either check ffi 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 applicitut (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a no 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 t a f ``� 202, Signature Print Form TS I I Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Lary. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as-'to its significant beneficial and'adverse effects upon the coastal area(which includes all of Southold Town, 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, 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 SITEAND PROPOSED ACTION SCTM# - - PROJECT NAME �c ; 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 o pppppp on: I ew 4' ry R I d F, Location of action: � ,p 7 F IN Fq Site acreage: _ SQ1J4AA­&N!F./ 0 , /a Present land use: Present zoning classification: Sj4� 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: CAAMOO&Z (b) Mailing address: , A) , N (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 ❑ 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 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 Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 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 ❑ 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 through 16 for evaluation criteria ❑ Yes ❑ 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 III —Policies Pages 16 throe 21for evaluation criteria Yes ❑ No KNot 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'HI—Policies; Pages 22 through 32 for eval a ' criteria. ❑ ❑ ^ t Yes No t 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 fore aluation criteria. F-1Yes ❑ No Not Applicable c ' 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 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. ❑ Ye n O N rNotpplicable Attach additional sheets ifnecessary WORKING COAST Pi',, [CIES --- Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. Se LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑ Yes ❑ No Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑ Yes ❑ N 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 evalua ' n criteria. ❑ Yes ❑ No , <OtApplicable Attach additional sheets if necessary Policy 13. Promote, appropriate use and development of energy and mineral resources. See LWRP Section III—Po ' 'es• ages 65 through 68 for evaluation criteria. ❑ Yes ❑ No Not Applicable PREPARED BY /� TITLE Y DATE0:24 o I