HomeMy WebLinkAboutInn the Vineyard Cantrell, Elizabeth
From: mkimack2@verizon.net
Sent: Friday, March 17, 2023 5:49 PM
To: Cantrell, Elizabeth
Subject: Nasary Application
Hi Liz:
I respectfully withdraw the recently submitted application for Veronica Nasary at
900 Fox Hollow road, Mattituck.
Thank you for your consideration in this matter
Michael A. Kimack,Agent
ATTENTION: This email came from an external source. Do not open attachments or click on links from
unknown senders or unexpected emails.
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Cantrell, Elizabeth
From: Cantrell, Elizabeth
Sent: Thursday, March 9, 2023 10:10 AM
To: mkimack2@veri2on.net
Subject: Inn The Vineyard Mattituck, LLC;SCTM# 1000-113-6-2
Attachments: 20230309100206.pdf
Mike,
The Board of Trustees performed their field inspections on the above referenced property and asked that I forward you
the field notes. Based on the field inspection comments,the Board is requesting revised plans for the project by
Monday for their work session or the application will have to be postponed from March's agenda.
Senior Office Assistant
Town of Southold
Board of Trustees
Office: 631-765-1892
Email: elizabethc@southoldtownny.gov
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•00 Fox Hollow .
1000-113-6-22
3/7/23
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Inn the Vineyard Mattituck,LLC
900 Fox Hollow Road,Mattituck
SCTM#: 1000-113-6-22
3/7/23
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OFFICE LOCATION: s MAILING ADDRESS:
Town Hall Annex ' P.O. Box 1179
54375 State Route 25 ° Southold,NY 11971
(cor.Main Rd. &Youngs Ave.)
Telephone: 631 765-1938
Southold, NY 11971 P
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
MEMORANDUM
To. Glenn Goldsmith, President
Town of Southold Board of Trustees
From: Mark Terry, AICP
LWRP Coordinator
Date: March 15, 2023
Re: LWRP Coastal Consistency Review for INN THE VINEYARD MATTITUCK, LLC,c/o VERONICA
NASARY
SCTM# 1000-113-6-22
Michael Kimack on behalf of INN THE VINEYARD MATTITUCK, LLC, c/o VERONICA NASARY requests a
Wetland Permit for the as-built 18'x36' (648sq.ft.) in-ground swimming pool, 1,179sq.ft. stone pool patio
surround, and 4' high pool enclosure fencing with two (2) gates(281 linear feet); as-built 8'x4' (32sq.ft.)
landing to a 4'x12' (48sq.ft.) staircase to a 3'x66.83' (200sq.ft.)catwalk; seven (7) as-built electric lights at
pool and along walkway to floating dock to be converted to Dark Sky compliant fixtures; and as-built 6'x40'
(240sq.ft.) floating dock with two (2) pilings to secure it in place, to replace in-kind previously approved
floating dock. Located: 900 Fox Hollow Road, Mattituck. SCTM# 1000-113-6-22
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 as-built are INCONSISTENT with LWRP
and, therefore, INCONSISTENT with the LWRP.
6.3 Protect and restore tidal and freshwater wetlands.
A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and
regulations for all Andros Patent and other lands under their jurisdiction
1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions.
The as-builts were constructed without a Board of Trustee review or permit.
Further the applicant has not demonstrated to the Board that the proposed action complies with 275-11. C.
(2) Docks outlined below.
275-11. C. (2) Docks
(d) Review and approval of dock applications. Before i; suing a permit for a dock structure, the Trustees shall
consider whether the dock will have any of the following harmful effects:
• Whether the dock will impair navigation or be located in areas of high vessel traffic or vessel
congestion;
• Whether the dock will unduly interfere with the public use of waterways for swimming, boating,
fishing, shellfishing, waterskiing and other water-dependant activities;
• Whether the dock will cause degradation of surface water quality and natural resources;
• Whether the dock will cause habitat fragmentation and loss of significant coastal fish and wildlife
habitats;
The dock is poorly designed. The height between intertidal ve etation and the bottom of the
dock',is insufficient to support the continued survival of species. The dock should be.
removed and reconstructed to an appropriate height to allow light penetration..
• Whether the dock will result in the destruction of or prevent the growth of vegetated wetlands,
seagrasses including eelgrass (Zostera marina) and widgeon grass (Ruppia maritima) or shellfish;
In the event the action is approved, it is recommended that the Board consider re uirin rid
decking in place of planks over vegetated wetlands to allow for the reestablishment of the
s artlna afterrrfflora or s artl a 12atens.
• Whether the cumulative impacts of a residential and commercial dock will change the waterway or
the environment and whether alternate design, construction, and location of the dock will minimize
cumulative impacts.
The following is recommended if the action is approved:
1. Require a vegetated buffer landward of the wetland and stormwater sink to handle runoff
From the pitch of the ro eLt to the waterbody.
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
1` vs�
Glenn Goldsmith,President '%N OGy_ Town Hall Annex
A.Nicholas Krupski,Vice President a < 54375 Route 25
Eric Sepenoski ,? P.O.Box 1179
Liz Gillooly �y • 0�� Southold,NY 11971
Elizabeth Peeples ��l �a,�p �r Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: Completed in field by:
Michael Kimack on behalf of INN THE VINEYARD MATTITUCK, LLC, c/o VERONICA
NASARY requests a Wetland Permit for the as-built 18'x36' (648sq.ft.) in-ground
swimming pool, 1,179sq.ft. stone pool patio surround, and 4' high pool enclosure.
fencing with two (2) gates (281 linear feet); as-built 8'x4' (32sq.ft.) landing to a 4'x12'
(48sq.ft.) staircase to a 3'x66.83' (200sq.ft.) catwalk; seven (7) as-built electric lights at
pool and along walkway to floating dock to be converted to Dark Sky compliant fixtures;
and as-built 6'x40' (240sq.ft.) floating dock with two (2) pilings to secure it in place, to
replace in-kind previously approved floating dock. Located: 900 Fox Hollow Road,
Mattituck. SCTM# 1000-113-6-22
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 needed/Modifications/Conditions/Etc.:
Present Were: G. Goldsmith N. Krupski E. Sepenoski
L. Gillooly E. Peeples
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ems:;,-. N,�`� �:�• -. .. ., ., .. : „•,."`::.;
#� r� , yii of;Southold: Town.,17ustees:::aat oriies.:arid'. errrii#s t ie foliowit
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all:':-►n accordance. with.6:deta�ledd s ecifications as.
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LANDING STAIRCASE WALKWAY D �C�`-E I V E
,JAN 3 2023 Veronica Nasary
I9 0 Fox Hollow Road,Mattituck
Smditola iocwn
Board ofTRlsdces SCTM:1000-113—6—22
TYPICAL DETAIL SECTION LEGALIZE " AS BUILT LANDING
SCALE:ONE INCH= 10 FEET
STAIRCASE AND WALKWAY
By.Michael A.Kimack Dated: dec.24,2022
S.C.T.M. NO. DISTRICT: 1000 SECTION: 113 BLOCK: 6 LOT(S):22
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EFFECTIVE 09/25/2009 PILING
THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL
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6.940 LOCA77ONS SHOWN ARE FROM FIELD OBSERVA77ONS
AND OR DATA OBTAINED FROM OTHERS
AREA:42,169.61 SQ.FT. or 0.97 ACRES ELEVA77ON DATUM:
UNAUTHORIZED ALTERAAON OR ADD177ON TO THIS SURVEY IS A WOLA77ON OF SEC77ON 7209 OF THE NEW YORK STATE EDUCA77ON LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID 7RUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM 774E SURVEY IS PREPARED AND ON HIS BEHALF TO THE 777LE COMPANY, GOVERNMENTAL AGENCY AND LENDING INS77TU77ON
LISTED HEREON, AND TO 774E ASSIGNEES OF THE LENDING INS77TU770N, GUARANTEES ARE NOT 7RANSFERABLE.
7HE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO 774E S7RUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE 7HEY ARE
NOT IN7FNDED TO MONUMENT 7HE PROPERTY LINES OR TO GUIDE THE EREC77ON OF FENCES, ADDITIONAL S7RUCTURES OR AND 07HER IMPROVEMENTS EASEMENTS
AND/OR SUBSURFACE STRUETURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON 774E PREMISES AT THE 77ME OF SURVEY
SURVEY OR DESCRIBED PROP ECEIVE CERTIFIED TO:. VERONICA NASARY;
MAP OF: -
FILED: JAN - 3 2023
SITUATED AT: MATTITUCK
TOWN OR SOUTHOLD nmf IDIT .#. KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW Y eDanaofTrusfees Professional Land Surveying and Design
j P.O. Bog 153 Aquebogue, New York 11931
PHONE (831)298-1588 FAX (631) 298-1588
FILE #222-155 scALE:1"=40' DATE: NOV. 10, 2022 N.YS. LISC. NO. 050882 maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk
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COUNTY OFSUFFOLK<q N NgTICE K srcna+No
\:J ,,,„, - __ Peal P-perry Tax`3ervice Agency
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P8 a rtuuxlv�i,>xroetx. or
Og%jFFQZ I.coG
John G.Stein,Chairperson CIO
Town Hall,53095 Main Rd.
Lauren Standish,Secretary P.O.Box 1179
,j, • �'� Southold,NY 11971
Telephone(631)765-1889
1 Fax(631)765-1823
Conservation Advisory Council
Town of Southold
At the meeting of the Southold Town Conservation Advisory Council held on Wed.,
February 8, 2023 the following recommendation.was made:
Moved by John Stein, seconded by John Chandler, it was
RESOLVED to SUPPORT the application of the INN THE VINEYARD MATTITUCK LLC
to legalize the as-built 18'X 36' in-ground pool and stone patio, 4' pool fence with two (2)
gates, 8'X 4' landing, 4'X 12' staircase and TX 66.83' walkway. Existing electric lights at
pool and along walkway to floating dock to be converted to permitted dark sky light
fixtures. Constructed 6'X 40' floating dock with two (2) pilings "as-built" to replace in kind
approved floating dock under Permit#1518 issued 1/4/82.
Located: 900 Fox Hollow Rd., Mattituck. SCTM#113-6-22
Inspected by: John Stein, Maggie Merrill, Caroline Burghardt
The CAC Supports the application with the condition the 6'X 40' floating dock is reduced
to 6'X 20', in compliance with Ch. 275 of the Town Code.
Vote of Council: Ayes: All
Motion Carried
i
DiSalvo, Diane
From: Michael A Kimack <mkimack2@verizon.net>
Sent: Monday, February 13, 2023 2:13 PM
To: DiSalvo, Diane
Subject: Re: Inn the Vineyard - 900 Fox Hollow Road
Yes
Sent from the all new AOL app for Android
On Mon, Feb 13, 2023 at 1:13 PM, DiSalvo, Diane
<diane.disalvo@town.southold.ny.us>wrote:
Your phone message was not clear—are you saying to move forward with the application as it stands?
Diane
1
1
f
Cantrell, Elizabeth
From: Cantrell, Elizabeth
Sent: Tuesday,January 31, 2023 11:44 AM
To: mkimack2@verizon.net
Cc: Goldsmith, Glenn
Subject: Nasary; SCTM1000-113.6-22
Mike,
Regarding the above application, at this time it has been deemed incomplete. You have not applied for the as-built dock
session from the edge of wetlands seaward,only the catwalk section over vegetated wetlands. As the rest of the
docking facility does not conform to Wetland Permit#1518,the entire docking facility requires a new Wetland permit. If
this office does not receive four sets of revised plans and revised written project descriptions by end of day tomorrow
this application is postponed from February's agenda.
Also be advised due to the fact the dock was at some point reconstructed longer than the originally approved dock the
Board may require a hydrographical survey of the area be submitted, as well as a plan depicting the nearest adjacent
docks on either side of this dock.
Senior Office Assistant
Town of Southold
Board of Trustees
Office: 631-765-1892
Email: elizabethc@southoldtownny.gov
Glenn.Goldsmith, President ;i k lf � Town Hall Annex
A. Nicholas Krupski,Vice President ,c G; 54375 Route 25
;� ° x•t P.O.Box 1179
Eric Sepenoski � Southold, New York 11971
Liz Gillooly
r Telephone(631) 765-1892
Elizabeth Peeples ',c % ��l Fax (631) 765-6641
.BOARD OF TOWN TRUSTEES
TOWN OF SOUTROLD
This Section For Office Use Only
Coastal Erosion Permit Application Q E.
�� . ..�
X Wetland Permit Application DD
Administrative Permit
Amendment/Transfer/Extension 3 JAN 3 2023
$ Received Application: _
Received Fee::$.
Completed Application: l•(of�2�3 a Board ofTntsfces
Incomplete:
�SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date:
Coordination:(date sent):
—�LWRP Consistency Asses sm nt Form Sent: �3
C Referral Sent: !* a2 cot
Date of Inspection: �_�311�..23
Receipt of CAC Report:
Technical Review:
Public Hearing Held:
Resolution: 3f�r o23
Owner(s) Legal Name of Property (as shown on Deed): C
Mailing Address: AR le L,Q/�� 61A7Mn4C1eo/1,V 119
Phone Number:
Suffolk County "Tax Map Number: 1000 - /13_ 6 — ZZ
Property Location: 900 rCY R04MW Rp,�Arary_C)
(If necessary, provide LILCO Pole#, distance to cross streets, and location)
AGENT(If applicable): /V1 CAM& A ck
Mailing Address: J`6 71
Phone Number476 CO- 6,847 Email: keM C 1Z0/(1.1(1"7_
C,j'jS�J'
3/�l Z3
Beard of Tru,si;ee3 Application
GENERAL DATA
Land Area(in square feet): /16
Area Zoning:
Previous use of property:,_
Intended use of property: 24,1_
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 4 variance from the Zoning Board of Appeals? Yes _. L 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 VN0
Does the structure (s) on property have a valid Certificate of Occupancy? Yes No
Prior permits/approvals for site improvements:
Agency Date
No prior permits/approvals for site: improvements.
Has any permit/approval ever been revoked or suspended by a governmental agency?_><'_No Yes
If yes, provide explanation:,
Project Description (use attachmo.rnts if necessary):
CJ,76e7 Cl 'f?`/d/t 6-7
NASARY PROJECT DESCRIPTION
To legalize "as built" 18 ft. x 36 ft. in ground pool ( 648 SF), pool stone patio surround
( 1179 SF ), 4 ft. pool fence ( 281 lin. ft. )w/two (2) gates, 8 ft. x 4 ft. landing( 32 SF ),
4 ft. x 12 ft. staircase ( 48 SF ), 3 ft. x 66.83 ft. walkway ( 200.5 SF ).
Existing electric lights ( 7) at pool and along walkway to floating dock to be
converted to permitted dark sky light fixtures.
Constructed 6 ft. x 40 ft. floating dock ( 240 SF )w/two (2) pilings "as built' to replace
in kind approved floating dock under Permit No. 1518 issued January 4, 1982
Board of Trustees Application
WETLAND/TRUSTEE LANDS APPLICATION DATA
Purpose of the proposed operations: 7- L�&Ae Z?,4 W OOP /�1>N&
aka O D �-� s, ('A r"►�t/�Q��
Area of wetlands on lot: square feet
Percent coverage of lot: %
Closest distance between nearest existing structure and upland edge of wetlands: —�-�-- feet
Closest distance between nearest proposed structure and upland edge of wetlands: feet
Does the project involve excavation or filling? X^No Yes
If yes,how much material will be excavated? &ON556 cubic yards
How much material will be filled? A/(Iy cubic yards
Depth of which material will be removed or deposited: NIA feet
Proposed slope throughout the area of operations:
Manner in which material will be removed or deposited: 14
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):
�_ 10414.
OZ20
Appendix:B
Short Environmental Assessment Form
Int;trudions for COTIJIIciiE
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 an:nver as thoroughly as possible based on current information.
Complete all items in Pert 1. You may also provide any additional information which you believe will be needed by or useful
to the lead agency;attadh additional pages as necessary to supplement any item.
Part.1 -Project and Sponsor Information
Name of Action or Project:
Project Location(describe,and attach a location map):
Brief Description of Proposed Action: '
Name of Applicantor Sponsor: - Telephone s Z4:7
M_ �I1. A'Z t ����'!l�tGE Ma 4 C a V�IC�i
Address:
Cit;/PO State: Zip Code:
1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NOT 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. ff no,continue to question 2.
El
2. Does the proposed action rf:quire a permit,approval or funding from any other—govern ment.TAgency? _ NO` YES
If Yes, list agency(s)name anc:permit or approval:
3.a.Total acreage of the site of the proposed action? acres
b.Total acreage to beiphysically disturbed? — _ acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the,applicant or project sponsor? " acres
4. Check all land uses that occur on,adjoining and near the proposed
Urban q Rural (non-agriculture) 0Industrial ❑Commercial Residential(suburban)
❑Forest []Agriculture ❑Aquatic: ❑Other(specify):
❑Parkland
Page .l of 4
NASARY PROJECT DESCRIPTION
To legalize "as built" 18 ft. x 36 ft. in ground pool ( 648 SF), pool stone patio surround
( 1179 SF ), 4 ft. pool fence ( 281 lin. ft. )w/two (2) gates, 8 ft. x 4 ft. landing ( 32 SF ),
4 ft. x 12 ft. staircase ( 48 SF ), 3 ft. x 66.83 ft. walkway ( 200.5 SF ).
Existing electric lights ( 7) at pool and along walkway to floating dock to be
converted to permitted dark sky light fixtures.
Constructed 6 ft. x 40 ft. floating dock ( 240 SF ) w/two (2) pilings "as built' to replace
in kind approved floating dock under Permit No. 1518 issued January 4, 1982
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? ❑
6. is the proposed action consistent with the predominant character of the existing built or natural NO YES
landscape? ❑
7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES
If Yes,identify: � ❑
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES
b.Are public transportation service(s)available at or near the site of the proposed action? ❑
c. Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? ❑
9.Does the proposed action meet or exceed the state energy code requirements? O YES
If the proposed action will exceed requirements,describe design features and technologies- ❑
N
10. Will the proposed action connect to an existing public/private water supply? NO YES
If No,describe method for providing potable water: /�(�� _ ❑
11.Will the proposed action connect to existing wastewater utilities? NO YES
If No,describe method for providing wastewater treatment: _ � ] ❑
12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES
Places? ❑
b.Is the proposed action located in an archeological sensitive area?
13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES
wetlands or other waterbodies regulated by a federal,state or local agency? ❑ ( —
b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? { I❑�I_
If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: J�J
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 DI 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? jam{ ❑
16.Is the project site located in the 100 year flood plain? NO YES
17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES
If Yes,
a.Will storm water discharges flow to adjacent properties? ❑NO OYES ❑
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
i
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)?
f Yes,explain purpose and size:
19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES
solid waste management facility?
If Yes,describe: �___.. _.�. ❑
20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES
completed)for hazardous waste?
If Yes,describe: �� ❑
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY
KNOWLEDGE
Applieant/sponsornarne: Date; /8 OZZ
Signature:
Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following
questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or
otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my
responses been reasonable considering the scale and context of the proposed action?'
No,or Moderate
small to large
impact impact
may may
occur occur
l. Will the proposed action create a material conflict with an adopted land use plan or zoning Elregulations?
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? _l
4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ El
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? El
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? L_ !
7. Will the proposed action impact existing: j o
a.public/private water supplies? El
b.public/private wastewater treatment utilities?
8. Will the proposed action impair the character or quality of important historic,archaeological, jam ❑
architectural or aesthetic resources? j]
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ ❑
waterbodies,groundwater,air quality,Flora and fauna)?
Page 3 of 4
No,or Moderate
small to large
impact impact
may may
occur occur
10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage El _ Elproblems?
11. Will the proposed action create a hazard to environmental resources or human health? ❑ 1 1:1
Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. Tor every
question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular
element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3.
Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by
the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact
may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring,
duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term, long-term and
cumulative impacts.
FJCheck this box if you have determined,based on the information and analysis above,and any supporting docurentation,
that the proposed action may result in one or more potentially large or significant adverse impacts and an
environmental impact statement is required.
Check this box if you have determined,based on the information and analysis above,and any supporting documentation,
that the proposed action will not result in any significant adverse environmental impacts.
Town of Southold-Board of Trustees
_._._....._
Name of Lead Agency Date
President
Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer
_..._..._.._.._.. ..._.._. _. ......._... — _ _ .............. ...........................
Signature of Responsible Officer in Lead Agency Signature of Preparer(if different from Responsible Officer)
PRINT Page 4 of 4
Bcard of Trustees Application
AUTHORIZATION
i.Where the applicant is not the owner)
owners of the property identif ed as SCTM# 1000-_/r 3 - S ' Z.Z. in the town of
__. A9.4T7M M C14e _ New York,hereby authorizes
--- HI WAeL -4ACA 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 prof erty.
Property Owner's Signature — Property -
b p y Owner's Signature
&A-PCI l/CA A4 N,45;q,ey
swoRN TO BEFORE ME TVIS_ DAY O
06
Kw ,
Notary Public
MICHAELA.KIMACK
Notary Public,State of New York
No.02KI5056823
Qualified in Nassau County
Commission Expires March 11,2026
Bcard of Trustees Application
AFFIDAVIT
_ VrROW/C-T _A N S,¢RY BEING DULY SWORN
DISPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE
DESCRIBED PERMIT(S)A.ND THAT ALI:STATEMENTS CONTAINED HEREIN
ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT
ALI, 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 IIf►RMLESS AND FRI+_',E 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 AGENTS)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 Or TO MY PROPERTY AND AS REQUIRED TO INSURE
COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL
EROSION PERMIT ISSUE:)BY THE BOARD OF TRUSTEES DURING THE TERM
OF THE PERMIT.
Signature of Property Owner Signature of Property Owner
V,&,00A11CA A NA WARY
SVl'ORN TO BEFORE ME THIS DAY OF
Notary Public
MICHAELA.KIMACK
Notary Public,State of New York
No. 02KI5056823
Qualified in Nassau County
Commission Expires March 11,2026
APPLICANT/AGENTIREPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORIVI
The Town of Southold's Code of lithlca prohibits conflicts of inlcrest on thr p:1rt of town officers and empinvice>.'Ilhr ur lo5r of
this form is to provide infiormation which can alert the town of nossihle conflicts of interest and allow it to take whatever action is
necessary to avoid same.
YOUR NAME: ----
(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.)
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 wr through •our company.<pousc.siblin_%parent.or.hddl h:nr a rclanon-Jup w ilh any officer or emplo:cc
of the Town of Southold? "Relationship"include:,h\ blood,marriage.or hu::nr..uttcrr,t "Itusmc..>inter si'vlcam a hu>incss.
including a partnrrshlp.In which the town officer or cinplo%ee has C%Cn,11.1rtl.11 1W.11Clshlp of I1-1 Cm;Ill_111C111 tit 1.1 Ci111101.111011
in which the torn ollice?or employee owns u:orc than S°.of the shares.
YES — NO X
I f 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/agentlrepresentative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
A)the owner of greater than 59.of(lie shares of the corporate stock of the.1pplic:mt
(when the applicant is a corporation);
B)the legal or beneficial owner of any interest in a non-corporate entity 1 w hell Ale
applicant is not a corporation);
_C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant.
DESCRIPTION OF RELATIONSHIP
Submitted this _day of �U t 20
Signature ,f1 (.vvy�
Print Name (W A14S11A ®®
Form TS 1
APPLICANT/AGENT/REPRESENTATIVE
TRANSACTIONAL DISCLOSURE FORM
T e Town of Southold' C d a Ethics cs rahibits conflicts of interest an the art. f tovm offiders and em 1 ees.The u ose.of
this fomt is Eo nrov ile information which cart'alert the-town-of-possible conflicts of interest and allow it to take whatever action is
necessaryto avoid.sante.
YOUR NAME: _ I IM/ti CAL
(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 offrccr or employee has even a partial ownership of(or employment by)a corporation
in which the down officer or employee owns more than 5%of the shares.
YES NO
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check
the appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply):
A)the owner of greater than 5%of the shares of the corporate stock of the applicant
(when the applicant is a corporation);
B)the legal or beneficial owner of any interest in a non-corporate entity(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 9,4///da of 2 0--2?—
Signature
Print Name
Form TS I
, ,)ard of Trustees Applicat:,
PROOF OF MAILING OF NOTICE
ATTACH CERTIFIED MAIL RECEIPTS
APPLICATION NAME & SCTTx/rv- /
NAME: o 'c��n
I13= � � ►
1 ► 3 - � " a�
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 720
Notary Public
ING
NOTICt. - OF
HEAN"I
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: INN THE VINEYARD MATTITUCK, LLC, c/o VERONICA NASARY
SUBJECT OF PUBLIC HEARING: For a Wetland Permit for the as-built 18'x36'
(648sq.ft.) in-ground swimming pool, 1,179sq.ft. stone pool patio surround,
and 4' high pool enclosure fencing with two (2) gates (281 linear feet); as-built
8'x4' (32sq.ft.) landing to a 4'x12' (48sq.ft.) staircase to a 3'x66.83' (200sq.ft.)
catwalk; seven (7) as-built electric lights at pool and along walkway to floating
dock to be converted to Dark Sky compliant fixtures; and as-built 6'x40'
(240sq.ft.) floating dock with two (2) pilings to secure it in place, to replace in-
kind previously approved floating dock. Located: 900 Fox Hollow Road,
Mattituck. SCTM# 1000-113-6-22
TIME & DATE OF PUBLIC HEARING: Wednesday, March 15, 2023 — 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
Town of Southold
LBV:RP CONSISTEP4,CY ASSESSMENT FORM
A. INSTRUCTIONS
1. All applicA, nts for permits* including Town of Southold agencies, shall. complete this CCA.F for
proposed action,:,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 Erasion Hazard Area.
2. Before answering the questions in Section C, the prepac•er of this form should review the ex:ernpt
minor action list, policies and explanations of each policy contained in the Town of Southold Local
Waterfront, Revitalization Program, A._l_ioposed action will be evalu�tcd. as to its si�rni:Licanl.
beneficial rind adverse c;ffects upon the coastal area which includes all of Southold Tgwn).
3. I:f any question in Section C on this form is answered "yes" or "no", theri the proposed action will
affect the achievement of the LWRP policy standards and conditions contained in the consistency
review law. Thus, ea.eh answer must_be explained in detail, iistiri ► br�fh stt� oi.tia�� and non-
supportiitts facts. If all action cannot be-
,certified as consistent with the LWRP policy standards and
conditions,'iitt shall not be ind.ert�l:en.
A copy of the L'WRP 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 ]"own Clerk's office.
B. D►ESCRIPTION(OF SITE AND PROPOSED ACTION
SCTM# 01Z
.PROJECT NAME
The Application has beep submitted to (check appropriate response):
Town Board ❑ Planning;Board❑ BuildingDept, ❑ Board of Trustees iRI
1. Category of Town lof Southold agency action (check appropriate response):
(a) Action undertaken directly by Town agency(e.g. capital
construction,plai!irung activity, agency regulation,land transaction)
❑
(b) Financial assistance (e.gy, grant, loan, subsidy)
(c) Permit, approval, license,certification:
Nature and extent of action:
NASARY PROJECT DESCRIPTION
To legalize " as built" 18 ft. x 36 ft. in ground pool ( 648 SF), pool stone patio surround
( 1179 SF ), 4 ft. pool fence ( 281 lin. ft. )w/two (2) gates, 8 ft. x 4 ft. landing( 32 SF ),
4 ft. x 12 ft. staircase ( 48 SF ), 3 ft. x 66.83 ft. walkway ( 200.5 SF ).
Existing electric lights ( 7) at pool and along walkway to floating dock to be
converted to permitted dark sky light fixtures.
Constructed 6 ft. x 40 ft. floating dock ( 240 SF )w/two (2) pilings "as built'-to�replace
in kind approved floating dock under Permit No. 1518 issued January 4, 1982
Location of action:
Site acreage: F7
Present land use: NT1A4 0A E 1--,4 NIL _
Present zoning classification: _ -40
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: Ck
(b) Mailing address: P Q. R OK �Q 4
s-a Ual/6 W, N' /,/77,/
(c) Telephone number: Area Code 146 6,6 Iq- 7
(d) Application number,if any: A)16
Will the action be directly undertaken,require funding, or approval by a state or federal agency?
IV
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
N"N c QU-1
C s5
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 XR21 Not Applicable
C04�t/ C LD /c4L
4 p)
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 Z Not Ap licab e
Paz)ex -1 Y-0 77115 &e& 0-57-V 01,1
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
PM/ cy 4 N .9 2'V 7W15 Q9�dN
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 A plic le
GG1 C? 40 7-0 Z !S OPAL c,9t 7'da.0
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
Dcy 06 ,00
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.
❑ � Not Applicable
Yes ❑No
FoU eY 7 NIA ;o �5 .¢&W 04rlalu
Attach additional sheets if necessary
Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous
substances and wastes. See LV6-P Section III—Policies; Pages 34.through 38 for evaluation criteria.
❑ Yes ❑ No � Not Applicable
?-01- Y 8 W1W r Q MIT 4R&ZC4
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 NoX] Not Applicable
PoL/cY 9 AV,,1,4 ,2' 0 15' A29?Z1 c-47701V
Attach additional sheets if necessary
l
1
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 X Not Applicable
,D IV
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 Z 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 L5ZNJ Not Applicable
CxA/,o!Qr 6A1
OU �
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
S` A 0 /J
PREPARED SY f ('IL TITLE_ 1J�,Ehl 2"— DAT