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HomeMy WebLinkAbout31 East Properties, LLC Glenn Goldsmith,President ��® Town Hall Annex F SOUr�® 54375 Route 25 A. Nicholas Krupski,Vice President ® ®. P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly rda Telephone(631) 765-1892 Elizabeth Peeples �� Fax(631) 765-6641 OUM BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NOTICE OF DISAPPROVAL - ADMINISTRATIVE PERMIT Date of Receipt of Application: July 26, 2023 Applicant: 31 East Properties LLC & Sha Property Holdings LLC SCTM#: 1000-135-3-23 Project Location: 65 Grove Road, Southold Date of Resolution/Issuance: August 16, 2023 Reviewed by: Board of Trustees Project Description: Install alongside rear external staircase a 6.5'x6.5' hot tub, grade a 48sq.ft. area with a landscaped border, fill with 4" of pea gravel; clear dead fallen trees in non-disturbance area. Findings: The Board of Trustees DENIES the application as submitted. The proximity of the proposed project to the wetlands would have an adverse impact on the wetlands, and the clearing of trees would disturb the established non- disturbance area. The project does not meet the requirements for issuance of an Administrative Permit as set forth in Southold Town Code Chapter 275-12A. — Adversely affects the wetlands of the Town. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. Glenn Goldsmith, President Board of Trustees %-nviln Goldsmith,President �0' - CpGy -- F "" _ ,Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route 25 Co Eric Sepenoski W ,? P.O.Box 1179 Liz Gillooly �y • ��� Southold,NY 11971 Elizabeth Peeples HCl �a Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 23 Completed in field by: i 10d LkA cy 31 EAST PROPERTIES LLC & SHA PROPERTY HOLDINGS LLC request an Administrative Permit to install alongside rear external staircase a 6.5'x6.5'.hot tub, grade a 48sq.ft. area with a landscaped border, fill with 4" of pea gravel; clear dead fallen trees in non-disturbance area. Located: 65 Grove Road, Southold. SCTM#: 1000-135-3-23 Type of area to be impacted: , XSaltwater Wetland Freshwater Wetland Sound Bay Part of Town Code proposed work falls under: 4_Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment _KAdministrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No k Not Applicable Info needed/Modifications/Conditions/Etc.: 'SC-uSs W ' o-r`O�• 0 1" o�s.SQ6311 " rt �G 16 6u j Present Were: G. Goldsmith N. Krupski E. Sepenoski -1� L. Gillooly E. Peeples 5,q S,C.T.M. N0. DISTRICT: 1000 SECTION: 135 BLOCK: 3 LOT(S):23 DWELLINGS / W/PUBLIC WATER 150' / CHURCH r W/PUBLIC WATER ! E C 150' 0 JUL 2 6 2023 S 9g°0¢r ZONE AE(EL 6) ?4n� FLOOD ZONE BOUNDARY SSDU i01d Towrl 32600, Board ofTrllotees o y1P'' IBE STYLE \ ZONE X Oc r} ` ,/``x 1 O K REBAR 1 i 3 BEDROOM SYSTEM \ C7 rte. 4 1,000 GAL S.T. \ 1 --------_ !' \ U.P. (3)8.5'x4.75'LEAC GALLEY \ 1 "- ------- \ ® \ rr \ COLUMN r----40'- : 4'ASNDWARD OELINEATEDTBYFSUFFOLKATER ENVIRON WETLANDS BOO 111 CONSULTING, INC. MAY 31, 2019. CLEAN D OUT 4D 'o+ f 1 ------- \ COVERED y.::. I' c9` A ---- _ �Oi \ PORCH 5'x8' CANRLEVER 1 7 tea{ 191S81I -- o 3. - w -_ rr 62.3¢' qB'\ EL 14.0 \ j. O ,�1�• '� z 'S2' 'L •P . Jty'A 2'CANTILEVER TIDAL WETLANDS BOUNDARY AS '+fps _ W TED 3`SLAG - \ 70 O 2Sts,�r , DENS ULTING,�INC.SUFFOLK UNE 10, 200ENVIRON ENTAL O T j�1 \ l 1. \\ .SER;r I I Q LAG � ---- = I X6.791 K 0 :,P.. 1 g I v81o� , p s PND ' •� FLAG , 63, 6. (3)ADDITIONAL WETLAND FLAGS - ``� AS DELINEATED BY NYSDEC \ I DWELLINGS - W/PUBLIC WATER 150' \ / GUYG� DWELLINGS �aG W/PUBLIC WATER / •\ PIPE a O\moi 150' \ cl U.P. \ O / \ PRE—EXISITNG AVERAGE FRONT YARD SETBACK ALONG THE EASTERLY SIDE OF GROVE ROAD = 40.5't \ (3 NEAREST HOMES) \ PRE—EXISTING AVERAGE FRONT YARD SETBACK ALONG THE NORTHERLY SIDE OF MILL LANE = 36.6't (3 NEAREST HOMES) THE WATER SUPPLY, WELLS, DRYWELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS FEMA MAP#36103CO158H AREA: 36,453 SQ.FT. or 0.84 ACRES ELEVATION DATUM: NLV_D88------------------- UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INS77R/770N, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUC-TURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: DESCRIBED PROPERTY OF NEW CERTIFIED TO: MARK LAZAROVIC; MAP OF: �P�E N M. W0}I0�p FIRST AMERICAN TITLE COMPANY; FILED: CO ?� r' •F PRONATIONAL TITLE AGENCY; W � * CORRECT TYPO ON BEARING 08-16-22 SITUATED AT: SOUTHOLD ° FINAL SURVEY 11-15-21 r TOWN OF: SOUTHOLD o 0� UNDER CONST. 07-19-21 SUFFOLK COUNTY, NEW YORKREVISED 02-13-21 J KENNETH M WOYCHUK LAND SURVEYING, PLLC ysF 050852 ofProfessional Land Surveying and Design REVISED 11-23-20 P.O. Box 153 Aquebogue, New York 11931 REVISED 04-20-20 FILE #19-77 SCALE: 1„=40' DATE: JUNE 28, 2019 N.Y.S. LISC. NO. 050882 PHONE (831)298-1588 FAX (631) 298-1588 _F -Glenn Goldsmith,President �0�� �OG� Town Hall Annex A.Nicholas Krupski,Vice President 54375 Route.25 0 Eric Sepenoski ,? P.O.Box 1179 Liz Gillooly �y • 0�� Southold,NY 11971 Elizabeth Peeples l '1� Telephone(631)765-1892 Fax(631)765-6641 Southold Town-Board of Trustees Field' Inspection Report Date/Time: 2 22 Completed in field by: L . D d � Kristin Hendrick, owner on behalf of THIRTY ONE EAST PROPERTIES,LLC requests a Pre-Submission Inspection to discuss a proposed access path for the second egress (back door) of the dwelling for emergency purposes. Located: 65 Grove Road', Southold.'SCTM# 1000-135-3-23 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 X Not Applicable Info needed/Modifications/Conditions/Etc.: ec4Lo l ( 1,9 Aux k%' vn 6AlfCh k c6w a - J 5 rr e i\/IGt r 4- Ate C4-Met- is OL , k-C ✓lc P Present Were: G. Goldsmith N. Krupski C E. Sepenoski L. Gillooly _ E. Peeples sVIM til ct5 � SS aVV( a `a �j 1 w b w�. ^i 6 , NFM el mmu � SOUND ISLAND i \ LOQ i ° ``, Arai UNITS `\ � M 1411 � � U 4i , n � • � I s ,•� 4 �9 e m • �i j 9' s, e at. a l6o) e ° rxcr.v ,g e s � 44 I+r :once COUNTY OF SUFFOLK © E SOimgLD SECTIDN NO Real Property Tax Samoa Agency v M ' 135 p...w xt r.�xlNae •• —__ ...0 --.-- .rte--r-- xu. yYj' P rot rNc.w 1<f10 PROPERTY b1M J OFFICE LOCATION: so yp. MAILING ADDRESS: Town Hall Annex O P.O. Box 1179 54375 State Route 25 Southold,NY 11971 (cor.Main Rd. &Youngs Ave.) N Southold,NY 11971 Q Telephone: 631765-1938 LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, AICP LWRP Coordinator Date: August 10, 2023 Re: LWRP Coastal Consistency Review for 31 EAST PROPERTIES LLC & SHA PROPERTY HOLDINGS LLC SCTM# 1000-135-3-23 31 EAST PROPERTIES LLC & SHA PROPERTY HOLDINGS LLC request an Administrative Permit to install alongside rear external staircase a 6.5'x6.5' hot tub, grade a 48sq.ft. area with a landscaped border, fill with 4" of pea gravel; clear dead fallen trees in non-disturbance area. Located: 65 Grove Road, Southold. SCTM#: 1000-135-3-23 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 action is INCONSISTENT with the LWRP Policy 6. The intent of a nondisturbance buffer is to leave the area in its natural state. The clearing of trees would disturb the buffer area. 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 DiSalvo, Diane From: Kristin Hendrick <thirtyonenortheast@gmail.com> Sent: Thursday,July 27, 2023 10:43 AM To: DiSalvo, Diane Subject: [SPAM] - Re: [SPAM] - Re: [SPAM] - Re: [SPAM] - Re: 65,Grove Road In the square box a hot tub to be installed that is 6.5 ft by 6.5 ft. Grade 48 sq feet alongside the rear external staircase. Install landscaping border around 48 sq ft area. FII with 4 inches of pea gravel to act as bedding for a fiberglass 4 person hot tub to be used for personal therapeutic use. Hot tub will be on the personal side of the fence, not the non disturbance side. Also requesting permission to clear the dead fallen trees on the non-disturbance side that are blocking access to Hashamomuck pond. Thank you. On Thu,Jul 27, 2023 at 10:03 AM Kristin Hendrick<thirtvonenortheast@gmail.com>wrote: Okay thank you. Here are the article for SHA. Description to follow. On Thu,Jul 27, 2023 at 10:02 AM DiSalvo, Diane<diane.disalvo@town.southold.ny.us>wrote: I Yes,on the smaller survey which was originally submitted with the application there was a blue box drawn with j ! wording that I could not decipher due to the size. i i . Diane � i From: Kristin Hendrick<thirtvonenortheast@gmail.com> Sent:Thursday,July 27,2023 9:58 AM To: DiSalvo,,Diane<diane.disalvo@town.southold.nv.us> Subject: [SPAM] - Re: [SPAM] - Re: [SPAM] -Re: 65 Grove Road ' ! Thank you for your help Diane. I am trying to do this from memory, but is there a box drawn on the survey? I believe we drew the box and were trying to attach the description separately. On Thu,Jul 27, 2023 at 9:46 AM DiSalvo, Diane<diane.disalvo@town.southold.nv.us>wrote: Yes, please call. , i I i 1 Glenn Goldsmith,President ,{f� ���)t S()1/��, Town Hall Annex jt' t'i 4Y; 54375 Route 25 A.Nicholas Krupski,Vice President �© P.O. Box 1179 Eric Sepenoski s"r �L Southold,New York 11971 Liz Gillooly cn Elizabeth Peeples c� Q O j Telephone (631) 765-1892 ,Y Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only nstees Coastal Erosion Permit ApplicationWetland Permit ApplicationX Administrative Permit Amendment/Transfer/Extension 6 20234 Received Application: -7•Z�v•�3Received Fee: $ Z5---Completed Application: 7•Z7•Z� Incomplete: SEQRA Classification: Type I __ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: _ _/oordination:(date sent): ✓ LWRP Consistency Assessment Form Sent: _ CAC 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): 31 EAST PROPERTIES LLC _ Mailing Address: Phone Number: Suffolk County Tax Map Number: 1000 -473889 135.-3-23 Property Location: 65 Grove Rd Southold NY --- corner _corner of Sound Ave (CR North 48) (If necessary, provide LILCO Pole #, distance to cross streets, and location) AGENT (If applicable): Mailing Address: 65 Grove Rd Southold NY 11971 Phone Number: 516 238 5700 Email:thirtyonenortheast@gmail.com __ Board of Trustees Applia ".on GENERAL DATA Land Area(in square feet): see attached survey Area Zoning: protected whetlands rating "X" Previous use of property: none Intended use of property: hot tub Covenants and Restrictions on property? Yes _2_No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes _nNo 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 _FZ]_No If"Yes", please provide copy of decision. Whis project req} any demolition as per Town Code or as determined by the Building Dept.? MYes �/ No Does the structure(s) on property have a valid Certificate of Occupancy? Yes —1 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? NoE] Yes If yes, provide explanation: Project Description (use attachments if necessary): Attached survey shows request for hot tub Board of Trustees Applic Lon WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: physical therapy Area of wetlands on lot: don' t know _ square feet Percent coverage of lot: don' t know Closest distance between nearest existing structure and upland edge of wetlands: 30 feet Closest distance between nearest proposed structure and upland edge of wetlands: 100 feet Does the project involve excavation or filling? ❑ No - Ft—/I — Yes If yes, how much material will be excavated? 0 cubic yards How much material will be filled? 2 yards cubic yards Depth of which material will be removed or deposited: 4 inches feet Proposed slope throughout the area of operations: no slope Manner in which material will be removed or deposited: wheel barrel, very small amount of pea gravel to level the dirt to accept hot tub Additionally, requesting permission to remove dead, fallen trees in non-disturbance area 1 are blocking access to Hashamomuck pond Statement of the effect, if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): The hot tub will be inside fenced area on resident' s side of the post/rail fence, not on the non-disturbance side of fence (see survey 617.20 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 1 -Project and Sponsor Information 31 East Properties LLC (property owner) Name of Action or Project: hot tub installation Project Location(describe,and attach a location map): see attached survey Brief Description of Proposed Action: add 4 inches of pea gravel to accept hot tub (42 sq feet) Also requesting permission to remove fallen, dead trees obstructing access to long creek Name of Applicant or Sponsor: Telephone: 31 East Properties LLC (property owner) E-Mail:thirtyonenortheast@gmail.col Address: 65 Grove Rd City/PO: State: Zip Code: Southold NY 111971 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 F1may be affected in the municipality and proceed to Part 2. if no,continue to question 2. Fk12. 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: ❑ ❑ 3.a.Total acreage of the site of the proposed action? .41 acres b.Total acreage to be physically disturbed? 42sa feet_acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0 acres 4. Che I land us at occur on,adjoining an ar the prop action. Urban ORural (non-agriculture) Industrial Commercial [;]Residential (suburban) Forest ❑Agriculture H,/ Aquatic ©Other(specify): house of worship Parkland Page 1 of 4 5. Is the proposed action, NO YES N/A a. A permitted use under the zoning regulations? b.Consistent with the adopted comprehensive plan? ✓ LL 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? —t/]- 7. 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? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ ❑ 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: F ❑ 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 qYE 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: 14. Identify the typic bitat types that ocn,or are likely to be found on t>--rcject site. Check all that apply: HShoreline Forest Agricultural/grasslands Early mid-successional Wetland LJ Urban USuburban 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? FV El 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? PN[O If Yes, a. Will storm water discharges flow to adjacent properties? FZ1NO OYES 110- b. Will storm water discharges be directed to established conveyance systems ff an m drains)? If Yes, briefly describe: ZNO ES Page 2 of 4 18. Does the proposed action include construction or other activities that result in the impoundment of NO I YES water or other liquids (e.g.retention pond, waste lagoon, dam)? If 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: _�T _ _ ❑ 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: F✓ ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Kristin Hendrick, Robert Hendrick DateD6/27/2023 Signature: Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the following questions in Part 2 using the information contained in Part I and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning F-1 ❑ regulations? 2. Will the proposed action result in a change in the use or intensity of use of land? ❑ i. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the El 1:1establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit, biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate ❑ ❑ reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a. public/private water supplies? b. public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, ❑ architectural or aesthetic resources? 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ Elwaterbodies,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? 11. Will the proposed action create a hazard to environmental resources or human health? Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 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,based on the information and analysis above,and any supporting documentation, that the proposed action may .result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. Check this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmental impacts. Town of Southold-Board of Trustees ---.__._._...._...__._._. Name of Lead Agency Date President Print or Type Name of Responsible Officer in Lead Agency Title of Responsible Officer^rn Signature of Responsible Officer in Lead Agency Signature of Preparer(if different fi-om Responsible Officer) PRINT Page 4 of 4 , Board of Trustees Applic on AFFIDAVIT Kristin Hendrick & Robert Hendrick BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMITS) 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. Signa ure oProperty Owner Signature of Property Owner SWORN TO BEFORE ME THIS I DAY OF , 24-3 Notary Publi BERNADETTE SALEM 'Notary Public, State of New York No. 4826616 Oualified in Nassau county _9-5 commission Expires December 31, 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 pumose 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, YOURNAME: 31 East LLC & SHA Properties (Last name,first name,rpiddle 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 br 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 appliwt _n (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the ]qapplicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this d 3 day of-Ij- 20 Z 3 Signature G/� •�/ Print Name AL 44z ,, � Form TS 1 Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,.it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM#473889 -135. _3-23 PROJECT NAME Hot tub installation 6.5 ft by 6.5 ft (48 sq ft) The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees ❑✓ 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g, capital ❑ construction,planning activity, agency regulation, land transaction) ❑ (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit, approval, license,certification: ❑✓ Nature and extent of action: Grade 48 sq ft area alongside the rear external staircase (area marked with 3 ft stale Install landscaping border around 48 sq ft area. Install 4 inches of pea gravel to act as bedding for a fiberglass 4 person hot tub for personal theraputic use. 9 Location of action: Alongside external rear staircase. This location is not in the nonji6l:�/''CJRmmg�� Site acreage: -41 Present land use: residential Present zoning classification: residential 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: 31 East Properties LLC & SHA Properties LLC ` (b) Mailing address: 65 Grove Rd Southold, NY 11971 (c) Telephone number: 516 238 5700 Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes ❑ No❑✓ If yes, which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Practices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy 1. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure, makes beneficial use of a coastal location, and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. ❑Yes ❑ No ❑ Not Applicable Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria ❑ Yes ❑ No 0 Not Applicable Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria ❑ Yes ❑ No ❑✓ Not Applicable Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria ❑ Yes ❑ No ❑✓ Not Applicable Attach additional sheets if necessary Policy 5. Protect and improve water quality and supply in the Town of.Southold. See LWRP Section III — Policies Pages 16 through 21 for evaluation criteria ❑ Yes ❑ No [;]Not Applicable Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. ❑ Yes ❑No ❑✓ Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section III — Policies Pages 32 through 34 for evaluation criteria. ❑ Yes ❑No 0 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. ❑ Ye-T-1 No 0 Not Applicable Attach additional sheets if necessary WORKING COAST POLIO; LS Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No ❑✓ Not Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. ❑Yes ❑ No 2 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 2 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 Kristin Hendrick TITLE DATE 6/27/2023