HomeMy WebLinkAboutTR-10158A Glenn Goldsmith, President �a Solu Town Hall Annex
A. Nicholas Krupski,Vice President �® ®�® 54375 Route 25
Eric Sepenoski P.O. Box 1179
Liz Gillooly � `y:
Southold, New York 11971
Elizabeth Peeples Telephone(631) 765-1892
® Fax(631) 765-6641
Court�
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
1" day of construction
Y2 constructed
When project complete, call for compliance inspection;
Glenn Goldsmith, President ®g sou Town Hall Annex
A. Nicholas Krupski,Vice President ,L®� ®�® 54375 Route 25
�s2, P.O. Box 1179
Eric Sepenoski Izr Southold, New York 11971
Liz Gillooly co
Elizabeth Peeples Telephone(631) 765-1892
Y Fax(631) 765-6641
Nil
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 10158A
Date of Receipt of Application: May 12, 2022
Applicant: Michael McAllister & Barbara Jones
SCTM#: 1000-51-1-3
Project Location: 17665 Soundview Avenue, Southold
Date of Resolution/Issuance: June 15, 2022
Date of Expiration: June 15, 2024
Reviewed by: Liz Gillooly, Trustee
Project Description: Replace existing pool enclosure fencing in same location with
approximately 174 If of new 4-foot high pool enclosure fencing.
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
Michael K. Wicks Land Surveying, last dated April 26, 2022, and stamped approved on
June 15, 2022.
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.
Glenn Goldsmith, President
Board of Trustees
Long Island Sound
SURVEYOFPROPERTY N79'31'14"E 149.96
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SITUATE Co M
SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
SURVEYED: APRIL 11, 2018
REVISED: APRIL 26, 2022 PROP. POOL FENCE
NOTES: Q3
1. PROPERTY KNOWN AS TAX MAP# 1000-051-01-03
2. LOT AREA =88,365 SQ.FT. (2.028 ACRE(S))
3. THIS SURVEY WAS PREPARED USING A TRIMBLE
S3 ROBOTIC TOTAL STATION. o
4. PROPERTY CORNER MONUMENTS WERE NOT SET AS
PART OF THIS SURVEY. 'STRUCTURES SEAWARD OF TOP OF BLUFF NOT DEPICTED HEREON
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STANDARD NOTES:
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1. COPYRIGHT 2022 MICHAEL K. MUCKS LAND SURVEYING TOP OF BLUFF Cb
2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP BEARING A
LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209,
SUB-DIVISION 2, OF NEW YORK STATE EDUCATION LAW. h
3. ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL r4
ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL 111.
ti
WORK AND OPINION. ,1
4. CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP A
WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF
PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE
ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, INC. THE CERTIFICATION IS
LIMITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED,
TO THE TITLE COMPANY, TO THE GOVERNMENTAL AGENCY,AND TO THE U
LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP, D%5'YETIL FENCE
5. THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE. lO BE RE w
6. THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE
NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED. IF ANY UNDERGROUND 250
IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN,THE
IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY. 16r321N GROUND POOL O
7. THE OFFSET (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO
THE PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE 4v
ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS,
POOLS. PATIOS PLANTING AREAS,ADDITIONS TO BUILDINGS, AND ANY OTHER
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TYPE OF CONSTRUCTION. -
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COPIES OF 'THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED uT
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LAND SURVEYING
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200 BELLE VIEW AVENUE,
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CENTER MORICHES, NEW YORK 11934 5,wErK F011III E/
VOICE: 631.874.0156 - FAX: 631.909.3845
www.wickslandsurveyi�rg.com, o o+'" 950.00
RECORDS OF RICHARD C. DRAKE 573027'30"w a
SCALE: SURVEYED BY: DRAWN BY: SHEET: (Var• >gidth) M
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Glenn 601asmith, President ��p�o Town Hall Annex
A.Nicholas Krupski,Vice President .c 54375 Route 25
0
Eric Sepenoski ? P.O. Box 1179
Liz Gillooly �y • ®�� Southold,NY 11971
Elizabeth Peeples dol �a Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: 5L2,1 22. Completed in field by: L- 'get 1��
En-Consultants on behalf of MICHAEL McALLISTER & BARBARA JONES requests
an Administrative Permit to.replace existing pool enclosure fencing in same location
with approximately 174 If of new 4-foot high pool enclosure fencing. Located: 17665
Soundview Avenue, Southold. SCTM#: 1000-51-1-3
Type of area to be impacted:
Saltwater Wetland Freshwater Wetland Sound Bay
Part of Town Code proposed work falls under: _>-Chapt.275 Chapt. 111 other
Type of Application: Wetland Coastal Erosion Amendment
_XAdministrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No -V' Not Applicable
Info needed/Modifications/Conditions/Etc.: O vrc Sim er 4m <e 014 m4e, �
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Present Were: G. Goldsmith N. Krupski E. Sepenoski
K L. Gillooly E. Peeples
Long Island Sound
SURVEYOF' PROPERTY -1-
X79°31'19'rE 149.96
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SITUATE c co
SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
SURVEYED: APRIL 11, 2018
REVISED: APRIL 26, 2022 PROP. POOL FENCE
NOTES:
x
1. PROPERTY KNOWN AS TAX MAP# 1000-051-01-03
2. LOT AREA =88,365 SQ.FT. (2.028 ACRE(S))
3. THIS SURVEY WAS PREPARED USING A TRIMBLE
S3 ROBOTIC TOTAL STATION.
4. PROPERTY CORNER MONUMENTS WERE NOT SET AS 'SfRUCTURFS SEAWARD OF TOP OF BLUFF NOT DEPICTED HEREON'
PART OF THIS SURVEY.
F
h
STANDARD NOTES:
F
1, COPYRIGHT 2022 MICHAEL K. WICKS LAND SURVEYING TOP OF Wff
2. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY MAP BEARING A
LICENSED LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209, '
SUB-DIVISION 2, OF NEW YORK SPATE EDUCATION LAW. EF
3. ONLY BOUNDARY SURVEY MAPS WITH THE SURVEYOR'S EMBOSSED SEAL W
ARE GENUINE TRUE AND CORRECT COPIES OF THE SURVEYOR'S ORIGINAL k,
WORK AND OPINION. .i
4. CERTIFICATIONS ON THIS BOUNDARY SURVEY MAP SIGNIFY THAT THE MAP A
WAS PREPARED IN ACCORDANCE WITH THE CURRENT EXISTING CODE OF
PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE eC
ASSOCIATION OF PROFESSIONAL LAND SURVEYORS, INC. THE CERTIFICATION IS
LIMITED TO PERSONS FOR WHOM THE BOUNDARY SURVEY MAP IS PREPARED, O
TO THE TITLE COMPANY, TO THE GOVERNMENTAL.AGENCY,AND TO THE U
LENDING INSTITUTION LISTED ON THIS BOUNDARY SURVEY MAP, ppST,BE U
5. THE CERTIFICATIONS HEREIN ARE NOT TRANSFERABLE. [�
6. THE LOCATION OF UNDERGROUND IMPROVEMENTS OR ENCROACHMENTS ARE 91,3' ca
NOT ALWAYS KNOWN AND OFTEN MUST BE ESTIMATED. IF ANY UNDERGROUND 2B,B'
IMPROVEMENTS OR ENCROACHMENTS EXIST OR ARE SHOWN,THE
IMPROVEMENTS OR ENCROACHMENTS ARE NOT COVERED BY THIS SURVEY. 16x32 IN GROORO POOL O
7. THE OFFSET (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES T'O $ ~'
THE PROPERTY LINES ARE FOR ASPECIFIC PURPOSE AND USE AND THEREFORE c4J W
ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES, RETAINING WALLS,
POOLS, PATIOS PLANTING AREAS, ADDITIONS TO BUILDINGS, AND ANY OTHER u r
TYPE OF CONSTRUCTION.
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RECORDS OF RICHARD C. DRAKE -" 573,27 30 yV a
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E wr Rt) �.. O d.... --.-- s.� -- -- f E OOUT1101D
__ __ __ ____ __ Real Property Tax ServiceAgency v
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—___ PROPERTY IMP
Glenn Goldsmith,President *Q,f S®!/r�0 Town Hall Annex
Michael J.Domino,Vice-President �® , 54375 Route 25
. � P.O.Box 1179
John M.Bredemeypr III Southold,New York 11971
A.Nicholas Krupski G Telephone(631)765-1892
Greg Williams + ^ate Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
This Section For Office Use Only
Coastal Erosion Permit Application D /� ' �/"
Wetland Permit Application V
K Administrative Permit
Amendment/Transfer/Extension
X Received Application: S.l2'?.0, MAY 12 20]Q
X Received Fee: $ 100,
1l Completed Application: • 3•L�
Incomplete: fuf T�
nfT4
SEQRA Classification: Type I Type II Unliste e tive Dec.
Lead Agency Determination Date:
�oordination:(date sent):
LWRP Consistency Assessment Form Sent:
XAC Referral Sent:
Date of Inspection: •g•
Receipt of CAC Report:
Technical Review:
Public Hearing Heid: •/542—
Resolution:
Name of Applicant Michael McAllister&Barbara C.Jones
Address .17665 Soundview Aenue,P.O.Box 596,Southold,NY 11971
Phone Number: Ea 842-1176
Suffolk County Tax Map Number: 1000 - 51 - 1 -3
Property Location: 17665 Soundview Avenue,Southold
(property located on north side of Soundview Avenue,+/-619'west of Mt.Beulah Avenue)
(provide LILCO Pole #, distance to cross streets, and location)
AGENT: En-Consultants
(If applicable)
Address: 1319 North Sea Road,Southampton,NY 11968
Phone:631-283-6360
Board of Trustees Applic€�_,,�)ri
GENERAL DATA
Land Area(in square feet): 88,365 sf
Area Zoning: R-80
Previous use of property: Residential,single-family dwelling with swimming pool
Intended use of property: No change
Covenants and Restrictions: X Yes No
If"Yes", please provide copy. Copy provided
Will this project require a Building Permit as per Town Code? X Yes No
If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review
and Elevation Plans will be required.
Does this project require a variance from the Zoning Board of Appeals Yes X No
If"Yes", please provide copy of decision.
Will this project require any demolition as per Town Code or as determined by Building
Dept. Yes X No
Does the structure(s) on property have a valid Certificate of Occupancy X Yes No
Prior permits/approvals for site improvements:
Agency Date
Southold Trustees Letter of Non-Jurisdiction
(swimming pool) October 30,2000
Southold Trustees Permit No. 5253 November 21,2000
Southold Trustees Permit No.7692& November 16,2011 (amended August 22,
7692C 2012)
No prior permits/approvals for site improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?
X No Yes
If yes, provide explanation:
Project Description (use attachments if necessary):
Replace existing pool enclosure fencing in same location with approximately 174 if of new 4-foot high pool enclosure fencing,as
depicted on the survey prepared by Michael K.Wicks Land Surveying,last dated April 26,2022.
hard of Trustees Applicatio"
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:
Replacement of existing pool enclosure fencing.
f
Area of wetlands on lot: -0- square feet
Percent coverage of lot: -0- 0/0
Closest distance between nearest existing structure and upland
edge of wetlands: N/A feet
Closest distance between nearest proposed structure and upland
edge of wetlands: N/A feet
Does the project involve excavation or filling?
X No Yes
If yes, how much material will be excavated? N/A cubic yards
How much material will be filled? N/A cubic yards
Depth of which material will be removed or deposited: N/A feet
Proposed slope throughout the area of operations: N/A
Manner in which material will be removed or deposited:
N/A
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):
The project includes only the installation of a code-compliant pool enclosure fence in place of an existing pool fence. A
Town Wetlands Permit is required for the fencing due to its location within 100 feet of the crest of bluff along Long Island
Sound,but the installation of the new fence will have no adverse effects or impacts on the adjacent bluff,beach,or waters
of Long Island Sound.
(fie the applicant is not the owner)
II I es HOW MRAllieter
-,4
owners of the property identified as SCTM# 1000- 5"1=3 in the town of
�e�thgid .New York,hereby authorizes
En4gnwItant§ to act as my agent and handle all
necessary work involved with the application process for permits, from the Southold gown
Board of Trustees for this property,
NIA
Property Owner's Suture property Owner's Signature
Mishael MoAllMer
SWORN TO BEFORE ME THIS � DAY OF #
JASON BENCIVENGA
Notary Public=State of New York
No,01 BE6365257 y
MQyuaG mimioRniWres 012/2025
N®t
AUTHORIZATION
(err,the idiot is not the owner)
I/We, ftftrg dens§
owners of the property Identified as SCS# 1000a 61.1.3 in the tow of
6991h9id New York,hereby authorizes
n=Can§uIt@nt§ to act as my @Sent and handle all
neeossary work involved with the application process for permit(s)from the Southold Town
Board of Trustees for this property.
�&wua NSA
Property Owner's Slanat1w property Owner's Signature
Barbiirg d9nQ.
rd
SWORN T BEFORE E THIS L DNY OF
Notary publig —
REBECCA A LUCAK
.Notary Public-State of New York
No.01 LU6386882
oualified in Suffolk�county 2023
my commission Exp
R" ;d of Truotg®s A li®atio�l
AFFIDAVIT
Micheel McAPIWor BEING DULY SWOIR
DEPOSES AN,D AFFIRMS THATHE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE REST OF HIS/HER KNOWLEDGE AND BELIEF,I',AND THAT
ALL ORI(WILL BE DONE IN THE MANNER,SET FORTH IN TH-IS 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 HARM-LESS AND FREE FROM ANY AND ALL DAMAGES
AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID EE IT(S),IF
GRANTED, IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE, THE
TRUSTEES,THEIR AGENTS) OR.REPRESENTATIVES9 INCLUDING THE
CONSERVATION ADVISOR'S COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CON,JUNCTION WITH THIS APPLICATION,
INCLUDING A FINAL INSPECTION, I FORT_ R AUTHORIZE THE BOARD OF
TRUSTEES TO.ENTER ONTO MY PROPERTY AND AS REQUIRED TO INS-URE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR..COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
NIA
Suture of Property Owner Signature of property Owner
Mlsheel MsAlll§ter
SWORN TO BEFORE ME T14-18 DAV OF ' 20 �Z
JASON BENCIVENGA
Notary Public—State of New York
No.01BE6365257
Qualified in Richmond County
- i My Commission Expires 101212025
B� d of Trustgoo
ftbare JAn@§ BRING DUIX SWORN
DEPOSES AND AFFIRIUMS 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- KN,OWLEDGE AND BELIEF,AND THAT
ALL WOTUf WILL BE DONE IN THE MANNER,SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BARD OF TRUSTEES,
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE
BARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES
AND CLAIMS ARISING UNDER-R BY VIRTUE OF SAID PE IT(S)q IF
GRANTED, COMPLETING THIS APIPLICATION,I BY AUTHORIZE THE
TRUSTEM THEM-AGENT(S)OR REPRESENTATIVES,INCLUDING THE
CONSERVATION ADVISORY COCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION
INCLUDING A-FINAL INSPECTION- 1 FIR T_ R AUTHORIZE THE BOARD OF
TRUSTEES,TO ENTER ONTO MI PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WT ANY CONDITION OF ANY WE,TLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT,
NIA
Signature of Property 6A-9r Suture of Property Owner
Barbara Jana,5
SWOPX TO BEF® ME THIS d 3 my OF
Notary Public,
REBECCA A LUCAK
Notary Public-State of New`fork
No.01 LU6386882
Qualified in Suffolk County
My Commission Expires Feb.04,2023
AP TVAGENTMPIRESENTATWE
T-RANSA, O -AL DISCLOSE FOR
Thi ��+ crt hr�utiarrlde� t '1 tlt;�s;r�r�aiaibitn��t�fii�� k'�+rd t 3it�i1 17 -n rt cit t9 vn�,ffic:ar�a r�tt 3 r���+ � �� c�
9s e�rin iw t�__v s ,1 IrAr ifillcm Whigh A an aigrk tip r� rr orimcig1t�. ��trfhs n1 i_W"I- ci s�ii 3t t is k� vN�[�v
YOUR-NXM-gr _ MsAl119ter,Mlcheel -
(1,91 name,Mt nan@,Ariddis init(al,"01999 YOU Un Applying�`a Fk HMO Of
9om@0ne @100 or Act entity,9nch a9 a company,if 99,Indican the other
psr9On'9 or @Om11Ary'B rramo')
NAME OF APPLICATION: (Ch99k all drat 9pp1y.)
Tat grievance __ _ Building
Vari9ncc — Trr M X -
Chnngn Of ZOns _ OOMW Bro9lon _
Approval of plat __ _ Mooring _-
Exemption from plat Or official map -Planning _--
Other
(if"Other`,name the a@tivity,) - -
Do you psraolmlly(of through your E0111p9ny,gpowe,Sibling,tmnb or child)have O r@lationghil)Avith MY,OM69r Or gni fiivyee
of the Town of Southold? "lglatlongh*_' lneludgs by blood,Marringe,or buibiggs lntoregL°Businggii interesr-rr gma a l7ug1ne§§,
Including it partnerghlp,in evhl@h th@ townofile@r Or sinfllOysa:IRM Mn it paaitaal arwn@fslaip of(at employtn@trt try)a corporation
In which thu town offlc@r or emplOyee O%ym more than 51/0 sir the-ghWo,
YES - - NO
if you an9w@md`YBF",@ompl@t@ the balance of thl9 form and date and slur where Indleated.
rams of perm employed by the Town of Southold -
Title®r po9ltiOn Of that 11@€9On - -- -
D@9c€ib@ the€elatlenghip bstw@@O yOnrtrelf(the appli@ant(@gontlr@pfgacntative)€nd the town Officer Or employes,Elthsr 6991f
the appropriate lin@ A)through D)and/or d99909 in the 911999 ROAM,
Tire town offlss€or employs@ or hI9 of h@r 9pou9s,91bling,par@%or child 19(check all that apply):
A)the 0wggr of gwate.f thaafr 5%ofth@ ghare8 of the e011aor9te 9tOck of the 9ppi1980
(avlign th@ appli� m Iv a Wrptit�ailOu);
l3)the 1@gal orl�r09lal Olvnsr Of airy intst�fft 1n as norr=cO�€ate sntliy(wlusir tIr®
applisfurt Ig fiat a corporfatiofl);
dljiga3t,dlraetOr,partner,Of urrrplaysar.of the applicant;or
` P)the actual applicant.
DESCRIPTION OF RELATIONSHIP
. �l�ranttlre -
lRlirtigRog Mlehpel MsAllleter
Form TS l
HEMY YORKALL-PURPOSE ACKNOMMEDGMEKT
REAL PROPERTY LAW Q3D8'
State of New York
Countyal'A
Day Month , aveor .,Aj
the undersigned personally appeared cl-t-.00 --
t3 A. Name of Signet,
(and Name of Additional Signet-, if Any )personally known to rne or
proved tOOleOAthe basis 0fsatisfactory evidence tObethe\OUkAdU8\hdwhose O80ekA\s(Un)subscribed
to the within instrument and acknowledged to me that he/she/they executed the sarne in his/her/their
capaclty(ies),and that by his/her/their signature(s)on the Instrument,the individual(s),or the person upon
behalf ofwhich the i instrument.
State of.New Yo
Place Seal Below OR Complete Lines Below `
Cq
Notary Public-State of New York
No.OIBE6365257
W1 I ratified
Qualified in Richmond Count Name of Co ty in it(,-i Originally Ot.,
My Comirnission Expires 10/2/2015
^ , Commission E piration Dote
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Norne of County in 111/flich Certificate of Official
Character Filed(If required)
OPTIONAL
Completing this information con deter alteration of the document at-
fraudulent reattachment of this form to on unintended document.
Description of Attached Document �e'gc-
Title or Type of Document: '"A-
CN
Document Date: Number of Pages:
Signer(s)Other Than Named Above:
MAMMA,M14M.,
`
� CO2O17National Notary Association
M1304-15 (09/17)
AP-PL1C-A—Ti TMAGENT/1RUMUSENTA WE
IRANSA 0TNAL DISCLOSURE FO:
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YOORNAM: _ dc-)n@§,Barbara
(Lmt name,AM mune,jtlddle Initial,Rim you'Life Applying In the t1e_rrte of
oomeol g else or otter untlty,such 0 a cotnpmy.If o®,Indica-.the other
ponao or eg€npArry'e tt�rte�)
NAME OF APPLIOATiON: (Cheek A_11 that appty)
TW(grievARN _ - Building
Varlifae-0
`Prrlotee x
Change of Pone Oogl fyrosion
Approval of pint _ _ Mooring
Exemption from plat or sftlsi-1 map planning
Other
(If-Ow,nom the activity,) - -
Do you peroOrtally(or through your COMM,slew Ming,parent;or zhlld)nava;a MIAtlonghip•with My tit'ftgsr Of Omploy9a
of the Town rel'Soudwid? �'I�lilonshlifl lmhirlss by blood,rilairrridge,or briMmi intayrest:"flushness hrter€se!ingam u bAsinego,
Inaylading n partnerslllli,in jvhieh the to€ort officer or ernployce hris even u partial ownership of(of ernploynta;nt by)a corporation
In whleh the tobvtr ofilser or employ@g owns rrtore than 5 A ofthey chane.
YES NO
Ifyou ammmd``YES",complete the baience of dtio!Orin and r�sign where t dle�teA.
Nam of person employed by the Town of Southold_ -
Tltle b€position of that perm - --- — -
Moeribe the relationship between y®uMIf(tie uppllenrlt(ugsttt/repressntotive)and the town olftcvr or ernplaygm Either oheel€
the appropriate tine A)through O)anddtor dm4bg In the opaM provlded=
Th§town ofttmr or employee or his or her spgnse,sibling,pAr %air child to(chock all that apply):
flts O.,yner€,f greater thurt 5%ofthe shorm of the eorjsrrate otoek of the applte9ot
(vehon ttre applWant Is a mpot'attrilt);
1:1)flis legal-or'Wriufa5l€il f»vugr of tiny iatert pt in a iron=�rp®m a ntlry(wta�ri iiia
a�pplisartt Is Clot a sorppratfon)
_X)an cheer,dimmor,partner,Or ctrtployco of the applimnt;or
the aetml Applicant.
DESORIPTION OF RELATIONSHIP
$tlbmitt@d ad day of 20
PrintN@m@ BarbaraJonog U --
Form TS t
0 APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and emplovees.The purpose of this
form is to provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME : Herrmann, Robert E.
(Last name,first name,middle 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.)
TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit
Variance Trustee Permit X X
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
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 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 that 5%of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this y of 2022
Signature
Print Name Robert E, errm ann
4
617.20
Appendix B
Short Environmental Assessment Form
Instructions for Completinz
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:
McAllister&Jones Fence
Project Location(describe,and attach a location map):
17665 Soundview Avenue,Town of Southold,Suffolk County,NY,SCTM#1000-51-1-3;property is located on north
side of Soundview Avenue,+/-619'west of Mt.Beulah Avenue,location map attached.
Brief Description of Proposed Action:
Replace existing pool enclosure fencing in same location with approximately 1741f of new 4-foot high pool enclosure
fencing,as depicted on the survey prepared by Michael K.Wicks Land Surveying,last dated April 26,2022.
Name of Applicant or Sponsor: Telephone: 917-842-1176
Michael McAllister&Barbara C.Jones E-Mail: meallisterjones@msn.com
Address:
17665 Soundview Avenue,PO Box 596
City/PO: State: Zip Code:
Southold NY 11971
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES
administrative rule,or regulation?
If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that
may be affected in the municipality and proceed to Part 2.If no,continue to question 2. X
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:
X
3.a. Total acreage of the site of the proposed action? 2.028 acres
b.Total acreage to be physically disturbed? +/-2,500 sf
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 2.028 acres
4.Check all land uses that occur on,adjoining and near the proposed action.
❑Urban ❑ Rural(non-agriculture) ❑Industrial ❑ Commercial N Residential(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? X
b. Consistent with the adopted comprehensive plan? X
6.Is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape?
X
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:
X
8. a. Will the proposed action result in a substantial increase in traffic above present levels? NO YES
X
b.Are public transportation service(s)available at or near the site of the proposed action? X
c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X
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:
N/A
10.Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: N/A
11. Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: N/A
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? X
X
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency? X
b. Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? X
If Yes, identify the wetland or waterbody and extent of alterations in square feet or acres:
14. Identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply.
® Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional
® Wetland ❑Urban ® Suburban
15. Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES
by the State or Federal government as threatened or endangered? X
16. Is the project site located in the 100 year flood plain? NO YES
X
17.Will the proposed action create storm water discharge,either from point or non-point sources? 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❑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: X
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: X
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:
X
I AFFIRM THAT THE INFO ATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applicant/sponsor name: Ro Herrmann,Coastal Mgmt. Specialist Date: May 12,2022
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 I 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?
2. Will the proposed action result in a change in the use or intensity of use of land?
3. Will the proposed action impair the character or quality of the existing community?
4. Will the proposed action have an impact on the environmental characteristics that caused the
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or
affect existing infrastructure for mass transit,biking or walkway?
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public/private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic, archaeological,
architectural or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur
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 I
Part 3 should, in sufficient detail, identify the impact, including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts.Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration, irreversibility,geographic scope and magnitude.Also consider the potential for short-term, long-term and
cumulative impacts.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
❑ Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Name of Lead Agency Date
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)
Page 4 of 4
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Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
1 , All applicants for permits* including Town of Southold agencies, shall complete this CCAF for
proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This
assessment is intended to supplement other information used by a Town of Southold agency in
making a determination of consistency. *Except minor exempt actions including Building Permits
and other ministerial permits not located within the Coastal Erosion Hazard Area.
2. Before answering the questions in Section C, the preparer of this form should review the exempt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront Revitalization Program. A proposed action will be evaluated as to its significant
beneficial and adverse effects upon the coastal area (which includes all of Southold Town).
If any question in Section C on this form is answered "yes" or "no", then the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, each answer must be explained in detail, listing both supporting and non-
supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and
conditions, it shall not be undertaken.
A copy of the LWRP is available in the following places: online at the Town of Southold's website
(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local
libraries and the Town Clerk's office.
B. DESCRIPTION OF SITE AND PROPOSED ACTION
SCTM# 51 - 1 - 3
PROJECT NAME Michael McAllister&Barbara C.Jones
The Application has been submitted to (check appropriate response):
Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees
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:
Replace existing pool enclosure fencing in same location with approximately 1741f of new 4-foot high pool enclosure fencing,as
depicted on the survey prepared by Michael K.Wicks Land Surveying,last dated April 26,2022.
Pursuant to Southold Town Code§268-5 ("Review of Actions")and the corresponding definitions of"action"and"minor action"by
§286-3 ("Definitions"),the proposed variance relief meets the following defmition of a minor action and should thus be determined to
be exempt from waterfront consistency review pursuant to chapter 268: "B.Replacement,rehabilitation or reconstruction of a structure
or facility,in kind,on the same site(in place),including upgrading buildings to meet building or fire codes,except for structures in
areas designated by the Coastal Erosion Hazard Area(CEHA)law where structures may not be replaced,rehabilitated or reconstructed
without a permit... ." Therefore,all policies are noted as being"Not Applicable."
Location of action: 17665 Soundview Avenue,Southold
Site acreage: 2.028 acres
Present land use: Residential,single-family dwelling with swimming pool
Present zoning classification: R-80
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: Michael McAllister&Barbara C.Jones
(b) Mailing address: 17665 Soundview Avenue,P.O.Box 596
Southold,NY 11971
(c) Telephone number: Area Code 917-842-1176
(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
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 8 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 through 21 for evaluation criteria
❑Yes 1:1 No VN Not Applicable
Attach additional sheets if necessary
Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including
Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III - Policies; Pages 22
through 32 for evaluation criteria.
❑Yes ❑ No ® Not Applicable
Attach additional sheets if necessary
Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies
Pages 32 through 34 for evaluation criteria.
❑ Yes ❑ No® 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 1:1No ® 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.
❑ Yes ❑ No® Not Applicable
Attach additional sheets if necessary
WORKING COAST POLICIES.
Policy 10. Protect Southold's ware-dependent uses and promote sitn�' Uf 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 ® 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 ® 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 TITLE Coastal Mgmt. Specialist DATEMay 12,2022
Robert E.H rr
Amended on 811105
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM
`b PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
Q� a 1000 51 1 3 STORM-WATER,GRADING,DRAINAGE AMP EROSION CONTROL PLAN
1T3 sof Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM#/WORK ASSESSMENT Yes No
a.What is the Total Area of the Project Parcels? 1 Will this Project Retain All Storm-Water Run-Off
(include Total Area of all Parcels located within 2,(S.F./Acres))028 Acres Generated by a Two(2")Inch Rainfall on Site? Elthe Scope of work for Proposed Construction) (This item will include all run-off created by site
b,What is the Total Area of Land Clearing clearing and/or construction activities as well as all
and/or Ground Disturbance for the proposed j-/-2,500 sf Site improvements and the permanent creation of
construction activity? (S.F./Acres) impervious surfaces.)
2 Does the Site Plan and/or Survey Show All Proposed ❑
PROVIDE BRIEF PROJECT DESCRIPTION(Provide Additional Pages as Needed)) Drainage structures Indicating Size&Location?This
item shall include all proposed Grade Changes and
Replace existing pool enclosure fencing in same location with Slopes Controlling Surface Water Flow,
approximately 1741f of new 4-foot high pool enclosure fencing, 3 Does the Site Plan and/or Survey describe the erosion XF as depicted on the survey prepared by Michael K.Wicks Land and sediment control practices that will be used to
Surveying,last dated April 26,2022. control site erosion and storm water discharger.This
Item must be maintained throughout the Entire
Construction Period.
4 Will this Project Require any Land Filling,Grading or ❑
Excavation where fhere is a change to the Natural
Existing Grade involving more than 200 Cubic Yards
of Material within any Parcel?
5 Will this Application Require Land DisturbingActivities ❑
Encompassing an Area in Excess of Five Tousand
(5,000 S.F.)Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site?Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements: or within One Hundred(100)feet of a Wetland or Ix
Submission of a SWPPP is required for all Construction activities involving soil Beach?
disturbances of one(1)or more acres:including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes Elare part of a larger common plan that will ultimately disturb one or more acres of lands; which Exceed Fifteen(15)feet of Vertical Rise to
Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance?
the DEC has determined that a SPDES permit is required for storm water discharges, p
(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit O Will Driveways,Parking Areas or other impervious
for Storm Water Discharges from Construction activity-Permit No.GP-0-10-001.) Surfaces be Sloped to Direct Storm-Water Run-Off ❑ X
1.The SWPPP shall be prepared prior to the submittal of the NOI. The NOI shall be into and/or in the direction of a Town right-of-way?
submitted to the Department prior to the commencement of construction activity.
2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, ❑
required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliance with the terms and conditions of this permit. In addition,the SWPPP shall Area?(This item will NOT include the installation of Driveway Aprons.)
identify potential sources of pollution which may reasonably be expected to affect the
quality of storm water discharges. NOTE:If Any Answer to Questions One through Nine is Answered with a Check Mark
3.All SWPPPs that require the post-construction storm water management practice in a Box and the construction site disturbance is between 5,000 S.F.&1 Acre in area,
component shall be prepared by a qualified Design Professional Licensed in New York a Storm-Water,Grading,Drainage&Erosion Control Plan is Required by the Town of
that is knowledgeable in theprinciples and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit.
g P g (NOTE:A Check Mark(X)and/or Answer for each Question is R aired for a Completed Application).
STATE OF NEW YORK,
COUNTY OF -Suffolk------------------------SS
That I, Robert E.He=ann being duty sworn,deposes and says that he/she is the applicant for Permit,
(Name of individual signing Document)
And that he/she is the -Agent-for-the-owner
- - ---- ------------------ -----------------------------------------------------------------------------------------------------
(Owner,Contractor,Agent,Corporate Officer,etc.
Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and to
make and file this application;that all statements contained in this application are true to the bes his knowledge and belief;and
that the work will be performed.in the manners set forth in the application filed herewith.
Sworn to before me this;
Llth May ,20 22
- -----------da f--
NotaryP -- ---- ---- -------------K-1-M--R- --S_T.E P H EIS----------------- _---------------------------
- -------- - ---- --
NnTARY PURI- IC (signa plicant)
FORM - 06/10 Vp STATE OF NEW YORK
COMMISSION NO . 5015931
0 U A L I F I E 0 IN SUFFOLK COUNTY
EXPIRES AUGUST 2. 2025
EN-CONSULTANTS
May 12, 2022
REQUEST FOR AN ADMMSTRATLW WETLANDSP . MIT
Town of Southold
Board of Trustees D
54375 Main Road
Post Office Box 1179
Southold,New York 11971 ,
Re: Michael McAllister&Barbara C. Jones
17665 Soundview Avenue, Southold �Tr
SCTM#1000-51-1-3
Dear Board of Trustees:
In regard to the above referenced property, enclosed are the following for the Board of Trustees review:
1. Four (4)Wetland Permit Applications including:
a) Authorization&Disclosure Forms;
b) Short Environmental Assessment Form;
2. Four(4)LWRP Consistency Assessment Form
3. Four(4) survey site plans prepared by Michael K.Wicks Land Surveying,last dated April 26,
2022.
4. Two(2) sets of site photographs.
5. One(1)copy of Declaration of Covenants, Liber 12838 Page 332,recorded October 27,2015.
6. Application fee of$100.00.
I hope this information shall allow you to process our permit request. Should any additional information
be required,please do not hesitate to contact our office.
Sincere ,
Robert E.Herrmann
Coastal Management Specialist
/khs
Enc.
J
L'
1319 North Sea Road I Southampton,New York 11968 p 631.283.6360 f 631.283.6136 www.enconsultants.com
environmental consulting