HomeMy WebLinkAboutTR-10218 Glenn Goldsmith,President � ���p� Town Hall Annex
® 54375 Route 25
A. Nicholas Krupski,Vice President P.O. Box 1179
Eric Sepenoski Southold, New York 11971
Liz Gillooly � � Telephone (631) 765-1892
Elizabeth Peeples ® Fax(631) 765-6641
UU1 ,�
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
15t day of construction
% constructed
When project complete, call for compliance inspection;
A
BOARD OF SOUTHOLD TOWN TRUSTEES
SOUTHOLD, NEW YORK
PERMIT NO. 10218 DATE: SEPTEMBER 14,2022
ISSUED TO: DAVID &HELEN LEIS
PROPERTY OPERTY ADDRESS: 1150 GRAND AVENUE,MATTITUCK
SCTM# 1000-107-8-44.1
AUTHORIZATION
Pursuant to the provisions of Chapter 275 of the Town Code of the Town of Southold and in
accordance with the Resolution of the Board of Trustees adopted at the meeting held on September 14, 2022,
and in consideration of application fee in the sum of$250.00 paid by David & Helen Leis and subject to the
Terms and Conditions as stated in the Resolution,the Southold Town Board of Trustees authorizes and permits
the following:
Wetland Permit for the as-built(per Emergency Permit#9584E) removal and replacement of
existing sanitary system with a new UA type in a further landward location than existing; and
to install a proposed second story 9'3"x13'4"deck with step to ground; and as depicted on the
5
site plan prepared by Jeffrey Patanj o, dated July 3,2022,and stamped approved on September
14,2022.
IN WITNESS WHEREOF,the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these
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presents to be subscribed by a majority of the said Board as of the day and year first above written.
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TERMS AND CONDITIONS
The Permittee David & Helen Leis residing at 1150 Grand Avenue Mattituck,New York
as part of the consideration for the issuance of the Permit does understand and prescribe to
the following:
1. That the said Board of Trustees and the Town of Southold are released from any and all
damages, or claims for damages, of suits arising directly or indirectly as a result of any
operation performed pursuant to this permit, and the said Permittee will, at his or her own
expense, defend any and all such suits initiated by third parties, and the said Permittee
assumes full liability with respect thereto, to the complete exclusion of the Board of
Trustees of the Town of Southold.
2. That this Permit is valid for a period of 24 months, which is considered to be the estimated
time required to complete the work involved, but should circumstances warrant, request for
an extension may be made to the Board at a later date.
3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to
maintain the structure or project involved,to provide evidence to anyone concerned that
authorization was originally obtained.
4. That the work involved will be subject to the inspection and approval of the Board or its
agents, and non-compliance with the provisions of the originating application may be cause
for revocation of this Permit by resolution of the said Board.
5. That there will be no unreasonable interference with navigation as a result of the work
herein authorized.
6. That there shall be no interference with the right of the public to pass and repass along the
beach between high and low water marks.
7. That if future operations of the Town of Southold require the removal and/or alterations in
the location of the work herein authorized, or if, in the opinion of the Board of Trustees,
the work shall cause unreasonable obstruction to free navigation,the said Permittee will be
required, upon due notice,to remove or alter this work project herein stated without
expenses to the Town of Southold.
8. That the said Board will be notified by the Permittee of the completion of the work
authorized.
9. That the Permittee will obtain all other permits and consents that may be required
supplemental to this permit, which may be subject to revoke upon failure to obtain same.
10. No right to trespass or interfere with riparian rights. This permit does not convey to the
permittee any right to trespass upon the lands or interfere with the riparian rights of others
in order to perform the permitted work nor does it authorize the impairment of any rights,
title, or interest in real or personal property held or vested in a person not a party to the
permit.
Glenn Goldsmith,President so Town Hall Annex
A. Nicholas Krupski,Vice President 54375 Route 25
��
P.O. Box 1179
Eric Sepenoski Southold, New York 11971
Liz Gillooly �
G Telephone (631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
September 16, 2022
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
RE: DAVID & HELEN LEIS
1150 GRAND AVENUE, MATTITUCK
SCTM# 1000-107-8-44.1
Dear Mr. Patanjo:
The Board of Town Trustees took the following action during its regular meeting held on
Wednesday, September 14, 2022 regarding the above matter:
WHEREAS, Jeffrey Patanjo on behalf of DAVID & HELEN LEIS applied to the Southold
Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town
Code, the Wetland Ordinance of the Town of Southold, application dated July 14, 2022,
and,
WHEREAS, said application was referred to the Southold Town Conservation Advisory
Council and to the Local Waterfront Revitalization Program Coordinator for their findings
and recommendations, and,
WHEREAS, the LWRP Coordinator recommended that the proposed application be
found Consistent with the LWRP, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
application on September 14, 2022, at which time all interested persons were given an
opportunity to be heard, and,
WHEREAS, the Board members have personally viewed and are familiar with the
premises in question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submitted
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 275 of the
Southold Town Code,
WHEREAS, the Board has determined that ther ' t
as
health, safety and general welfare of the people of thetownroposed will not affect the
NOW THEREFORE BE IT,
RESOLVED, that for the mitigating factors and based upon the Be
Practice requirement imposed above, the Board of Trustees deemst Management
Consistent with the Local Waterfront Revitalization Program ursua the action to be
of the Southold Town Code, and, P nt to Chapter 268-5
RESOLVED, that the Board of Trustees a
prove theLEIS for the as-built (per Emergency Permit#9584E)aremlovicaalon and AVID & HELEN
existing sanitary system with a new I/A type in a further landward location
and to install a proposed second story 9'3"x13'4" replacement of
depicted on the site plan prepared by Jeffre Pa deck with than existing;
step to ground; and as
approved on September 14, 2022. y tanjo, dated July 3, 2022, and stamped
Permit to construct and complete project will expire two years from t
is signed. Fees must be paid, if applicable, and permit issued withinhe date the permit
date of this notification. six months of the
Inspections are required at a fee of$50.00 per inspection. See
( attached schedule.)
Fees: $50.00
Very truly yours,
0
ee4
Glenn Goldsm
President, Board of Trustees
GG:dd
GRAND AVENUE
N 11 17'20"W 245.98'
N58'00'20"W - - - - � r - - - - — � � — — — — —
13.74' 740f'
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sss PROPOSED 9'3" X 13'4" SECOND STORY N
DECK ADDITITION W/ STEPS TO BELOW `�"
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ss I/A TREATMENT � _1 Ole GEOMAT
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s SANITARY SYSTEM
9 DISTRIBUTION PROPERTY OWNER:
0 W POOL / DAVID & HELEN LEIS
'o �F, 1150 GRAND AVENUE
®11x0 \ �%% ��'\° MATTITUCK, NY 11952
APPROVED BY C41?tt 8 .03, S°c� PREPARED BY:
JEFFREY PATANJO
_J90ARU OF I RIJSTEES P.O. BOX 582
BOHEMIA, NY 11716
"TOW OF SO
IJTH®L® 631-484-9332
JJPatonjo@gmail.com
Q PROPOSED PERMIT PLANS SCALE:
I 1"=30'
JUL 14 2W
PROPOSED PLAN DATE:
7-3-22
SouBraldTown 1150 GRAND AVENUE
Board ofTtid m MATTITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY SHEET:
TAX YAP N0. 1000-107-8-44.1 1 of 1
O��g�FFOC,fcoG
Glenn Goldsmith, President �� y Town Trustees
A Nicholas Krupski, Vice-President y = 54375 Route 25
Eric Sepenoski �o '" P.O. Box 1179
Liz Gillooly '1.fj ao�� Southold, NY 11971
Elizabeth Peeples "�` Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
TO: DAVID & HELEN LEIS c/o JEFF PATANJO
Please be advised that your application dated July 14, 2022 has been
reviewed by this Board at the regular meeting of September 14, 2022 and your
application has been approved pending the completion of the following items checked
off below.
Revised Plans for proposed project—
Pre-Construction Hay Bale Line Inspection Fee ($50.00)
1St Day of Construction ($50.00)
'/Constructed ($50.00)
x Final Inspection Fee ($50.00) -
Dock Fees ($3.00 per sq. ft.)
The Permittee is required to provide evidence that the non-turf buffer condition of the
Trustee permit has been recorded with the Suffolk County Clerk's Office as a notice covenant-
and deed restriction to the deed of the subject parcel. Such evidence shall be provided within
ninety (90) calendar days of issuance of this permit.
Permit fees are now due. Please make check or money order payable to Town of Southold.
The fee is computed below according to the schedule of rates as set forth in Chapter 275 of the
Southold Town Code.
The following fee must be paid within 90 days or re-application fees will be necessary. You will
receive your permit upon completion of the above.
COMPUTATION OF PERMIT FEES:
TOTAL FEES DUE: $ 50.00 I
BY: Glenn Goldsmith, President 2
Board of Trustees gas
Glenn Goldsmith,President gQFFD(�'�O
��O Gy� Town Hall Annex
A.Nicholas Krupski,Vice President < 54375 Route 25
Eric Sepenoski ,? P.O.Box 1179
Liz Gillooly �y • 541-V Southold,NY 11971
Elizabeth Peeples � *r �� Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report I
Date/Time: Completed in field by:
Jeffrey Patanjo on behalf of DAVID & HELEN LEIS requests a Wetland Permit for the
as-built (per Emergency Permit#9584E) removal and replacement of existing sanitary
system with a new I/A type in a further landward location than existing; and to install a
proposed second story 9'3"x13'4" deck with step to ground. Located: 1150 Grand
Avenue, Mattituck. SCTM# 1000-107-8-44.1
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
Administrative Emergency Pre-Submission Violation
Notice of Hearing card posted on property: Yes No Not Applicable
Info need ed/Modifications/C\onditions/Etc.:
Present Were: /.G. Idsmith N. Krupski E:Sepenoski
/L. ;Gillooly E. Peeples
GRAND AVENUE
N11'17'20"W 245.98'
N58'00'20"W - - - - - - - - - - - - — — — —
13.74' 740f�
125.00'
N20-452� 0.
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PROPOSED 9'3" X 13'4" SECOND STORY o
DECK ADDITITION W/ STEPS TO BELOW
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61.8\3• p= �
SEPTIC ° j
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ss I/A TREATMENT °_1 GEOMAT
ABANDON EXIST.-'v'f-� /
SANITARY SYSTEM
DISTRIBUTION PROPERTY OWNER:
p w POOL / DAVID & HELEN LEIS
T r 1150 GRAND AVENUE
1 V MATTITUCK, NY 11952
c
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3. PREPARED BY:
JEFFREY PATANJO
i1 P.O. BOX 582
BOHEMIA, NY 11716
631-484-9332
JJPotanjo@gmail.com
p EC 1VE
PROPOSED PERMIT PLANS SCALE:
1"=30'
JUL 14 202 PROPOSED PLAN DATE:
7-3-22
SwumTown 1150 GRAND AVENUE
.Board ofTrust" MATTITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NY SHEET:
TAX MAP N0. 1000-107-8-44.1 1 of 1
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MEMORANDUM
To: Glenn Goldsmith, President
Town of Southold Board of Trustees
From: Mark Terry, AICP
LWRP Coordinator
Date: September 12, 2022
Re: LWRP Coastal Consistency Review for DAVID & HELEN LEIS
SCTM# 1000-107-8-44.1
Jeffrey Patanjo on behalf of DAVID & HELEN LEIS requests a Wetland Permit for the as-built (per
Emergency Permit#9584E) removal and replacement of existing sanitary system with a new I/A
type in a further landward location than existing; and to install a proposed second story 9'3"x13'4"
deck with step to ground. Located: 1150 Grand Avenue, Mattituck. SCTM# 1000-107-8-44.1
The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the
Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy
Standards. Based upon the information provided on the LWRP Consistency Assessment Form
submitted to this department, as well as the records available to me, it is my recommendation that
the proposal is CONSISTENT with LWRP Policies and 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: Honorable Lori Hulse, Attorney
John G. Stein,Chairperson Town Hall,53095 Main Rd.
Lauren Standish,Secretary P.O.Box 1179
Southold,NY 11971
Telephone(631)765-1889
" Fax(631)765-1823
Conservation Advisory Council
Town of Southold
At the meeting of the Southold Town Conservation Advisory Council held Wed.,
September 7, 2022 the following recommendation was made:
Moved by Inga Van Eysden, seconded by Caroline Burghardt, it was
RESOLVED to SUPPORT the application of DAVID & HELEN LEIS for the as-built
removal and replacement of existing sanitary system with new I/A type in a further
landward location as existing. Install proposed second-story deck with step to grade,
overall dimensions to be 9'3"X 13.4" in size.
Located: 1150 Grand Ave., Mattituck. SCTM#107-8-44.1
Inspected by: Caroline Burghardt, Maggie Merrill, John Stein
Vote of Council: Ayes: All
Motion Carried
t
Glenn Goldsmith, President �:: Q��_��,�` Town Hall Annex
A. Nicholas Krupski, Vice President '�Q.=
' C54375 Route 25
P.O.Box 1179
John M.Bredemeyer III Southold,New York 11971
Michael J.Domino Tele
phone(631) 765-1892
Greg Williams a'.r Yom' Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
This Section For Office Use Only
_ Coastal Erosion Permit Application D EC E IV
IFWetland Permit Application
Administrative Permit
Amendment/Transfer/Extensio JUL 14 20&
Received Application: �.��.Ly
_�teceived Fee: $ x.00
dTon
�/Completed Application: 7./g�Z2° oardofiTru*e
$o2td ot'Tmstees
Incomplete:_
SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date:
Coordination:(date sent):
CWRP Consistency Asse sine t Form Sent:
AC Referral Sent:
Date of Inspection:
__Receipt of CAC Report:
Technical Review:
Public Hearing Held:
Resolution:
Owner(s)Legal Name of Property(as shown on Deed): David &Helen Leis
Mailing Address: 1150 Grand Avenue, Mattituck, NY 11952
Phone Number: 917-678-9327
Suffolk County Tax Map Number: 1000- 107-8-44.1
Property Location: 1150 Grand Avenue, Mattituck, NY 11952 (aka 990 Grand Ave.)
See location map
(If necessary,provide LILCO Pole#, distance to cross streets, and location)
AGENT(If applicable): Jeffrey Patanjo
Mailing Address: P.O. Box 582, Bohemia, NY 11716
Phone Number: 631-484-9332 Email: JJPatanjo@gmail.com
cc;;f6�
VI ail
Board of Trustees App1i,__.1;ion .
GENERAL DATA
Land Area(in square feet)::
46,609 sf
Res.
Area Zoning:
Previous-use of property:
Res.
Res.
Intended use of property:
Covenants and Restrictions on property. ❑ Yes ✓❑ No
If"Yes",please provide a copy.
Will this project require a'Building Permit as per Town Code? .� Yes ❑ No
If"Yes",be advised this application will be reviewed by.the Building.Dept prior to a Board of Trustee review
and Elevation Plans will be required.
Does this project require.a variance from the Zoning Board of Appeals?. ❑ .Yes. No
If"Yes",please provide copy of decision.
Will this project require any demolition as per.Town Code or as determined by the Building Dept.?
❑. Yes . No
Does:the structure (s),onproperty have.a valid Certificate of Occupancy? 47Yes=No
Prior.permits/approvals for site improvements:
Agency Date .
Trustees#9584E Nov. 18, 2019
No prior permits/approvals'for site improvements.
Has any permit/approval ever been revoked or suspended by-a governmental agency? No ❑ :Yes
If yes, provide explanation:.
Project Description(use attachments if necessary):
As-built for the removal&replacement of existing sanitary system with new I/A type in a further landward location as existing.
Install:proposed second story deck with step to.grade as shown on plans,overall,dimensions to be 9'3"x 13'4"in size.
:ion
Board, of Trustees Appli'
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations:.
As-built for the removal&replacement of existing sanitary,system with new I/A type in a further landward location as existing.
Install proposed second story deck with step to grade as shown on plans;overall dimensions to be-9'3"x 13'4"in size.
Area of wetlands on lot: 850 . square feet .
Percent coverage of lot: 1.8
Closest distance between nearest existing structure and upland edge of wetlands:: 30 feet
Closest distance between nearest proposed structure and-upland edge of-wetlands: 30 feet
Does the project involve excavation or filling? ❑� No 0 Yes
N/A
If yes,how much material will,be excavated? cubic yards
N/A
How much material will be filled?_ cubic yards
Depth of which material will be removed.or deposited: (VSA feet
Proposed slope throughout the area of operations: 04%
Manner in which material will be remo :ved or depositedN/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(useattachments if appropriate):
There will be a positive effect on wetlands due to reduced nitrogen from original failing sanitary
system replacement with new low-nitrogen type I/A system and relocation of.discharge to
location more landward of previous system.
Short Environmental Assessment Form
Part I -Project Information
Instructions for Completing
Part 1—Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the
application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part 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 1—Project and Sponsor Information
Name of Action or Project:
1150 Grand Ave-Mattituck
Project Location(describe,and attach a location map):
See location map
Brief Description of Proposed Action:
Remove&replace existing sanitary system with new IIA type system.Construct second story deck addition.
Name of Applicant or Sponsor.
Telephone: 917-678-9327
David&Helen Leis E-Mail:
david.leis@yahoo.com
Address:
1150 Grand Avenue(aka 990 Grand Ave.)
City/PO: State: Zip Code:
Mattituck NY 111952
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.
2. Does the proposed action require a permit,approval or funding from any other government Agency? NO YES
If Yes,list agency(s)name and permit or approval:SCDHS(Approved) ❑
3. a.Total acreage of the site of the proposed action? 1.05 acres
b.Total acreage to be physically disturbed? 0.15 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 1.05 acres
4. Check all land uses that occur on,are adjoining or near the proposed action:
5. ❑Urban ❑ Rural(non-agriculture) ❑ Industrial ❑ Commercial m Residential(suburban)
❑Forest ❑ Agriculture ❑ Aquatic ❑ Other(Specify):
❑Parkland
Page I of 3
5. Is the proposed action, NO YES N/A
a. A permitted use under the zoning regulations? ❑ 7 ❑
b. Consistent with the adopted comprehensive plan? ❑ W1 ❑
NO YES
6. Is the proposed action consistent with the predominant character of the existing built or natural landscape? [�
11 Ir I
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: ❑
NO YES
S. a. Will the proposed action result in a substantial increase in traffic above present levels? IZI ❑
b. Are public transportation services available at or near the site of the proposed action? IZI ❑
c. Are any pedestrian accommodations or bicycle routes available on or near the 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:
❑ Ir.I
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water:
11. Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment:
Project is replacement of existing facilities 17 ❑
12. a.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district NO YES
which is listed on the National or State Register of Historic Places,or that has been determined by the ❑
Commissioner of the NYS Office of Parks,Recreation and Historic Preservation to be eligible for listing on the
State Register of Historic Places?
b.Is the project site,or any portion of it,located in or adjacent to an area designated as sensitive for ❑
archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory?
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? ❑
1Z1—
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? a ❑
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres:
Page 2 of 3
1i L
14. Vdentify the typical habitat types that occur on,or are likely to be found on the project site Check all that apply:
®Shoreline [D Forest EJ Agricultural/grasslands ❑Early mid-successional
®Wetland M Urban 0 Suburban
15. Does the site of the pro2osed action contain My species of animal or associated habitats listed by the State orl NO YES
Federal government as threatened or endangered ❑ ❑
16. is the Droject s4e located in the 100- ear flood lan. NO YES
® FI
17. NVill the]2rol2osed action create storm water discharge,either from i3oint or non-point sources NO YES
If Yes, z
a. Will storm water discharges flow to adjacent properties? ED El
b. Will storm water discharges be directed to.established conveyance systems(runoff and storm drains)? ` EJ El
If Yes,briefly describe:
18.IlDoes the ro os:,d action fi,clude construction or other activities that would result in the impoundment ol—waterl NO YES
or ottier liquicis(e.g.,retention pond,waste lagoon,dam)'Ii
If Yes,explain the purpose and size of the impoundment: 17
-19. JHas the site ci rite-proposed actyoii or an Ld oining roe een a ocation o an active or c ose so 1 wast NO YES
management facility
If Yes,describe:
LZ 11
20. as tha site of'tF:,� :ooasea action or an adjoining property been the subject of remediation(ongoing o NO YES
om leted for hazardous waste
If Yes,describe:
{
i
I CE!WTI IF"Y T _i1,T':rte' IINFOR ATION PRO VIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF
Applicant/sp nsor/naa —delen Leis Date:
Si arature _ C Title:Owners
PMMT FORM Page 3 of 3
Part 2-Impact Assessi The Lead Agency is responsible for the comp,' i of Part 2. Answer all of the following
questions in Part 2 using nformation contained in Part I and other material, .,1mitted 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 i
small to large
impact impact
may may
occur occur
i. Will the proposed action create a material conflict with an adopted land use plan oraoning F-1 {
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?
4. Witt the proposed action have an impact on the environmental characlertstics that caused the �
establishment of Critical Environmental Area(CEA)? F�
5. Will the proposed action result in an adverse change in the existing level of traffic or �'1
affect existing infrastructure for mass transit,biking or walkway? E l
6. Will the proposed action cause an increase in the use of energy and it fails to incorporate Q ❑
reasonably available energy conservation or renewable energy opportunities?
7. Will the proposed action impact existing:
a.public I private water supplies?
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ L___1
architectural or aesthetic resources? u
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands,
waterbodies,groundwater,air quality,flora and fauna)? C {
El
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage
problems?
11. Wit I the proposed action create a hazard to environmental resources or human health? El Q
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 considerthe potential for short-term,long-term and
cumulative impacts.
r
f�-x-11 EJ 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 y
j Print or"Type Name of Responsible Officer in Lead Agency Title of Responsible Officer i
Signature of Responsible Officer 1n Lead Agency - Signature of Preparer(if different from Responsible Officer)
EAF Mapper Summary Report Tuesday, September 24, 2019 9:28 PM
Disclaimer: The EAF Mapper is a screening tool intended to assist
,; project sponsors and reviewing agencies in preparing an environmental
1 t C, t=is='t'>g41Ct ;r> ?� -107 00-900-4? `' assessment form EAF Not all questions asked in the EAF are
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IC,_11.00-800 3r 0QA,,
to obtain data not provided by the Mapper.Digital data Is not a
`10700-900-8000,f`t0 substitute for agency determinations.
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Area]
Part 11 Question 12a [National or State No
Register of Historic Places or State Eligible
Sites]
Part 1 /Question 12b [Archeological Sites] No
Part 1 /Question 13a [Wetlands or Other -Yes-Digital mapping information on local and federal wetlands and
Regulated Waterbodies] waterbodies is known to be incomplete.Refer to EAF Workbook.
Part 1 /Question 15[Threatened or No
Endangered Animal]
Part 1 /Question 16[100 Year Flood Plain] Yes
Part 11 Question 20[Remediation Site] No
Short Environmental Assessment Form- EAF Mapper Summary Report Z
�f Board of Trustees Application
AFFIDAVIT
David & Helen Leis
BEING DULY SWORN
DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT
ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION
AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES.
THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE
BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES
AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF
GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE
TRUSTEES,THEIR AGENT(S) OR REPRESENTATIVES,INCLUDING THE
CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO
INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION,
INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF
TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
Signature of Property Owner Signature of Property Owner
SWORN TO BEFORE ME THIS _DAY OFJy�T ,20'M
otar ublic
DANA MEYRAN
Notary Public, State of New York
No. 01 ME6246851
Qualified in Suffolk County
Commission Expires Aug 15,203
Board of Trustees Application
AUTHORIZATION
(Where the applicant is not the owner)
I/We, David & Helen Leis
1
owners of the property identified as SCTM# 1000- 107-8-44. in the town of
Mattituck _ New York,hereby authorizes Jeffrey Patanjo
to act as my agent and handle all
necessary work involved with the application process for permit(s) from the Southold Town
Board of Trustees for this property.
Property Owner's Signature Property Owner's Signature
SWORN TO BEFORE ME THIS _DAY OF J ,207e—
Notary Publi DANA MEYRAN
Notary Public, State of New York
No. 01 ME6246851
Qualified in Suffolk County
Commission Expires Aug 15, 206
APPLICANUAGENUREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits_coriflicts of interest-ort-the part of town.officers and employees.The purpose of
this form is to provide information which can alert..the_town.of_possible.conflicts_of_interest and allow it to takewhatever action is,
necessary to avoid same.
YOUR NAME: Leis,David
(Last name,first name,.griddle initial,unless you are applying'in the name of
someone else or otherentity,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.)
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 W]
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):
O_A)the owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
F_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 thi � da of _ 202 Z-
Signature
Print Name David Leis
Form TS l
APPLICANT/AGENT/REPRESENTATIVF
TRANSACTIONAL DISCLOSURE FORM
The.Tovm-of_Southold s Code'of Ethics mohibits conflicts of interest-on.thewit of town-Qfficers'and'emnlovee§.The mryose'of
this-form is toyprovide information which can-alert the-town-cifoossible-confUc interesfand allow-jt to take.whateyer.action i `:
necessarv-to avoid•same.
YOUR NAME: Leis,Helen
(Last name,first name,.ipiddle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's name,)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance -- Building -
Variance Trustee ~ ✓
Change of Zone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map _ Planning
Other
(If"Other',name the activity.)
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee
of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"means a business,
including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES �� NO
If you answered"YES", complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold—
Title or position of that person —
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
0—A)the owner of greater than 5%of the shares of the corporate stock of the applicant
EJ (when the applicant is a corporation);
B)the legal or-beneficial owner of any interest in a non-corporate entity,(where the
9Lapplicant is not a corporation);
C)an officer,director,partner,or employee of the applicant;or
—D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this ' '� 'SC
Signature.: - _
Print Name en Leis
Form TS I
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
The:Town:of Southold='s.Code of Ethics piofii6its confiiets:of interest;onl,—&�4(4—town oflieers:and`employees::The;nuroose.of`:
thi§_form;isto`pro'vide'intoniiation-which Can;alerf the towntof aossibleeontlictsif interest=and allow if to=takwhatever action:is:'
.-form
avoid=sonic: •
YOUR NAME: Fatanjo,Jeffrey..
(Last name,first name,:giiddle initial,unless you are applying iti:the name of
someone else or other entity,such as a company.If so,indicate the other
person's or company's narrie.)
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,). —
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
iin which the town officer or employee.owns more than 5%of the shares.
YES _1❑:<re NO �
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold=.
Title or position of that person
Describe.the relationship between yourself(the applicant/agent/representative)and the town officer oremployee.'Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or herspouse,sibling,parent,or child is(checkall that apply):
A)the owner of greater than 5%of the shares of the corporate stock of the applicant
EL (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 7/03/2022
Print Name Je ey,Patanjo.
Form TS I
Board of Trustees Applic,_ on
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
APPLICATION NAME & SCTM#:
NAME:
37
107 - 3- /4
STATE OF NEW YORK
COUNTY OF SUFFOLK
residing at
being duly sworn, deposes and says that on
the day of , 20 , deponent mailed a true copy of the
Notice set forth in the Board of Trustees Application, directed to each of the above named
persons at the addresses set opposite their respective names; that the addresses set opposite the
names of said persons are the address of said persons as shown on the current assessment roll of
the Town of Southold; that said Notices were mailed at the United States Post Office located at
, that said Notices were mailed to
each of said persons by CERTIFIED MAIL/RETURN RECEIPT.
Signature
Sworn to before me this
Day of . 20
Notary Public
NOTICE OF HwLm. ARINC
NOTICE IS HEREBY GIVEN that a Public Hearing will be held by the Southold Town Board of
Trustees at the Town Hall, 53095 Main Road, Southold, New York, concerning this property.
OWNER(S) OF RECORD: DAVID & HELEN LEIS
SUBJECT OF PUBLIC HEARING: For a Wetland Permit for the as-built (per
Emergency Permit #9584E) removal and replacement of existing
sanitary system with" a new I/A type in a further landward location than
existing; and to install a proposed second story 9'3"x13'4" deck with
step to ground. Located: 1150 Grand Avenue, Mattituck. SCTM# 1000-
107-8-44.1
TIME & DATE OF PUBLIC HEARING: Wednesday, September 14, 2022 —
at or about 5:30P.M. If you have an interest in this project, you are invited to view the
Town file(s) which are available online at www.southoldtownny.gov and/or in the Trustee
Office until to the day of the hearing during normal business days between the hours of 8 a.m.
and 4 p.m.
BOARD OF TRUSTEES * TOWN OF SOUTHOLD * (631) 765-1892
September 14, 2022
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179
Southold, New York 11971
RE: DAVID& HELEN LEIS
1150 GRAND AVE. -MATTITUCK
SCTM No. 1000-107-8-44.1
AFFIDAVIT OF POSTING
Dear Trustees:
Attached, please find Affidavit of Posting for above referenced project.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290.
Very truly yours,
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
Glenn Goldsmith,President A, :-2'
�Ot��oG Town Hall Annex
A.Nicholas Krupski,Vice President e 54375 Route 25
Eric Sepenoski y z P.O.Box 1179
Liz Gillooly o ® Southold,NY 11971
Elizabeth Peeples y�jod �a Telephone(631)765-1892
Fax(631)765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
BOARD OF TRUSTEES: TOWN OF SOUTHOLD
---------------------------------------------------------------
In the Matter of the Application of
DAVID & HELEN LEIS
COUNTY OF SUFFOLK
STATE OF NEW YORK
AFFIDAVIT OF POSTING
10
P� *1�II�TGIYAIVI �1F -
residing at/dba .
henn► or ,'�� 111 I (o
being duly sworn, depose and say:
That on the 3rd day of Sc&rrbey-, 2022, 1 personally posted the property known as
NSD C-DQ A ONE. 'Makl�-�d 44_ 10�1 k\g52-
by placing the Board of Trustees official noticing poster where it can easily be seen from the
street, and that I have checked to be sure the noticing poster has remained in place for a full
seven days immediately preceding the date of the public hearing. Date of hearing noted thereon
to be held Wednesday, September 14, 2022.
Dated: e)CP�—_mbf_>y- ILA 1 22
(sig to e
Sworn to before me this
I L1-b-4ay of;gyp 20 2 �- JESSICA L. GEREMINA
NOTARY PUBLIC-STATE OF NEW YORK
No.01GE6418131
Qualified in Suffolk County
My Commission Expires 06.01-2026
oy ub
September 6, 2022
Town of Southold Trustees
Town Hall Annex Building
54375 Rte. 25
P.O. Box 1179
Southold, New York 11971
RE: DAVID& HELEN LEIS
1150 GRAND AVE. -MATTITUCK
SCTM No. 1000-107-8-44.1
AFFIDAVIT OF MAILING
Dear Trustees:
Attached, please find Affidavit of Mailing along with certified return receipts for above
referenced project.
If you should have any questions or require anything further, please do not hesitate to
call me at 631-487-5290.
Verytruly yours,
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 11716
Board of Trustees Application
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
APPLICATION NAME & SCTM#: lun— in - Z' y]Li ,
NAME: ADDRESS:
1000-107-8-37
Mackey Daniel A 1000-107-3-11.6
Tully-Mackey Brianne L Keyser Kevin
1145 Grand Ave 46 Cedar St
Mattituck, NY 11952 East Hampton, NY 11937
1000-107-8-34 1000-107-3-16
Trupia Maria Kempski Ronald
1395 Sleepy Hollow Ln Kempski Margie M
Southold, NY 11971 651 S 9th St
Lindenhurst, NY 11757
STATE OF NEW YORK
COUNTY OF SUFFOLK
JC41(e(1 %A an c , residing atP, 0."hDx 2
cI'�ll'a �y cm\` lo, , being duly sworn, deposes and says that on
the 60 day of �P�1 YYl�� , 20 212 , deponent mailed a true copy of the
Notice set forth in the Board of Trustees Application, directed to each of the above named
persons at the addresses set opposite their respective names; that the addresses set opposite the
names of said persons are the address of said persons as shown on the current assessment roll of
the Town of Southold; that said Notices were mailed at the United States Post Office located at
a
Epvc-m i n 2 c h I e , that said Notices were mailed to
each of said persons by CERTIFIED MAIL/RETURN RE EIPT.
J
j�ZF .
SV-n; re
Sworn to before me this (034--_
Day ofSjJOM�r , 202-2 JESSICA L. GEREMINA
NOTARY PUBLIC-STATE OF NEW YORK
No,01G16418131
Qualified in Suffolk County
My Commission Expires 06-01-2025
otar a li
PostalT11
Postal Service"
CERTIFIED MAILPRECEIPT CERTIFIED MAIL@ RECEIPT
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to $ �
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epprppnate)' v� �R �" Extra Services&Fees(check box,add fee as appropdate).rf °
❑Return Receipt(hardcopy) $ <'
El Return Receipt(hardcopy) $
C:1 ❑Return Receipt(electronic) $ 'f t +!_� p C
0 Postmark ❑ReturnReceipt(electronic) $ •( Postmark
❑Certified Mali Restricted Delivery $ i�•;- 7 ! O Certified Mail Restricted Delivery (�.`-,'l 1
O \ Hare w ❑ ry $ j Here �4
El Adult Signature Required $ '1" O /
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El Adult Signature Restricted Delivery$ Q!•'•1 U� �� I ❑Adult Signature Restricted Delivery$
p Postage - ;'y ✓ IPostage
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0 46 Cedar St r sa 1395 Sleepy Hollow Ln
r- East Hampton, NY 11937 i Southold, NY 11971
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1000-107-8-37 I o
M I m 1000-107-3-16
Mackey Daniel A Kempski Ronald
cO Tully-Mackey Brianne L a Kempski Margie M
N 1145 Grand Ave 651 S 9th St
Mattituck, NY 11952Lindenhurst, NY 11757 ------------------
PS Form 3 8000 d 7530-02-000-9047 :r r , r d r r d
Town of Southold
LWRP CONSISTENCY ASSESSMENT FORM
A. INSTRUCTIONS
L" 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.:Mill; .be .-valuated as to .its sienificant
beneficial and adverse effects upon the coastal area.(which includes all of.Southold
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 inthe:consistency
review law. Thus;..each.answer..must.be explained in.detail...Iisting both.supporting. and non
. . .. . . . ..
:6u'0)0A1:6�fkts' If.
an'lkon cannot be certified asconsistent with the LWRP.policy standards and
conditions,.-it shallmot.: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# 107 8. 44.1
1150 Grand Avenue (aka 990 Grand Ave.)- Mattituck
PROJECT NAME ... .:_... . ;. . ............. .:
The Application has been submitted to(check appropriate-response):
T.own.Board ❑ Planning Board❑ B.uilding 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:
F7
Nature and extent of action:
As-built for the removal&replacement of existing sanitary system with new I/A type in a further landward location as existing.
Install proposed second story deck with step to grade as shown on plans,overall dimensions to be 9'3"x 13'4"in size.
Location of action: 1150 Grand Ave-Mattituck,NY 11952
Site _. .. _.... 1.07
acreage.
Present land-use: Res.
Present zoning classification:Res.. ..: .
2. If an application for the proposed action has,been filed with the Town of Southold agency;the following
information shall be provided:-
(a)
rovided:(a) Name of applicant:. David&.Helen Leis... ..:...
(b) Mailing address: 1150 Grand Ave,,.Mattituck,NY 11952
.(c) Telephone number: Area Code. 917-678-9327
(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?NYSDEC
C. Evaluate the project to the following policies by analyzinghow 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
No effect
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 O No❑✓ Not Applicable
No effect
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 0 Not Applicable.
No effect
Attach additional she 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 0 Not Applicable
No effect _ , .. .. ... ..
'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 ❑. No ❑Not Applicable
Project provides for a reduced nitrogen sanitary system.which will protect the waters
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 Seetion III Policies; Pages,.22,
through 32 for evaluation criteria.
✓❑Yes ❑No .❑Not Applicable
Project provides for a reduced nitrogen'sanitary system which will protect the waters ( .
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 Z :Noi Applicable
No'effect
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
77
No effect
PUBLIC COAST POLICIES
Policy 9. Providefor 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. ;
❑. WE No Not Applicable
No effect. .
Z.
-Attach additional sheets'if necessary : .
WORKING 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
No effect
t
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 El No W1 Not Applicable {
No effect
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 El No 0 Not Applicable
No effect
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 0 Not Applicable
No effect
Jeff Patanjo Agent
PREPARED.BY : TITLE.. DATE 10i23i21
rr� Vii. �1
July 7, 2022
Town of Southold Trustees
Town Hall Annex Building ,,,
54375 Rte. 25' n `
P.O. Box 1179 V
Southold, New York 11971 JUL 14 2002
RE: DAVID& HELEN LEIS
ri
1150 GRAND AVE. -MATTITUCK SOtJfl101d T4w11
SCTM No. 1000-107-8-44.1 Board ' rusts
PERMIT APPLICATION
Dear Trustees:
I
We hereby submit one (1) original and three (3) copies of the proposed project plans,
applications and check for above referenced project approval. This application includes
a proposed deck addition and the as-built approval for a previous installation of sanitary
system under emergency permit#9584E.
Ifou should have any y questions or require anything further, please do not hesitate to
call me at 631-487-5290.
Very truly yours,
Jeffrey Patanjo
P.O. Box 582
Bohemia, NY 117116
1