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HomeMy WebLinkAboutKatsiris, Julia Melinda Orlie Glenn Goldsr ',._President Town",Hall Ahht-x A. Nicholas-01%'rupski, Vice-President `543 7 oyt.e'25 ""D John M. Bredemeyer, Ill cm P.O. Box 1179 Michael J. Domino Southold, NY 11971 Greg Williams 4,, �� Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Date/Time: I-Z-1 Completed in field by: JULIA MELINDA ORLIE-KATSIRIS requests an Administrative Permit to erect an 8' deer fence. Located: 400 Lakeside Drive N., Southold. SCTM#: 1000-90-3-3 CH. 275-3 - SETBACKS WETLAND BOUNDARY: Actual Footage or OK-4 Setback Waiver Required 1. Residence: 100 feet 2. Driveway: 50 feet 3. Sanitary Leaching Pool (cesspool): 100 feet 4. Septic Tank: 75 feet 5. Swimming Pool and related structures: 50 feet 6. Landscaping or gardening: 50 feet 7. Placement of C&D material: 100 feet TOP OF BLUFF: 1. Residence: 100 feet 2. Driveway: 100 feet 3. Sanitary leaching pool (cesspool) 100 feet: 4. Swimming pool and related structures: 100 feet Public Notice of Hearing Card Posted: Y / N Ch. 275 � Ch. 111 SEQRA Type: I II Unlisted Action Type of Application: Pre-Submission Administrative Amendment Wetland Coastal Erosion Emergency Violation Non-Jurisdiction Survey :5 5 years: Y/N Wetland Line by: C.E.H.A. Line Additional information/suggested modifications/conditions/need for outside review/consultant/application completeness/comments/standards: 5 c e e_e 6-e PJ0 LOA P4� -Zt4 o4e ov- I have read & acknowledged the foregoing Trustees comments: Agent/Owner: © on-'e 1q, 202 Present were: J. Brederneyer M. Domino ; 'J _tZG. Williams Other i U05 At�o f 5;dpu4 Aj6_ CND*POP I. pAj SURVEY OF LOT 55 ANAP OF CEDAR iBEACH P.4* ' fie.• . rthwz:a rnLn Grw•c�.•ti,�tc� S.I TVA TE. llvl LC -� BAYVIEW TOWN OF SOUTHOLD �n FOLK COUNTY','NEW YORK Jt1N 2 8 2021 SCALE," APRIL 8,2021 tl f3z C�h i Southold Towm i Board of Trustees 1 STORY FfiAB:1E . nw er<.x.rc+eacwnw eracr ••••' °t�ns.��i`'i e:e<ia"��i o'.e'n•^'i AERIAL LAND SURVEYING D.P.C. . lo..W. !]Ff..£�G7M1c {. -••wn.nrsi�n�.wx�.oar..� ro.e•x. c�ya;,c 1:1:1:87..�"w.f "� "'�r:,w:u.�w°e.`.�a�w•v,.<. - E.V.i'CS.'�Ycr'�-^y.EF1A'.Ut£:Y+1'EY.•fu WW "�K�..V.^'�°,,,,,"rs<m.�m nr�a� V1.E:`-t't,77tP. _6::Li,'G�^..?J=1'tY_•LCIG DJSTR6T:l.0 LOT-3 Pi0CK37SECiXksJ tiv sa _ 6W'Fdi pic 40 - .:a� H'A •.• LY:P Of:AapC!Cely ci�UlPrl �+,•: ai'�";•.., , STILLWATERLAY:E j 1i r ll)}�:+./•.1y'' ICiALrWATERI ME NO;TElO CCQ.M TAX O:1DW-2;CCOL�VO?.VCO \i•�. - r: SrtUATEOAT:fLyrkHi,Tcrnd Sov:.ufd �'-�;;",,.� , W:DM1TSgV tlAP LOTRS;SS � � 9 L CATS.-A,t B, � J _ Rem°on osaxaos osfza+ x azlaz x 02ala+ Iwonn '•t is YOM OF sourNOQo ^' pqk b = I< zo7 13A(=) U A PprNr tvt �n oa x n. -- t.aA U TOWN OF COD souT.. s� CfOgR � y I :T:, PplHT r TO—OF SOUTNOIP T - W. WEST IQ ^^ 9 ^ 2 LANE Q x n^ .r� n^ i a CFD`�q s `0 t, b e •� te.t x9 Iw TOM �fy, Q ' �Kdy a Ix.1 I<.1 •.e b Wl ISM DR 'f.TA(c) le n le 18 i11A(c) z HOG 'm NECK BAY E =� _�_ „Y (2) •-' -----' m'__ NOTICE a+P� COUNTYOFSUFFOLK © E °° SOUTHOLD SECTION NO E.�..�.�.. ------ . "' --"-- m.l..--.,-- 4 e Real Prouew.amo,Qervi'ce Agency v tA°t:O. N e�..l c... - no...n n morn --t— m.w • — « M 090 p .. » .... �z,a.r la •� —_ o.nu. --.-- o.mtr--r-- mw rwcr xo ..� zl h I c w1Y F 1000 PROPERTY MAP SU*VEY OF LOT,55 MAP OF. �; 2 (('� (� [�f� (2 CEDAR SEACW PARK 5 rb. D �,C vu U U E �ie;ti.aora�.ace••�.•%co.- Of ��,� � SITUATE ff BAYVIEW l 8 TOWN OF SOUTHOLD JUN 2Q1 OUNTY,NEW YORK o o SCALE), d0' _ APRIL 8,2621. . CI tv 1 •i!...., 4 n _ Southold Town Board of Trustees tWORYFRAME - �+ NOVSE I rsse,,.r en a.,,w w c'w`mrauas AERIAL LAND SURVEYING DAC, w•© :J FFrpV'nhE Fr!Ct.?a Ep3!78T',9 arr�4 �c1221 MTTR,CT:ix•]LOT:3 OLOCK 3'SEC"11DVW?9 tUIP ME NR°1J WENR R'A VAP 07:1.'3aclCY3t 8iaU,Psn �;,•rr�::,rr-"-.� CWP FXto Calf:LY�Ct'=..IC. ' STILLWATER LA�;C• 1'3ALTLYATfiR1 TILE NP.rw j<�F`a.t/. �; ✓ t. COWNTAX[r,10=4cwz*or' 10 %1.1 r t• y'il - r1TUATFDAT:Oayr'rr,icrndSa,oL1 - U,3D.i15711!F l!AP LOifS;SS __"`" 9 CAITE Ap:2,:3:7 OFFICE LOCATION: OF SO!/j�o MAILING ADDRESS: Town Hall Annex P.O. Box 1179 54375 State Route 25 Southold, NY 11971 (cor.Main Rd. &Youngs Ave.) Southold, NY 11971 • �Q Telephone: 631 765-1938 �yCOUNVI LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOtTHOLD MEMORANDUM To: Glenn Goldsmith, President Town of Southold Board of Trustees From: Mark Terry, Assistant Town Planning Director LWRP Coordinator Date: July 9, 2021 Re: Local Waterfront Coastal Consistency Review for JULIA MELINDA ORLIE-KATSIRIS SCTM# 1000-90-3-3 . JULIA MELINDA ORLIE-KATSIRIS requests an Administrative Permit to erect an 8' deer fence. Located: 400 Lakeside Drive N., Southold. SCTM#: 1000-90-3-3 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that. . the proposed action is CONSISTENT with the LWRP. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Damon Hagan, Assistant Town Attorney Town Hall Annex Glenn Goldsmith,Presidentr� 54375 Route 25 A.Nicholas Krupsld,Vice President ' P.O.Box 1179 John 1V Bredemeyer III ,: Southold,d,New York 11971 Michael J.Domino Telephone(631) 765-1892 Greg Williams Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD This Section For Office Use Only Coastal Erosion Permit Application E E Q L! E Wetland Permit Application D r ._Administrative Permit Amendment/Transfer/Extension jUN 2 8 M Received Application-.... , 6'�•Z�. Received Fee: $ Completed Application: L$. Southold Town Incomplete:: Roard of Trustees SEQRA Classification: Type I Type H Unlisted Negative Dec. Positive Dec. Lead Agency Determination Date: Coordination:(date sent): . LWRP Consistency Assessment Form Sent: CAC Referral Sent: Date of Inspection:. . . Receipt of CAC Report: . . Technical Review: Public Hearing Held:. W Resolution:... shown on Deed o Me h'h d /(r e - IC7� .S .r Owner(s)Legal Name•f Property(ass : �) Mailing Address: 3 o D Aef SM, j(/k /V y /03 W Phone Number: (�4 34 Z'. 89 .,.. —_ Suffolk County Tax Map Number: 1000 - Property Location: +0 0 laKQ Si de Or /1',SDu Ao 1,1 WV It (If necessary,provide LILCO Pole#,distance to cross streets, and location) AGENT(If applicable): Mailing Address: Phone Number: Email: Board of Trustees Applic,, %.won GENERAL DATA Land Area(in square feet):. )- of C r-d l 2 Area Zoning:. 2 S�'c�,[h �► u . Previous use of roe r�S 'At A41*.4 t..:..h.o► a .. . 1... p p rty: Intended use of property: Yt S i oLCen-{'id ( 6 rnA Covenants and Restrictions on property? Yes No If"Yes",please provide a'copy. Will this project require a Building Permit as per Town Code? Yes ✓ No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes . .✓ No If"Yes",please provide copy of'decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes ✓ No Does the structure(s) on property have a valid Certificate of Occupancy?_J/ Yes No Prior permits/approvals for site improvements: Agency Date h k No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency?__A/ No Yes If yes,provide explanation: Project Description(use attachments if necessary):. Q d d /l d d4rr rk/7 c ci yJ a r-d 5-e e- SaKV �� a �Cker Board of Trustees Applic�_ on WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations:,. kA 4or CZ C ce s s La ac as ,I rn C" I i rl�a�Area of wetlands on lot: feet 1 VV dY Jr S l2 Gt Il D� S � k ' L,a►�2 Z$ � Percent coverage of lot: % Closest distance between nearest existing structure and upland edge of wetlands: feet Closest distance between nearest proposed structure,and upland edge of wetlands: _ a feet Yes Does the project involve excavation or filling? . . -.No 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): � � K 617.20 Appendix B Short Environmental Assessment Form Iastruetioris far Cbttipletin� I 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 l 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: Of of ./N1 Q O/n„f -6gr P7 Project Location(describe,and attach a location ma ). 00 14Pst a a/d Brief Description of Proposed Action: /1 S cllan baar��rzl - _- - . Name of Applicant or Sponsor. Telephone: qb J J-14 11 A �/�` Ce "��s/ E-Mail: i�d cs . 0 !r.� sh (• ewz' Address: v6 ....._Dr, C /PO: Zip Code' i : ty Sin L� Uld �Y 5L/ 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 E `l 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: I Jvat 'A61 d b�cl� /►� j:a:Total acreage of tiie site of the proposed action? _ :_l�.._acres b.Total acreage to be physically disturbed? t acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? _acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban ❑Rural(non-agriculture) ❑Industrial ❑Commercial [ Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic j]Other(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? ❑ 6. Is the proposed action consistent with the predominant character of the existing built or natural NO_ _YE landscape? 7: Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO. ,YES If Yes,identify:.. - _....: _..._ ------ ............... .._._-_.-,.. .. ........... _ ... _ -. - ..... 8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO .. YES- b.Are public transportation service(s)available at or near the site of the proposed action? c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? 9.Does the proposed action meet or exceed the state energy code requirements? NO YES- If the action will exceed requirements,describe design features and technologies: proposed eq t;n - _. 10. Will the proposed action connect to an existing public/private iwater supply? 'NO- -YES If No,describe method for providing potable water: EJ 11.Will the proposed action connect to existingwastewater utiliti' . p P _..... _ .... es?.. .__ ....... _. NO.. YES Ef El If No,describe method for providing wastewater treatmen It:: .._...._.._..... . - -- 12: a_Does the site contain a structure fi at is fisted on either the State of National Register of Historic NO - YES PIaces? b.Is the proposed action located in an archeological sensitive area? ❑, - ❑:. , Y P NO. ... YE 13.a_Does an portion of the site of the proposed action,or lands the proposed action,contain _ ' 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 typical habitat types that occur on,or are likely to be found on the project site. Check all that apply::- Shoreline ❑Forest ❑Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban ❑Suburban I S_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_Is the project site located in the 100 year flood plain? _.._. .... ........... ,...- 17.Will the proposed action create storm water discharge,either from-point or nori=point sources?- -- NO YES If Yes, a.Will storm water discharges flow to adjacent properties? [2NO ❑YES LJ.. ❑ b.Will.stofff water discharges be directed to established conveyance systems(R!26ffand storm drains)? If Yes,briefly describe: NO DYES Page 2 of 4 I S.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: - Q 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:- - -.....:... ._ - -. - 26.Has the site of the proposed action or an adjoining roe been the subject of remediation(ongoing or P Fo J g property rty J ( g g -NO.... .YES completed)for hazardous waste? If Yes,describe: 13 ..... ............ I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE �j Applicant/sponsor name:`/14 I/d::..:�h (A U'.(mil-�lC-�c71,� Date:_,O� 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 regulations? L YJ El 2. Will the e inro proposed action result in a than the use or intensity of use of land? Cl F P g 3. Will the proposed action impair the character or quality of the existing community? LZ ... 4. Will the proposed action have an impact on the environmental characteristics that caused the establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or affect existing infrastructure for mass transit,biking or walkway? 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: a.public/private water supplies? El - b.public/private wastewater treatment utilities? 8. Will the proposed action impair the character or quality of important historic,archaeological, architectural or aesthetic resources?..... _---.:-1 ..-..1=---..._. 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, ❑ waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage problems? .. 11. Will theproposed action create a hazard to environmental resou rces 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. I ECheck 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. 0 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 Offficer in Lead Agency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of Board of Trustees Appli< = -ion I AFFIDAVIT l it a r l6 S 1'r 13 BEING DULY SWORN DEPO'§E—S*AlqD AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TOI ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. Signature of Property Owner Signature of Property Owner SWORN TO BEFORE ME a.3 .. DAY OF.. _ M4126 .20� ERIC CLARK Notary Public, Stat.;;of New York No.OICL6088023 Qualified in Queens County Not PLlb11C Commission Expires March 03,20 7 aDa 3 APPLICANT/AGENT/REPRESENTATM TRANSACTIONAL DISCLOSUREETORM The Torvii df•Sfluthold's'GoiCe of.Ethics nrohibits"conflicts ofinterest_on the Bart -flown nfFicersarid emnlovees:TtiO cur s�e:af this farm is to provide�nforntatirin which can alert thetdwn of go��ble conflrcts�bf interest and allow rt to take whatever action rs riecessaty4o avoidsamei YOURNAME:. r7� �1 C r Ic s;r-r s 1,(►�A A4 " (Last name,first name,griddle initial,unless you are applying:to 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 Trustee - Variance .._....__. . ._..-. - -- - 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,rnarriage,or business interest"Business interest"means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO If you answered"YES",complete the balance of this form and date and sign where indicated Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this 0-3 day of 209,1 • Signature". , Print Name Form TS I Town of Southold LWRP CONSISTENCY.ASSESSMENT FORM A. INSTRUCTIONS 1. All applicants for permits* including Town Iof 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 j 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. I 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 6wlained.in detail,.Iisting:both supportinz and non- snnpotin >facts: If an action cannot be certified as co the nsistent with LWRP policy standards and conditions,it shalLnot.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 SCTW_ PROJECT NAME ._ :_.q o The Application has been submitted to(check appropriate response): Town Board ❑ Planning Board❑ Building Dept. U 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) Perini,approval,license,certification: Nature and extent of action: CG I a�d� n � AV P _ Location of action: `COb Q l�S l Y• N b g GAG(4 G�J Site acreage: V Z a G K. Present land use: re S Present zoning classification:. .._:.�l�C s l din 'f'�.A• _..... ..._. ... . 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: Ut(_('a �'`�(J n- (b) Mailing address: b b I�-�C�r ( r / ( 5 (c) Telephone number:Area Code (d) Application number,if any:. 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. R Yes E 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—ZApplicable • Pages 3 through 6 for evaluation criteria Yes U No I 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 Q Yes .Q No Not Applicable f. 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 D Yes El 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 throe h 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. 0: E1 Yes No Not Applicable Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LVVRP Section III — Policies Pages 32 through 34 for evaluation criteria. Q Yes Q No Not Applicable Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and roast See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. Yes 0 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 LMW Section III—Policies; Pages 38 through 46 for evaluation criteria. o �ejD No d Not Applicable Attach additional sheets if necessary WORK NG COAST POLICIES Policy 10. Protect Southold's water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III•—Policies; Pages 47 through 56 for evaluation criteria. 0 Yes 0 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. F, E]Yes E No RiNot Applicable Attach additional sheets ifnecessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for ev luation criteria. Yes No Not Applicable Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; ages 65 through 68 for evaluation criteria. 0 Yes D No D Not Applicable PREPARED BY...L ._(_l.d.:...["•l.dd&GUI .._.. ........... ....TITLE DW JqZ� ..., . DATE_G S