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HomeMy WebLinkAboutMartorana, Frank & Mindy C DiSalvo, Diane From: Johnson, Benjamin Sent: Monday, December 11, 2023 11:16 AM To: DiSalvo, Diane Subject: RE: Martorana 3450 Deep Hole Drive Follow Up Flag: Follow up Flag Status: Flagged Hi Diane, Ms. Martorana has a court date on December 20, 2023. She apparently has already pled guilty via email to to court. I will have her arraigned and inform her that she needs to remove the as-built structure and re-establish the required 40' non-turf buffer before we can resolve the ticket. Thank you, Ben Benjamin F. Johnson Assistant Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main RD) P.O.Box 11791 Southold,NY 11971 Office(631)765-1939 Fax(631)765-6639 CONFIDENTIALITY NOTICE: This electronic mail transmission is intended only for the use of the individual or entity to which it is addressed and may contain confidential information belonging to the sender which is protected by the attorney-client privilege.If you are not the intended recipient,you are hereby notified that any disclosure, copying, distribution,or the taking of any action in reliance on the contents of this information is strictly prohibited.If you have received this transmission in error,please notify the sender immediately by e-mail and delete the original message. ATTENTION: This email came from an external source.Do not open attachments or click on links from unknown senders or unexpected emails. From: DiSalvo, Diane<diane.disalvo@town.southold.ny.us> Sent: Monday, December 11, 2023 9:57 AM To:Johnson, Benjamin<benjaminj@southoldtownny.gov> Subject: FW: Martorana 3450 Deep Hole Drive FYI—He is supposed to remove the as-built structure and re-establish the 40' non-turf buffer. Diane From: DiSalvo, Diane Sent: Friday, November 17, 2023 9:11 AM i Glenn Goldsmith,President ��®� s®U��® Town Hall Annex A. Nicholas Krupski,Vice President �® �® 54375 Route 25 P.O. Box 1179 Eric Sepenoski Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples �® ® �® Fax(631) 765-6641 C®UNN BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD NOTICE OF DISAPPROVAL - ADMINISTRATIVE PERMIT Date of Receipt of Application: October 30, 2023 Applicant: Frank & Mindy Martorana SCTM#: 1000-115-17-10.1 Project Location: 3450 Deep Hole Drive, Mattituck Date of Resolution/Issuance: November 15, 2023 Reviewed by: Glenn Goldsmith, President Project Description: For the as-built masonry outdoor fireplace/pizza oven on a concrete foundation with footings; 8'6" wide x 5' deep x 6'8" tall with a 5'4" chimney. Findings: The Board of Trustees DENIES the application as submitted. 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. Previously approved 40' non-turf buffer has been removed. Having this as-built structure within the non-turf buffer area violates this designated area. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. to— a"'y_W Glenn Goldsmith, President Board of Trustees Glenn Goldsmith,President Town Hall Annex �O Gy q A.Nicholas Krupski,Vice President < 54375 Route 25 Eric Sepenoski * P.O.Box 1179 Liz Gillooly �y • 0! f Southold,NY 11971 Elizabeth Peeples �� ' Telephone(631)765-1892 Fax(631)765-6641 Southold Town Board of Trustees Field Inspection Report Date/Time: 103L/Z3 Completed infield by: c"z G"f ds M-A FRANK & MINDY MARTORANA requests an Administrative Permit for an as-built masonry outdoor fireplace/pizza oven on a concrete foundation with footings; 8'6" wide x 5' deep x 6'8" tall with a 5'4" chimney. Located: 3450 Deep Hole Drive, Mattituck. SCTM#: 1000-115-17-10.1 Type of area to be impacted: Saltwater Wetland Freshwater Wetland Sound ✓ Bay Part of Town Code proposed work falls under: -✓Chapt.275 Chapt. 111 other Type of Application: Wetland Coastal Erosion Amendment Z Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes No Not Applicable Info needed/Modifications/Conditions/Etc.: ff Need L ANe-A �'�t'- 'm-.A 1-s or,V o jD� ,0_r%k exq b U WO—Ir . Present Were: ✓ G. Goldsmith N. Krupski E. Sepenoski L. Gillooly E. Peeples ,kp iz oil' yf I 1 1 I I I I ► ! I i t I I I I i� �t I �,E9EFS i- iI I 44 — ( — ; l i l i � i t �� 1 1 ( I l I—►—L l- - _ S� -l-L (- - - , 1 Ll ,�t.�--`„`��..I�i��I -�-v�-• - ---� - -- ---i----- -I -- -- - I - I -I - -i '�� -i i lil` I I � a- _ ! I Li – I - � �.�i_ ,-!L--j�---�i �� i {' ,�. - U - i � - •I 1 �_I-J low A I_PL-I I 'd T LI IE FTt Lil- T-F ! 41 A94 /"DW I ,kc SURVEY OF PROPERTY AT MA TTITUCK SCDHS REF. RIO-10-0033 TOWN OF SOUTOLD SUFFOLK COUNTY, N. Y. 0C� 3 0 ;? 1000-115-17-10.1 r SCALE: 1'- 20' JANUARY 21, 2015 FEB. 18, 2015 (B.0.H. info.) FEB. 24, 2015 (CONTOUR LINES.) ,S'rJ��;,OL NOV. 3, 2015 (PROPOSED ADD/TION) VE N/per (PUBuc �� WATER) rn EXISTING 5EPTIG SYSTEM N 1-1200 GAL. C.YLINDRACAL 5EPTIG TANK 3-6 X 4' DEEP LEAGHINCG POOL r TEST HOLE 11 DATA RAIN RUNOFF CONTAINMENT MCDONALD GEOSCIENCE EX15TING HOUSE-EX151TINC7 D.W. ® 1,4AIC& 5/20103 PROPOSED ADDITION 1046 5Q. FT. AS Dc D /�'f�TS OF �R EL. 11.5' 1046 X 1 X 0.17=176 SQ. FT. ([AND V EAZD 6Y nDA/ <\ DARK BROWN LOAM OL 178/42.2 PROV DE t 4 VF 1 DW 6� 5' DEEP ELMET. S79•�O, ) ON AUG Bp�4N Phi S 4 1. OR EQUAL BROWN CLAYEY SAND SC STOCKADE S79000,00., OR � c0 �O 3, PALE BROWN FINE WETLAND AREA 36 SQ. FT. '-=� ' ' ��`5>.ZQ' � �G��� TO MEDIUM SAND SP UPLAND AREA = 11917 5Q. FT. LPI " Com"GEN. 1 r ( x • '�� �--TEST HOLES '�'�'��,o r FE f� p,"r EL. 0.2' 11.3' P) , 35.6' r cs r r 0.4 N l p r WATER IN PALE BROWN 15UILDABLE LAND N (4 I I r FINE TO MEDIUM SAND SP 1166 5QFT. 1.� O -' i-'�� 34 O' ` ► r LOT COVERAGE '� �' p" Q PROPOS ' r ' - 17' EXISTING+ A H2O i� LP2 b ApSTORYO HOUSE DECK = 1224 5Q.FT. METER r ED �i / 4! rco 1224/11661 10.31. o N WITH SLEEPING r' x J` r N PROPOSEDW I` Ile QUARTERS NEW ADDITION , 1046 TEST if 0,_ _ i Z z w 1046/1161 6.6r HOLE r _ `. '^ 19.1x z Z I #2ST Z � a a ��i WASTE p` i Z 1O ir �' Q i -0\ LINES LINES WATER SUPPLY �� 0 w J i LP3�_�� \� r \�` 391 N 3 ~ �T , TEST HOLE 12 DATA •A. 27.4' MCDONALD GEOSCIENCE j i STONEI r 5/20/03 W -B. 2 STORY EL. 11.5' 0' i 4.6'^ FRaMY W E O BROWN LOAM OL cv HOUSE o r I BROWN SANDY SILT ML i (fin.flr.el.]7,p') 2 '"--37.3' 32 1__---_ STONE .WALK i J' PALE BROWN FINE WATER 1 CANT. I r DOCK TO MEDIUM SAND SP LINE ;-,� I , EL. 1.2' 10.3' OWI U/G.PROPI �. TNK. WATER IN PALE BROWN FINE CINE �� GRAyEL 11,A i I � � TO MEDIUM SAND SP � END it ri p 17• WALL 000,00 W o s. o NjOA ALlCrPA 118 32 ; I (PUBLIC ftaA De ftes v ® = MONUMENT WATER) ® = WETLANDS FLAG Z = TEST HOLE ELEVATIONS & CONTOUR LINES ARE REFERENCED TO NA VD '88 FLOOD ZONES FROM FIRM 3610JC0482H 9/25/09 SEPTIC LOCA TION „A" "B" ANY AL TERA TION OR ADDI TION TO THIS SURVEY IS A VIOLA TION ST. 28.5j 32.5 OF SECTION 7209OF THE NEW YORK STATE EDUCA 77ON LAW. EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS LP1 53' 60.5 ANY AL TERA TION OR ADD17ION TO THIS SURVEY IS A VIOLA TION LP2 41' :4d7'OF SECTION 7209OF THE NEW YORK STATE EDUCA77ON LAW. 0. 49618 EXCEPT AS PER SECTION 7209-SUBDIVISION2. ALL CERTIFICATIONS30PECONIC SURVEYORS, C HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF (631) IC SURE FAX (631) 765-1797 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR NOTE. ST. AND LP.s HAVE AREA = 11,HS1 SQ. FT. TO TlE LINE P.O. 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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: November 15, 2023 Re: LWRP Coastal Consistency Review for FRANK & MINDY MARTORANA SCTM#: 1000-115-17-10.1 FRANK & MINDY MARTORANA requests an Administrative Permit for an as-built masonry outdoor fireplace/pizza oven on a concrete foundation with footings; 8'6" wide x 5' deep x 6'8" tall with a 5'4" chimney. Located: 3450 Deep Hole Drive, Mattituck. SCTM#: 1000-115-17-10.1 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the action is INCONSISTENT with the LWRP. The as-built oven does not meet policy 6.3 which supports the Boards authority and permit process. 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 S 0,�Y""' Town Hall Annex Glenn Goldsmith,President A.Nicholas Krupski,Vice President 54375 Route 25 P.O.Box 1179 Eric Sepenoski JLt Southold,New York 11971 Liz Gillooly Telephone(631) 765-1892 Elizabeth Peeples Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Applicationi Wetland Permit Application X Administrative Permit OCT 3 0 2023 —Amendment/Transfer/Extension V Received Application: X0.30-IZ-35 ""'.':�C�'' K Received Fee: Completed Application- 10.3p.Z-3 Incomplete: - SEQRA Classification: Type l__ Type II Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: oordination:(date sent): --VgLWRP Consistency Assessment Form Sent: CAC Referral Sent: 7;;�Date of Inspection: -Receipt of CAC Report: —Technical Review: _Public Hearing Held: I Resolution: Owner(s)Legal Name of Property (as shown on Deed): /Q'q-FZ-1nj?/W/4 Mailing Address:. U 4E 1,U A--TT-j—1d Ce I-IV l 1 '-75<2 Phone Number: 7-1Lm-c) Suffolk County Tax Map Number: 1000- + Property Location: 77, 10NAM IP-1 (If necessary,provide LILCO Pole distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Email: loard of Trustees Applica, a GENERAL DATA Land Area(in square feet): . _ Area Zoning: ��5�����✓�> f Previous use of property: 5/�/G/f � •�ySi����C.� Intended use of property: S//VW/z5A•,/z Covenants and Restrictions on property? Yes _fa:_No If"Yes", please provide a copy. Will this project require a Building Permit as per Town Code? Yes No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? =Yes _2:' No If"Yes", please provide copy of decision. Wrfis project rLpif eq Mi as per Town Code or as determined by the Building Dept.? Yes J�✓ -No Does the structure(s) on property have a valid Certificate of Occupancy? Yes g—No Prior permits/approvals for site improvements: Agency Date _[Z'No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?_E]_Nog Yes If yes, provide explanation: Project Description(use attachments if necessary): ec oard of Trustees Applicat n WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: "� �G� �� 0 i f bd d/Z Area of wetlands on lot: 349 square feet Percent coverage of lot: r J003 % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure and upland edge of wetlands: Meet Does the project involve excavation or filling? No 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): 61 Z20 Appenclix 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 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 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1 -Project and Sponsor Information Name of Action or Project: �," D►ls/- fq G% 19A( d I�10�2 f 4�1L' ' ro/ Project Location(describe,and attach a location map): A( r��r� Are 7 �,� 4r(,+t-1Pv Brief Description of Proposed Action: MA__5e e_l_ )��zs Name of Applicant or Sponsor: Telephone: AA& E-Mail: Address: City/PO: State, Zip Code: r-t-u c �l zz 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: ❑ 3.a.Total acreage of the site of the proposed action? % /7 eems .5& b.Total acreage to be physically disturbed? ex � ae�s �� c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? —aGFOS' 0 4. Che ka 11 land us at occur on,adjoining an ar the prop action. Urban Rural(non-agriculture) Industrial Commercial ECsidential(suburban) Forest Agriculture Aquatic QOther(specify): 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? 07 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: Erl❑ 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:.. ❑ 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? b. Is the proposed action located in an archeological sensitive area? 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 14. ntify the typic bitat types that oc n,or are likely to be found on t)�-project 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 NNO YES by the State or Federal government as threatened or endangered? 16.Is the project site located in the 100-year flood plain? YES 17.Will the proposed action create storm water discharge,either from point or non-poi sources? NO If Yes, a. Will storm water discharges flow to adjacent properties? 00 DES El b.Will storm water discharges be directed to established conveyance systemsan m 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: ❑ Rr 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES,_ solid waste management facility? If Yes,describe: ❑ 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: ❑ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applican po r m /�� � Date:.. Signature: Com_It U—U— _ 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 El E]regulations? 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? E 4. Will the proposed action have an impact on the environmental characteristics that caused the ❑ El of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or ❑ ❑ affect existing infrastructure for mass transit, biking or walkway? 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? 11 E 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 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 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. YOUR NAME: 'Pw t Prn n�A (Last name,first name,_i;►iddle init' 1,un ess 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 applicantlagent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal orbeneficial 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 . 1L Submitted da of 200 Signature. Print Na e — Form TS 1 Board of Trustees Applica `I'n - AFFIDAVIT re�% 1'4 ��l��J 6 P*A/A BEING DULY SWORN DEPOSES AND AFFIRMS T AT 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. Signature o operty Owner Signature P operty Owner SWORN TO BEFORE ME THIS 211 DAY OF , 20 fiu;tl 04r Notary Public DIANE DISALVO NOTARY PUBLIC-STATE OF NEW YORK No. O1 D1475593 Qualified in Suffolk County MY Commission Expires April 30, 20Z� 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.an&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'details Mink both supporting and non-. supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it-shall no0e 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# ?' / PROJECT NAME &FCb&J/Z The Application has been submitted to (check appropriate response): Town Board ❑ Planning Board❑ Building Dept. ❑ Board of Trustees I� 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: `�c��-7' Location of action: Vere) 1660 `rive, �A—ITi I wI2 /t/I/ /1I6®R Sitesa'1eT: � Z Present land use: . —S/1yW11� Present zoning classification: 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 ofapplicant l �f- rN Mailing address: ro � (c) Telephone number: _� 715157-7— Will 15157-7—Will the action be directly undertaken,require funding,or approval by a state or federal agency? Yes 1:1No� 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—Poli 'SEs Pages 3 through 6 for evaluation criteria F-1Yes ❑ No Not Applicable Attach additional sheets if necess ii 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 hrough 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 tMot for evaluation criteria ❑ Yes ❑ Nopplicable Attach additional sheets ifnecessary 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 of Applicable 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 E]No /Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances andwastes. ee LWRP Section III—Policies; Pages 34 through 38 for evaluatiop criteria. ❑Yes ❑ No 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❑ No Not Applicable Attach additional sheets if necessary e o WORKING COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations;Not Section III—Policies; Pages 47 through 56 for evaluation criteria. ❑Yes ❑ No Applicable Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town water : See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. [:]Yes 0 No 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=Not criteria. ❑Yes ❑ Nopplicable Attach additional sheets if necessary Policy 13. Promote app opriate use and development of energy and mineral resources. See LWRP Section III—Policies; P es 65 through 68 for evaluation criteria. L]Yes ❑ No Not Applicable PREPARED BY �� 9,417UAIVI . TITLE DATE49:06 a:0o a3