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HomeMy WebLinkAboutTR-9579A Glenn Goldsmith,President Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President d r9 P.O. Box 1179 John M. Bredemeyer III A � � Southold,New York 11971 Michael J.Domino � ti k � � r Telephone(631) 765-1892 Greg Williams �` � Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 21, 2021 John C. Milazzo 28 Croft Lane Smithtown, NY 11787 RE: ROSE L. MILAZZO REVOCABLE TRUST 1165 ISLAND VIEW LANE, GREENPORT SCTM# 1000-57-2-20 Dear Mr. Milazzo: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, October 20, 2021: RESOLVED that the Southold Town Board of Trustees grants a (1) One-Year Extension to Administrative Permit#9579A, as issued on November 13, 2019. This is not an approval from any other agency. If you have any questions, please do not hesitate to contact this office. Sincerely, t Gle n Goldsr i h President, Board of Trustees GG:dd Glenn Gol(' Ith, President o��S�FFOi= ` G Town Hall Annex A. Nichu'ra� Krupski, Vice-President ,�� y� 54375 Route 25 John M. Bredemeyer, III o ` P.O. Box 1179 Michael J. Domino o Southold, NY 11971 Greg Williams pr Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES l g TOWN OF SOUTHOLD Date/Time: / 1 / '­5�J Completed in field by: ROSE L. MILAZZO REVOCABLE TRUST requests a One (1) Year Extension to Administrative Permit#9579A, as issued on November 13, 2019. Located: 1165 Island View Lane, Greenport. SCTM#: 1000-57-2-20 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: 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 completenes /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 Rose L. Milazzo Revocable Trust 28 Croft Lane Smithtown,New York 11787 September 27, 2021 Glenn Goldsmith President Southold Town Hall AnnexDIE C 2 n rp E n� 54375 Main Rd. U V P.O. Box 1179 Southold,NY 11971fil SEP 2 9 2021 Re: 1165 Island View Lane, Greenport, SCTM#1000-57-2-20 Trustee Permit#9579A Southold Town Extension Request Board of Trustees Dear Mr. Goldsmith: On Novmber 13, 2019, the Trustees issued the above referenced permit. For various reasons,the activities authorized under the permit have not yet been started. Therefore, I am respectfully requesting that the permit be extended. If you any questions concerning this request or if you need any additional information, please free to give me a call at 631-974-3110. Thank you for your consideration of this request. Very truly yours, ohn C. Milazz Trustee sufFocK�. Michael J. Domino, President �,�o�o oo�y� Town Hall Annex John M. Bredemeyer, III, Vice-President 1tl 54375 Route 25 Glenn Goldsmith r N z k P.O. Box 1179 A Nicholas Krupski Southold, NY 11971 Greg Williams � 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 r 1St day of construction constructed When project complete, call for compliance inspection; Rose L. Milazzo Revocable Trust 1165 Island View Lane, Greenport, New York OCT 1 5 2019 i Bulkhead Project N / E �ri�ii (I tll�'!n 1 Bna d i' T'_' _'-S — { $ SITE DATA View `LanecuscamlzorJ — —arsn I=MV ani � APPROVED BY P„_Ie ro•,e -- -- FROPERfLAWUWARD OF WE iLwNDS ®®^y^ PROPOSED RDUSC _ 7 due:;F 70 37% OFT RUSTEES __ E,fISiIWG ,PROPOSED DEr,I els S r d od% N85'40 'ki 310 96' ( — T®WI�I ®F S®UTHOLD ,Ory 16— RI PROPOSED LOC UDVERAGE _SCu S F 75 ob% (9 lop ATE Sas ,� oe\o. Land 19vt�, �<,,,,�,.y -,F "N \ +/-34 feet Low Sill Bulkhead to be IVav6*06'le- 13 �apiq �S�R 1 3° p I Esc,1, l,vi F,nrrulr� Irr•,t 0 o �'{0\� \ removed and replaced. See details JDr - Pk'i P, ELY TEG on sheet 2. cWAYI T”NN¢r�oi -� 155 n TV Pao v9T,41 ITCRY 53 feet Regular bulkhead to 31 +v74 be removed and replaced. See �� ob\0 �� (9�'W 41. - ;' '� \ s; details on sheet 3. go30 00 14 y \ N Nn, i ! 5 yoh' � Ifo"e�o'h oi• Length of return to increase from NOTE5- 5 feet to 20 feet. 0 • MONUMENT FOUND �`S• \ o PIPE FOUND N69°!gt• WETLAND FLAGS INDICATING LANDWARD /�(? /'1' LIMIT OF TIDAL WETLANDS AS DELINEATED BY SUFFOLK ENVIRONMENTAL GONSULTING,Inc ON 3/20/200-1 AREA= 10b22 SP OR 02439 ACRE(DEED DESGRIPTION) ELEVATIONS REFERENCE VGVD'29 DAVM sheet 1 of 3 ILL— October 2019 5URVEY OF PROPERTY Lot N SITUATE: AR-5HAMOMOQUE TOWN: 5OUTHOLD A -1,-, 4, SUFFOLK GOUNT-i-, NY i ow OCT 4 2019 w Fi E IIS;SURVEYED MAY2006 PROPOSED ADDITION MAY 29,2001 SUFFOLK COUNTY TAX MAP NUMBER 1000-51-2-:20 Br)lffct(AJT� DATA --J CP51T-- Lzr COVEPAG.- ""and 77—r�---— --- cElPlh-.=Ifla. - VIM Lane FjOSE L UMLP=ID PJFf0CAB]LElflmJJST PHO!"EkT, LANC%AH1 P90POSED HOUSE 1,31j" 6 h 16 37% EAIST114G F PF01`05ED DECk N85*40130"pq oloqr 0 PROPOSED LOr CgiERAGE 1 -1 R-d, 9 60 16' Right L 0 it d i 10\ 0 1 lut i,�-I E7,,:i i 11 F 10 � 0 Ff- I I-TF+ 11 1 is m 555,12'00"E I"I fill 168 -To, IDD .,q %A 00. YE, PROPOSED TWO -STORY FOUlt 5ED .0 ol 00 0 0" 6 coo, L--j 0 o" NOTES IIICHAELD IIAPES WYSPE L-1c--1-10�1-_q------- MONUMENT FOUND /V617./ O PIPE FOUND .500, �v /o I �v WETLAND FLAGS IND`IGATIN5 LANDWARD LIMIT OF TIDAL NETLAND5 AS DELINEATED BY SUFFOLK ENVIRONMENTAL CONSULTING,Inc. ON 5/20/200-1ouli` ERR-.., AREA = 10,622 5 F OR 0245qAGRE(DEED DESGRIPTIOW JOHN C. EHLERS LAND SURVEYOR ELEVATIONS REFERENCE NO\/D29 DATUM NYS LIC NO 50202 6 EAST MAIN STREET GRAPHIC SCALE 30' RIVERHEAD,N.Y.11901 369-8288 Fax 369-8287 REF.-\\Compaqserver\prosN06\06-171 with nukes septifl OCT 1 5 2019 ; Rose L. Milazzo Revocable Trust 1165 Island View Lane, Greenport, New York _ Regular Bulkhead Replacement Details new bulkhead top-same o height as existing ara •�--- Distonce { '} ----t; Whaler Description approx. 5' T varies from 20'to 35' 6" x 6"(2) from top of �X � bulkhead to creek bottom � Sockfill 8" x 16' (or larger depending on f(Amount+ Type} �- Piling Description field conditions)- No fill required ' `fie Rod -~ � � Sheathing Description S625 or equal 16' vinyl and Deadman Description r 2' 7" 8" lay log Mean High Watar 8 deadmen 01011 x 18' tie rod r Moon Low Water �- - Vinyl sheathing, piles and e)(SUP b bracing system subject to math { �} bo bracing change based on field con- `� ditions I Existira Bottom Not to Scale Depth of Persetrotion t `} Scale sheet 3 of 3 October 2019 Rose L. Milazzo Revocable Trust OCT 1 5 2019 �� 1165 Island View Lane, Greenport, New York Low Sill Bulkhead Replacement Details O b 31' s ` 1 •- X LU ; I ; S. Alterniflora j AHW 2'-7» :$fEs new bulkhead top: ___° ----------- Elev^ 1'-7" same height as Vinyl sheathing, piles, and bracing system existing ALW=0'-0" subject to change based on field conditions whalers (6" x(6/"') batter pile (8"x 12') vinyl sheathing (5625 or equal 12') pile (8" x 12') sheet 2 ***Not to Scale*** October 20101 3 9 - r Michael J.Domino,President QF S0!/TTown Hall Annex ��� Ol0 54375 Route 25 John M.Bredemeyer III,Vice-President P.O.Box 1179 Glenn Goldsmith Southold,New York 11971 A.Nicholas Krupski G Telephone(631) 765-1892 Greg Williams COU Fax(631) 765-6641 OUNT`l, BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 9579A Date of Receipt of Application: October 4, 2019 Applicant: Rose,L. Milazzo Revocable Trust SCTM#: 1000-57-2-20 Project Location: 1165 Island View Lane, Greenport Date of Resolution/Issuance: November 13, 2019 Date of Expiration:,November 13, 2021 Reviewed by: John M. Bredemeyer, III Vice-President Project Description: Remove and replace in-place approximately 531f of existing vinyl bulkhead; construct 341f low sill-vinyl bulkhead and increase vinyl southerly return to 20', re-establish disturbed plantings. 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 site plan submitted by John Milazzo, received on October 15, 2019 and stamped approved on November 13, 2019. 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. Michael J. Domino, President Board of Trustees d SUFFO(,� Michael J. Domino, Pre at �Q l� Town Hall Annex John M. Bredemeyer III, Vice'4°."c,sident ,��� GV_ 54375 Route 25 Glenn Goldsmithy z P.O. Box 1179 A.Nicholas Krupski Southold,NY 11971 Greg Williams ?' ©! Telephone(631)765-1892 Fax(631)765-6641 BOARD OF TOWN TRUSTEES fTOWN OF SOUTHOLD / Date/Time: ��/ / J�,35- Completed in field by: -- ROSE L. MILAZZO REVOCABLE TRUST requests an Administrative Permit to remove and replace in-place approximately 531f of existing vinyl bulkhead; construct 341f low sill vinyl bulkhead and increase vinyl southerly return to 20', re-establish disturbed plantings. Located: 1165 Island View Lane, Greenport. SCTM#: 1000-57-2-20 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-Submissiony/ 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: /t/( // I have read & acknowledged the foregoing Trustees comments: Agent/Owner: Present were: 411J. Bredemeyer M. Domino G. Goldsmith N. Krupski G. Williams Other Print-Maps Page 1 of 1 tJV bing Maps 1165 Island View Lane, Greenport OCT 1 5 2 19 .1�the g U> m.bmg.com _ ...,bcns b 30 1. F • Bird's eye view maps can't be printed, so another map view has been substituted. http://www.bing.com/maps/print.aspx?mkt=en-us&z=16&s=b&cp=41.079231,-72.378105&pt=pb 7/23/2014 Rose L. Milazzo Revocable Trust 1165 Island View Lane Greenport, NY s - - T _ 'W 01 r �11yy bulkhead, looking south bulkhead, looking north 8/18/2019 8/18/2019 Rose L. Milazzo Revocable 1165 Island View Lane Greenport, ..a jam( • •• �• C All - M � � ,►ter .~7 ,�� . � ry;-i `� � .. ' � 1. I• � .- .. ~��'. Ali►. bulkhead, looking west ----------- —SEESEC NO OS] NmaM h "TARp�N MATCN_�goR —_ �_ — --_— — _- _- -.. - -_---- LINE __—_—�.___ —_ _ MATCH N 1 G FOR PCL.NO _ J R4 b •]p.2 ♦ � gp' FOR PCL NO. SEE SEC.NO 0T 65 111'2. 5 r Zm,; 5 6 1 Z+rc) (5p) /—gXyl A / 123HC1 SEE SEC NO OS1.OBW9.9 P R,9 r9 m o•b I' ] 1 Is 30 •/?� �"''z'+lcH, ' „ �.�' � • u. .� 22 p sz�.0 tiu� Y (COD uS ( /20.1A(0) _ t SOUND ISLAND SHELTF-R G a 9 NOTICE Off. COUNTY OF SUFFOLK © E py2 py Sd1TNOLD SECTION NO t Real Property Tax Seryice Agency v MosT57 Wax,ExNkE w .� ��. o....r_ uun u rr. +^ assaucauOry T.xw sPxw arEO �; Ex` ase �. u C.iO.r Rlr.rlwa N +u A pe,meT NO 1000 PROPERTY MAP SOUTH OFFICE LOCATION: h®� ®�® MAILING ADDRESS: Town Hall Annex P.O.Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) eAs Southold, NY 11971 a� Telephone: 631 765-1938 ® Fax: 631765-3136 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: November 8, 2019 Re: LWRP Coastal Consistency Review ROSE L. MILAZZO REVOCABLE TRUST SCTM# 1000-57-2-20 ROSE L. MILAZZO REVOCABLE TRUST requests an Administrative Permit to remove and replace in-place approximately 531f of existing vinyl bulkhead; construct 341f low sill vinyl bulkhead and increase vinyl southerly return to 20', re-establish disturbed plantings. Located: 1165 Island View Lane, Greenport. SCTM#: 1000-57-2-20 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 provided the following is considered: It is recommended that the Board verify if the bulkheads warrant removal and reconstruction. Submitted photos show that the bulkheads are functioning. In the event the action is approved, turbidity control during construction operations is recommended. 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 ;}� °� a/ Town Hall Annex John M.Bredemeyer III,Vice-President, 54375 Route 25 # g h P.O.Box 1179 Glenn Goldsmith •• :,. } Southold,New York 11971 A.Nicholas Kru ski 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 Wetland Permit Application Administrative Permit Amendment/Transfer/Extension OCT 4 2019 Received Application: 4. . Received Fee: $ ��� -- Com leted A lication: p P.p Boar of T•,1s!,,,g Incomplete: SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: VCoordination,(date sent):-., ._•__ !! ��d LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: Technical Review: :]V-_ Public;Hearing Held: `01W-71� Resolution: Owner(s)Legal Name of Property(as shown on Deed): S, Mailing Address: � V1�� c� Phone Number: G a t— 9 3- 1— 9 Suffolk County Tax Map Number: 1000- a- 4 0 Property Location: ( �(U S �� V (��y l��0w�'PArJ r (If necessary,provide LILCO Pole#, distance to cross streets,and location) AGENT-(If applicable): Mailing Address: Phone Number: Board of Trustees Application GENERAL DATA Land Area(in square feet): -_ a`a` � _ Area Zoning: - Previous use of property: Intended use of property: S to 5 6,ul S/ICY l�Ccs 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 Y No If"Yes",please provide copy of decision. Will this project reqany demolition as per Town Code or as determined by the Building Dept.? ­ -Yes it� No Does the structure(s)on property have a valid Certificate of Occupancy?_ Yes No Prior permits/approvals for site improvements: Age c Date /vWa 1)6(, L2-1>11of a w/I0) o No prior permits/approvals for site improvements. 'SCDHS 116111 Has any pen-nit/approval ever been revoked or suspended by a governmental agency?—X No _Yes If yes,provide explanation: Project Description(use attachments if necessary):'i 40tacc, eLLa, � r, CO cyp it e� l C� 53 OC( CC(CV 5C( GP �� 3 r��w ��,Ik � w,(� �i r��J����� o P - rn _�E�•l.p!�i'n- -( .?_°_5t I( Pn\J 11 u(or ��_(� cA -{O- ©_ e ._C�!C q< ( UC ' Board of Trustees Application WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: C J I OO OAd A-c.. 6�o_n_of p��� � -�' of r�S Wa,r d u o f�L cll Lod �� f low sitl, �I re (ceE t-SWr qold p c n C cs SOA\ttln &1\_Ctill 10 L_+- tOW S 1 NO "[� � a._® but 1h (�cr�t1� Area of wetlands on lot: square feet Percent coverage of lot: _ ��� _% Closest distance between nearest existing structure and upland edge of wetlands: _ a ......_,_feet Closest distance between nearest proposed structure and upland edge of wetlands: �-o _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: r3-���h Manner in which material will be removed or deposited: r 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): r _rUsZ� c� l rn&J� G.AfGAto cpd nc��i r t u( a1�Acc"�s Lot,� Board of Trustees Application AFFIDAVIT IBEING DULY SWORN DEPOSES AND AFFI S TH T IIE/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. enature rt Owner Signature of Property Owner SWORN TO BEFQRE ME THIS _DAY OF ,24LIF-- tary Public NINA JOSHI Notary Public,State of New York No.0 iJ0502E173 Qualified in Suftolk County Commission Expires 05/23/ 02 Z— APPLICANT/AGENT/REPRESENTATIirE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Cede,of Ethics prohibits conflicts of interest on the p-irt of town ofliccrs and employees.The ouroose of this form is to provide,information which can alert the town of j2ossible conflicts of interest and allow it to take Whatever action is necessary to avoid came.f YOURNAME t tC,Z'Lt) , R�Sc� L.r (Last name,fir9t name,;aiddle 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.) _...e..� Do you personally(or through your company,spouse,sibling,parent,or child)have a relaiionship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriaGe,or business interest "business interest meads a business, including a partnership,in which the town officer or employee has even a pirtiai ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO _ X 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); l3}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 d y f �S� 20 Signature._ Print Name Form TS l 617.20 Appendix B Short Environmental Assessment Form Instructions for Coniplctilttr. Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 Name of Action or Project: �� 41,e Iu ILl- c C) CO." Project Location(describe,and attach a location map): C(ky --Fz(e4� CJIP�-J Jnr Cypfn� r Brief Description of Proposed Action: PC) C4.(01- lVG o✓+� �' d f l `fir �� �U l L�c�. �rc9ft6� ©�� CGUS�' Con1YGC1nCJ�l � 4&WOsr�lrQ �c J%PCRoSe Q'[t rA S` -D "'Oft 1„&( bu w,,,dkD rClIMd Name of Applican/t�or Sponsor: _ Telephone: In -0 a i> +VllGZ?+�� �� f I�y E-Mail: J Addss: � r) ((ll IVf1,n � pct _____.___._...__._ City/PO: J� State _ Zip Co : , Ilyd 1.Does thpv0pos4Ztion only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that 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 Agency9 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 i c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? _m acres 4. Check all land uses that occur on,adjoining and near the proposed action. _E]Urban E3 Rural(non-agriculture) ❑Industrial [_—]Commercial Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic El Other(specify): ❑Parkland Page 1 of 4 5. Is the proposed action, _ NO YES N/A 4_ a.A permitted use under the zoning regulations? ❑ ❑ b.Consistent with the adopted comprehensive plan? ' ❑ ❑ 6. Is the proposed action consistent with the predominant-character of the existing built or natural NO, YES landscape? ❑ 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: _ _ l;_I ❑ 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES #/A b.Are public transportation service(s)available at or near the site of the proposed action? (—j ❑ 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. v/A ❑ ❑ !• 10. Will the proposed action connect to an existing public/private water supply? / NO YES If No,describe method for providing potable water: _ _ +V f _ —1 ❑ ' 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: e IA— ❑ ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? 2 ❑ b.Is the proposed action located in an archeological sensitive area? I el ❑ 13.a.Does any portion()f the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? ❑ b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? (� If Yes,identify the wetlan r wate rbocLY and extent of alteratio s 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 El Forest ❑Agricultural/grasslands E3 Early mid-successional [9 Wetland ❑Urban X1 Suburban f 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 YE 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 ❑YES b.Will storm water discharges be directed to established conveyance systems(runoff and storm drains)? If Yes,briefly describe: ❑NO DYES Page 2 of 4 a 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)? ; 1f Yes,explain purpose and size: _ _,T _„ .__ -_. -m�-- �_ �-�-__`_.. .__._ � ❑ 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 ❑ _. -.._.._..___ 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: (�/' ❑ j 1 AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: _ 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 11. Will the proposed action create a material conflict with an adopted land use plan or zoning I ❑ 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. i 4 Will the proposed action have an impact on the environmental characteristics that caused the ❑ F-1establishment 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? j 7. Will the proposed action impact existing: - a.public/private water supplies? b.public/private wastewater treatment utilities? ❑ i ❑ € 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 i may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage D El problems? 11. Will the proposed action create a hazard to environmental resources or human health? 0 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. ElCheck 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 Si nat gePreparer(if dl r Responsible Officer) PRINT J Page 4 of 4 i ' 3 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CdkF 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 a 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 siniticant 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'ext)lainM in detail, listing both supe-orting and non- supportingfacts. 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 t SCTM#�0 o PROJECT NAME '6U1 Va ` 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 xtent o action: 4G(mve IV Le (J�6✓►�6�c.c on o LP o.( (Z0) .Sd1 buj. Y J Uv'[I _4J (`F 6o C1Pcou c 60n cos-,s�dls � DCtS�rc� NJOC." u c,to✓ 4 >l�-�__ ul��� � � rice �• ao ' rr P Location of action: b, G / te� ' 61P t�l Site acreage: 3 G ct Present land use:' *C Present zoning classification: V` C� 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:____,_ (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 ❑ 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 �2P'Ak m G� PfYtML )C u to if 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 11 Yes ❑ No [)(Not Applicable �cno►t��� ��e `F C-�)(_o 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 �monpbrww Of i eS c,. Awcrj Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria n Yes F1 No P%J 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 Yes 1-1 No N Not Applicable Jr i GL e. 'c C 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. 1-1 F1 X Yes No Not Applicable ( [al 6 CAI / OR,141 6 Lt lU-Iwo WI R - < modF� 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 Fj No 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. ❑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�] No RNot Applicable 40 C Attach additional sheets if necessary __ WORIUNG COAST POLICIES 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. ❑ Yes ❑ No 9 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. ❑ Yes ❑ No LnJ 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_;'l (-91(C 22c7 TITLE DAT16 1�< f Rose L. Milazzo Revocable Trust 137 Kings Road Hauppauge,New York 11788 October 1, 2019 Michael Domino Board of Trustees President Southold Town Hall Annex --------- 54375 Main Rd. P.O. Box 1179 Southold,NY 11971 ;j OCT 4 2019 Re: 1165 Island View Lane, Greenport Trustees Pen-nit#7054 Dear President Domino: Due to circumstances beyond my control I find myself before your Board requesting substantially the same relief that was granted to me just a few years ago. In 2010, 1 applied for and received permission to replace a bulkhead and install a new low sill bulkhead on my property. Four years later, I requested permission to modify the permit to increase the regular bulkhead's height by 18 inches. Both requests were approved. I hired a contractor to perform the work. After the work was completed, I discovered that the contractor had unscrupulously and unbeknownst to me"shortsheeted"my project. That is,he installed vinyl sheeting that was less the required height. He also did not install the proper bracing systems. The results were predictable, my bulkhead is failing and not achieving its intended goals. While the relief I request normally requires a full hearing, I am respectfully ask that an adminstrative permit be issued under these unique circumstances. My request is the same as was approved, with the minor exception of increasing the landward length of the return between the high and low sill bulkheads. If the matter cannot handled administratively, I am fully prepared to appear at a public hearing to consider this matter. Thank you for your consideration of my request. If you have any questions, please contact my son, John, as he is ftilly versed in the intricacies of this matter. His number is 631-974-3110. Very t J.1y yours Rose L. Milazzo Trustee