HomeMy WebLinkAboutTR-10476A Glenn Goldsmith,President Town Hall Annex
�® 4F S®U�A�®�® 54375 Route 25
A. Nicholas Krupski,Vice President P.O. Box 1179
Eric Sepenoski Southold,New York 11971
Liz Gillooly CA-) 41C Telephone(631) 765-1892
Elizabeth Peeples ® a0 Fax(631) 765-6641
- BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
#2134 C Date: May 30, 2024
THIS CERTIFIES that the as-built 345 sq.ft. patio with 49 sq.ft.hot tub.
At 505 Bungalow Lane,Mattituck
Suffolk County Tax Map#1000-123-3-7
Conforms to the application for a Trustees Permit heretofore filed in this
office Dated October 3, 2023 pursuant to which Trustees Administrative Permit#10476A
Dated October 18, 2023,was issued and conforms to all of the
requirements and conditions of the applicable provisions of law. The project
for which this certificate is being issued is for the as-built 345 sq.ft.patio with 49 sq.ft. hot tub.
The certificate is issued to 505 BUNGALOW LLC owners of the aforesaid property.
4'.— 4"_
Authorized Signature
„y
Glenn Goldsmith, President ®�\10F s®�, Town Hall Annex
54375 Route 25
A. Nicholas Krupski,Vice President ® P.O. Box 1179
Eric Sepenoski , Southold, New York 11971
Liz Gillooly ro'
Telephone(631) 765-1892
Elizabeth Peeples ® a® Fax(631) 765-6641
Court
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
DATE OF INSPECTION: S12!9/;'q
INSPECTED BY: G. 0g))S1,iA
Ch. 275 Ch. 111
INSPECTION SCHEDULE
Pre-construction, haybale line/silt boom/silt curtain
1st day of construction
% constructed
Project complete, compliance inspection
COMMENTS:
$►„1 ic, acres. �ce� w� aorr^;=F' 1o4 )ZA a.ati pla►v,S S a - •�
CERTIFICATE OF COMPLIANCE:
Glenn Goldsmith, President �Q� �9u 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
t®U °I,�
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;
3 Lt� OCT - 3 2023
Southold,TOnq.
' Beard of Trustees
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SURVEY OF
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SITUATE
MATTITUCK, TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
TAX No. 1000-12300-0300-007000
SCALE 1"=30'
NOVEMBER 7,2022
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Glenn Goldsmith,President ®f S®U,�
Town Hall Annex
A. Nicholas Krupski,Vice President ®� ®�® 54375 Route 25
R.O.Box 1179
Eric Sepenoski Jft Southold,New York 11971
Liz Gillooly @ Telephone(631) 765-1892
Elizabeth Peeples Fax(631) 765-6641
C4Uw,��
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 10476A
Date of Receipt of Application: October 3, 2023
Applicant: 505 Bungalow LLC
SCTM#: 1000-123-3-7
Project Location: 505 Bungalow Lane, Mattituck
Date of Resolution/Issuance: October 18, 2023
Date of Expiration: October 18,' 2026
Reviewed by: Glenn Goldsmith, President
Project Description: As-built 345sq.ft. patio with 49sq.ft. hot tub.
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 project plan prepared
by Michael D'Angelo, received on October 3, 2023, and stamped approved on October
18, 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.
c
Glenn Goldsmith, President
Board of Trustees
Glenn Goldsmith,President ��Su�V ^COGy Town Hall Annex
A.Nicholas Krupski,Vice President <Q 54375 Route 25
0
Eric Sepenoski * ,? P.O.Box 1179
Liz Gillooly �y • o��y Southold,NY 11971
Elizabeth Peeples ����✓ Telephone(631)765-1892
Fax(631)765-6641
Southold Town Board of Trustees
Field Inspection Report
Date/Time: f0%s/23 Completed in field by: G 66I�sM
Michael D'Angelo on behalf of 505 BUNGALOW LLC requests an Administrative Permit
for an as-built 345sq.ft. patio with 49sq.ft. hot tub. Located: 505 Bungalow Lane,
Mattituck. SCTM#: 1000-123-3-7
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
Typp 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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OFFICE LOCATION: ��OF SO(/ryO MAILING ADDRESS:
Town Hall Annex �� l0 P.O. Box 1179
54375 State Route 25 [ #[ Southold, NY 11971
(cor.Main Rd. &Youngs Ave.) va
Southold,NY 11971 Q Telephone: 631765-1938
COU
LOCAL WATERFRONT REVITALIZATION PROGRAM
TOWN OF SOUTHOLD
To: Glenn Goldsmith, President
Town of Southold Board of Trustees
From: Mark Terry, AICP
LWRP Coordinator
Date: October 16, 2023
Re: LWRP Coastal Consistency Review for 505 BUNGALOW LLC
SCTM# 1000-123-3-7
Michael D'Angelo on behalf of 505 BUNGALOW LLC requests an Administrative Permit for an as-
built 345sq.ft. patio with 49sq.ft. hot tub. Located: 505 Bungalow Lane, Mattituck. SCTM#: 1000-
123-3-7
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 6.3
Structures were built without Board approval.
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
Maim Diane
From: Mike D'Angelo <mike@newhamptonhomes.com>
Sent: Wednesday, October 4, 2023 1:43 PM
To: DiSalvo, Diane
Subject: [SPAM] - Re: 505 Bungalow LLC
Hello,
The patio is 345 SQFT and the hot tub is 49 SQFT.
Please let me know if you have any other questions.
Thank you,
Mike D'Angelo
New Hampton Homes
On Wed, Oct 4, 2023 at 10:27 AM DiSalvo, Diane<diane.disalvo@town.southold.ny.us>wrote:
With regard to Administrative application for above please specify by return email the size (either dimensions or square
footage)of both the hot tub and patio.
Thank You
+.ce
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So tl�o.a T Dvvvt, Tn-cLtees
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Glenn Goldsmith,President � �' ,�
Town Hall Annex
�� � * 54375 Route 25
A.Nicholas Krupski,Vice President P.O.Box 1179
Eric Sepenoski ry Southold,New York 11971
Liz Gillooly A Telephone(631)765-1892
Elizabeth Peeples '�`�.. ��,� Fax(631)765-6641
C�co!!NT[�i�,
BOARD OF TOWN'#WSTEES
TOWN OF SOUT ,OLD
This Section For Office Use Only Jul
Coastal Erosion Permit Application OCT _ 3 2023
Wetland Permit Application
X_ Administrative Permit
Amendment(Transfer/Extension Southold Town
Received Application: 10.0." Board of Trustees
Received Feer$ !000.00 lld
Completed Application: . IO•�f. 3
Incomplete: .--
SEQRA Classification: Type I Type II Unlisted Negative Dec. Positive Dec.
Lead Agency Determination Date:
Coordination:(date sent):..
x LWRP Consistency Assessment Foran Sent:
' AC Referral Sent:
✓ Date of Inspection: 10•!x•23.
Receipt of CAC Report:
_7�-'Technical Review:
v Public Hearing Held:,. •I
Resolution: .
Owner(s)Legal Name of Property (as shown on Deed): 505 Bungalow LLC.-
Mailing Address: 42 Turtleback Road, Califon, NJ 07830
Phone Number: (908) 507-3248 .
Suffolk County Tax Map Number: 1000- 123-00-03-00-007-000
Property Location: 505 Bungalow Lane, Mattituck, NY 11952
(If necessary,provide LILCO Pole#, distance to cross streets,and location)
AGENT(If applicable): Michael D'Angelo
Mailing Address:12 Little Neck Rd, Suite 201, Centerport, NY 11721
Phone Number: 631-626-4005 Emaikmike(newhamptonhomes.com
Board of 'Truste®s Appli .. .,:ion.
GENERAL:DATA`
.Aea(in squazLande feet)`.:. .
Area Zoning:
Previous use of property:.
Intended use of.property: C -
Co'venants and Restrictions on property?- Yes L�'..No
If.`.`.Yes",:please provide a copy.
Will this pro'ect're uire a Building Permit as per Town Code? Yes No
J q g P � �.
If"Yes",.be;advised this application,will,be reviewed by the Building Dept.prior to a Board of Trustee review . .
and Elevation:PlarisWill be required.
Does this project require a.vanance from the Zoning Board of Appeals? Yes No
If"Yes",please provide copy of decision.
is.project re. " y:demolition as per Town Code or as determined by the Building Dept.?
Yes �No
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 permiUapproval.euer been revoked or suspended by a governmental,agency? off Yes
If yes, provide explanation:.
Prosect Description(use attachments if necessary).:
c� tv c
Board of Trustees Appli ion
WETLAND/TRUSTEE LANDS APPLICATION DATA ..
Purpose of the proposed operations:
Area of wetlands on lot: square feet
Percent coverage of lot: 0/0
Closest
Closest distance between nearest existing structure and upland edge of wetlands: . 0 feet
Closest distance between nearest proposed structure and upland edge of wetlands:LU_.: feet
Does the project involve excavation or filling? No. L._I.._.� Yes
If yes,how much material will be excavated? cubic yards
How much material will be filled?,_: . cubic,.yards
Depth of which material_will be removed or deposited: . ...feet
Proposed slope throughout the.area of operations: .
Manner in which material will be removed or deposited:
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):
/l�
• . - 617.20
Appendix.B
Short Environmental Assessment Form
Instructions fior Completing
Part 1 -Project Information:: The.applicant or project sponsor is responsible for the.completion of Part 1. Responses
become part ofthe application for approval or funding,are subject to public review,and.may be subject to further verification.
Complete Part 1.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 I. 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 l Project'and Sponsor Information"
Name of Action or-Project:
Project Location(describe;and attach a location.map):
Brief Description ofl'roposed Action::
T V1 1 04 U> On ?e4i D AteOf ly
CA J c in 5kY�3C-fuYom) V1 A D W 0.� inAli -�-ems,
f`r'oP�'-�`il '
Name of Applicant orSponsor Telephone:
1
E-Mail,
�S
Address: .,.. . .... . .
City/PO: State. Zip'Code::. :.. .
I:Does the proposed action only involve the legislative adoption'of a plan;Iocal law,ordinance NO. YES
administrative rule,.or regulation?..
If Yes,attach a narrative description.ofthe intent of the proposed action and the'environmental resources that.< . 2
may be affected in the municipality and proceed to Part 2. If no,continue to question 2.
F7.
.
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:
3.a.Total acreage of the site of the proposed action? O . apeg
b.Total acreage to be physically disturbed? .acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor?
4. Che 1 land us at occur on,adjoining an ar the proPaction.
Urban Rural:(non-agriculture) Industrial , CommercialResidential(suburban)
Forest ❑Agriculture Aquatic QOther(specify)..,
Parkland
Page 1 of 4
5.. Is the proposed action;- NO YE$ :NIA.
a. A permitted use under the zoning regulations? Z:
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? . TT
7..`.Is the site of the proposed action located in,or does it adjoin,a state listed:Critical Environmental Area?. .NO .. YES
i.If Yes,identify:......
8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO:. . YES1.
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;actionvill exceed requirements,describe design features and technologies:
-ETF
10. Will the proposed action connect to an existing public/private water supply? NO.
If No,describe method for providing potable water:
rp
1 T:Will the proposed action connect to exisiing.wastewater utilities? :.NO. :.YES'; ,
If No,describe method for providing wastewater treatment:.... ....... ... ❑
12. a.Does the site b6ntaih a structurethaf 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 otherwaterbodies 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 t"roject.site. Check all that apply:
Shoreline Forest. A riculWral/grasslands Early mid-successional
Wetland Urban . uburban
I5.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?
16.1s the project site located in the 1.00 year flood plain? NO YES
Er
17.Will the, roposed action create storm water'discharge,.either from point'or non=p sources? NO...
If Yes, rM
a. Will storm water discharges flow to adjacent properties? Wr
0 ES
❑.
b.Will storm water discharges be directed to established conveyance systems5ff an drains)?
If Yes, briefly describe: 0 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)?
If Yes,explain purpose and size:_
RN
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: .
Z ,F
I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE.BEST OF MY
KNOWLEDGE n 2
Applicant/sponsor name: Michael D'Angelo Date:. J.-7
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
i. Will the proposed action create a material conflict with an adopted land use plan or zoning ❑ Elregulations?
J.2. Will the proposed action result in a change in the use or intensity of use of land? ❑
3. Will the proposed action impair the character or quality of the existing community? ❑
4. Will the proposed action have an impact on the environmental characteristics that caused the a ❑
establishment of a Critical Environmental Area(CEA)?
5. Will the proposed action result in an adverse change in the existing level of traffic or a 1:1affect 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? El
S. Will the proposed action impair the character or quality of important historic,archaeological, El EJ
or aesthetic resources?
9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, El 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? . .
11. W ill the proposed aotion"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,itr.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 Idesign 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-Jong-term and
cumulative impacts.
Checkahis boz 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. bate
President..
Print or Type::Name of Responsible Officer in Lead Agency Title of Responsible Officer
Signature of Responsible.Ofiicer in Lead Agency . Signature of Preparer(if different from Responsible 0fTicer)
PRINT Page.4 of 4
Board of Trustees Appli :ion
AFFIDAVIT
D.:.. : . : , 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 SOUTH OLD.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
TRUSTEE- ,.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.
Signatu&fidfroper y Owner Signature 6f Property.Owner
SWORN TO BEFORE ME THIS !. DAY OF. V-e �eM �e� 20:
Notary Public DIANA PEARCE
Notary Public
State Of New Jersey
My Commission Expires October 17,2026
Board of Trustees Appli :ion
AUTHORIZATION:
(Where the.applicant is not the.owner):
I/We. C_ 71 S J O TO V'F: q1 c7 Z( c
owners of the property identified as SGTM# 1000- :® in the toVY9. 'swn of
New York,hereby authorizes
l o as h
11
l
t act my agent and andle all
necessary work involved with the application process for permit(s)from the.Southold Town
Board of Trustees for this property.
Prope O er's. gnature operty.Owner's Signature
S WORN TO.BEFORE ME THIS., DAY OF.fie ►: e , 20. 23
,7
Notary Public
DIANA PEARCE
;Notary Public
State Of New.Jersey
My Commission Expires.October 17;2026
1
APPLICANT/AGENT/REPRESENTATIW
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest'on the part oftown officers and emblovees.The pumose of
this form is to provide inforrnation.whick ari Wait the town'of possible'conflicts of itrferzst.and allow itto take whatevereMon is
necessary to avoid same..
YOURNAME: D'Angelo. Michael
(Last name,first nameMiddle initial,unless you are applying in the name of
someone else or other entity,such as a company.If so,indicate ihe.other
person's or company's name.)
NAME OF APPLICATION: (Check all that apply.)
Tax grievance Building
Variance Trustee
Change ofZone Coastal Erosion
Approval of plat Mooring
Exemption from plat or official map Planning
Other
(lf"Other",name the activity.)
Do you Persona lly(or through yourcompany,spouse;sibling,parent;or child)have a relbtionship:with any ofticer.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 towrfofliccror employce,has even a.partial:ownmhip of(or employment by)a corporation
in which the town officer,or employee owns more than S%of the shares. j
YES F NO n .
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):
f,A)the owner of greater than 5%of the shares of the corporate stock of the applicant. x
EL (when the applicant is a corprnObn);
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 1nday of erh iv(JO
Signature.
Pr;ntf+Tame Michael. 'Angelo
Form IS I
Town of Southold
.LWRP CONSISTENCY ASSESS1ti1ENT 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
assessmentis 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 actionJist, 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 stiF
;beneficial°and adverse effects:Wdn.the coastal:area(which includesAls of Southold Townl:
3 If:any question in Section.C.on.this form is answered "yes".or"no", then the proposed action will . .
affectthe achievement of the LWRP policy standards and conditions contained,in the consistency .
review law. .:Thus.::each:answer must.be:eicnl`aired M' eil.:°1tstina*both suppornng'a
Ad non-
supporting faets If an action cannot be_certified as consistent with the LWRP policy standards and
con ons,if, not be undertake ..
A copy,of the LWRP:isavailable-in.the following places: online at the.Town of Southold's
webstte (southoldtown:northfork.net), the Board of Trustees Office;the Planning Department, all
local libraries and the Town Clerk's office.,
B. DESCRIPTION OFSITE.AND PROPOSED ACTION
PROJECT NAME -�.O.x sar oqL�oLJ :. ...
The Application has been submitted to (check appropriate response).:
Town Board Plannin Board
Building De t. Board of Trustees... Z'
❑ $ D g p 0 L �
1. Category of Town of Southold agency action(check appropriate iesponse):
(a) Action undertaken directlyby.Town agency(e.g.:capital ❑
construction,planning activity,agency regulation,-land transaction)
El
(b) Financial assistance(e.g.grant;loan,subsidy)_
(c) Permit,approval;license;certification:
Nature and extent of action:
, .
Q,
Location of action: RIO " ,
Site acreage:
Present land use: 1(� '�r)
Present zoningclassification:_
, .. :
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 appi100t ::.,
(b)`:Mailing address: _ ..I '�'�- .� . i U l -
�...
1 fnC.
(c) Telephone number:
a
Will the actio71f
'tly undertaken,require funding,or approval by a state.or federal agency?
Yes:0 No yes,which tate 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 PALICY
Policyl Foster apattern of development in the Town of Southoldahat enhances community character,
preserves-open space, makes eiticient.use of infrastructure,'makes-beneficial.use of a coastal location,and.
minimizes;adverse effects of development. See LWRP Section ulPolicies;_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 M—_Policies_ Pages 3.through.6 for evaluation criteria:
Yes 0 No. Not Applicable
. .. .
.. - ..
Attach additional sheets ffnecessary
Policy 3. .Enhance visual quality and protect scenic'resources .throughout.the.Town.of Southold. See
LWRP Section III—P olic' s Pages 6 through 7 for evaluation criteria
El❑ Yes No Not Applicable .
.. ..:. ..... . :.... . ..
Attach additional sheets if necessary
NATURAL COAST POLICIES
Policy 4.. Mum e loss of.life, structures, and natural resources from flooding and erosion. See LWRP
Section III—Policies Pagy.s 8.through 16 for evaluation criteria
0.. Yes.7.:No' . Not Applicable
Attach additional sheets if necessary:
Policy S. Protect and improve water quality and.supply in'the Town:of Southold.See LWRP Section III
— Policies Pages.16 throu h 21 for evaluation criteria
0 .Yes:D No .ffNot Applicable
Attach ad itional sheets' necess
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
Q`:.
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�ot Applicable
Attack 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.
O Yes'
0No, Not Applicable
PUBLIC.COAST POLICIES.
Policy.9. Provide for public:access to, and recreational use of, coastal waters, public lands,'aud public.
resources of the Town of.Southold. See LWRP Section III-Policies; Pages 38 through 46 for.evaluation ;
criteria.
YZI No L_1 Not Applicable
Attach additional sheets if necess
WORKING COAST POLICIES
Policy 10. Protect Southold's water-dependent uses, and promote;siting of newwater-dependent uses in
suitable locations. See IMW Section M'_Policies; Pages 47 through 56 for-evaluation'criteria: :.
❑Yes.'❑..No Q Not Applicable
Attach additional`sheets if necessary.
Policy 11. Promote.sustainable. use of living:marine resources in:Long F Island. Sound, the: Peconic
Estuary and Town waters. See LWRP Section III-Policies; Pages 57 through 62 for evaluation criteria.
Yes. 0 No / &ble
u Not A licpp .
Attach additional sheets if necessary
Policy 12. Protect'agricultural.lands in the Town of,Southold. See LWRP Section III-:Policies;Pages: .
:61 through 65 for.evaluation:criteria.
Q Yes.. No L`J Not App licoble
Attach additional sheets if necessary
Poolicy.13. :Promote.appropriate: use and developmentof energy, and .mineral resources. See.LWRP
Section III--Policies,_P ges 65 through 68 for:evaluation criteria.
Q Yes '❑.No: Not Applicable
PREPARED BY.
:. - TITLE_ . :�.:; .. .: ;.. ; DATE: