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Home My WebLink AboutTR-10364A Glenn Goldsmith, President `�®F s®(��y Town Hall Annex A. Nicholas Krupski,Vice President ®�v ®�® 54375 Route 25 P.O. Box 1179 Eric Sepenoski ! J Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples • �® Fax(631) 765-6641 C®U6�T1,� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE 2043C Date: June 26, 2023 THIS CERTIFIES that the removal of an existing block septic tank and one 6' deep leaching pool and install in same location a HydroAction AN500 I/A OWTS and a new 6' deep, 8' diameter leaching pool; At 1290 Willow Terrace Lane, Orient Suffolk County Tax Map 91000-26-2-24 Conforms to the application for a Trustees Permit heretofore filed in this office Dated April 10, 2023 pursuant to which Trustees Administrative Permit#10364A Dated May 17,2023,was issued and conforms to all the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for removal of an existing block septic tank and one 6' deep leaching pool and install in same location a HydroAction AN500 I/A OWTS and a new 6' deep, 8' diameter leaching-pool. The certificate is issued to Robert N. Hulsmann Trust&Ann Hulsmann Trust owner of the aforesaid property. s Authorized Signature 1 Glenn Goldsmith, President SO1,+ 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 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DATE OF INSPECTION: INSPECTED BY: _ Ch. 275 Ch. 111 INSPECTION SCHEDULE Pre-construction, haybale line/silt boom/silt curtain 1St day of construction % constructed Project complete, compliance inspection COMMENTS: LIP �°✓�,moi �� `036%A . D!� CERTIFICATE OF COMPLIANCE: /!C Glenn Goldsmith, President � so � Town Hall Annex ®� 54375 Route 25 A. Nicholas Krupski,Vice President ®m, P.O. Box 1179 Eric Sepenoski Southold, New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 COUN-N,� 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 1St day of construction % constructed When project complete, call for compliance inspection; Glenn Goldsmith,President ®� s®(/1� Town Hall Annex 54375 Route 25 A. Nicholas Krupski,Vice President ,`®� (,CIO P.O.Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples � .�� Fax(631) 765-6641 cOm� BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 10364A Date of Receipt of Application: April 10, 2023 Applicant: Robert N. Hulsmann Trust & Ann Hulsmann Trust SCTM#: 1000-26-2-24 Project Location: 1290 Willow Terrace Lane, Orient Date of Resolution/Issuance: May 17, 2023 Date of Expiration: May 17, 2025 Reviewed by: Eric Sepenoski, Trustee Project Description: Remove an existing block septic tank and one 6' deep leaching pool and install in same location a HydroAction AN500 I/A OWTS, and a new 6' deep, 8' diameter leaching pool. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Glynis M. Berry, RA, dated April 5, 2023, and stamped approved on May 17, 2023. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. -A—4&71� Glenn Goldsmith, President Board of Trustees SANITARY SYSTEM DESIGN: O RESIDENTIAL 066 PUMP COMPRESSER POWER CIRCUIT NOTE: ALL MOTORS 0241/2" (11541/4" 73" �_ G I' CB1 MUST HAVE #OF BEDROOMS: 4 TIMER INTERNAL OVERLOAD ADVANCED TREATMENT UNIT: HYDROACTION AN500 024 7/8" 70" I L1 euc "�'a"` -I PROTECTION. FLOAT&PUMP CONNECTIONS WELL IAOWTS CAPACITY REQUIRED: 440 GAL PER DAY,AS PER TABLE 3, SCDHS I ' ' TlcxTex�Nc TORQUECO -1s IN-LBS RESIDENTIAL STANDARDS ° 124 7/8„ > N wM ' ' euc _ __ -- I/AOWTS CAPACITY DESIGNED: 550 GAL PER DAY / 032 1/°" INSTALL Ln -- P 1�?' i~SPRAY ;PUMP RATINGS: + SECONDARY B1� 1 �ti�, 2 `' f PUMP ; 1 HP 0 115V ° I ° ° � � " MOTOR ��° SAFETY DEVICE, wHr 15.0 F.L.A. L1 N SP1 N RP1 N C1 1 2 3 4 � _ _ N ----------- (2) - -- LEACHING SYSTEM : INLET j -n,P• ______ (2)U DEEP, V DIA LEACHING POOLS N ° 76"IQ , x M1 a x a _ m ALL PIPE ° �" �" P1 ----------/RECIRC\,PUMP RATINGS: .-�- BAS O \ PENETRATIONS ° ° WW ,Y„r ( PUMP ;1/2HP ® 115V 0 4 1/2" ---- ° � ED ON SURVEY OF LOT 5 \ TO USE A ° � ,� �'10.0 F.L.A. � ON A CERTAIN SUBDIVISION MAP ENTITLED "MAP OF WILLOW TERRACE, SECTION 1 \ I I- LN -----------I MOTOR . o w FILED IN THE,SUFFOLK COUNTY CLERKS OFFICE ON NOVEMBER 28, 1969 AS MAP NO 5407 / WATERTIGHT, 1 � � U U � Z = SITUATE: ORIENT SEALED CB3 F F ° TOWN: SOUTHOLD FLEXIBLE JOINT 0-11/4 ° ° ° ° - Gam. C1 ----------� COMP ,COMP. RATINGS: WELL FASTENED TO ° ° ,MR ;1/4HP 0 115V SUFFOLK COUNTY, NY THE PIPE WITH 057 1/4" 076" ° ° _� MOTOR , N --------- , 5.4 F.L.A. VEYD 10/31/2013 BY JOHN C. FREERS LAND SURVEYOR \ AREA 18,116 SF, 0.416 ACRES t� A STAINLESS AIR SWITCH STEEL Cgq Y OQ �� O PLC CONTROL PANEL s RUN AND SURVEY ASSOCIATED WITH SCDHS NO 87-50-152 LAST UPDATED 12/9/1988 J��S�� ' GS�LF RETRACTABLE 132" eu, �---�� BY RODERICK VAN TUYL Q� Q,� 15.3' \ FS SpA CLAMP. W/HP80 esu 3 ti-V- 4 RM 0 `�° LR1 COMPRESSOR MUTE i °fG W r TEST HOLE REFERENCED FILED MAP, NOT REQ'D. J5 TO BE MOUNTED � F O SQ60 `� \ O- \ \ REMOTELY '""T LR1 ew B"' 1TEST AUDIBLE POWER CONNECTION OALARM 5 15 RISERS, INSTALL SECONDARY ew 1 \ SAFETY DEVICE, TYP. RE-CIRCULATION LR 1 LR 1-Q 1 01 DIAGRAM NO, (SIMPLEX) SANITARY SYSTEM TH � ��' �3' FASTENER, wHr aw ' � auc wHr EXISTING LEACHING POOL TO BE PUMPED AND O / \ 3/8-16 X 3 3/4"AT M 1 RED PLC-5030 REMOVED. NEW 6' DEEP, 8' DIA INSTALLED IN SAME \ / \ \ H CS LOCATION / BEST FIT REQU ED \ v/� 16"LONG 4"PVC - ' <'o SCH35 wHr EXISTING 6' DEEP, 8'bIA LEACHING / \ \� 9s'0y � 28"LONG 4"PVC --- POOL TO BE RETAINED/REUSED �-� 9�rP J• SCH35 0 r / i / 9�1y ��NOTES: MAIN PANEL DISCONNECT MUST BE PROVIDED BY INSTALLER. 6' ` i/ �Pl \ 9~ LEVELING RISER T = FlELDEWIRING SMUST BE A MINDICATE MNIMUM 0S NOT �60'C COPPER WIRNTAINED IN THE E.REMOVE EXIST. BLOCK SEPTIC TANK, INSTALL / S' oPa \ \. C REQUIRED TORQUE FOR TERMINAL BLOCK SCREWS IS 16 in-lbs. HYDRO ACTION AN500 � � \ F w NE . �9 0b i PyQ \OO \ �� 06 , ,' \01 \ 4"SCH 35G, BACK FILL SCHEMATIC ELECTRICAL NOTE: HOUSE TRAP ►� 4 5 PRESENT,VENT REQUIRED N4 / - / �� j \ TEE,STRAIGHT 4" PVC SXS COMPACT IN 6" LIFTS SIMPLEX W/EXT. CORD /0 ( (i 9�?3 \� SCH35 I PART NO. 891/2" PLC-5030 TEMPORARY SILT FENCE / � � p � � i \ APPROXI 166'TO AP600 ATU LOT 4 ! ' H0 "R �� MAJORS POND ROAD 10"LONG 4"PVC I W/ j \ SCH35 PLATFORM i 64" COMPLETE �,, \ RI �� VENT cH, ,� WELL FG CONNECTING 63" ELEC DIAGRAM HYDRO ACTION AN500 �' 2-STORY F/RAME °ot- 14.0' PANEL 24X19 4 a� HOUSE &/GARAGE � N.T.$. FAO ) / TANK,AN500 245 WELL PRETREATMENT / �- 24" SLATE OR OTHER MALE THREADED MALE THREADED POWER SUPPLY / 71/2.. ±" U SUITABLE COVER ADAPTER AND CAP ADAPTER AND CAP CONNECTED TO DEDICATED / _.,.,.st 115 VOLT AC, SINGLE- LLQ PHASE, 20 AMP CIRCUIT 14.2' �O� y r 321/2' / 71/2" �w BREAKER ON HOUSE MAIN; \ �2 TANK,AN500 245 NITROGEN REDUCTI Y o°0 0 1 2 FT 471/2' ON 4 COMPACTED J 1 s �f �Y ao Y Y ^J Y =rZ w GRAVEL, SAND OR � � r- �✓ � � y✓ y SIN- i / AN500 245 NITROGEN REDUCTION SYSTEM FINE CRUSHED y SEWER PIPE > STONE LEVELING DOUBLE SIDED C� PAD PERSPECTIVE VIEW WYE / hti' HYDRO ACTION AN500 DETAfLS WYE D448-040 3 36" MINIMUM 2 x 2 TpA LOT 5 / ^ U 1/Z° - 1'-O" FENCE POST 30 DEG ELBOW 60 DEG WYE p�` ' OR EQ. POWER SUPPLY WOVEN WIRE FEN -- (6x6 - 10!10 WWF) CONNECTED TO FILTER CLOTH ABBREVIATIONS: tiQ \\ ,�' LOT6 DEDICATED 115 VOLT AC, SINGLE-PHASE 20 AMP CIRCUIT EMBED FILTER CLOT ALTERNATE 2: FOR USE WITH o �; O ALTERNATE 1: FOR USE WITH & AND c�j, �i\@ AT � �\ OQRvv BREAKER ON HOUSE PANEL MIN. 6" INTO GROUND BLDG. EXTENSION/CONNECTION BLDG, EXTENSION/CONNECTION B.C. BOTTOM OF CURB Ss,� \ \` `yy w CONTROL PANEL+ � W/DOUBLE SIDED SWEEP \� '> -'s co SECTION DETAIL CLEAN OUT DETAIL FOR AREAS NOT SUBJECT TO VEHICULAR TRAFFIC BW BOTTOM OF WALL ��,,, BLOWER IN COVER ON PAD CONC. CONCRETE �? J GROUND ELEVATION 15.4' C.O. CLEAN OUT O �� / 4"(2"MIN.)DIA. HDPE n SILT FENCE DETAIL 6 CLEANOUT DETAILS DB DISTRIBUTION BOX �7 ` otic / VENT W/CARBON FILTER `' NTS E or ELEC. ELECTRIC �� \ c/ OL .5' DARK BROWN LOAM 18 MIN.ABOVE GRADE, N.T.S. ELEV. or EL. ELEVATION y,9 ' ��y \ / 4j� - - - - 36" MIN. FROM ANY G GAS �Qe �� o \ >\M CL 3, BROWN SILT WINDOW OR DOOR DISTRIBUTION BOX 4"WASTE HDPE HIGH-DENSITY POLYETHYLENE O / - - - - POLYLOK 20" CLASS 2400 OR SDR 35, I/A OWTS INNOVATIVE AND ALTERNATIVE ONSITE �� \ � 4"WASTE W/24" RISER 1/8" PER 12"SLOPE MIN. PALE BROWN FINE CAST IRON WITHIN 2' FROM W/SECONQARY WASTEWATER TREATMENT SYSTEM ,� 70 / � FOUNDATION WALL, CONTINUED TO INV. INVERT i 7 SW TO COARSE SAND HOUSE SAFETY DEVICE LG LEACHING GALLEY i �c�' \ \13.1"/ EL 1' _ - - 14.5' CLASS 2400 OR SDR 35, (OR SDR40) 1/4 PER 12 SLOPE MIN. 15" RISERS W/ NEW 8' DEEP, 8' DIA MAX. LEACHING POOL \y SW WATER IN PALE SECONDARY SAFETY LEACHING POOL MMAXIMUM /F \ / BROWN FINE TO DEVICES TYP MIN. MINIMUM �/tib \ 17 COARSE SAND EL. 15.75'+/ ( ) N.T.S. NOT TO SCALE r, �t N PROP. PROPOSED I EL. 14.7'+/- EL. 14.7'+/- EL. 15.0'+/- EL. 15.0"+/_ z - I - EQ, REQUIRED -� I C.O. � TEST HOLE BY _ _ _ -- _ DH SUFFOLK COUNTY DEPARTMENT OF MCDONALD GEOSCIENCES J�� - -CO N `- HEALTH SERVICES N CV I -C° ST SEPTIC TANK a 1 20 40 11/3/18 _-- �� C? ®(pny'� TOP OF CELLAR * �'�I w t. a.� .-.- � ;-F T.C. TOP OF CURB HIGHEST EXPECTED GROUNDWATER ELEVATION - I - * _ TW TOP OF WALL 1.0' AN500 r I I 1 I I I E3Os�oD O I PUSTEES W WATER NOTE: USGS LI DEPTH TO GROUNDWATER VIEW N W/ WITH LISTED 17'TO GROUNDWATER, LOWER THAN 0.0' I o I I I I TC��I''i`i �✓I= S JUTH®(.D EXISTING C° +N D 6' DEEP,_ I I/A OWTS LAYOUT ICTI I POOL I I I LEACHING I ®AT ►1gf1}�! 17i 2023 TEST HOLE DATA " - ZO'-O° Z I POOL I I - - - ---------- N.T.S. T � I I Lu HIGHEST EXPECTED + X I O I Z _ - GROUNDWATER EL. 1.0' in I _ CO 022.45" - :� � � .1-' O LO i� 021.65" - - - _ _ - - - - - J- - - -OZ �- -J-O-J- - - - w _J 1 INLET, EL.0.0 > > j -� _ - CO - _ M_ _ - O : I 7 OUTLETS z z m O w ? z m z z r _ z 020.65" W LL -' PROJECT: No.BACKFILL p w L Description Date z CONCRETE COVER > HIGHEST > O Innovative and Alternative Onsite MATERIAL TO BE I POLYLOK 20"COVER ON 0 5 10 FT REUSE EXISTING 6'POOL LOWER AS NEEDED TO z O � EXPECTED ? CLEAN SAND AND 24" RISER WITH F p (0 Wastewater Treatment System (I/A GRAVEL CONCRETE 12"RISER TOP�/IEW DEVICE SAFETY MATCH INVERT ELEV(MAX 0.5) z �6 GROUNDWATER ori OWTS) [Street] II OuJ EL. 1.0 O -i m W Z studio a/b architects j - 23.55" m w EL.XX' 7 SECTION DIAGRAM OT West Main Street, 3/ 651 ° IMPERVIOUS BOX ACCEPTS: Riverhead, NY 11901 631 591 2402 A LIGHT COVER#3009C GENERAL CONDITIONS :d 20" MIN. ® ® ® N. ; _ SOIL o HEAVY COVER#3017-C20 631 3231426 A C" INLET P° �I ® ® ®� NLl GRATE #3017-G20 1. INSTALLATION SHALL COMPLY WITH SUFFOLK COUNTY DEPARTMENT OF glynis@studioabarchitects.com r` xx � F" ® ®� - �' - Q HEALTH SERVICES'REGULATIONS, STANDARDS,AND REQUIREMENTS,AND SEPTIC TANK&I/A OWTS INSTALLATION STANDARDS: I m-° o v 22.45' 6"TALL RISER#3009 SHALL BE STRICTLY IN ACCORDANCE TO THE MANUFACTURER'S SEPTIC/TREATMENT CONSTRUCTION CRITERIA: mailin address: APR 1 0 2p23 MIN.4' DIA. ° APPROVED oQD ® ®� "`3'-0" MIN. �$ 6' MIN. I 12 TALL RISER#3009-R12 9 9, LEACHING ® ® INSTRUCTIONS. 1 EACH SEPTIC TANK&I/A OWTS SHALL BE IDENTIFIED BY THE 1.ALL APPLICABLE RECOMMENDATIONS PROVIDED BY THE MANUFACTURER PO Box 444 PIPE m PENETRATION ENDCAP TYPE MANUFACTURER AND DISPLAY THE FOLLOWING INFORMATION SHALL BE IMPLEMENTED. _=" d- " :, SECTIONS ® ® °°COLLAR;- PERMANENTLY MARKED AT THE INLET END OF HE TANK: Orient NY 11957 1 �� PITCHED 1/8 - INTO A VIRGIN 2.THE INSTALLER MUST HOLD A CURRENT LIQUID WASTE LICENSE PURSUANT rn I LEVELING DEVICE nr , en 1. MANUFACTURER NAME OR LOGO - `v PER 12" MIN. °- a ® ® ®� P o STRATA OF �` _ TO CHAPTER 563 ARTICLE VII(SEPTIC INDUSTRY BUSINESSESI AND 2.THE SEPTIC TANK&I/A OWTS SHALL BE INSTALLED AT LEVEL IN ALLa ENDORSEMENT J INNOVATIVE AND ALTERNATIVE TREATMEN-SYSTEM 2. CAPACITY AND NUMBER OF OPENINGS DIRECTIONS(WITH A MAXIMUM TOLERANCE IN ANY DIRECTION OF+/-ONE 00 ® ® ®� SAND AND ifl ( 3. MAXIMUM DESIGN LOA[) QUARTER INCH)ON A MINIMUM 3 INCH THICK(OR MANUFACTURER'S z INSTALLER)THROUGH THE SUFFOLK COUNTY DEPARTMENT OF LABOR, 4. THE DATE MANUFACTURED. RECOMMENDATION BED OF ® ® .;- , GRAVEL " BOX SEAL, LICENSING AND CONSUMER AFFAIRS, PURSUANT TO SUFFOLK COUNTY CODE ) PROPERLY LEVELED AND COMPACTED SAND(FREE POLYLOK SEAL §563-79(11)(J). 2 ALL COVERS SHALL BE SET AT FINISHED GRADE, BE FROM ROCKS)OR PEA GRAVEL.BACKFILL SH _ LOCKING TAM ALL BE PLACED AROUND THE I ,- -h 1' �- ; =d .�? d d•_ - --` IF MIN. PENETRATION IS 2"INCREMENT, #3001 TYP.40PLCSTYP• PER-RESISTANT,WATERTIGHT, INSECT-PROOF, FLAT SKID- Owner:TANK&I/A OWTS IN SUCH A M I r ANNER AS TO AVOID DAMAGE AND Owner: a I -�• I 3.ALL INSTALLED I/A OWTS ARE REQUIRED TO HAVE AN INITIAL 3-YEAR PROOF,AND BE APPROVED FOR SEWAGE USE. COVERS AND RISERS COMPACTED IN I/ INCH LIFTS.BACKFILL SHALL BE F $ -� ` NOT AVAILABLE, TYP. �� REE OF LARGE STONES, EXCAVATE AND INLET OUT MIN. 12 COMPACTED WARRANTY. SHALL BE CAPABLE I WITHSTANDING A TRUCK WHEEL LOAD(IN S IN.OF STUMPS,AND CONSTRUCTION DEBRIS. Ann + Robert I/A OWTS Layout ' SAND OR PEA GRAVEL 2500 LB FOR 60 MIN WITH A MAX.VERTICAL DEFLECTION OF 1.5 IN. Y - - _ _ - _ - - M _ REPLACE SOIL W/ INV. EL. INV. EL. 11.47' LEVELING PAD 4.ALL INSTALLED I/A OWTS ARE REQUIRED TO HAVE ACTIVE C&M(OPERATION 3. IF A RISER COVER WEIGHS LESS THAN 60LBS A SECONDARY SAFETY GENERAL NOTE CLEAN SAND AND 11.73' BOTTOM OF BOX EL. 11.47' AND MAINTENANCE)AGREEMENTS BETWEEN THE PROPERTY OWNER AND LID OR DEVICE SHALL BE PROVIDED. 1. BEFORE ANY EXECUTION,VERIFY ON SITE,IF APPLICABLE: H u IS m a n n Project number 23213 HIGHEST RECORDED HIGH - GRAVEL, SERVICE PROVIDER. 4. ALL SEPTIC TANK& I/A OWTS MUST BE CERTIFIED AS WATERTIGHT -GRADE ELEVATIONS AT THE HOUSE WHERE THE WASTE MAIN GROUNDWATER TO REACH TO SP OR BY MANUFACTURER PENETRATES. Date 4/5/2023 ELEVATION 1.0' SW SOIL, WHICH DEPTH POLYLOK 20" D-BOX 0 1 2 FT 5.SERVICE PROVIDERS MUST REPORT ALL O&M ACTIVITIES TO SCDHS 5. ALL PENETRATIONS PIPES SHALL BE CONNECTED TO TANKS WITH A -GRADE ELEVATIONS WHERE EACH UNIT WILL BE INSTALLED. FRONT/SIDE VIEW I I I (SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES). WATERTIGHT,SEALED FLEXIBLE JOINT AND THE PIPE GASKET SHALL BE property Tax Ma #: GB IZ -HOUSE WASTE LINE MAIN LOCATIONS AND INVERT ELEVATIONS. p P y P Drawn by IS MORE THAN 6' MATERIAL-HDPE FASTENED TO THE PIPE WITH A STAINLESS STEEL RETRACTABLE CLAMP. -ANY UNDERGROUND UTILITIES, INFRASTRUCTURES,AND/OR STRUCTURES 1000-026.00-02.00-024.000 d 6.COVENANTS MAY BE REQUIRED ON PROPERTIES WHERE I/A OWTS ARE -ANY TREES WHICH MAY AFFECT TO THE I/A OWTS INSTALLATION Checked by HA o INSTALLED REQUIRING; SYSTEM REPLACEMENT IN EVENT OF FAILURE; O&M 2. GARBAGE DISPOSAL UNITS SHALL NOT BE USED WITH A I/A OWTS. site street address: 8 1/411 = 1'-O"TYPICAL LEACHING POOL DETAIL J DISTRIBUTION BOX Polylok DETAILS REQUIREMENT;ACCESS TO DHS INSPECTION/SAMPLING ON QUARTERLY BASIS 3. TANKS SHOULD NOT BE PUMPED WHEN GROUNDWATER IS HIGH OR FLOOD 1290 Willow Terrace Lane M 1/2-.. _ 1 -011 IF NEEDED;OTHER REQUIREMENTS THAT SCDHS DEEMS NECESSARY. CONDITIONS EXIST. Orient, NY 11957 .O N Scale As indicated - r Gloms Goldsmith,President ��p��S�FF' OGS Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Eric Sepenoski H ,? P.O.Box 1179 Liz Gillooly �.y ® �� Southold,NY 11971 O Elizabeth Peeples �Ol �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 3 Completed in field.by: ROBERT N. HULSMANN TRUST & ANN HULSMANN TRUST request an Administrative Permit to remove an existing block septic tank and one 6' deep leaching pool and install in same location a HydroAction AN500 I/A OWTS, and a new 6' deep, 8' diameter leaching pool. Located: 1290 Willow Terrace Lane, Orient. SCTM#: 1000- 26-2-24 Type of area to be impacted: X Saltwater Wetland Freshwater Wetland Sound W Bay Part of Town Code proposed work falls under: +-- Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment c 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 OFFICE LOCATION: � SU(/r�,pl MAILING ADDRESS: Town Hall Annex O P.O. Box 1179 54375 State Route 25 [ [ Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) va Southold, NY 11971 �Q Telephone: 631 765-1938 ol�cou 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: May 16, 2023 Re: LWRP Coastal Consistency Review for ROBERT N. HULSMANN TRUST & ANN HULSMANN TRUST SCTM#: 1000-26-2-24 ROBERT N. HULSMANN TRUST &ANN HULSMANN TRUST request an Administrative Permit to remove an existing block septic tank and one 6' deep leaching pool and install in same location a HydroAction AN500 I/A OWTS, and a new 6' deep, 8' diameter leaching pool. Located: 1290 Willow Terrace Lane, Orient. SCTM#: 1000-26-2-24 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is CONSISTENT with the Policy Standards and therefore is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: The Honorable Lori M. Hulse, Attorney Glenn Goldsmith,PresidentQ nTown'Hall Annex A.Nicholas Krupski,Vice President ,�� pl� 54375 Route 25 P.O.Box 1179 Eric Sepenoski JxK Southold,New York 11971 Liz Gillooly -,INC Telephone(631) 765-1892 Elizabeth PeeplesFax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application :_-;. /Wetland Permit Application ► Administrative Permit _ Amendment/Transfer/Exten 'on /--Received Application: it+to+A3 APR 1 0 2023 ✓ Received Fee: $ ��• Completed Application: — '- Incomplete: _ SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: �Coordination:(date sent): LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection: Receipt of CAC Report: _ Technical Review: Public Hearing Held: 5-4-7.?--;31 Resolution: Owner(s) Legal Name of Property (as shown on Deed): Robert N. Hulsmann Trust +Ann HulstD—ann Trust Mailing Address: 1290 Willow Terrace Lane, Orient, NY 11957 Phone Number: 631 323 2789 c 631 375 6134 Suffolk County Tax Map Number: 1000- 026.00-02.00-024.000 Property Location: 1290 Willow Terrace Lane, Orient, NY 11957 (If necessary,provide LILCO Pole#,distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Email:r.hulsmann@yahoo.com __ Board of Trustees Applic&--on GENERAL DATA Land Area(in square feet): 18,116 sf Area Zoning:R-40 Previous use of property: Residence Intended use of property: Residence Covenants and Restrictions on property? —ayes _.,_�No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? F1 Yes Jallo 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 _R]_No If"Yes",please provide copy of decision. his project regprq any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Removal of existing septic tank and one leaching pool Does the structure(s) on property have a valid Certificate of Occupancy? Yes=No Prior permits/approvals for site improvements: Agency Date Trustees 3/19/2014 ❑ No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?]a NoE Yes If yes, provide explanation: Project Description(use attachments if necessary): Remove existing block septic tank and one 6' deep, 8' dia leaching pool. Replace in the same locations, with a HydroAction AN500 I/A OWTS (enhanced wastewater treatment system)and a new 6' deep, 8' dia leaching pool. One pool was unused (due to poor installation) and can be reused. Board of Trustees Applic&L..,.on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Improve the treatment of watewater. Area of wetlands on lot: 0 square feet Percent coverage of lot: 0 Closest distance between nearest existing structure and upland edge of wetlands: 80 feet Closest distance between nearest proposed structure and upland edge of wetlands: 80 feet Does the project involve excavation or filling? ❑ No Yes If yes, how much material will be excavated?471 cubic yards How much material will be filled? 170 cubic yards Depth of which material will be removed or deposited: 8-1.0 . feet Proposed slope throughout the area of operations: 0 Manner in which material will be removed or deposited: Excavator, pump truck and truck 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): Will increase the quality of the effluent entering groundwater and the bay. Decreases Nitrogen loading, which contributes to hypoxia and algal blooms. 61Z20 Appendix B Short Environmental Assessment Form 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 I Project and Sponsor Information Install I/A OWTS and new leaching Pool Name of Action or Project: Sanitary upgrade Project Location(describe,and attach a location map): 1290 Willow Terrace Lane, Orient, NY Brief Description of Proposed Action: Remove existing septic tank (block) and one 6' deep, 8' dia leaching pool and replace in the same location with a Hydro Action AN 500 and a new 6' deep, 8' dia leaching pool Name of Applicant or Sponsor: Telephone:631 323 2789 Robert Hulsmann E-Mail:r.hulsmann@yahoo.com Address: 1290 Willow Terrace Lane City/PO: State: Zip Code: Orient NY 11,957 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 governmental Agency? NO YES If Yes, list agency(s)name and permit or approval: Suffolk County Department of Wastewater Services 3.a.Total acreage of the site of the proposed action? .0058 acres b.Total acreage to be physically disturbed? ,0116 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 18,116 acres 4. CheI land us at occur on,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial ❑✓Residential(suburban) Forest [:]Agriculture ✓Aquatic ❑Other(specify): OParkland Page 1 of 4 5. is the proposed action, NO ` YES NIA a. A permitted use under the zoning regulations? ✓ b.Consistent with the adopted comprehensive plan? ✓ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? 7. is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: Peconic Bay ❑ Z. S. 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? NO YES If the proposed action will exceed requirements,describe design features and technologies: N/A D ❑ 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: ❑ F 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: ❑ New I/A OWTS 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? JH I 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? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: ]4. ntify the typic bitat types that oc n,or are likely to be found on tt}e.groject site. Check all that apply: ✓ Shoreline Forest Agricultural/grasslands Early mid-successional Wetland Urban ✓Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? Northern Cricket Frog ✓ 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 If Yes, a. Will storm water discharges flow to adjacent properties? ❑NO DYES ❑ b.Will storm water discharges be directed to established conveyance systemsff an m drains)? If Yes,briefly describe: X10 �'ES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond, waste lagoon,dam)? ]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: Fa/1 ❑ 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 Applicant/sponsorname: R bert + Ann.Hulsman`'1 _ Date: 1 2_ Signature: ��-�.s �lf (L��/ t��,c�e,.�W,,�-�.c.� 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 1. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? a 3. Will the proposed action impair the character or quality of the existing community? 1:1 ❑ 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ ❑ establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ ❑ a. public/private water supplies? b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, F-1 0- 9- or aesthetic resources? 9_ Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? E' IL Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. Check this box if you have determined,ba-sed-on the information and analysis above,and any supporting documentation, that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer Signature of Responsible Officer'in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees.The purpose of this form is to provide information which can alert the town of possible conflicts.of interest and allow it to take whatever,action is necessary to avoid same. '/ YOUR NAME: H L I S h't6Lh_h 6(10 V (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/representadve)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): E,A)the owner of greater than 5%of the shares of the corporate stock of the applicant _n (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 1day oft'f f 20 Z Signature V .2� Print Nametqhh V, U1,-SkytCt-fAK Form TS 1 APPLICANT/AGENT/REPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the parf off&M officers and emblovees.The purpose of this form is to provide information which can alert the town of possible conflicts of ifiterest`and allow,it to take-whatever action is necessary to avoid same. YOUR NAME: v` (Last name,first name,middle initial, less you are applying in the name of someone else or other entity,such as a tompany.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 bus iness-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): _nA)the owner of greater than 5%of the shares of the corporate stock of the appliewit _n (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 Submiited this 1 day of 20 Signature r Print Name Foran TS 1 Board of Trustees Applich',..�on AFFIDAVIT V-X ey N .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 OKSOUTHOLD 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 I. DAY OF I 20 +N46Public JENNA KOCKENMEISTER Notary Public,State of New Yolk Reg.No. Commission Exp 01K06402096ty Qualified Expires December 23,2023 Board of Trustees Applica'W+jn AFFIDAVIT A h v, �-L t-�-.�s.h1�-In �. . 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. Lam-- Signature of Property Owner. Signature of Property Owner SWORN TO BEFORE ME THIS DAY OF otar}%Public JENNA MEISTER Notary Public,sta a of New Yib* Reg.No.01 K06402096 Quaiified in Suffolk Count�yy Commission Expires Decemberl,2023 t Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A .proposed action will .be, evaluated as to its si fii�cant beneficial and'adverse effects upon the coastal area(which includes all of Southold Town). 1 If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be'explained in detailiAisting both supportingand non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website(southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION ' SCTM# 026.00 -02.00 _0024.00 PROJECT NAME Hulsmann I/A OWTS installation The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees a 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g.capital ❑ construction,planning activity,agency regulation,land transaction) ❑ (b) Financial assistance(e.g.grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Removal.of an existing block septic tank and one 6' deep,.8' dia leaching pool to be replaced in the.same locations with a HydroAction AN500 and a new 6' deep, 8' dia leaching pool Location of action: 1290 Willow Terrace Lane, Orient Site acreage: 0.416 Present land use: Residence Present zoning classification:R-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: Robert Hulsmann (b) Mailing address: 1290 Willow Terrace Lane, Orient, NY 11957 (c) Telephone number: 631 323 2789 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No 0 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. a Yes ❑ No ❑ Not Applicable Minimizes the impact of development by treating wastewater to a higher,quality, reducing nitrogen loading to Orient Harbor 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 Z Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No❑✓ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of Nouthold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria ❑✓ Yes ❑ No ❑Not Applicable Enhanced treatment of wastewater. 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. 7 Yes ❑No ❑ Not Applicable Reduces nitrogen loading which contributes to hypoxia and algal blooms Attach additional sheets ifnecessary 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 F✓ Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ❑Yes ❑ No 0 Not Applicable PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. n ❑ YeEl No 0 Not Applicable 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 M.—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No 0 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 0 Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. ❑Yes ❑ No❑✓ Not Applicable PREPARED BY Glynis Berry,AIA LEED AP TITLE Designer of I/A OWTS DATE 4/6/2023